The SHED-IT Community Trial: A Randomized Controlled Trial of Internet- and Paper-Based Weight Loss Programs Tailored for Overweight and Obese Men

Background

There is limited evidence for effective obesity treatment programs that engage men.

Purpose

This study evaluated the efficacy of two gender-tailored weight loss interventions for men, which required no face-to-face contact.

Methods

This was a three-arm, randomized controlled trial: (1) Resources (n?=?54), gender-tailored weight loss materials (DVD, handbooks, pedometer, tape measure); (2) Online (n?=?53), Resources materials plus study website and e-feedback; and (3) Wait-list control (n?=?52). The interventions lasted 3 months and were grounded in Social Cognitive Theory.

Results

At 6 months, significantly greater weight loss was observed for the Online (?4.7 kg; 95 % CI ?6.1, ?3.2) and Resources (?3.7 kg; 95 % CI ?4.9, ?2.5) groups compared to the control (?0.5 kg; 95 % CI ?1.4, 0.4). Additionally, both intervention groups significantly improved body mass index, percent body fat, waist circumference, blood pressure, physical activity, quality of life, alcohol risk, and portion size, compared to controls.

Conclusions

Men achieved significant weight loss after receiving novel, minimal-contact, gender-tailored programs, which were designed for widespread dissemination.     

State of the Art of Short Dental Implants: A Systematic Review of the Literature

Background: Short implants (≤8 mm) are manufactured for use in atrophic regions of the jaws. As implant length in many studies has been proven to play a major role in implant survival it is indicated to evaluate survival of short implants in the present literature. Purpose: The purpose of this study was systematically to evaluate publications concerning short dental implants defined as an implant with a length of ≤8 mm installed in the maxilla or in the mandible with special reference to implant type, survival rate, location of implant site, and observation time. Materials and Methods: A Medline and a hand search were conducted to identify studies concerning short dental implants of length ≤8 mm published between 1992 and October 2009. The articles included in this study report data on implant length ≤8 mm, implant surface, registered region of installment, observation time, single tooth restorations, supporting overdentures, splinted implants, and implants used for prostheses. Results: The 27 included studies represent zero randomized clinical trial studies, 15 prospective nonrandomized, noncontrolled clinical trials, 11 retrospective nonrandomized, noncontrolled clinical trials, and one review. Data on 6‐mm implants were few and most frequent represented was manufactured Straumann implants representing 441 out of 549 implants. Brånemark implants, 7 mm in length, comprised 1607 implants out of 1808. Straumann implants, 8 mm in length, comprised 2040 out of 2352 implants. Failures varied between 0 and 14.5%, 0 and 37.5% and 0 and 22.9% of the 6‐, 7‐, and 8‐mm‐long implants, respectively. Conclusion: Short implant length was not related to observation time, installment region, failures, and dropouts were not specified, subsequently a meta‐analysis was not possible to perform.     

Quality in healthcare: process

Recent studies have shown startling rates of adverse events and preventable mortality in hospitalised patients around the world. Research using root cause analysis and incident monitoring has improved our understanding of why these errors occur. These approaches are useful in identifying contributing factors and stakeholders involved in adverse and sentinel events. The factors that contribute to these events have been well described, and range from institutional and management decisions down to the individual health care professionals involved and the environment they work in. We discuss healthcare processes, and present a proactive approach of workflow process modelling using sequence diagrams to identify the factors involved. These diagrams can then be used in conjunction with simple calculations for risk analysis to prioritise the value of interventions at different steps of the healthcare process. We discuss how these analyses can be used to plan interventions to improve patient safety and quality of healthcare.