Search

HIV disproportionately affects populations experiencing incarceration. Preexposure prophylaxis (PrEP) is an effective approach to preventing HIV acquisition among populations at increased risk of acquiring HIV. Yet few, if any, efforts have been made to offer PrEP in correctional settings. Beginning in November 2019, the Rhode Island Department of Corrections (RIDOC) implemented a systemwide PrEP initiation program with linkage to PrEP care in the community upon reentry. Incarcerated individuals identified as being potentially at increased risk of HIV acquisition during standard clinical screenings and medical care were referred to a PrEP care provider for potential PrEP initiation. Of the 309 people who met with a PrEP care provider, 35% (n = 109; 88 men, 21 women) agreed to initiate PrEP while incarcerated. Clinical testing and evaluation were completed for 82% (n = 89; 69 men, 20 women) of those who agreed to initiate PrEP. Of those, 54% (n = 48; 29 men, 19 women) completed the necessary clinical evaluation to initiate PrEP, were determined to be appropriate candidates for PrEP use, and had the medication delivered to a RIDOC facility for initiation. Only 8 people (4 men, 4 women) were successfully linked to a PrEP care provider in the community after release. The RIDOC experience demonstrates notable levels of PrEP interest and moderate levels of PrEP uptake among this population. However, PrEP engagement in care after release and persistence in taking PrEP when in the community were relatively poor, indicating a need to better understand approaches to overcoming barriers to PrEP care in this unique setting. [ABSTRACT FROM AUTHOR]

Traces the development of Languages for Specific Purposes in the United States, presents a rationale for its place within the foreign language curriculum, and offers an assessment of its research base. (212 references) (GLR)

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Women experiencing incarceration (WEI) in the United States are disproportionately impacted by HIV, yet HIV pre-exposure prophylaxis (PrEP) is underutilized by women in the United States. In order to inform an intervention to promote PrEP initiation during incarceration and facilitate linkage to PrEP care following release from incarceration, we conducted individual, semistructured qualitative interviews with WEI (N = 21) and key stakeholders (N = 14). While WEI had little or no previous knowledge about PrEP, they viewed it as something that would benefit women involved in the criminal justice system. Participants stated that HIV-related stigma and underestimation of HIV risk might serve as barriers to PrEP initiation during incarceration. Participants reported that competing priorities, difficulty scheduling an appointment, and lack of motivation could interfere with linkage to PrEP care in the community. Further, cost, substance use, and difficulty remembering to take the medication were cited most commonly as likely barriers to adherence. [ABSTRACT FROM AUTHOR]

Background: Health care providers nationwide are routinely trained in Advanced Cardiac Life Support (ACLS), an American Heart Association program that teaches cardiac arrest management. Recent changes in the ACLS approach have de-emphasized routine pulse checks in an effort to promote uninterrupted chest compressions. We hypothesized that this new ACLS algorithm may lead to uncertainty regarding the appropriate action following detection of a pulse during a cardiac arrest. Methods: We conducted an observational study in which a Web-based survey was sent to ACLS-trained medical providers at 4 major urban tertiary care centers in the United States. The survey consisted of 5 multiple-choice, scenario-based ACLS questions, including our question of interest. Adult staff members with a valid ACLS certification were included. Results: A total of 347 surveys were analyzed. The response rate was 28.1%. The majority (53.6%) of responders were between 18 and 32 years old, and 59.9% were female. The majority (54.2%) of responders incorrectly stated that they would continue CPR and possibly administer additional therapies when a team member detects a pulse immediately following defibrillation. Secondarily, only 51.9% of respondents correctly chose to perform a rhythm check following 2 minutes of CPR. The other 3 survey questions were correctly answered an average of 89.1% of the time. Conclusion: Confusion exists regarding whether or not CPR and cardiac medications should be continued in the presence of a pulse. Education may be warranted to emphasize avoiding compressions and medications when a palpable pulse is detected. [ABSTRACT FROM AUTHOR]

The extent to which drinking water turbidity measurements indicate the risk of gastrointestinal illness is not well understood. Despite major advances in drinking water treatment and delivery, infectious disease can still be transmitted through drinking water in the United States, and it is important to have reliable indicators of microbial water quality to inform public health decisions. The objective of our study was to assess the relationship between gastrointestinal illness, quantified through emergency department visits, and drinking water quality, quantified as raw water and filtered water turbidity measured at the treatment plant. We examined the relationship between turbidity levels of raw and filtered surface water measured at eight major drinking water treatment plants in the metropolitan area of Atlanta, Georgia, and over 240,000 emergency department visits for gastrointestinal illness during 1993–2004 among the population served by these plants. We fit Poisson time-series statistical regression models that included turbidity in a 21-day distributed lag and that controlled for meteorological factors and long-term time trends. For filtered water turbidity, the results were consistent with no association with emergency department visits for gastrointestinal illness. We observed a modest association between raw water turbidity and emergency department visits for gastrointestinal illness. Our results suggest that source water quality may contribute modestly to endemic gastrointestinal illness in the study area. The association between turbidity and emergency department visits for gastrointestinal illness was only observed when raw water turbidity was considered; filtered water turbidity may not serve as a reliable indicator of modest pathogen risk at all treatment plants. [ABSTRACT FROM AUTHOR]

