SummaryPhysical activity (PA) is an important adjunct to bariatric surgery in the treatment of severe obesity; however, patient PA levels prior to and in the short‐term following surgery are usually low. Scarce data exist describing PA and sedentary behaviours in the long term following surgery. The objectives were to describe PA and sitting time in bariatric patients 1–16 years post‐surgery and assess their associations with patient, surgery and weight‐loss characteristics. A total of 398 bariatric patients (73% female; mean age 47 ± 11 years, mean 6 ± 4 years since surgery) completed a telephone questionnaire. Patients reported moderate‐to‐vigorous PA (MVPA: # sessions week−1 ≥30 min), sitting time (h d−1) and change in PA and sitting time vs. pre‐surgery (more/same/less). Associations with patient, surgery and weight‐loss characteristics were assessed. Only 53% of patients reported ≥1 session week−1 MVPA, mean sitting time was 7 ± 4 h d−1, 74% of patients reported more PA and 53% reported less sitting, now vs. pre‐surgery. Age, sex, smoking status, pre‐surgery body mass index, time‐since‐surgery and percent excess weight lost were significantly associated with PA and/or sitting outcomes. Patients currently experiencing ≥50% excess weight loss had over three times the odds of reporting ≥1 session week−1 MVPA (odds ratio [95% confidence interval] 3.28 [1.57, 6.89]) and almost four times greater odds of reporting ‘more’ PA vs. pre‐surgery (3.78 [2.15, 6.62]) compared with their less successful counterparts. Results point to low PA and high sedentariness among bariatric patients in the long‐term following surgery, associated with several characteristics. Associations with long‐term weight management highlight the need for tailored interventions to promote active living in this patient population.

CorrespondenceshouldbeaddressedtoS.P.J.Kremers,s.kremers@maastrichtuniversity.nlReceived 4 July 2012; Accepted 4 July 2012Copyright © 2012 S. P. J. Kremers et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

Objectives: To assess efficacy of two support surfaces RIK (R) gel mattress and a Power Air (R) overlay in preventing and healing pressure ulcersDesign: Retrospective analysis of patient recordsSetting: An academic affiliated 240-bed long-term care facility in Baltimore, MD, USASubjects and Method: All patients with pressure sores at the start of the study were included. One hundred and twenty-two patient records and weekly wound measurements on 173 pressure ulcers done by a dedicated team of wound nurses and technicians were retrospectively analyzed. The two surfaces studied were assigned by the respective physicians and nurses of each unit.Intervention: NoneResults: The two patient groups were comparable at the start of the study. One third of all patients developed one or more wounds during the study period or 48% of all ulcers studied. Healing rates were similar for both surfaces. New stage II ulcers were most common. There was a trend toward higher risk in patients assigned to the Power Air overlay mattress. Patients assigned to the gel mattress developed pressure ulcers less frequently than those on the Power Air overlay; however, the Power Air overlay tended to heal more ulcers. Controlling for the total amount of time each group spent on the respective mattresses, the efficacy of the gel surface in preventing new ulcers equaled or outweighed the benefit of the Power Air overlay. Since the gel fluid mattress is less costly we would favor the use of the gel mattress system.

Although both frailty and low vitamin D have been separately associated with an increased risk for adverse health, their joined effects on mortality have not been reported. The current study examined prospectively the effects of frailty and vitamin D status on mortality in US older adults. Participants aged ⩾60 years in The Third National Health and Nutrition Examination Survey with 12 years of mortality follow-up were included in the analysis (n=4731). Frailty was defined as meeting three or more criteria and pre-frailty as meeting one or two of the five frailty criteria (low body mass index (BMI), slow walking, weakness, exhaustion and low physical activity). Vitamin D status was assessed by serum 25-hydroxyvitamin D (25(OH)D) and categorized into quartiles. Analyses were adjusted for gender, race, age, smoking, education, latitude and other comorbid conditions. Serum 25(OH)D concentrations were lowest in participants with frailty, intermediate in participants with pre-frailty and highest in participants without frailty. The odds of frailty in the lowest quartile of serum 25(OH)D was 1.94 times the odds in the highest quartile (95% confidence interval (CI): 1.09–3.44). Mortality was positively associated with frailty, with the risk among participants who were frail and had low serum 25(OH)D being significantly higher than those who were not frail and who had high concentrations of serum 25(OH)D (hazards ratio 2.98; 95% CI: 2.01–4.42). Our results suggest that low serum 25(OH)D is associated with frailty, and there is additive joint effects of serum 25(OH)D and frailty on all-cause mortality in older adults.

Bariatric surgery is the most successful treatment option for seriously obese individuals and results in rapid reductions in body weight. However, this procedure is not without risk and the occurrence of complications after bariatric surgery is associated with reduced cardiorespiratory fitness levels prior to surgery.

Osteoarthritis is the most prevalent joint disease in the United States. In 1998, the estimated prevalence in this country was 43 million ((1)). Between 1988 and 1994, 18.1% of US men and 23.5% of US women reported that they had experienced significant knee pain ((1)). The prevalence of self-reported arthritis in the United States is projected to increase from 15% of the population in 1990, to 18% (59 million people) in 2000, an increase of 20% ((2)).

An active lifestyle can play an important role in helping overweight patients both lose and manage their weight. The traditional exercise prescription of regular bouts of continuous vigorous exercise may need to be modified to increase rates of adoption and compliance. Recent data suggest that accumulating several short bouts of moderate to vigorous activity each day may improve adherence to the program. Understanding the barriers to activity that overweight people face-such as fear or embarrassment-can help physicians prescribe appropriate exercise routines, which may ultimately help them with better weight management.

The purpose of this study was to determine if an on-site test battery would distinguish among three levels of giant slalom skiing ability. The test battery consisted of a 20-m shuttle run test, Wingate 60s cycling test, hexagonal obstacle test, high box test, double leg jumping test and vertical jump test. These tests were selected since previous studies have identified aerobic endurance, anaerobic endurance, power and agility as important components for Alpine skiers. Both construct validity and criterion related validity of the test battery were examined using data from 11 club skiers, 14 divisional level skiers, and 9 provincial level skiers. To establish construct validity, univariate F tests examined differences among the three levels of skiers. Significant (P less than 0.05) differences were found between the club skiers and the better skiers (divisional and provincial level) for the following test variables: peak power, mean power, and post-exercise lactate for a 60s Wingate cycle ergometer test, high box test, hexagonal obstacle test, double leg jumping test, and shuttle run test. Criterion related validity was established since there were significant correlations between giant slalom performance time and the hexagonal obstacle test (r = 0.82), high box test (r = -0.80), and double leg jumping (r = -0.86). These data illustrate that an on-site test battery can be used to distinguish among giant slalom Alpine skiers.