We found that the EVS has good face and discriminant validity and may provide more conservative estimates of PA behavior when compared with national surveys. The EVS has the potential to provide information about the relationship between exercise and health care use, cost, and chronic disease that has not been previously available at the population level.

Purpose: To conduct a pilot randomized trial testing an exercise program specifically adapted for post-bariatric patients. Methods: A total of 51 post-bariatric patients, 6-24 months post-surgery, were randomly assigned to usual care control (n = 25) or the exercise intervention (n = 26). The intervention included twice weekly 60 minute group exercise classes with functional strength, flexibility, and aerobic activities; at least three days per week of self-directed exercise; daily pedometer; recording of steps and activities; and weekly telephone counseling. There was also a six month maintenance period. Results: Patients were 49 ± 12 years old, 84% female, 59% non-Hispanic white, with a BMI of 32.9 ± 5.7 kg/m2 and percent excess BMI loss since surgery of 56% ± 35%. Patients were 14 ± 5 months post-surgery. A total of 44 patients (86%) completed both phases of the program and all assessments. The following measures improved significantly for intervention participants with no significant change in control participants: yards walked in six minutes, seconds for 8-foot up-and-go, number of arm curls, and distance in inches for chair sit-and-reach. Intervention changes remained after six months of maintenance. Conclusions: When compared to patients in usual care, a specially adapted exercise program for post-bariatric patients resulted in significant improvements in objectively monitored health outcomes. This program was delivered in a clinical setting and could be implemented in a variety of settings to improve health outcomes for post-bariatric patients.

No abstract

No abstract

IMPORTANCEThe risks and benefits of surveillance colonoscopy in elderly patients have not been well characterized.OBJECTIVE To investigate the relative impact of surveillance colonoscopy in elderly patients compared with a reference cohort. DESIGN, SETTING, AND PARTICIPANTSRetrospective cohort study from 2001 through 2010 of patients 50 years and older undergoing surveillance colonoscopy for a history of colorectal cancer (CRC) or adenomatous polyps at an integrated health care system in southern California. Patients were followed up from the surveillance examination until CRC diagnosis, death, disenrollment, IBD diagnosis, or study end date (December 31, 2010). MAIN OUTCOMES AND MEASURESThe primary outcome measure was incidence of CRC detected following surveillance colonoscopy. The secondary outcome was risk of procedure defined as postprocedure hospitalization within 30 days. Cox regression and multivariable logistic regression analyses were used to determine the impact of age on CRC incidence on surveillance examination as well as postprocedure hospitalization, respectively. RESULTSThe study cohort included 4834 elderly patients (age Ն75 years; 55.8% male) (median surveillance age, 79 years) and 22 929 individuals in the reference group (age 50-74 years; 57.7% male) (median surveillance age, 63 years). A total of 373 cancers were detected following surveillance colonoscopy (368 in the reference group and 5 among the elderly patients). There were a total of 711 postprocedure hospitalizations (184 in the reference group and 527 among the elderly patients). The CRC incidence among elderly patients undergoing surveillance was 0.24 per 1000 person-years vs 3.61 per 1000 person-years in the reference population (P < .001). In Cox regression analysis, the hazard ratio for CRC in the elderly patients compared with the reference group was 0.06 (95% CI, 0.02-0.13) (P < .001) after adjusting for comorbid illness, sex, and race/ethnicity. In logistic regression analysis, age 75 years and older was independently associated with increased risk of postprocedure hospitalization (adjusted odds ratio, 1.28 [95% CI, 1.07-1.53]; P = .006). Charlson score of 2 was also independently associated with increased risk of postprocedure hospitalization (adjusted odds ratio, 2.54 [95% CI, 2.06-3.14]; P < .001). CONCLUSIONS AND RELEVANCEA low incidence of CRC and relatively high rate of postprocedure hospitalization were found among elderly patients undergoing surveillance colonoscopy. Recommendations for ongoing surveillance in the elderly population should take into consideration the impact of comorbid illness and increasing age on the anticipated risks and benefits of colonoscopy.