IntroductionFarmers market programs may increase access to more healthful foods and reduce the high prevalence of obesity in low-income communities. The objective of this study was to examine outcomes of the Fresh Fund farmers market program serving low-income neighborhoods in San Diego, California.MethodsThrough its Farmers Market Fresh Fund Incentive Program, the County of San Diego Health and Human Services Agency offered monetary incentives to government nutrition assistance recipients to purchase fresh produce at 5 farmers markets. Participants enrolled at participating markets from June 1, 2010, through December 31, 2011; they completed baseline and follow-up surveys of daily consumption and weekly spending on fruits and vegetables. We examined enrollment, participation, participant health perceptions, and vendor revenue.ResultsDuring the study period, 7,298 eligible participants enrolled in Fresh Fund; most (82%) had previously never been to a farmers market. Among 252 participants with matched surveys at baseline and 12-month follow-up, the proportion who reported their diet to be “healthy” or “very healthy” increased from 4% to 63% (P < .001); nearly all (93%) stated that Fresh Fund was “important” or “very important” in their decision to shop at the farmers market. Vendors reported that 48% of all market revenue they received was received through the Fresh Fund program. At 2 markets, revenue from June 1, 2011, through January 31, 2012, increased by 74% and 68% compared with revenue from June 1, 2010, through January 31, 2011.ConclusionParticipants in the Fresh Fund program self-reported increases in daily consumption and weekly spending on fruits and vegetables, and vendors at participating farmers markets also increased their revenue.

Background Rapid diagnostics for bloodstream infections have been shown to improve outcomes. Most studies have focused on rapid diagnostics for a single pathogen and have been conducted in academic medical centers. The Verigene Gram‐Positive Blood Culture Test (BC‐GP) identifies 12 gram‐positive organisms and 3 genetic markers of antibiotic resistance from positive blood culture media in 2.5 hours. This study evaluates implementation of the Verigene BC‐GP panel in combination with real‐time support from the Antibiotic Stewardship Team (AST) in a community hospital system. Methods This multicenter, pre‐post, quasi‐experimental study was conducted at the five hospitals that compose Scripps Healthcare. Rapid diagnostic testing was performed at a central laboratory from 7 a.m.–7 p.m. Pharmacists notified physicians of results and assisted with antibiotic modifications. The primary outcomes were average time to targeted antibiotic therapy and difference in antibiotic duration for contaminants. Secondary end points included hospital length of stay, mortality, pharmacy costs, and overall hospitalization costs. Adult patients with a gram‐positive bacteremia admitted in 2011 (pre‐rapid testing) were compared with those admitted in 2014 (post‐rapid testing). Results There were 103 patients in the preintervention group and 64 patients in the intervention group. The optimized identification process, combined with AST intervention, improved mean time to targeted antibiotic therapy (61.1 vs 35.4 hrs, p<0.001) and decreased mean duration of antibiotic therapy for blood culture contaminants (42.3 vs 24.5 hrs, p=0.03). Median length of stay (9.1 vs 7.2 days, p=0.04) and overall median hospitalization costs ($17,530 vs $10,290, p=0.04) were lower in the intervention group. Mortality was similar between groups (9.1% vs 9.2%, p=0.98). Conclusion Rapid identification of gram‐positive blood cultures with AST intervention decreased time to targeted antibiotic therapy, length of unnecessary antibiotic therapy for blood culture contaminants, length of stay, and overall hospital costs.

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We assessed the effectiveness of a Lactobacillus probiotic on rates of health care facility–onset Clostridium difficile infection (HO-CDI) in patients receiving antibiotics. A total of 1576 patients were evaluated. There was no difference in the HO-CDI incidence between those who received probiotics and those who did not (1.8% vs 0.9%; P = .16).

The mechanism of redox scavenging of a highly active cyclic seleninate was modeled by using density functional theory and solvent‐assisted proton exchange (SAPE), a method of microsolvation intended to mimic the role of the solvent in proton‐transfer reactions. Models of the proposed mechanism suggest that a pathway to a selenenyl sulfide, a possible dead‐end intermediate, is favored over regeneration of the seleninate catalyst. Alternate pathways through selenurane intermediates and a cyclic selenenate also appear to lead to the selenenyl sulfide. Based upon the DFT‐SAPE results, we suggest that the high level of catalysis shown by the cyclic seleninate may be attributed to experimental reaction conditions, in which the excess oxidant ensures that the catalytic cycle bypasses the selenenyl sulfide. Catalysis under less oxidizing conditions are proposed to occur through oxidation of the selenenyl sulfide to the seleninyl sulfide.