Central Line Associated Bloodstream Infection Caused by Kodamaea ohmeri in a Young Child

INTRODUCTION: CASE REPORT: The patient is a 5-year-old male with a history of short gut syndrome, and total parenteral nutrition (TPN) dependence who presented to the emergency room with a two-day history of productive-cough, rhinorrhea, and fever. Antibiotic therapy was initiated with cefepime and vancomycin for suspected CLABSI. However, within the first twenty-four hours of his admission, his initial blood culture from his central venous catheter became positive for yeast so fluconazole was added due to suspicion of candidemia. During his admission, his initial central line and peripheral blood culture were later speciated as CONCLUSIONS: This case report further acknowledges that while rare, K. ohmeri is an emerging pathogen that has the potential to be life threatening if not accurately identified and treated with the optimal, empiric antifungal therapy. Due to potentially high mortality and antifungal resistance, this yeast species should be on the differential in patients that present with a central venous catheter and/or other underlying risk factors. Favorable outcomes can be achieved by removing indwelling catheters and administering optimal antifungal therapy

Examining Associations between Parental and Peer Social Support and Positive Health Behaviors in Adolescents

Parental and peer support has been shown to have an influence on adolescent dietary and physical activity behaviors. However, these associations have not been fully elucidated in multi-ethnic populations in early and late adolescence, and few studies have examined parental/peer support in school-based interventions that include a parental component in adolescent populations. The objective of this article is to present the results of two studies that examine the relationships between parental and peer support and adolescent diet and physical activity behaviors. The aim of the first study was to investigate associations between parental/peer social support, and adolescent’s physical activity and dietary behaviors, utilizing the School Physical Activity and Nutrition (SPAN) survey data, collected from 8th and 11th graders in 2009-2011. The SPAN survey is a cross-sectional statewide probability-based survey, used to assess obesity-related behaviors. Results from this study revealed that parental and peer support is associated with healthier dietary and physical activity behaviors in adolescents. The objective of the second study was to understand the dietary, physical activity, and weight-related effects of a school-based intervention with a parental support component on adolescents using the CATCH Middle School Project. The CATCH Middle School Project is a school-based health program to promote obesity prevention and related behaviors (diet, physical activity) among middle school 8th grade students living in central Texas. A group-randomized serial cross-sectional design was used to evaluate the effect of three program conditions. Adolescents in the intervention condition with a parental support component experienced the greatest significant increases in fruit, vegetable, and water consumption, as well as reporting an increase in overall support from parents. Data from these studies show: (1) parental/peer support is associated with healthier obesity-related behaviors, and (2) including parents in a school-based intervention program was shown to increase the healthfulness of adolescents’ diets. Future research should focus on strategies to increase parental/peer support for healthy eating and physical activity behaviors that could potentially be integrated into school health programs for adolescents.Public Healt

Obesity, Cardiorespiratory Fitness, and Cardiovascular Disease

Purpose of reviewObesity, generally defined by body mass index (BMI), is an established risk factor for the development of cardiovascular disease (CVD), while cardiorespiratory fitness (CRF) decreases risk. In chronic CVD, an obesity survival paradox in which higher BMI is associated with improved prognosis has been reported. This paper will examine the effect of obesity on CVD risk, explore obesity as a risk factor in patients with established CVD, and investigate the relationship between CRF, obesity, and CVD.Recent findingsThrough metabolic and hemodynamic changes, obesity increases the risk for CVD and contributes to the development of other cardiovascular risk factors such as diabetes, dyslipidemia, and hypertension. Obesity is associated with metabolic, hormonal, and inflammatory changes that leads to atherosclerosis increasing the risk for coronary artery disease, and myocardial remodeling increasing the risk for heart failure. However, it has also been observed that overweight/obese patients with established CVD have a better prognosis when compared to non-obese individuals termed the obesity paradox. CRF is a vital component of health associated with improved cardiovascular outcomes and furthermore has been shown to markedly attenuate or nullify the relationship between obesity and CVD risk/prognosis. Increasing CRF mitigates CVD risk factors and improves overall prognosis in CVD regardless of obesity status

Using a Rapid Assessment Methodology to Identify and Address Immediate Needs Among Low-income Households with Children during COVID-19

Objective: Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under shelter in place orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time ( high risk ), and to describe the response of Brighter Bites to these high risk families. Methods: The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question Please share your greatest concern at this time, or any other thoughts you would like to share with us. was asked at the end of each survey to triage high risk families. Responses were then used to articulate a response to meet the needs of these high risk families. Results: A total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as high risk (6.8% of survey respondents). During this time, 100% of the high risk participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the high risk category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable

Innovative Partnerships to Address Food Insecurity during the COVID-19 Pandemic: The Brighter Bites Produce Voucher Program

The purpose of this communication is to describe the Brighter Bites produce voucher program, and its implementation and utilization across Brighter Bites families in four cities in the U.S., during the COVID-19 pandemic. The voucher program was implemented over nine weeks starting April 2020, with up to four USD 25 store-specific produce coupons sent bi-weekly to the homes of each participating Brighter Bites family (USD 100 total/family). Measures included type of produce purchased, amount of voucher that was used, number of vouchers distributed and redeemed by families, and a post-program participant satisfaction survey. Descriptive statistics, including count, frequency, and percent, were computed, both overall and stratified by city. During this time, Brighter Bites distributed a total of over 43,982 vouchers to 12,482 low-income families, with a redemption rate of 60% (at least one voucher redeemed) across all cities. During times of crisis, non-profit–for-profit partnerships, such as the one between Brighter Bites and the grocery retail industry, are feasible, and successful in providing produce to families in need