How ready are colleges for an environmental approach that utilizes campus/community coalitions?

While there is optimism about an environmental management approach that utilizes campus-community coalitions to reduce levels of high-risk drinking, the readiness of schools to implement such an approach is unknown. We surveyed 100 colleges regarding their readiness based on eight factors: existence of a task force to address alcohol use on campus; the inclusion of the college/university President; inclusion of a community representative; frequent meetings; external funding to address alcohol use; previous environmental training; changes implemented as a result of environmental training; and a plan to institute environmental training in the future. Having an alcohol task force or coalition (57%) was associated with participation by the president and/or community representative on the task force, having extramural funding to address high-risk drinking, training in environmental management, implementation of changes after the training, plans for future training, school size, Greek organizations on campus, and being a state university.     

Impact of irbesartan, blood pressure control, and proteinuria on renal outcomes in the Irbesartan Diabetic Nephropathy Trial

BACKGROUND: It is important to know the reliability of early changes in proteinuria in predicting late renal outcomes. The IDNT was a trial in which treatment assignment, baseline and follow-up blood pressure determinations, and albumin/creatinine ratios (ACR), and renal outcomes were recorded. METHODS: Risk of renal outcomes in the IDNT was assessed by proportional hazards modeling as a function of treatment assignment, and achieved systolic blood pressure (SBP) both without, and then with, inclusion of values for baseline proteinuria and early changes in proteinuria. RESULTS: In models without ACR variables, both treatment with irbesartan and achieved SBP during follow-up were significantly predictive of the risk of renal outcomes. Addition of ACR variables to the models reduced the apparent impact of assignment to irbesartan by 52% to 81%, and irbesartan was no longer a significant predictor of renal outcomes. Conversely, addition of ACR variables to the models attenuated the effect of achieved follow-up SBP by only 32% to 46%, and follow-up BP remained a highly significant predictor of renal outcomes. CONCLUSION: The ability of early changes in proteinuria to predict the impact of treatment on renal outcomes is a function of the specific treatment. One must use caution in using early changes in proteinuria as a surrogate for longer-term renal outcomes.     

Analysis of injury criteria to assess chest and abdominal injury risks in blunt and ballistic impacts

BACKGROUND: The Viscous Criterion (VC) is an experimental measure developed by the automotive industry to assess injury risks for high-speed impacts. The Blunt Criterion (BC) is a prospective measure developed by the Department of Defense to predict injury from blunt projectiles. METHODS: The range of applicability of BC was extended and compared with VC for its ability to assess injury risk using published cadaver and animal data. Department of Defense projectiles were 0.05 to 0.43 kg mass at velocities up to 86 m/s. VC data were generated from impacts with 1.75 to 23.4 kg at 3.6 to 10.2 m/s. Chest and abdominal injuries ranged from Abbreviated Injury Scale scores of 1 to 6. RESULTS: Both criteria correlated very well with the experimental data, demonstrating correlation coefficients of R = 0.84 to 0.96. The correlation between VC and BC was R = 0.99. Logistic probability curves were derived to predict blunt impact injuries of Abbreviated Injury Scale scores of 1 to 6 for the chest and abdomen. CONCLUSION: BC and VC are virtually identical in their ability to assess blunt and ballistic impact injury risks. They are different measures of impact energy absorbed by the body. One is predictive using input parameters, and the other measures the impact response of the body.     

Incidence of hepatitis C virus infection and associated risk factors among Scottish prison inmates: a cohort study

To gauge the incidence of hepatitis C virus (HCV) infection and associated risk factors among inmates during their imprisonment, the authors recruited adult males in a long-stay Scottish prison into a cohort study between April 1999 and October 2000. On two occasions (at 0 and 6 months), saliva was collected for anonymous HCV antibody testing and risk behavior data were obtained through a self-administered questionnaire. The participation rate was 85% at both initial recruitment (612/719) and follow-up (375/441; 171 men were ineligible for follow-up). For inmates who reported never having injected drugs, ever having injected drugs, having injected drugs during follow-up, and having shared needles/syringes during follow-up, HCV incidences per 100 person-years of incarceration risk were 1, 12, 19, and 27, respectively. Ever having injected drugs (relative risk = 13.0, 95% confidence interval: 1.5, 114.3) and having shared needles/syringes during follow-up (relative risk = 9.0, 95% confidence interval: 1.1, 71.7) were significantly associated with HCV seroconversion. The effectiveness of existing interventions, including the provision of bleach tablets for sterilizing injection equipment, was suboptimal. The development of methadone maintenance programs in prisons and the creation of drug courts to keep offending drug injectors out of prison might help to reduce transmission in this setting.     

Progressive multifocal leukoencephalopathy successfully treated with highly active antiretroviral therapy and cidofovir in an adolescent infected with perinatal human immunodeficiency virus (HIV)

Progressive multifocal leukoencephalopathy is an infectious demyelinating brain disease caused by the JC virus that is associated with significant morbidity and mortality in the immunocompromised host. We report a case of progressive multifocal leukoencephalopathy successfully treated with highly active antiretroviral therapy and cidofovir in an adolescent patient perinatally infected with human immunodeficiency virus (HIV).