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Objectives. We determined the efficacy and cost-effectiveness of adding an evidence-based Internet behavioral weight loss intervention alone or combined with optional group sessions to ShapeUp Rhode Island 2011 (SURI), a 3-month statewide wellness campaign. Methods. We randomized participants (n = 230; body mass index = 34.3 ±6.8 kg/m(2); 84% female) to the standard SURI program (S) or to 1 of 2 enhanced programs: SURI plus Internet behavioral program (SI) or SI plus optional group sessions (SIG). The primary outcome was weight loss at the end of the 3-month program. Results. Weight losses differed among all 3 conditions (S: 1.1% ±0.9%; SI: 4.2% ±0.6%; SIG: 6.1% ±0.6%; Ps ≤ .04). Both SI and SIG increased the percentage of individuals who achieved a 5% weight loss (SI: 42%; SIG: 54%; S: 7%; Ps < .001). Cost per kilogram of weight loss was similar for S ($39) and SI ($35); both were lower than SIG ($114). Conclusions. Although weight losses were greatest at the end of SURI with optional group sessions, the addition of an Internet behavioral program was the most cost-effective method to enhance weight losses. [ABSTRACT FROM AUTHOR]

Background: Dietary variety is a factor that influences consumption but has received little attention in obesity treatment. Objective: This study examined the effect of limiting the variety of different non-nutrient-dense, energy-dense foods (NND-EDFs) (ie, chips, ice cream, cookies) on dietary intake and weight loss during an 18-mo lifestyle intervention. Design: Two hundred two adults aged 51.3 ± 9.5 y with a BMI (in kg/m2) 34.9 ± 4.3 (57.8% women, 92.2% white) were randomly assigned to 1 of 2 interventions: Lifestyle (1200-1500 kcal/d, ≤30% of energy as fat; n = 101) or Lifestyle + limited variety (LV) (limit variety of NND-EDFs, ie, 2 choices; n = 101). Both interventions involved 48 group sessions. Dietary intake, NND-EDF hedonics, NND-EDF variety in the home, and weight were assessed at 0, 6, 12, and 18 mo. Results: Intent-to-treat analyses showed that the Lifestyle+LV group consumed less variety (P < 0.01) and energy daily (P < 0.05) from NND-EDFs than did the Lifestyle group at 6, 12, and 18 mo. The Lifestyle+LV group consumed less total energy daily (P < 0.05) at 6 mo than did the Lifestyle group. The Lifestyle+LV group reported less (P < 0.05) NND-EDF variety in the home at 6 and 18 mo than did the Lifestyle group. The hedonics of one chosen NND-EDF decreased more (P < 0.05) in the Lifestyle+LV group. Despite these effects, no difference in percentage weight loss occurred at 18 mo (Lifestyle+LV: -9.9 ± 7.6%; Lifestyle: -9.6 ± 9.2%). Conclusions: Limitations in dietary variety decreased intakes in the targeted area but did not affect weight loss. Limiting variety in more areas may be needed to improve weight loss and weight-loss maintenance. This trial was registered at clinicaltrials.gov as NCT01096719. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking remains the leading preventable cause of death among American women. Aerobic exercise has shown promise as an aid to smoking cessation because it improves affect and reduces nicotine withdrawal symptoms. Studies outside the realm of smoking cessation have shown that yoga practice also reduces perceived stress and negative affect. Methods: This pilot study examines the feasibility and initial efficacy of yoga as a complementary therapy for smoking cessation. Fifty-five women were given 8-week group-based cognitive behavioral therapy for smoking cessation and were randomized to a twice-weekly program of Vinyasa yoga or a general health and wellness program (contact control). The primary outcome measure was 7-day point prevalence abstinence at the end of treatment validated by saliva cotinine testing. Longitudinal analyses were also conducted to examine the effect of intervention on smoking cessation at 3- and 6-month follow-up. We examined the effects of the intervention on potential mediating variables (e.g., confidence in quitting smoking, self-efficacy), as well as measures of depressive symptoms, anxiety, and perceived health (SF-36). Results: At end of treatment, women in the yoga group had a greater 7-day point-prevalence abstinence rate than controls (odds ratio [OR], 4.56; 95% CI, 1.1-18.6). Abstinence remained higher among yoga participants through the six month assessment (OR, 1.54; 95% CI, 0.34-6.92), although differences were no longer statistically significant. Women participating in the yoga program also showed reduced anxiety and improvements in perceived health and well-being when compared with controls. Conclusions: Yoga may be an efficacious complementary therapy for smoking cessation among women. [ABSTRACT FROM AUTHOR]

