Longitudinal Associations of Food Security with Health and Dietary Factors among Food FARMacy Participants during COVID-19 in New York City.

In cross-sectional studies, food insecurity is associated with adverse health and dietary outcomes. Whether self-reported health and dietary outcomes change in response to improvements in food security has not been examined. We sought to examine how increases in food security are related to changes in health and dietary factors. In this longitudinal, observational study, we included adult participants in a clinical-community emergency food assistance program in New York City from July 2020 to November 2021. Program staff measured food security with a validated six-item measure at program enrollment and six-month re-enrollment. Participants self-reported health and dietary factors (vegetable, fruit, juice, and sugar-sweetened beverage (SSB) consumption frequency). We used multivariable regression to examine associations between change in food security with change in health and dietary factors over six months. Among 310 participants, the mean food security score improved by 1.7 ± 2.3 points over six months. In unadjusted models, each point improvement in food security was associated with increased vegetable (ß = 0.10 times; 95% CI: 0.05-0.15); fruit (ß = 0.08 times; 95% CI: 0.03-0.14); and juice (ß = 0.10 times; 95% CI: 0.05-0.15) consumption. In adjusted models, results remained significant for vegetable and fruit consumption, but not juice. Change in food security was not associated with change in health or SSB outcomes. In this cohort during COVID-19, improved food security was associated with improved vegetable and fruit consumption. Randomized trials that examine the effectiveness of clinical-community partnerships focused on improving food security and nutrition are warranted.

Participant and Stakeholder Perceptions of the Food FARMacy Emergency Food Assistance Program for the Coronavirus Disease 2019 Pandemic: A Qualitative Study.

BACKGROUND: Food FARMacy is a clinical-community emergency food assistance program developed in response to food insecurity during the COVID-19 pandemic. Few qualitative studies have examined participant, and clinical and community stakeholder experiences with these food assistance programs. OBJECTIVE: To examine the motivations, experiences, and perceptions of Food FARMacy participants and program stakeholders. DESIGN: A qualitative study using in-depth interviews between March 2021 and July 2021. PARTICIPANTS AND SETTING: Twenty-four Food FARMacy participants and 10 program stakeholders in New York, NY (Manhattan, Brooklyn, and Queens) older than age 18 years were interviewed. STATISTICAL ANALYSES PERFORMED: Interviews were recorded, transcribed, translated, and analyzed using thematic analysis. Participant and program stakeholder interviews were analyzed separately. Themes that were salient in both groups were combined for reporting. RESULTS: Both program participants and stakeholders perceived: pandemic-related demands combined with reduced resources motivated participation; convenience, safety, and ease of access facilitated program retention; participants valued fresh produce and diversity of foods; the program improved diet and health; minimizing food waste was a priority; and social cohesion was an unexpected program benefit. Two additional themes among only program stakeholders also were identified: aligned values, flexibility, and communication were key to successful partnerships; and trust between community partners and community members drove programmatic success. CONCLUSIONS: Results suggest that a multisite clinical-community partnership to provide emergency food assistance in New York City can be leveraged to reduce barriers to healthy food access and address food insecurity during crises.

Non-dialysis care: an important component of care for elderly individuals with advanced stages of chronic kidney disease.

Non-dialysis care (NDC) is the provision of all aspects of renal care except for the dialysis process. While the nomenclature may vary, with terms such as 'conservative care', 'maximal conservative management' or 'non-dialytic treatment' having been associated with NDC, the clinical principle is to provide comprehensive care to patients who opt to forgo dialysis despite increasing uraemic symptoms. NDC therapies focus on pain relief, the use of erythropoietin-stimulating agents, anti-pruritics and anti-nausea therapies, with lower emphasis on strategies used to modulate the rate of renal progression. Patient selection remains the most challenging aspect of developing an NDC program, with selection often being based on physician instinct, family principles and population-based prognostic risk measures. Outcomes are fair with a significant proportion of NDC patients experiencing lower hospitalization days and higher rates of death at home (or in a preferred environment) rather than in acute-care hospitals.

Listeria monocytogenes peritonitis in a patient on peritoneal dialysis: a case report and review of the literature.

Listeria monocytogenes (LM) is one of the rare microorganisms causing peritonitis in peritoneal dialysis (PD) patients. We report a sporadic case of peritonitis caused by LM in a young female PD patient with lupus receiving corticosteroid therapy, who presented with abdominal pain, cloudy PD effluent, nausea, and conjunctivitis. The effluent showed a high PD effluent white cell count and monocytosis, and gram staining showed gram-positive bacilli in single or short chains and PD effluent culture grew LM. She was treated successfully with beta lactum antibiotics. LM peritonitis should be suspected if a patient presents with gram-positive bacilli and monocytosis in dialysis effluent.