These findings indicate that perceived risks and disapproval are important determinants of marijuana use. Accordingly, prevention efforts should include realistic information about risks and consequences of marijuana use.

Treatment with common household bleach containing hypochlorite destroys dust mites and denatures protein allergens. The purpose of this study was to determine if home use of hypochlorite products results in lowered exposure to bacteria, fungi, and protein allergens and improved quality of life (QOL) for asthmatic persons in the home. Asthmatic and nonasthmatic households containing at least three persons (between 2 and 17 years of age) were recruited. Households were supplied one of three sets of cleaning products (regular products, some containing hypochlorite; regular products plus three additional products with dilute hypochlorite; control, no products). Participants were supplied with cleaning instructions and asthma education. The control group was instructed to clean as usual. Participants completed general health and QOL questionnaires. Asthmatic participants completed an additional asthma QOL questionnaire. Families participated in the study for 8 weeks and completed the full set of questions every 2 weeks. Homes were visited at the beginning of the study and twice thereafter at monthly intervals. Samples evaluated were surface bacteria, viable and nonviable airborne spores, and dust antigen content. Reductions in surface bacteria, airborne fungal spores, and dust antigen levels were achieved. Significant improvement in general health parameters was seen for the asthmatic product groups over the control group. Significant improvement in general QOL and asthma-specific QOL was seen in the asthmatic group. Emphasis on cleaning and cleaning education combined with hypochlorite-based cleaning supplies resulted in significantly improved QOL for families with asthmatic children.

Intervention in the home environment to reduce asthma triggers theoretically improves health outcomes for asthmatic children. Practical benefit from application of these interventions has proven difficult. This single-blind study tested the effectiveness of simple low-cost home interventions in improving health scores of children with asthma. Families with at least one asthmatic child were recruited. Initial health examination, health, and home assessments were conducted and targeted interventions were implemented. Interventions included dehumidification, air filtration, furnace servicing, and high-efficiency furnace filters. When present, gross fungal contamination was remediated. Asthma education was provided along with education in healthy home practices. Follow-up assessments were conducted after 6 months. Health surveys were completed at enrollment and follow-up. This study enrolled 219 children with asthma. Home inspections and interventions were conducted in 181 homes and 83 families completed all phases. Reduction in asthma and allergy-related health scores was shown in follow-up health surveys. Health improvements were significant for cough when heating, ventilation, and air conditioning (HVAC) service and dehumidification were used. Breathing problems were significantly improved for dehumidification, HVAC service, and room air cleaners. Total dust allergen load was reduced for the dehumidification group (p < 0.05). Mold spore counts were reduced one order of magnitude in 25% of the homes. Indoor spore counts adjusted for outdoor spore levels were reduced overall (p < 0.01). Simple low-cost interventions directed to producing cleaner indoor air coupled with healthy home education improve the indoor air quality and health in asthmatic children.

No abstract

Enteral nutritional support is an important component of the care provided to infants receiving long-term peritoneal dialysis. In the majority of published experiences on this subject, the use of the nasogastric tube has facilitated the provision of required calorie and protein intake and resulted in an improved patient outcome. Advantages of the nasogastric route of nutritional support include the ease of administration, while recurrent emesis remains the most troublesome and frequent shortterm complication associated with its use. Impaired oralmotor development may also result from nonoral feeding and should be addressed throughout the course of tube feeding. The outcome of infants with ESRD receiving CPD has markedly improved since the introduction of NG feedings as a regular component of dialysis patient care. While complications associated with NG feedings have been documented, the benefits associated with this route of nutritional supplementation have been great. Currently, an increasing number of infants/ young children on CPD are receiving supplemental nutrition with the use of the gastrostomy tube/button (31). However, the risks associated with this route of therapy in the CPD population, especially in terms of infection, are as yet not well defined (32). Once the risk/benefit ratio of gastrostomy tube/button placement is determined, future efforts should be directed towards better defining how the two routes of enteral nutritional support (e.g., NG tube, gastrostomy tube/button) may best complement one another.