A new measure, the Rhode Island Stress and Coping Inventory (RISCI), was developed to examine perceived stress and coping independent of specific stress situations. An adult sample (N = 466) was randomly divided into equal halves for developmental and confirmatory instrument development. Initial instrument development used principal components analysis, item analysis, and a measure of internal consistency (Coefficient alpha). Confirmatory factor analysis (CFA) was employed on the confirmatory sample to examine the structure of the refined item set. Several CFA fit indices indicated excellent fit for a model that represents perceived stress and coping as two moderately correlated dimensions. Validity analyses found strong relationships in the expected directions for both RISCI subscales with the 5-item Mental Health Inventory. Further validity analyses supported the utility of the RISCI in applied research with smokers and confirmed past research findings that successful quitters experience less perceived stress and cope better than relapsers. [ABSTRACT FROM AUTHOR]

Objectives: The effect of the lunar cycle and seasonal variation on ascending aortic dissection surgery outcomes is unknown. We investigated these temporal effects on risk-adjusted hospital mortality and then on the length of stay (LOS) following surgery for survivors., Methods: We examined prospectively collected data from cardiac operations at two major centres within a single state between January 1996 and December 2011. We first examined the relationship between the lunar cycle and seasonal variation, along with demographic and risk profile covariates, with mortality using univariate analyses, followed by multiple logistic regression modelling that controlled for demographic and patient risk variables including age, gender, risk profile (diabetes, hypertension, dyslipidaemia and renal failure), and two surgical groups: Group A, consisting of patients having repair of ascending aorta dissection repair only, and Group B, with those having ascending aorta repair plus aortic valve surgery or coronary bypass surgery or both. We further examined the relationship with LOS using both univariate and multiple regression analyses., Results: There were 210 patients who had repair of dissection in the study period, with 109 patients in Group A and 101 in Group B. The average age of this sample was 59.5 (standard deviation = 16.0), 65.7% were male and 18.1% died prior to discharge following repair. The greatest percentage of deaths occurred in winter (31.6%, n = 12), while the least were in summer (21.1%, n = 8) and fall (21.1%, n = 8). An overall χ(2) test found there was no difference in mortality for season (P = 0.55). Univariate analyses also found the age of patients who died vs lived was significantly higher (65.9 vs 58.1 years; P = 0.001), and a significantly greater (P = 0.029) percentage of patients with diabetes vs without diabetes died (41.7 vs 16.7%). Univariate analyses found all other covariates were not significantly related to mortality. In the multiple logistic regression model, there was no significant effect for season, while the odds of dying increased with age (odds ratio [OR] = 1.04, 95% confidence interval [95% CI] = 1.01-1.07, P = 0.012), and the odds of dying in the full-moon cycle vs the new moon cycle was significantly reduced (OR = 0.21, 95% CI = 0.05-0.81, P = 0.024). No other covariate significantly increased or decreased the odds of death, including diabetes risk, which had been significantly related to death in the univariate analysis. Within a linear regression model that examined the relationship with LOS, Group B (P = 0.020), male sex (P = 0.036) and the full-moon lunar phase (P = 0.001) were significantly related to shorter LOS., Conclusions: Season had no effect on mortality or LOS following aortic dissection repair, while patient age significantly increased the odds of death. The full-moon cycle appeared to reduce the odds of death, and the full-moon cycle, along with being male and requiring a concomitant cardiac procedure, was associated with shorter LOS.

Objective: To assess the prevalence of weight gain among male and female college freshmen., Methods: Study 1 examined weight change over freshman and sophomore years among 904 students attending a state university in Indiana, from 2002-2004. Study 2 examined weight and BMI change over the freshman year among 382 students attending a private university in Rhode Island, from 2004-2006., Results: 77% of Study 1 participants and 70% of Study 2 participants gained weight during their freshman year, largely during the first semester. In Study 1, weight gain averaged 3.5 kg in females and males; in Study 2, weight gain averaged 1.6 kg for females and 2.5 kg for males. Students continued to gain weight their sophomore year, with females 4.2 kg and males 4.3 kg heavier than at start of college. Overweight/obesity rates increased from baseline to end of freshman year for Study 1 (21.6% to 36%) and Study 2 participants (14.7% to 17.8%)., Conclusion: The first years of college may be a critical developmental window for establishing weight gain prevention efforts.

The Transtheoretical Model (TTM) has been extensively validated in representative samples of adult smokers. Stage effects, i.e., the patterned relationships between Stage of Change (SOC) and other TTM variables, have been reported in a variety of samples. This study describes reliability data for the TTM variables and tests the stage effects with an ethnically diverse sample of 296 parents with young children. On the basis of theory and previous empirical evidence from a general population, it is possible to make quantitative predications about the magnitude of the expected effect sizes for the Decisional Balance, Situational Temptations, and Processes of Change subscales. For each variable, both a test of significance and a comparison with the expected effect sizes is reported. Results indicated significant stage differences for 8 of the 11 TTM subscales, and all quantitative predictions were confirmed. This study supports the use of TTM measures in an ethnically diverse sample.