I t is not atypical for patients with posttraumatic stress disorder (PTSD) to present with several concomitant physical and mental health problems. These most often include increased reporting of physical symptoms and physical health problems, increased alcohol consumption, and depressed mood (1,2). Recent evidence suggests that pain is one of the most commonly reported symptoms of patients with PTSD, regardless of the nature of their traumatic experience (for example, military combat, motor vehicle accident, or sexual assault). Similarly, patients who have persistent, chronic pain associated with musculoskeletal injury, serious burn injuries, and other pathologies (such as fibromyalgia, cancer, or AIDS) frequently present with symptoms of PTSD. In the past decade, investigation into the relation(s) between PTSD and the experience of pain has flourished. To a lesser degree, researchers have developed models that attempt to explain how the conditions may be linked (3). This paper has several purposes. First, we provide summary definitions of the conditions under discussion. Second, we highlight symptoms from each condition that have similar characteristics. Third, we summarize the literature on prevalence rates of pain experiences in PTSD populations, and vice versa. Fourth, we articulate potential explanations for the observed association between pain and PTSD. Finally, we discuss future directions for empirical investigation and clinical practice that stem from this line of inquiry. Clinical Implications· Clinicians treating patients with posttraumatic stress disorder (PTSD) need to pay careful attention to co-occurring symptoms of pain. · Likewise, those treating patients with chronic pain need to be aware of the potential influence of PTSD symptoms on clinical presentation. · Use of propranolol may be effective in simultaneous relief of co-occurring PTSD and pain symptoms. Limitation · The positions suggested in this review warrant careful empirical scrutiny.It is common for individuals with symptoms of posttraumatic stress disorder (PTSD) to present with cooccurring pain problems, and vice versa. However, the relation between these conditions often goes unrecognized in clinical settings. In this paper, we describe potential relations between PTSD and chronic pain and their implications for assessment and treatment. To accomplish this, we discuss phenomenological similarities of these conditions, the prevalence of chronic pain in patients with PTSD, and the prevalence of PTSD in patients with chronic pain. We also present several possible explanations for the co-occurrence of these disorders, based primarily on the notions of shared vulnerability and mutual maintenance. The paper concludes with an overview of future research directions, as well as practical recommendations for assessing and treating patients who present with co-occurring PTSD or chronic pain symptoms.

Sleep is increasingly recognized as an important lifestyle contributor to health. However, this has not always been the case, and an increasing number of Americans choose to curtail sleep in favor of other social, leisure, or work-related activities. This has resulted in a decline in average sleep duration over time. Sleep duration, mostly short sleep, and sleep disorders have emerged as being related to adverse cardiometabolic risk, including obesity, hypertension, type 2 diabetes mellitus, and cardiovascular disease. Here, we review the evidence relating sleep duration and sleep disorders to cardiometabolic risk and call for health organizations to include evidence-based sleep recommendations in their guidelines for optimal health.

We conclude that both population and high-risk strategies for health behaviour intervention are warranted, potentially synergistic and need intervention design that accounts for substitute and complementary relationships among bundled health behaviours. To maximize positive public health impact, a pressing need exists for bodies of basic and translational science that explain health behaviour bundling. Also needed is applied science that elucidates the following: (1) the optimal number of behaviours to intervene upon; (2) how target behaviours are best selected (e.g. greatest health impact; patient preference or positive effect on bundled behaviours); (3) whether to increase healthy or decrease unhealthy behaviours; (4) whether to intervene on health behaviours simultaneously or sequentially and (5) how to achieve positive synergies across individual-, group- and population-level intervention approaches.

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BackgroundObesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for ‘weight loss apps’ has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control.ObjectiveTo characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management.MethodsAn electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support.ResultsA total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the assessment criteria, with the majority of apps meeting less than two criteria.ConclusionsCommercial mobile apps for weight loss/management lack important evidence-based features, do not involve health care experts in their development process, and have not undergone rigorous scientific testing. This calls into question the validity of apps’ claims regarding their effectiveness and safety, at a time when the availability and growth in adoption of these tools is rapidly increasing. Collaborative efforts between developers, researchers, clinicians, and patients are needed to develop and test high-quality, evidence-based mobile apps for weight loss/management before they are widely disseminated in commercial markets.