Sleep, Health Outcomes and Body Weight (SHOW) study: a measurement burst design study on sleep and risk factors for obesity in black emerging adults in North Carolina, USA.

INTRODUCTION: Black emerging adults (18-28 years) have the highest risk of short sleep duration and obesity. This increased risk may be partly explained by greater stress levels, which may result from race-related stress (racial discrimination and heightened race-related vigilance) or living in more disadvantaged home and neighbourhood environments. Insufficient sleep may also impact obesity risk via several weight-related mechanisms including energy balance, appetite and food reward, cortisol profiles and hydration status. This paper describes the rationale, design and methods for the Sleep, Health Outcomes and Body Weight (SHOW) study. This study aims to prospectively assess the effects of sleep, race-related stress and home/neighbourhood environments on weight-related mechanisms and obesity markers (body weight, waist circumference and fat mass) in 150 black emerging adults. METHODS AND ANALYSIS: The SHOW study follows a measurement burst design that includes 3, 7-day data collection bursts (baseline, 6-month and 12-month follow-ups). Sleep is measured with three methods: sleep diary, actigraphy and polysomnography. Energy balance over 7 days is based on resting and postprandial energy expenditure measured via indirect calorimetry, physical activity via accelerometry and self-reported and ad libitum energy intake methods. Self-reported methods and blood biomarkers assess fasting and postprandial appetite profiles and a behavioural-choice task measures food reward. Cortisol awakening response and diurnal cortisol profiles over 3 days are assessed via saliva samples and chronic cortisol exposure via a hair sample. Hydration markers are assessed with 24-hour urine collection over 3 days and fasting blood biomarkers. Race-related stress is self-reported over 7 days. Home and neighbourhood environments (via the Windshield Survey) is observer assessed. ETHICS AND DISSEMINATION: Ethics approval was granted by the University of North Carolina at Greensboro's Institutional Review Board. Study findings will be disseminated through peer-reviewed publications, presentations at scientific meetings and reports, briefs/infographics for lay and community audiences.

Teaching personal and social responsibility after-school: a systematic review / Enseñando responsabilidad personal y social en un contexto extracurricular: una revisión sistemática / O Ensino da responsabilidade pessoal e social no contexto extracurricular: uma revisão sistemática

BACKGROUND: Teaching Personal and Social Responsibility (TPSR) has been studied and implemented through physical activity in different backgrounds for over three decades. However, there is no systematized review in the literature concerning the after-school context. AIM: Conducting a systematic review of literature on after-school interventions based on the TPSR model. METHODS: This study was driven by the following research questions: Which were the conclusions regarding the implementation of TPSR in after-school settings? Which research methodologies have been used to assess TPSR in after-school time settings? Which results related to TPSR were reported in after-school time settings? Cochrane protocol guidelines were followed. Papers were selected by two independent researchers, with Cohen's Kappa value of 81%. RESULTS AND DISCUSSION: Twenty-seven papers were selected, thirteen of which were reported with high scores. Most interventions were conducted in the USA on community-based after-school programs, lasting more than nine sessions, and led by school staff who prepared physical activities for youngsters from disadvantaged communities. Most of the reported studies resorted to qualitative methodologies. Some gaps were detected, such as lack of systematization of methods, lack of validity and reliability. Personal and social benefits were found. Other results were grouped into leadership, staff-youngsters relationship, values, transference, and impact on staff lives. We recommend future studies in the after-school context extend to extend to other countries, with more detailed descriptions of the specific used methods

CONTEXTO: Hace más de tres décadas, el Teaching Personal and Social Responsability(TPSR) ha sido estudiado e implementado, a través de la actividad física, en distintos contextos. No obstante, no ha ninguna revisión sistematizada en literatura en un contexto extracurricular. OBJETIVO: Llevar a una revisión sistemática de la literatura sobre intervenciones extracurriculares basadas en el modelo TPSR. MÉTODOS: Las preguntas de búsqueda que llevaron a este estudio fueron: ¿Cuáles las conclusiones relacionadas a la implementación del TPSR en contexto extracurricular? ¿Qué metodologías de investigación han sido utilizadas para examinar el TPSR en contexto extracurricular? ¿Qué resultados relacionados con el TPSR fueron presentados en contexto extracurricular? Han sido seguidas las orientaciones del protocolo de Cochrane. La selección de los artículos ha sido hecha por dos investigadores independientes, con valor de Kappa de Cohen de 81%. RESULTADOS Y DISCUSIÓN: Han sido seleccionados veintisiete artículos, trece de los cuales han sido relatados con elevada puntuación. La mayoría de las intervenciones han sido hechas en los EEUU, en programas extracurriculares para la comunidad, con una duración superior a nueve sesiones, encabezadas por staff de la escuela prepararon actividades físicas para jóvenes de comunidades desfavorecidas. Los estudios relatados apelaron, en su mayoría, a metodologías cualitativas. Algunos errores han sido detectados como la falta de sistematización de los métodos, la falta de validez y fiabilidad. Han sido encontrados beneficios personales y sociales. Otros resultados han sido agrupados en liderazgo, relaciones entre staff y jóvenes, valores, transferencia e impacto en la vida de las personas. Se recomienda que estudios futuros en el contexto extracurricular se extiendan a otros países, con descripciones más detalladas de los métodos utilizados y exactos

