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While discussing obesity with pediatric patients and their families can be difficult, it is an essential step toward appropriate weight management. There is paucity of data regarding language preferences when discussing obesity in this population. In this pilot qualitative study, we interviewed 8 parents of patients diagnosed with obesity to identify language and communication preferences for discussing their child’s weight. Interviews were analyzed for emerging themes. Important trends appeared revealing that parents prefer neutral, medical terms discussed at well-child checks or obesity-specific visits. Providers should frame lifestyle changes as positive for all patients and set achievable goals with the help of visual aids. Our analysis uncovered several important communication strategies that can better equip providers to discuss obesity with their pediatric patients. This research may serve as a foundation for larger studies into the topic.

Introduction The popularity of cycling in the United Kingdom is increasing, with a further rise likely due to recent government cycling promotion schemes. This study aims to characterise fractures sustained due to cycling-related collisions in patients presenting to a Major Trauma Centre, in the region with the highest cycling rates in the United Kingdom. Methods A retrospective analysis of cycling injuries presenting to our centre between January 2012 and December 2020 was performed using a prospectively collected electronic database. Comparison of fracture characteristics was made according to patient age and mechanism of injury (collision with a motorised vehicle versus collision with a non-motorised object.). Results Of the 737 patients who suffered a cycling-related injury, 292 (39.6%) suffered at least 1 fracture to the appendicular skeleton. Overall, fractures were most commonly seen in those over 50 years of age. Upper limb fractures were more common than lower limb fractures. Fractures sustained during motorised injuries were more likely to require surgical intervention than those sustained during non-motorised collisions. Conclusion This study provides valuable information regarding the nature, epidemiology and treatment of fractures sustained following cycling-related accidents, adding to the paucity of similar literature in the field. Given the likely increase in future cycling uptake, our results are important to clinicians treating patients with cycling-related injuries and policymakers designing safety interventions.

PrEP adoption among African-American men-who-have-sex-with-men (AAMSM) remains low. We applied Diffusion-of-Innovations (DOI) theory to understand PrEP adoption processes among young HIV-negative/status unknown AAMSM (AAYMSM; N = 181; 17-24 years). Quantitative and qualitative analyses were used to examine predictors of PrEP diffusion stages. Most AAYMSM were in the persuasion stage (PrEP-aware, hadn't adopted; 72.4%). Our results suggest that model antecedents are DOI stage-specific. PrEP awareness (knowledge stage) was associated with lower levels of social stigma (p .03) and greater health literacy (p .05), while sexual risk (p .03) and education (p .03) predicted PrEP adoption (12.2%). PrEP efficacy and side effects were primary innovation characteristics influencing adoption receptivity in the persuasion stage. Interventions to improve PrEP diffusion should be tailored to stage-specific antecedents depending on how a community is stratified across the DOI stages.La adopción de Pre-exposición Profilaxis (PrEP) entre hombres afroamericanos que tienen relaciones sexuales con otros hombres (HASH) sige baja. Aplicamos la teoría de la difusión de innovaciones para comprender los procesos de adopción de la PrEP entre los hombres jóvenes afroamericanos que tienen relaciones sexuales con otros hombres (HJASH) VIH negativos/estado desconocido (HJASH; N = 181; 17–24 años). Se utilizaron análisis cuantitativos y cualitativos para examinar los predictores de las etapas de difusión de PrEP. La mayoría de los HJASH se encontraban en la etapa de persuasión (conscientes de la PrEP, no la habían adoptado; 72.4%). Nuestros resultados sugieren que los antecedentes del modelo son específicos de la etapas de la difusión de innovaciones. La conciencia de la PrEP (etapa de conocimiento) se asoció con niveles más bajos de estigma social (p.03) y una mayor alfabetización en salud (p.05), mientras que el riesgo sexual (p.03) y la educación (p.03) predijeron la adopción de la PrEP (12.2%). La eficacia y los efectos secundarios de la PrEP fueron las principales características de la innovación que influyeron en la receptividad de la adopción en la etapa de persuasión. Las intervenciones para mejorar la difusión de la PrEP deben adaptarse a los antecedentes específicos de la etapa, dependiendo de cómo se estratifique una comunidad en las etapas del la difusión de innovaciones.

The aim of this study was to understand how endurance time, a proxy for physical fitness, has changed in healthy inner-city children and adolescents in the past three decades. This was a retrospective cross-sectional study. This study used exercise stress test in a laboratory of an inner-city teaching hospital. We reviewed all consecutive healthy children and adolescents who underwent an exercise Bruce protocol treadmill test from 1983 to 2010. The study population was divided into five groups of 5-year intervals based on the year of testing. Temporal trend in endurance time was analyzed, adjusting for gender, ethnicity, age, and body mass index (BMI). We analyzed the records of 435 healthy children and adolescents (mean age 12.6 ± 3.2 years, 57% males).There was a significant difference in the mean endurance time between children grouped in 5-year intervals (P

Spontaneous “off-line” reactivation of neuronal activity patterns may contribute to the consolidation of memory traces. The ventral striatum exhibits reactivation and has been implicated in the processing of motivational information. It is unknown, however, whether reactivating neuronal ensembles specifically recapitulate information relating to rewards that were encountered during wakefulness. We demonstrate a prolonged reactivation in rat ventral striatum during quiet wakefulness and slow-wave but not rapid eye movement sleep. Reactivation of reward-related information processed in this structure was particularly prominent, and this was primarily attributable to spike trains temporally linked to reward sites. It was accounted for by small, strongly correlated subgroups in recorded cell assemblies and can thus be characterized as a sparse phenomenon. Our results indicate that reactivated memory traces may not only comprise feature- and context-specific information but also contain a value component.