Race, age group, year of discharge, associated complications, and cancer type were significantly associated with risk of longer los and mortality. These factors may potentially help in identifying high-risk patients who might benefit from targeted antibiotic therapy or prophylactic hematopoietic growth factor support.

BackgroundExcessive gestational weight gain (GWG) is common and contributes to the development of obesity in women and their offspring. Electronic or e-health interventions have the potential to reach large groups of women and prevent excessive GWG, but their effectiveness has not been demonstrated. The purpose of this study was to evaluate, in a real-world setting, the effectiveness of a self-directed, integrated online and mobile phone behavioral intervention in preventing excessive GWG.MethodsThis effectiveness trial was a double-blind, three-arm trial with a parallel group design. Two arms received the same e-health intervention during pregnancy with the third arm serving as the placebo control. The intervention was based on a previously efficacious non-digital intervention that was adapted to electronic format. It included three behavior change tools: a weight gain tracker, and separate diet and physical activity goal-setting and self-monitoring tools. Both treatment conditions received access to informational tools, event reminders, and a blogging feature. Healthy pregnant women age 18-35 years with body mass indexes (BMI) ≥18.5 and < 35, at ≤20 weeks gestation, and an e-mail address were eligible. The proportion of women with excessive total GWG, as defined by the Institute of Medicine (IOM), was the primary outcome. 1689 randomized women were analyzed in the intent-to-treat (ITT) analysis. The study was designed to have 87% power to detect a 10 percentage point reduction from a control rate of 55% with a sample of 1641 (p = 0.0167, two-sided).ResultsIn the ITT sample, 48.1% (SD = 2.0%) gained excessively in the intervention group as did 46.2% (SD = 2.4%) in the placebo control group. These proportions were not significantly different (RR 1.09; 95% CI 0.98, 1.20, p = 0.12). The results were not altered in several sensitivity analyses.ConclusionThe addition of three behavior change tools to an informational placebo control did not result in a difference in the proportion of women with excessive total GWG compared to the placebo control in this effectiveness trial of an online, self-directed intervention. The similarity of intervention and control treatments and low usage of the behavior change tools in the intervention group are possible explanations.Trial registrationNCT01331564, ClinicalTrials.gov.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1767-4) contains supplementary material, which is available to authorized users.

Young adulthood has been identified as a high-risk period for the development of obesity but few interventions have been tested in this population. One way to escalate our learning about effective interventions is to test a number of interventions simultaneously as a consortium of research trials. This paper describes the Early Adult Reduction of weight through LifestYle intervention (EARLY) trials. Seven research sites were funded to conduct intervention trials, agreeing to test similar primary outcomes and cooperating to use a set of common measurement tools. The EARLY consortium was able to work cooperatively using an executive committee, a steering committee, workgroups and subcommittees to help direct the common work and implement a set of common protocol and measurement tools for seven independent but coordinated weight-related intervention trials. Using a consortium of studies to help young adults reach or maintain a healthy weight will result in increased efficiency and speed in understanding the most effective intervention strategies. KEYWORDSYoung adults, Obesity, Intervention trials, Research consortium BACKGROUND Obesity has reached epidemic proportions in American adults and youth and accounts for nearly 10 % of all annual medical spending [1,2]. By 2030, between 35 and 51 % of the population will be obese [3,4]. Young adults (18-35 years) are at higher risk for weight gain than older adults. According to a recent National Health and Examination Survey (NHANES) for US adults ages 25-74, major weight gain over 10 years (a gain in body mass index (BMI)≥5 kg/m 2 ) was highest at ages 25-34 [5]. Between 2004 and 2010, the prevalence of overweight and obesity rates for men ages 20-39 increased from 62.2 to 67.1 % and the prevalence for women in the same age range increased from

Background The relationships between worker health and productivity are becoming clearer. However, few large scale studies have measured the direct and indirect cost burden of overweight and obesity among employees using actual biometric values. Objective To quantify the direct medical and indirect (absence and productivity) cost burden of overweight and obesity in workers. Subjects A cross-sectional study of 10,026 employees in multiple professions and worksites across the U.S. Measures The main outcomes were five self-reported measures of workers’ annual healthcare use and productivity: doctor visits, emergency room visits, hospitalizations, absenteeism (days absent from work), and presenteeism (percent on-the-job productivity losses). Multivariate count and continuous data models (Poisson, negative binomial and zero-inflated Poisson) were estimated. Results After adjusting for covariates, obese employees had 20% higher doctor visits than normal weight employees (CI 16%, 24%, p < 0.01) and 26% higher emergency room visits (CI 11%, 42%, p < 0.01). Rates of doctor and emergency room visits for overweight employees were no different than those of normal weight employees. Compared to normal weight employees, presenteeism rates were 10% and 12% higher for overweight and obese employees, respectively (CI 5%, 15% and 5%, 19%, all p < 0.01). Taken together, compared to normal weight employees, obese and overweight workers were estimated to cost employers $644 and $201 more per employee per year, respectively. Conclusions This study provides evidence that employers face a financial burden imposed by obesity. Implementation of effective workplace programs for the prevention and management of excess weight will benefit employers and their workers.