CONTEXTO: Há mais de três décadas, o Teaching Personal and Social Responsibility(TPSR) tem sido estudado e implementado, através da atividade física, em diferentes contextos. No entanto, não há nenhuma revisão sistematizada na literatura em contexto extracurricular. PROPÓSITO: Conduzir uma revisão sistemática da literatura sobre intervenções extracurriculares baseadas no modelo TPSR. MÉTODOS: As perguntas de pesquisa que conduziram este estudo foram: quais as conclusões relacionadas à implementação do TPSR em contextos extracurriculares? Que metodologias de investigação têm sido utilizadas para examinar o TPSR em contextos extracurriculares? Que resultados relacionados com o TPSR foram reportados em contextos extracurriculares? Foram seguidas as orientações do protocolo de Cochrane. A seleção dos artigos foi feita por dois pesquisadores independentes, com valor de Kappa de Cohen de 81%. RESULTADOS E DISCUSSÃO: Foram selecionados vinte e sete artigos, treze dos quais foram relatados com elevada pontuação. A maioria das intervenções foi realizada nos EUA, em programas extracurriculares para a comunidade, com uma duração superior a nove sessões, lideradas por staff da escola que preparou atividades físicas para jovens de comunidades desfavorecidas. Os estudos relatados recorreram, na sua maioria, a metodologias qualitativas. Algumas lacunas foram detetadas como a falta de sistematização dos métodos, a falta de validade e confiabilidade. Foram encontrados benefícios pessoais e sociais. Outros resultados foram agrupados em liderança, relacionamento entre staff e jovens, valores, transferência e impacto na vida pessoal. Recomenda-se que estudos futuros no contexto extracurricular se estendam para outros países, com descrições mais detalhadas dos métodos usados e precisos

Tigecycline-induced acute pancreatitis in a cystic fibrosis patient: A case report and literature review.

PURPOSE: The purpose of this case report is to increase awareness of tigecycline-associated pancreatitis, specifically in patients who may be predisposed to develop pancreatitis. CASE SUMMARY: A 22-year-old male with cystic fibrosis developed acute bronchitis, with sputum cultures significant for Mycobacterium chelonae. He was started on tigecycline on two separate occasions, in each case developing pancreatitis as evidenced by symptomatology, elevated pancreatic enzymes and, in one case, by CT imaging. On both occasions, symptomatology improved and enzymes normalized after discontinuation of tigecycline. DISCUSSION: Current literature including two recent review pieces is discussed. The unique aspects of the case are highlighted, including the particular risk of drug-associated pancreatitis in those with cystic fibrosis. CONCLUSION: The results of this case, in the context of current literature, suggest that clinicians should be aware of the potential for pancreatitis when using tigecycline. Clinicians should be particularly mindful of this complication in patients with comorbidities that might increase the risk of pancreatitis above that of the general population.

Voiding cystourethrogram--are our protocols the same?

PURPOSE: Voiding cystourethrogram is the gold standard for evaluating and diagnosing vesicoureteral reflux. Reflux detection can potentially be affected by many parameters during voiding cystourethrogram. MATERIALS AND METHODS: A 29-item survey was sent via e-mail through SurveyMonkey® to the chairperson of pediatric radiology at 65 national pediatric hospitals. This survey included questions on institutional protocols for performing voiding cystourethrogram. RESULTS: Responses were received from 41 institutions from across North America, including 17 of 19 Randomized Intervention for Children with Vesicoureteral Reflux study sites. Many aspects of the reports of voiding cystourethrogram protocols were similar with 90% or greater agreement in allowing parents in the room, contrast infusion by gravity, catheter or feeding tube use without balloons, no contrast dilution and voiding without a catheter in place. The height at which contrast medium was raised for infusion was 40, 60, 80, 100 and greater than 100 cm at 2.4%, 17.1%, 17.1%, 39.0% and 12.2% of sites, respectively, while the height was not measured or it varied at 12.2%. The infilling phase stopped when the bladder appeared full at 2.4% of sites, infusion stopped itself at 12.2%, patient voided at 61.0%, volume attained age expected capacity at 12.2%, the patient was uncomfortable at 4.9% and results varied at 7.3%. CONCLUSIONS: Data reveal that voiding cystourethrogram is performed differently across North America and no standard protocol exists for the procedure. These differences could significantly impact voiding cystourethrogram results among institutions and taint our ability to compare results in the literature.

Kissing nevus discovered at circumcision consult.

A divided nevus of the penis is a rare embryological occurrence. The appearance of a congenital melanocytic nevus can be difficult to distinguish from penile melanosis. This article presents the successful excision and histopathologic evaluation of one such nevus.