Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial

Objective To determine if a school based educational programme aimed at reducing consumption of carbonated drinks can prevent excessive weight gain in children. Design Cluster randomised controlled trial. Setting Six primary schools in southwest England. Participants 644 children aged 7-11 years. Intervention Focused educational programme on nutrition over one school year. Main outcome measures Drink consumption and number of overweight and obese children. Results Consumption of carbonated drinks over three days decreased by 0.6 glasses (average glass size 250 ml) in the intervention group but increased by 0.2 glasses in the control group (mean difference 0.7, 95% confidence interval 0.1 to 1.3). At 12 months the percentage of overweight and obese children increased in the control group by 7.5%, compared with a decrease in the intervention group of 0.2% (mean difference 7.7%, 2.2% to 13.1%). Conclusion A targeted, school based education programme produced a modest reduction in the number of carbonated drinks consumed, which was associated with a reduction in the number of overweight and obese children

Pancreatitis following Olanzapine Therapy: A Report of Three Cases

CONTEXT: Atypical antipsychotic agents (clozapine, olanzapine) have been linked to metabolic effects and acute pancreatitis. CASE REPORT: We reviewed the inpatient and outpatient records of three patients who developed acute pancreatitis while being treated with olanzapine. The mean age of the patients was 37.7 years (range 18–54 years, 2 female, 1 male). No alternative cause of acute pancreatitis was found in two of the three patients. In the remaining patient, olanzapine may have contributed to acute pancreatitis in the setting of hypertriglyceridemia. Olanzapine was discontinued in all instances. Over a mean follow-up of 14 months, one patient has had a relapsing course, but the remaining two patients have been symptom free without recurrence of acute pancreatitis. CONCLUSIONS: Our case series adds further support to the potential link between olanzapine use and acute pancreatitis. Close monitoring of metabolic parameters is suggested in patients treated with olanzapine. Alternative antipsychotic agents should be considered in patients at high risk for pancreatitis

Age validation of quillback rockfish (Sebastes maliger) using bomb radiocarbon

Rockfishes (Sebastes spp.) support one of the most economically important f isheries of the Pacific Northwest and it is essential for sustainable management that age estimation procedures be validated for these species. Atmospheric testing of thermonuclear devices during the 1950s and 1960s created a global radiocarbon (14C) signal in the ocean environment that scientists have identified as a useful tracer and chronological marker in natural systems. In this study, we first demonstrated that fewer samples are necessary for age validation using the bomb-generated 14C signal by emphasizing the utility of the time-specific marker created by the initial rise of bomb-14C. Second, the bomb-generated 14C signal retained in fish otoliths was used to validate the age and age estimation method of the quillback rockfish (Sebastes maliger) in the waters of southeast Alaska. Radiocarbon values from the first year’s growth of quillback rockfish otoliths were plotted against estimated birth year to produce a 14C time series spanning 1950 to 1985. The initial rise in bomb-14C from prebomb levels (~ –90‰) occurred in 1959 [±1 year] and 14C levels rose relatively rapidly to peak Δ14C values in 1967 (+105.4‰) and subsequently declined through the end of the time series in 1985 (+15.4‰). The agreement between the year of initial rise of 14C levels from the quillback rockfish time series and the chronology determined for the waters of southeast Alaska from yelloweye rockfish (S. ruberrimus) otoliths validated the aging method for the quillback rockfish. The concordance of the entire quillback rockfish 14C time series with the yelloweye rockfish time series demonstrated the effectiveness of this age validation technique, confirmed the longevity of the quillback rockfish up to a minimum of 43 years, and strongly confirms higher age estimates of u

Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis.

BACKGROUND:Ecological research suggests that increased access to cannabis may facilitate reductions in opioid use and harms, and medical cannabis patients describe the substitution of opioids with cannabis for pain management. However, there is a lack of research using individual-level data to explore this question. We aimed to investigate the longitudinal association between frequency of cannabis use and illicit opioid use among people who use drugs (PWUD) experiencing chronic pain. METHODS AND FINDINGS:This study included data from people in 2 prospective cohorts of PWUD in Vancouver, Canada, who reported major or persistent pain from June 1, 2014, to December 1, 2017 (n = 1,152). We used descriptive statistics to examine reasons for cannabis use and a multivariable generalized linear mixed-effects model to estimate the relationship between daily (once or more per day) cannabis use and daily illicit opioid use. There were 424 (36.8%) women in the study, and the median age at baseline was 49.3 years (IQR 42.3-54.9). In total, 455 (40%) reported daily illicit opioid use, and 410 (36%) reported daily cannabis use during at least one 6-month follow-up period. The most commonly reported therapeutic reasons for cannabis use were pain (36%), sleep (35%), stress (31%), and nausea (30%). After adjusting for demographic characteristics, substance use, and health-related factors, daily cannabis use was associated with significantly lower odds of daily illicit opioid use (adjusted odds ratio 0.50, 95% CI 0.34-0.74, p < 0.001). Limitations of the study included self-reported measures of substance use and chronic pain, and a lack of data for cannabis preparations, dosages, and modes of administration. CONCLUSIONS:We observed an independent negative association between frequent cannabis use and frequent illicit opioid use among PWUD with chronic pain. These findings provide longitudinal observational evidence that cannabis may serve as an adjunct to or substitute for illicit opioid use among PWUD with chronic pain

