Growth pattern of infants fed with a mixture of extruded malted maize and cowpea

OBJECTIVE: Breast milk alone is insufficient to support normal growth during the second half of infancy, so I investigated supplementary feeding for infants' successful transition to solid food. METHODS: The nutrition status of 30 infants from a low socioeconomic background weaned onto an extruded formulated complementary diet from maize and cowpea (L(1)A(1)) were compared with 30 infants with a similar socioeconomic background (L(2)N, control group) and 30 infants from an above-average socioeconomic background (HN, reference group) without the supplementary diet. Infants within the control and reference groups were weaned onto different foods of the mothers' choice. The formulated diet was analyzed for nutrient composition. RESULTS: The results showed similarity in the estimated annual family income of the L(1)A(1) and L(2)N groups, which ranged from N 25 000 to 74 000 (US $208.30 to 616.70), whereas the estimated family income for the HN group was above N 225 000 (US $1875.00) annually. The formulated blend contained 17.3% protein, 5.0% fat, and 2106 kJ of energy. Mean weight at birth and 4 mo before the feeding intervention in HN infants was statistically (P < 0.05) higher than in L(1)A(1) and L(2)N infants. At the end of the study, L(1)A(1) and HN infants had a mean length within -1 standard deviation of the standard length for age. The mean length of L(2)N infants was within -3 standard deviations of the standard length for age. The effectiveness of the formulated diet was expressed in terms of similarity in anthropometric measurements of L(1)A(1)) and HN infants. CONCLUSIONS: Based on similarities in socioeconomic background and weight at birth and 4 mo in the L(1)A(1) and L(2)N infants, the better nutrition status of the L(1)A(1) is attributed to the formulated complementary diet. The contribution of this mixture to total nutrient intake seemed substantial enough to meet the infants' nutritional requirements. The use of a cheaply available plant protein will go a long way in reducing protein-energy malnutrition among children in developing countries. However, because of the low purchasing power of the low-income family, the costs of this product should be studied.     

Hepatitis C treatment candidacy and outcomes among 4318 US veterans with chronic hepatitis C virus infection: does a history of injection drug use matter?

BACKGROUND/GOALS: Many patients with a history of injection drug use (IDU) are excluded from hepatitis C virus (HCV) treatment. This prospective multicenter study aimed to determine the impact of IDU history on HCV treatment candidacy and outcomes. STUDY: Between 1999 and 2001, 4318 HCV-infected patients seen at 24 VA Medical Centers were evaluated for HCV treatment candidacy and followed prospectively. Univariate and multivariate logistic regression analyses were used to determine whether an IDU history was associated with HCV treatment candidacy, HCV treatment acceptance, early treatment discontinuation, and virologic response. RESULTS: Of 4318 participants, 2611 (61%) reported an IDU history. IDU history was not significantly associated with HCV treatment candidacy, acceptance, early discontinuation of therapy, or virologic response (all P values nonsignificant). Instead, reduced HCV treatment candidacy was independently associated with low-income [odds ratio (OR)=1.46, 95% confidence interval (CI)=1.22-1.74), education < or = 12 years (OR=1.23, 95% CI=1.03-1.46), and alcohol consumption > or = 3 drinks/d (OR=2.08, 95% CI=1.68-2.57), whereas early discontinuation of HCV therapy was independently associated with low-income and consuming > or = 3 alcoholic drinks/d. CONCLUSIONS: A history of IDU was not associated with HCV treatment candidacy or outcomes, supporting national guidelines to evaluate former IDUs on a case-by-case basis for HCV treatment.     

Informing Federal Policy on Firearm Restrictions for Veterans with Fiduciaries: Risk Indicators in the Post-Deployment Mental Health Study

This article examines the public safety rationale for a federal policy of prohibiting gun sales to veterans with psychiatric disabilities who are assigned a fiduciary to manage their benefits from the Department of Veterans Affairs. The policy was evaluated using data on 3200 post-deployment veterans from the Iraq and Afghanistan war era. Three proxy measures of fiduciary need—based on intellectual disability, drug abuse, or acute psychopathology—were associated in bivariate analysis with interpersonal violence and suicidality. In multivariate analysis, statistical significance remained only for the measure based on acute psychopathology. Implications for reforms to the fiduciary firearm restriction policy are discussed.