The combined influence of fitness and fatness on mortality risk in diverse populations has not been adequately explored. The authors' aim was to assess the relative impact of exercise capacity and body mass index (BMI) on all-cause mortality.

Few population-based studies have directly examined the relationship between time spent outdoors and mental health or how these experiences differ by race and ethnicity. This study examined the relationship between time spent outdoors and depression among American adults. Findings provide evidence that time spent outdoors is associated with fewer depressive symptoms, but this benefit may not be equally distributed by race and ethnicity, particularly given differences in occupational experiences and neighborhood environments. Analyses also reveal differences in time spent outdoors among different racial and ethnic groups.

This study set out to determine whether children's food choices and/or brain activations were altered after the viewing of typical food commercials. Functional MRI showed that watching food commercials before making food choices may bias children's decisions based solely on taste and may increase the likelihood that they make faster, more impulsive food choices. The ventromedial prefrontal cortex showed increased activity at the time of food choice after watching food commercials compared with nonfood commercials. These effects may make it more difficult for caregivers to encourage healthy food choices. Additionally, these findings may have implications for policies related to food advertising to children.

Chronic pain is a major health problem that involves a significant burden on an individual and societal level. Many suffer from pain that is not clearly medically understood. Research indicates that chronic pain sufferers might be prone to stigmatization by others. This work investigated whether observers socially exclude patients who experience medically unexplained pain. Study subjects from the general population viewed videos of four patients, each accompanied by a vignette describing the presence or absence of an explanation. Participants estimated patient pain and rated their sympathy as well as their inclination to help the patient. To measure social exclusion, study subjects indicated their willingness to interact with the patients. When no medical explanation was provided, participants attributed less pain, reported feeling less sympathy, and were less inclined to offer help. These results are indicative of social exclusion of patients with pain for which there is no clear medical explanation.

This comprehensive, longitudinal assessment of the range, rates, and onset of adolescents' problems in sexual function reveals high rates among both males and females. Half of the problems reached clinical levels of distress, with risk linked most closely to poorer sexual esteem and not being in a sexual relationship.

Are opioids, anxiolytics, and anticholinergics associated with a change in symptoms of pain intensity, anxiety, and shortness of breath while an elderly nursing home resident is dying? Researchers from Norway and the UK looked at the differences in symptoms on the day perceived as dying to the actual day of death. While symptom management provided relief, too many people had high levels of pain, pointing to a need for better education of nursing home staff.

Hereditary angioedema (HAE) is a genetic disorder characterized by recurrent, potentially life-threatening attacks of edema. Alkylated androgens (AAs) have been widely used for prophylaxis. This retrospective, cross-sectional survey of subjects with HAE (344 current, 180 past, and 126 never users of AAs), explored self-reported efficacy and side effects of AAs. AA treatment significantly decreased attack frequency and severity. There was substantial variability in efficacy. No dose effect was seen for the beneficial effects. Most users reported frequent side effects that were dose-related and often severe. With the advent of new therapies, the authors suggest not using AAs for most patients, and, if used, trialing the lowest possible dose.

Join us for an interactive CME/CNE Cystic Fibrosis Satellite Seminar on Friday, Oct. 28, in Orlando, Fla. The program will highlight the latest advancements, particularly in CFTR-based therapeutics, for the treatment of patients with cystic fibrosis. Expert faculty will utilize an interactive panel format to present and discuss the most up-to-date analysis for clinical decision-making, including updates on assessment, monitoring, and management of patients treated with CFTR modulator therapies. Register here for this live satellite seminar!

A review of randomized controlled trials, observational studies and meta-analyses found that statin therapy leads to a 25% reduction in the risk for ischemic stroke and other cardiovascular events, and the benefits outweigh an increased risk for hemorrhagic stroke. The findings, published in The Lancet, showed 50% of cardiovascular events could be prevented by every 2 millimole per liter reduction in LDL cholesterol in patients with receiving statin therapy.

A Norwegian prospective study in JAMA Internal Medicine showed men faced about twice the risk of incident myocardial infarction as women, even after adjusting for established cardiovascular risk factors. The findings, based on 33,997 patients, showed the gender gap was lifelong but shrank with increasing age.

Forty-one percent of nonsmoking US youths ages 3 to 11 and 34% of those ages 12 to 19 had the nicotine metabolite cotinine in their blood, according to an American Heart Association study published in the journal Circulation. The findings, based on 2011 to 2012 National Health and Nutrition Examination Survey data, also showed 68% of black children were exposed to secondhand smoke and 41% of exposed children lived below the poverty line.

Physicians will have four Quality Payment Program options next year under the Medicare Access and CHIP Reauthorization Act, acting CMS Administrator Andy Slavitt wrote in a blog post. Physicians can choose to test the program, participate for part of the year or for the full year, or participate in an alternative payment model such as an accountable care organization.

More participants in the Medicare Shared Savings Program and Pioneer ACO Model are succeeding, but the substantial variation in financial performance and quality results highlights the need for health care providers to transform how care is delivered, write David Muhlestein, Robert Saunders and Mark McClellan. The results also show that large, consolidated accountable care organizations do not necessarily achieve the best performance.

Researchers found that 26% of Medicare Part D beneficiaries -- nearly 5 million people -- missed doses or stopped taking their blood pressure medication, leaving them at higher risk of stroke and heart attack. The study, published in the CDC's Morbidity and Mortality Weekly Report, found that lower-income patients, those living in the "Stroke Belt" across the southern US, and certain racial and ethnic groups were most likely to be nonadherent.