The role of food and activity environment in a bariatric surgery population: impact on postoperative weight loss.

Background: Food and activity factors may have an impact on weight in the general population, but little is known about how this affects postbariatric surgery weight loss.

Objectives: To understand the impact of environmental food and activity factors on weight loss after bariatric surgery.

Setting: A multidisciplinary integrated health system with an accredited bariatric surgery program.

Mapping Drug Overdose Demographic and Socioeconomic Characteristics in the Community.

Introduction: Drug use and drug overdose have increased at an alarming rate.

Objective: To identify demographic and neighborhood social and economic factors associated with higher risk of overdose. These findings can be used to inform development of community programs and appropriately devote resources to prevent and treat drug abuse.

Perceived barriers to accessing adequate nutrition among food insecure households within a food desert.

Objectives: The US Department of Agriculture has identified an area in La Crosse, Wisconsin as a food desert-a low-income area with a low level of access to a grocery store or healthy, affordable food outlet. The purpose of this study was to determine the prevalence and potential predictors of severe food insecurity in this area.

Methods: Questionnaires assessing food insecurity and perceived barriers to accessing adequate nutrition were sent out to 2,068 households located within the food desert in La Crosse.

The POLST program: a retrospective review of the demographics of use and outcomes in one community where advance directives are prevalent.

Objectives: Determine the use and utility of the Physician Orders for Life-Sustaining Treatment (POLST) program in a community where powers of attorney for health care (POAHCs) are prevalent.

Methods: A retrospective review of medical record and death certificate data of 400 adults who died between September 1, 2007, and March 31, 2008, in the La Crosse County, Wisconsin community. Demographic and cause-of-death data were collected from death certificates.

Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort.

To determine how characteristics of pregnancy, birth, and early infancy are related to offspring obesity at three critical developmental periods. Mothers were followed through pregnancy and 10-15 years after. Offspring data were obtained through medical record review.

A comparative, retrospective, observational study of the prevalence, availability, and specificity of advance care plans in a county that implemented an advance care planning microsystem.

Objectives: To determine whether outcomes have changed over time for a managed, systematic approach to advance care planning (ACP).

Design: Retrospective comparison of medical record and death certificate data of adults who died over a 7-month period in 2007/08 with those of adults who died over an 11-month period in 1995/96.

Setting: All healthcare organizations in La Crosse County, Wisconsin.

Social determinants of smoking among Hmong Americans residing in Wisconsin.

Objective: This study examined correlates of tobacco use among Hmong people residing in Wisconsin.

Methods: Surveys of youth (ages 12-17) and adults (ages > or =18), available in English and Hmong, were distributed in 14 communities through Hmong Mutual Assistance Associations and analyzed centrally. Surveys assessed daily and ever use of tobacco, as well as other sociodemographic characteristics.

The value of a web-based interactive regional health scorecard in setting public health priorities.

Introduction: Community-based health improvement efforts sometimes focus on emerging health issues rather than following a more proactive planning process. Although there is an abundance of easily accessible data on state and national websites, community leaders frequently don't know where to find data that will help them to prioritize local efforts.

Methods: The La Crosse Medical Health Science Consortium (LMHSC) is a formal collaborative of the 2 major health care providers and 3 higher education institutions in La Crosse, Wisconsin, and covers 20 counties in western Wisconsin, southeastern Minnesota, and northeastern Iowa.

Minutes in motion: motivating a community to move.

Introduction: "Minutes in Motion" (MIM) was a community-based exercise challenge designed to recruit a large number of people to increase their physical activity for 6 weeks. We examined participant characteristics that improved the likelihood of success.

Methods: This program challenged community members to engage in 30 minutes of physical activity every day for 6 weeks.

On call: a survey of Wisconsin obstetric groups.

Objective: The purpose of this study was to identify patterns of obstetric call in order to identify areas of focus for future evaluation of "best practices."

Study Design: A telephone survey of obstetricians in Wisconsin was conducted, attempting to sample 1 physician from each group or call pool in every hospital in the state.

Results: Sixty-six physicians responded to this survey.

Impact of perinatal weight change on long-term obesity and obesity-related illnesses.

Objective: To estimate the impact of perinatal weight change on obesity, weight gain, and development of obesity-related illnesses 15 years after pregnancy.

Methods: Pregnancy-related factors and weights of 795 women were recorded at first prenatal visit and 6 months postpartum and were available through medical record review at 4, 10, and 15 years. Obesity-related illnesses were recorded 15 years later.

Growing healthy families: family use of pedometers to increase physical activity and slow the rate of obesity.

Objective: We conducted a study to determine if wearing a pedometer affects weight, body mass index (BMI), or mediators of physical activity among families.

Methods: Eighty-seven families were randomized to 1 of 3 treatments: pedometer plus education (PE), pedometer (P), or control (C). Participants in the PE and P groups wore pedometers and were encouraged to walk 10,000 steps daily for 12 weeks.

Quit and Win smoking cessation contest for Wisconsin college students.

Objective: To determine effectiveness of smoking cessation contests at 3 Wisconsin colleges.

Design: Pre-post program evaluation, with 6-month follow-up.

Setting: Two-year technical college, private 4-year college, and state university in spring and fall of 2000.

Ultrasound assessment of first-trimester bleeding.

Objective: To assess the outcome (to the end of the first trimester) of pregnancies with vaginal bleeding and the influence of ultrasound-acquired information on care and cost of care.

Methods: A chart review was performed of 1,240 patients receiving care at an integrated medical center for threatened abortion from 1998-2000. Records from 715 patients with adequate follow-up data were reviewed and outcomes studied.

Functional fitness, disease and independence in community-dwelling older adults in western Wisconsin.

Objective: Older adults are at higher risk for developing chronic conditions such as diabetes, heart disease, or arthritis. Despite the aging process, maintaining independence is a major goal for older adults. Functional fitness has been found to be predictive of one's ability to perform necessary everyday activities needed to maintain independence.

Quantitative analysis of limb anomalies in CHARGE syndrome: correlation with diagnosis and characteristic CHARGE anomalies.

CHARGE syndrome was initially not thought to involve the limb. Several subsequent reports have shown that limb anomalies are not uncommon. To date, there have been no quantitative studies of limb anomalies in CHARGE syndrome.

Is knowing enough? Increasing physical activity by wearing a pedometer.

Objective: Physical inactivity is a health concern in the United States with nearly 70% of the population getting inadequate amounts of exercise. We set out to determine if wearing a pedometer could significantly increase awareness and amount of physical activity among female employees at a large health care setting.

Methods: Employees purchased a pedometer, completed a survey, and were encouraged to walk 10,000 steps daily.

A smoking cessation clinic with a 57% success rate: what makes it work?

Objective: To describe an outpatient smoking cessation clinic, and what predicts participant success.

Methods: In 1999, a 12-week smoking cessation clinic was begun. In 2000, the duration was expanded to include an additional 12 weeks of relapse prevention.

Excess pregnancy weight gain and long-term obesity: one decade later.

Objective: To estimate the impact of excess pregnancy weight gain and failure to lose weight by 6 months postpartum on excess weight 8-10 years later.

Methods: Seven hundred ninety-five women were observed through pregnancy and 6 months postpartum to examine factors that affect weight loss. Weight was recorded 10 years later through a medical record review to examine the impact of retained weight on long-term obesity.