Improving Accessibility of Food Resources in Polk County

This project sought to increase awareness regarding food insecurity and available food resources in Polk County to bridge the gaps of food availability for residents. The SOAR (strengths, opportunities, aspirations, results) model was used to facilitate change. Research on available food assistance agencies and Community Health Assessments (CHA) proved a greater need for available food resources throughout Polk County. In the wake of the COVID-19 pandemic, a need was identified for increased awareness and access of food resources. A survey of Polk County residents indicated a gap of knowledge regarding food bank and food pantry locations and a recurring trend of inaccessibility (Polk County Family and Community Outreach, 2020). Additionally, a majority of the surveyed residents responded that they would “absolutely use” a food box delivery service and indicated evening hour preference for accessing food banks and food pantries (Polk County Family and Community Outreach, 2020). Barriers to combating food insecurity included: pandemic restrictions, limited communication between food banks, and volunteer-run agencies that limited hours of operation. From this research it was concluded that Polk County residents would benefit from an increase in food resource availability with additional volunteers, extended hours of operations, communication between food assistance agencies, use of food delivery services, and more accessible marketing of the available resources. Keywords: food insecurity, food resources, food accessibility, Polk County, food bank, food pantry References Polk County Family and Community Outreach. (2020). Access to food in Polk County [Unpublished raw data]. Stavros, J. M., & Hinrichs, G. (2009). The thin book of SOAR: Building strengths-based strategy. Thin Book Publishing

Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial

Background Phenytoin is the recommended second-line intravenous anticonvulsant for treatment of paediatric convulsive status epilepticus in the UK; however, some evidence suggests that levetiracetam could be an effective and safer alternative. This trial compared the efficacy and safety of phenytoin and levetiracetam for second-line management of paediatric convulsive status epilepticus.Methods This open-label, randomised clinical trial was undertaken at 30 UK emergency departments at secondary and tertiary care centres. Participants aged 6 months to under 18 years, with convulsive status epilepticus requiring second-line treatment, were randomly assigned (1:1) using a computer-generated randomisation schedule to receive levetiracetam (40 mg/kg over 5 min) or phenytoin (20 mg/kg over at least 20 min), stratified by centre. The primary outcome was time from randomisation to cessation of convulsive status epilepticus, analysed in the modified intention-to-treat population (excluding those who did not require second-line treatment after randomisation and those who did not provide consent). This trial is registered with ISRCTN, number ISRCTN22567894.Findings Between July 17, 2015, and April 7, 2018, 1432 patients were assessed for eligibility. After exclusion of ineligible patients, 404 patients were randomly assigned. After exclusion of those who did not require second-line treatment and those who did not consent, 286 randomised participants were treated and had available data: 152 allocated to levetiracetam, and 134 to phenytoin. Convulsive status epilepticus was terminated in 106 (70%) children in the levetiracetam group and in 86 (64%) in the phenytoin group. Median time from randomisation to cessation of convulsive status epilepticus was 35 min (IQR 20 to not assessable) in the levetiracetam group and 45 min (24 to not assessable) in the phenytoin group (hazard ratio 1·20, 95% CI 0·91–1·60; p=0·20). One participant who received levetiracetam followed by phenytoin died as a result of catastrophic cerebral oedema unrelated to either treatment. One participant who received phenytoin had serious adverse reactions related to study treatment (hypotension considered to be immediately life-threatening [a serious adverse reaction] and increased focal seizures and decreased consciousness considered to be medically significant [a suspected unexpected serious adverse reaction]). Interpretation Although levetiracetam was not significantly superior to phenytoin, the results, together with previously reported safety profiles and comparative ease of administration of levetiracetam, suggest it could be an appropriate alternative to phenytoin as the first-choice, second-line anticonvulsant in the treatment of paediatric convulsive status epilepticus