OBJECTIVE -The objective of this study was to determine if a community-based modified Diabetes Prevention Program Group Lifestyle Balance (GLB) intervention, for individuals with metabolic syndrome, was effective in decreasing risk for type 2 diabetes and cardiovascular disease (CVD) in an urban medically underserved community, and subsequently to determine if improvements in clinical outcomes could be sustained in the short term. RESEARCH DESIGN AND METHODS-This nonrandomized prospective intervention study used a one-group design to test the effectiveness of a community-based GLB intervention. Residents from 11 targeted neighborhoods were screened for metabolic syndrome (n ϭ 573) and took part in a 12-week GLB intervention (n ϭ 88) that addressed safe weight loss and physical activity.RESULTS -A marked decline in weight (46.4% lost Ն5% and 26.1% lost Ն7%) was observed in individuals after completion of the intervention. Of these subjects, 87.5% (n ϭ 28) and 66.7% (n ϭ 12) sustained the 5% and 7% reduction, respectively, at the 6-month reassessment. Over one-third of the population (43.5%, n ϭ 30) experienced improvements in one or more component of metabolic syndrome, and 73.3% (n ϭ 22) sustained this improvement at the 6-month reassessment. Additional improvements occurred in waist circumference (P Ͻ 0.009) and blood pressure levels (P ϭ 0.04) after adjustment for age, sex, race, mean number of GLB classes attended, and time.CONCLUSIONS -Adults in an urban medically underserved community can decrease their risk for type 2 diabetes and CVD through participation in a GLB intervention, and shortterm sustainability is feasible. Future research will include long-term follow-up of these subjects.

OBJECTIVETo determine the comparative effectiveness of three lifestyle intervention modalities in decreasing risk for diabetes.RESEARCH DESIGN AND METHODSFive hundred and fifty-five individuals (86.1% female, 95.1% white, and 55.8% obese) from eight rural communities were screened for BMI ≥25 kg/m2 and waist circumference >40 inches in men and >35 inches in women. Communities with their eligible participants (n = 493; mean age 51 years, 87.6% female, 94.1% Caucasian) were assigned to four Group Lifestyle Balance (GLB) intervention groups: face to face (FF) (n = 119), DVD (n = 113), internet (INT) (n = 101), and self-selection (SS) (n = 101). SS participants chose the GLB modality. GLB is a comprehensive lifestyle behavior–change program.RESULTSA marked decline was observed in weight after the intervention in all groups (FF −12.5 lbs, P = 0.01; DVD −12.2 lbs, P < 0.0001; INT −13.7 lbs, P < 0.0001; and SS −14 lbs, P < 0.0001). Participants in SS experienced the largest average weight loss. Weight loss was sustained in >90% of participants in each group at 6 months (FF 90.7%, DVD 90.9%, INT 92.1%, and SS 100%). All groups experienced improvements in the proportion of participants with CVD risk factors. The proportion of individuals with CVD risk factors remained steady between 3 and 6 months in all groups and never returned back to baseline. All associations remained after multivariate adjustment.CONCLUSIONSDespite the modality, the GLB intervention was effective at decreasing weight and improving CVD risk factor control. SS and FF participants experienced greater improvements in outcomes compared with other groups, establishing the importance of patient-centered decision making and a support network for successful behavior change.

Risk reduction and weight loss maintenance are possible following a GLB intervention and have substantial potential for future public health impact.

Objective/aim To identify small particle concentrations (eight categories: ≤0.1 µm × ≤5.0 µm) induced by aerosol-generating procedures (AGPs; high-speed tooth preparation, ultrasonic scaling; air polishing) under high-flow suction with a 16-mm intraoral cannula with and without an additional mobile extraoral scavenger (EOS) device during student training. Materials and methods Twenty tests were performed (16.94 m2 room without ventilation with constant temperature (26.7 (1.1) °C and humidity (56.53 (4.20)%)). Data were collected 2 min before, 2 min during, and 6 min after AGPs. The EOS device and the air sampler for particle counting were placed 0.35 m from the open mouth of a manikin head. The particle number concentration (PN, counts/m3) was measured to calculate ΔPN (ΔPN = [post-PN] − [pre-PN]). Results Mean ΔPN (SD) ranged between −8.65E+06 (2.86E+07) counts/m3 for 0.15 µm and 6.41E+04 (2.77E+05) counts/m3 for 1.0 µm particles. No significant differences were found among the AGP groups (p > 0.05) or between the AGP and control groups (p > 0.05). With an EOS device, lower ΔPN was detected for smaller particles by high-speed tooth preparation (0.1–0.3 µm; p < 0.001). Discussion A greater reduction in the number of smaller particles generated by the EOS device was found for high-speed tooth preparation. Low ΔPN by all AGPs demonstrated the efficacy of high-flow suction. Conclusions The additional use of an EOS device should be carefully considered when performing treatments, such as high-speed tooth preparation, that generate particularly small particles when more people are present and all other protective options have been exhausted.

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