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Context: Healthy vending machine policies are viewed as a promising strategy for combating the growing obesity epidemic in the United States. Few studies have evaluated the short- and intermediate-term outcomes of healthy vending policies, especially for interventions that require 100% healthy products to be stocked., Objective: To evaluate the potential impact of a 100% healthy vending machine nutrition policy., Design: The vendor's quarterly revenue, product sales records, and nutritional information data from 359 unique vending machines were used to conduct a baseline and follow-up policy analysis., Setting: County of Los Angeles facilities, 2013-2015., Participants: Vending machines in facilities located across Los Angeles County., Intervention: A healthy vending machine policy executed in 2013 that required 100% of all products sold in contracted machines meet specified nutrition standards., Outcome Measures: Policy adherence; average number of calories, sugar, and sodium in food products sold; revenue change., Results: Policy adherence increased for snacks and beverages sold by the vending machines by 89% and 98%, respectively. Average snack and beverage revenues decreased by 37% and 34%, respectively, during the sampled period., Conclusions: Although a 100% healthy vending policy represents a promising strategy for encouraging purchases of healthier foods, steps should be taken to counteract potential revenue changes when planning its implementation.

Context: Few studies have described the range and health impacts of obesity prevention strategies in local communities supported by the Communities Putting Prevention to Work program., Objective: To address this gap, we reviewed implemented strategies in Los Angeles County (LAC) for 3 program focus areas: physical activity-promotion, health marketing, and creation of healthy food environments. Local context and results from an impact simulation are presented., Design: Information on population reach and program milestones was synthesized to describe historical and programmatic progress of the obesity prevention efforts during 2010-2012. To forecast health impacts, the Prevention Impacts Simulation Model (PRISM) was used to simulate population health outcomes, including projected changes in obesity burden and health behaviors 30 years into the future., Setting: LAC with more than 9.8 million residents., Participants: Low-income adults and youth who were the intended audiences of the Communities Putting Prevention to Work program in LAC., Intervention: Implemented strategies for the 3 focus areas., Main Outcome Measures: Documentation of program reach and PRISM forecasting of obesity rates and health impacts., Results: Implemented strategies in LAC ranged from best practices in healthy food procurement (estimated reach: 600 000 students, 300 000 meals per day) to completed shared-use agreements (10+ agreements across 5 school districts) to a series of strategically designed health marketing campaigns on healthy eating (>515 million impressions). On the basis of PRISM simulations, these highlighted program activities have the potential to reduce by 2040 the number of youth (-29 870) and adults (-94 136) with obesity, youth (-112 453) and adults (-855 855) below recommended levels of physical activity, and youth (-14 544) and adults (-28 835) who consumed excess junk food, as compared with baseline (2010-2011)., Conclusions: Program context and PRISM-simulated health impacts showed modest but promising results in LAC, which may lead to further population health improvements in the future. Downstream health and behavioral surveillance data are needed to confirm these estimates.

Objective: This study sought to assess promotional activities undertaken to raise public awareness of the Choose Health LA Restaurants program in Los Angeles County, an environmental change strategy that recognizes restaurants for offering reduced-size and healthier menu options., Design: We used multiple methods to assess public awareness of and reactions to the promotional activities, including an assessment of the reach of core promotional activities, a content analysis of earned media, and an Internet panel survey., Setting: The study was conducted in Los Angeles County, home to more than 10 million residents., Participants: An online survey firm recruited participants for an Internet panel survey; to facilitate generalization of results to the county's population, statistical weights were applied to analyses of the survey data., Intervention: Promotional activities to raise awareness of the program included community engagement, in-store promotion, and a media campaign., Main Outcome Measures: Outcomes included media impressions, the number of people who reported seeing the Choose Health LA Restaurants logo, and a description of the themes present in earned media., Results: Collectively, paid media outlets reported 335 587 229 total impressions. The Internet panel survey showed that 12% of people reported seeing the program logo. Common themes in earned media included the Choose Health LA Restaurants program aims to provide restaurant patrons with more choices, represents a new opportunity for restaurants and public health to work together, will benefit participating restaurants, and will positively impact health., Conclusions: Promotional activities for the Choose Health LA Restaurants program achieved modest reach and positive reactions from media outlets and consumers. The program strategy and lessons learned can help inform present and future efforts to combine environmental and individually focused strategies that target key influences of consumer food selection.

Spinothalamic tract lesions in patients with Wallenberg's syndrome can be demonstrated by abnormalities in the laser evoked potentials (LEPs) to stimulation of the affected side. However, before reaching the structures generating LEPs, laser stimuli can induce effects at a subcortical level. We examined LEPs and laser-induced prepulse inhibition of the blink reflex in seven patients with Wallenberg's syndrome within a month after the infarct. All patients had abnormally elevated thresholds for temperature and pain sensation, and for pinprick pain induced by laser stimuli, in the affected vs the non-affected side. LEPs to stimulation of the affected side were abnormal because of absent, reduced or delayed responses. However, the same laser stimuli that were unable to induce LEPs generated normal inhibition of the blink reflex response when applied 250ms before a trigeminal nerve electrical stimulus. The percentage inhibition induced in the R2 response of the blink reflex by laser stimulation of the affected side was not different from that induced by stimulation of the non-affected side, or in control subjects. These results are compatible with either a different pathway for prepulse inhibition and evoked potentials or a reduced energy requirement of the sensory input generating prepulse inhibition in comparison to that generating evoked potentials.