How providing a low-cost water filter pitcher led Latino parents to reduce sugar-sweetened beverages and increase their water intake: explanatory qualitative results from the Water Up!@Home intervention trial.

OBJECTIVE: This study sought to explain results of the Water Up!@Home randomised controlled trial where low-income parents were randomised to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in sugar-sweetened beverages (SSB) and increases in water intake post-intervention. DESIGN: Qualitative explanatory in-depth interviews analysed thematically and deductively. SETTING: Washington, DC metropolitan area, USA. PARTICIPANTS: Low-income Latino parents of infants/toddlers who had participated in the Water Up! @Home randomised controlled trial. RESULTS: The filter-stimulated water consumption in both groups by (1) increasing parents' perception of water safety; (2) acting as a cue to action to drink water; (3) improving the flavour of water (which was linked to perceptions of safety) and (4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake. CONCLUSIONS: A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption.

Treatment Failure with Direct Antiviral Agents in Patients with Hepatitis C Virus Genotype 1 Infection at the Veteran Affairs Caribbean Healthcare System in San Juan, Puerto Rico.

OBJECTIVE: We performed a descriptive study of patients who have failed to DDAs in our Veteran population. The primary outcome of this study is to describe the clinical profile of these patients and to evaluate their respective resistance mutation panel. METHODS: This investigation is a descriptive retrospective study of patients with chronic hepatitis C between the ages of 21 to 89 years from the Veteran Affairs Caribbean Healthcare System in P.R. Eligible cases were Veterans treated for hepatitis C with second generation of DAAs from January 1, 2015 to December 31, 2016 who failed to therapy. Patient records were reviewed and those who met inclusion criteria were included. RESULTS: Among Hispanic Veterans treated with DAA for genotype 1 HCV infection, 3.9% had failure to treatment with the second generation DAAs. 90% were genotype 1a; while 10% were 1b. 80% of these were identified as cirrhotic and the other 20% were non cirrhotic. 90% had resistant variants for Ns5a. Eight patients had Ns3 RASs testing requested of which 50% had presence of resistant variants. Five patients had Ns5b RASs testing performed of which 40% had positivity for resistant variants to Ns5b. CONCLUSION: Despite DAA effectiveness, phase III clinical trials with new IFN-free DAA-based therapies have a 5-7% treatment failure rates. Real-life data has showed that <15% of patients fail to achieve SVR in the most difficult to cure groups such as those with cirrhosis or subtype 1a. These findings are comparable with our current study.

How Latina mothers navigate a 'food swamp' to feed their children: a photovoice approach.

OBJECTIVE: To understand how mothers who recently migrated from Central America to the USA feed their children in a neighbourhood saturated with unhealthful food choices ('food swamp') and to formulate a mother-driven plan of action to facilitate their acquisition of foods. Design/Setting/Subjects We purposively sampled mothers with children (<10 years old) who were recent immigrants/refugees from Central America and lived in a 'food swamp' neighbourhood. We used the photovoice approach to elicit textual data from thirty in-depth interviews, a participatory workshop, and visual data from photographs. Analyses were guided by the Social Ecological Framework and Social Cognitive Theory to identify barriers, facilitators and strategies that support parents in feeding their children. RESULTS: Mothers valued foods that they considered to be 'traditional' and 'healthful'. They navigated their food retail environment looking for these foods (of good quality and well-priced). Food values were reinforced by pre-migration food customs and culture, health professionals' advice and, in some cases, by the desire to avoid conflict with their children. The neighbourhood food environment could directly influence children's food preferences and often created conflict between what the child wanted to eat and the foods that mothers valued. Mothers in this 'food swamp' wanted to be engaged in addressing the selection of foods offered in schools and in neighbourhood food venues to reflect their own food values. CONCLUSIONS: These mothers' feeding choices were influenced directly by their food values, and indirectly by the neighbourhood and school food environments via their children's preferences.

Cortical DNA methylation maintains remote memory.

A behavioral memory's lifetime represents multiple molecular lifetimes, suggesting the necessity for a self-perpetuating signal. One candidate is DNA methylation, a transcriptional repression mechanism that maintains cellular memory throughout development. We found that persistent, gene-specific cortical hypermethylation was induced in rats by a single, hippocampus-dependent associative learning experience and pharmacologic inhibition of methylation 1 month after learning disrupted remote memory. We propose that the adult brain utilizes DNA methylation to preserve long-lasting memories.