A Simple Family of Analytical Trumpet Slices of the Schwarzschild Spacetime

We describe a simple family of analytical coordinate systems for the Schwarzschild spacetime. The coordinates penetrate the horizon smoothly and are spatially isotropic. Spatial slices of constant coordinate time $t$ feature a trumpet geometry with an asymptotically cylindrical end inside the horizon at a prescribed areal radius $R_0$ (with $0<R_{0}\leq M$) that serves as the free parameter for the family. The slices also have an asymptotically flat end at spatial infinity. In the limit $R_{0}=0$ the spatial slices lose their trumpet geometry and become flat -- in this limit, our coordinates reduce to Painlev\'e-Gullstrand coordinates.Comment: 7 pages, 3 figure

Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators' self-report

Neurophenomenological studies seek to utilize first-person self-report to elucidate cognitive processes related to physiological data. Grounded theory offers an approach to the qualitative analysis of self-report, whereby theoretical constructs are derived from empirical data. Here we used grounded theory methodology to assess how the first-person experience of meditation relates to neural activity in a core region of the default mode network –the posterior cingulate cortex. We analyzed first-person data consisting of meditators’ accounts of their subjective experience during runs of a real-time fMRI neurofeedback study of meditation, and third-person data consisting of corresponding feedback graphs of posterior cingulate cortex activity during the same runs. We found that for meditators, the subjective experiences of ‘undistracted awareness’ such as ‘concentration’ and ‘observing sensory experience’, and ‘effortless doing’ such as ‘observing sensory experience’, ‘not efforting’, and ‘contentment’, correspond with posterior cingulate cortex deactivation. Further, the subjective experiences of ‘distracted awareness’ such as ‘distraction’ and ‘interpreting’, and ‘controlling’ such as ‘efforting’ and ‘discontentment’, correspond with posterior cingulate cortex activation. Moreover, we derived several novel hypotheses about how specific qualities of cognitive processes during meditation relate to posterior cingulate cortex activity, such as the difference between meditation and ‘trying to meditate’. These findings offer novel insights into the relationship between meditation and self-related thinking and neural activity in the default mode network, driven by the first-person experience

Epidemiology of Knee Sprains in Youth, High School, and Collegiate American Football Players

Context: Assessment of health-related quality of life (HRQOL) after injury is important. Differences in HRQOL between nonathletes and athletes and between injured and uninjured athletes have been demonstrated; however, the evidence has not been synthesized. Objective: To answer the following questions: (1) Does HRQOL differ among adolescent and collegiate athletes and nonathletes? (2) Does HRQOL differ between injured adolescent and collegiate athletes or between athletes with a history of injury and uninjured athletes or those without a history of injury? Data Sources: We systematically searched CINAHL, MEDLINE, SPORTDiscus, and PubMed. A hand search of references was also conducted. Study Selection: Studies were included if they used generic instruments to compare HRQOL outcomes between athletes and nonathletes and between uninjured and injured athletes. Studies were excluded if they did not use a generic instrument, pertained to instrument development, or included retired athletes or athletes with a chronic disease. Data Extraction: We assessed study quality using the modified Downs and Black Index Tool. Bias-corrected Hedges g effect sizes and 95% confidence intervals (CIs) were calculated. The Strength of Recommendation Taxonomy (SORT) was used to determine the overall strength of the recommendation. A random-effects meta-analysis was performed for all studies using the composite or total score. Data Synthesis: Eight studies with modified Downs and Black scores ranging from 70.6% to 88.4% were included. For question 1, the overall random-effects meta-analysis was weak (effect size = 0.27, 95% confidence interval = 0.14, 0.40; P \u3c .001). For question 2, the overall random-effects meta-analysis was moderate (effect size = 0.68, 95% confidence interval = 0.42, 0.95; P \u3c .001). Conclusions: Grade A evidence indicates that athletes reported better HRQOL than nonathletes and that uninjured athletes reported better HRQOL than injured athletes. However, the overall effect for question 1 was weak, suggesting that the differences between athletes and nonathletes may not be clinically meaningful. Clinicians should monitor HRQOL after injury to ensure that all dimensions of health are appropriately treated