A systematic review of strategies to increase drinking‐water access and consumption among 0‐ to 5‐year‐olds

The objective of this study is to identify promising strategies for improving drinking‐water access and consumption among children aged 0 to 5 years. MEDLINE/PubMed, Embase, ERIC, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched in this review. Studies included peer‐reviewed, full‐text studies from high‐income countries, published in English between January 1, 2000, and January 12, 2018, that evaluated interventions to increase water access or consumption in children aged 0 to 5 years. Twenty‐five studies met inclusion criteria; 19 used an effective intervention strategy to increase water access or water consumption. Three studies addressed both water access and consumption. Frequently used strategies included policy and practice changes, increasing water access and convenience, and education, training, or social support for caregivers. Studies were of fair methodological quality (average score: 18.8 of 26) for randomized studies and of moderate quality (5.1 of 9) for non‐randomized studies. To date, few high‐quality studies with objectively measured outcomes have clearly demonstrated strategies that may influence water intake and consumption among young children aged 0 to 5 years.     

Pathways to heroin dependence: time to re‐appraise self‐medication

The self‐medication hypothesis emphasizes the role of distressing affect as the primary motivator for the compulsive use that leads to substance dependence. The model also postulates that there will be psychopharmacological specificity between symptom presentation and the primary drug of dependence. In this review, the self‐medication hypothesis is examined in relation to the development and chronicity of heroin dependence. It is argued that if self‐medication has a role in engendering and extending substance dependence, it should be apparent in the use of a drug that carries such overwhelming personal risk. The psychopathology seen among adult users is certainly consistent with the model. More importantly, however, are the extraordinarily high levels of childhood trauma and psychopathology that occur typically well before the initiation of heroin use. In contrast, the postulate of drug specificity appears less supported by the polydrug use patterns typical of heroin users, and does not appear to be a necessary corollary of the model.     

Eighteen‐ to 30‐year‐olds more likely to link to hepatitis C virus care: an opportunity to decrease transmission

Hepatitis C virus (HCV) infection incidence among 18‐ to 30‐year‐olds is increasing and guidelines recommend treatment of active injection drug users to limit transmission. We aimed to : 1 measure linkage to HCV care among 18‐ to 30‐year‐olds and identify factors associated with linkage; 2 compare linkage among 18‐ to 30‐year‐olds to that of patients >30 years. We used the electronic medical record at an urban safety net hospital to create a retrospective cohort with reactive HCV antibody between 2005 and 2010. We report seroprevalence and demographics of seropositive patients, and used multivariable logistic regression to identify factors associated with linkage to HCV care. We defined linkage as having evidence of HCV RNA testing after reactive antibody. Thirty two thousand four hundred and eighteen individuals were tested, including 8873 between 18 and 30 years. The seropositivity rate among those ages 18–30 was 10%. In multivariate analysis, among those 18–30, diagnosis location (Outpatient vs Inpatient/ED) (OR 1.78, 95% CI 1.28–2.49) and number of visits after diagnosis (OR 5.30, 95% CI 3.91–7.19) were associated with higher odds of linking to care. When we compared linkage in patients ages 18–30 to that among those older than 30, patients in the 18–30 years age group were more likely to link to HCV care than those in the older cohort even when controlling for gender, ethnicity, socioeconomic status, birthplace, diagnosis location and duration of follow‐up. Eighteen‐ to 30‐year‐olds are more likely to link to HCV care than their older counterparts. During the interferon‐free treatment era, there is an opportunity to prevent further HCV transmission in this population.     

A Longitudinal Study of Motives for Wishing to Be Thinner and Weight‐control Practices in 7‐ to 18‐Year‐Old Swedish Girls

The main aim of this seven‐year longitudinal study, of 411 Swedish pre‐adolescent girls (aged 7–11 years, Year 1), was to examine a wish to be thinner, dieting attempts, described motives for wishing to be thinner and weight‐control practices. A further aim was to examine to what extent body mass index (BMI) accounted for motives for wishing to be thinner and weight‐control practices. A wish to be thinner and dieting attempts increased significantly with increasing age between the ages of 9 and 18. The most frequently reported motive for wishing to be thinner was to ‘feel better about yourself’. Categories that emerged from the qualitative analysis of self‐described motives for the wish to be thinner were, for example, to ‘correspond to the societal ideal’ and to ‘wear particular clothes’. A majority of the girls adopted weight‐control practices that would be considered as healthy, but extreme weight‐control practices increased with age. Girls with BMIs over the 75th percentile reported a greater number of motives for wishing to be thinner and used extreme weight‐control practices significantly more often than the other girls. However, of the girls who changed BMI from above the 75th percentile to under the 75th percentile, 34.1% reported that they had not used any weight‐control practices at all. Our results show that girls at a very early age are aware of the ‘thin’ ideal in our society, wish to be thinner and try to lose weight. The results point to the importance of detecting girls who wish to be thinner as early as possible. If we can employ preventive action in time, it is possible that dieting behaviour will never develop. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Biopsy‐proven adenoviral diarrhea responding to low‐dose cidofovir

Abstract: We present a case of diarrhea secondary to biopsy‐proven adenovirus (ADV) infection after autologous peripheral hematopoietic stem cell transplant for multiple myeloma. The patient had a negative plasma polymerase chain reaction for ADV and a dramatic clinical response to low‐dose cidofovir. To our knowledge, this is the first report in an adult hematopoietic stem cell recipient of the use of low‐dose cidofovir to treat proven ADV gastrointestinal infection.