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Introduction: The purpose of this study was to simulate potential changes in dietary intake and food costs by replacing juice with whole fruit among children ages 1-5 years attending U.S. early care and education settings between 2008 and 2020., Methods: Estimated mean changes in daily intake of calories, sugar, fiber, calcium, vitamin C and overall food costs under plausible scenarios of replacing juice with whole fruit. Researchers fit hierarchical regression with children nested within early care and education nested within studies, adjusting for potential confounders., Results: The sample consisted of 6,304 days of direct observation (90% aged 2 years or older, 51% female, 38% Black/African American) in 846 early care and education facilities (73% centers, 75% Child and Adult Care Food Program participants). Replacing juice with whole fruit would reduce energy intake by 8.2-27.3 kcal/day, reduce sugar by 3.4-5.6 g/d, increase fiber by 0.5-1.3 g/d, and have negligible impact on vitamin C and calcium. Replacing juice with whole fruit in early care and education would increase per-child daily food costs between $0.44 and 0.49, representing an increase from 3.8% for juice to approximately 9.8%-10.7% for whole fruit as a percent of total food costs., Conclusions: Replacing juice with whole fruit in early care and education would result in increased fiber intake and decreased sugar and calories. A policy to replace juice with whole fruit in early care and education would likely cause an increased daily food cost and given the potential broad benefit of this dietary intervention, there may be reason to expand funding within nutrition assistance programs in early care and education., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Despite rising morbidity and mortality from the opioid epidemic and other addictions, people who inject drugs (PWID) remain understudied regarding pain outcomes. Data among PWID regarding chronic pain and drug use, including non-medical use of opioids, is largely unknown. We examined the prevalence of chronic pain and drug use for pain in this population., Methods: Standardized surveys captured self-report of demographics, chronic pain, and non-prescription drug use in 203 PWID in an urban syringe services program between April and November 2016. Chronic pain was defined as self-report of chronic pain diagnosis or persistent pains over the past 6 months., Results: Overall, 47% (95% CI, 40%-54%) of PWID reported chronic pain, while 35% (95% CI, 29%-42%) reported non-prescription drug use of any type for pain. Among those with chronic pain, drug use to treat pain was commonly reported (76%; 95% CI, 66%-83%). Non-medical opioid use did not differ among PWID with or without chronic pain or drug use for pain. A multivariable logistic regression model showed chronic pain was more likely among non-Hispanic whites and those with arthritis, older age, and homelessness., Conclusions: Chronic pain serves as an important factor in the persistence of drug use in more than one-third of PWID in this sample. The high prevalence of chronic pain with drug use for pain suggests that proper pain management is likely to be an essential component of preventing or regressing injection drug use in PWID, with data needed on effective interventions for this population., (Copyright © 2019. Published by Elsevier Ltd.)