The US Environmental Protection Agency (EPA) is the lead federal agency for the security of drinking water in the United States. The agency is responsible for providing information and technical assistance to the more than 50,000 water utilities across the country. The distributed physical layout of drinking-water utilities makes them inherently vulnerable to contamination incidents caused by terrorists. To counter this threat, the EPA is using operations research to design, test, and deploy contamination warning systems (CWSs) that rapidly detect the presence of contaminants in drinking water. We developed a software tool to optimize the design process, published a decision-making process to assist utilities in applying the tool, pilot-tested the tool on nine large water utilities, and provided training and technical assistance to a larger group of utilities. We formed a collaborative team of industry, academia, and government to critique our approach and share CWS deployment experiences. Our work has demonstrated that a CWS is a cost-effective, timely, and capable method of detecting a broad range of contaminants. Widespread application of these new systems will significantly reduce the risks associated with catastrophic contamination incidents: the median estimated fatalities reduction for the nine utilities already studied is 48 percent; the corresponding economic-impact reduction is over $19 billion. Because of this operations research program, online monitoring programs, such as a CWS, are now the accepted technology for reducing contamination risks in drinking water. [ABSTRACT FROM AUTHOR]

The article explores the impact of technology and globalization on the changes in business languages in the U.S. It highlights a study on the three key players which have affected the business language field including business schools accredited by the Association to Advance Collegiate Schools of Business (AACSB) that follow accreditation standards, the U.S. Department of Education Title VI programs, and foreign language departments. It cites the changes in business languages which include programs, internships, and general cross-disciplinary aspects between language and business in the curriculum. It comments on the need for business languages and cultural understanding to continue to evolve in the global economy.

Following the events of September 11, 2001, in the United States, world public awareness for possible terrorist attacks on water supply systems has increased dramatically. Among the different threats for a water distribution system, the most difficult to address is a deliberate chemical or biological contaminant injection, due to both the uncertainty of the type of injected contaminant and its consequences, and the uncertainty of the time and location of the injection. An online contaminant monitoring system is considered as a major opportunity to protect against the impacts of a deliberate contaminant intrusion. However, although optimization models and solution algorithms have been developed for locating sensors, little is known about how these design algorithms compare to the efforts of human designers, and thus, the advantages they propose for practical design of sensor networks. To explore these issues, the Battle of the Water Sensor Networks (BWSN) was undertaken as part of the 8th Annual Water Distribution Systems Analysis Symposium, Cincinnati, Ohio, August 27–29, 2006. This paper summarizes the outcome of the BWSN effort and suggests future directions for water sensor networks research and implementation. [ABSTRACT FROM AUTHOR]

The article presents a study that examines the content, goals, requirements, and instructional materials of the Teaching English as a Second Language (TESOL) methods course in the U.S. The survey sample consisted of 120 teacher preparation programs. The study examined 77 questionnaires and 55 course syllabi returned from 94 institutions. Total response rate was 78%. Respondents identified five areas for improvement of the TESOL methods course including: more observations of skilled teachers; more videotaping of students for feedback; greater emphasis on solving classroom problems; and improved teaching materials. The analysis of course goals reveals a lack of emphasis on either classroom-based research or the use of technology in the classroom. The study emphasizes for the preparation of "reflective" teachers, and a recognition of teachers abilities to solve their own problems.

Discusses the application of language for specific purposes (LSP) in the foreign language curriculum in higher education in the U.S. Profile of characteristics of institutions that offer LSP; Overview of the number, type, level and enrollment in LSP courses; Information on attitudes of chairs and departments toward the LSP courses.

Reports on a survey of foreign languages for business and the professions at U.S. colleges and universities as of September 1985. Trends in applied language studies; Scope of the survey; Relationship between the size of institution and the offering of foreign language courses for specific purposes (FLSP); FLSP courses at institutions with professional schools.

Background: Gastrointestinal bleeding (GIB) is common in left ventricular assist device (LVAD) patients. Serotonin release from platelets promotes platelet aggregation, and selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) therapy inhibits the transporter responsible for re-uptake.Methods: We reviewed the records of LVAD (HeartMateII™, Abbott Medical, Lake Bluff, IL, USA and Heartware™, Medtronic, Minneapolis, MN, USA) patients at the Medical University of South Carolina and Johns Hopkins Hospital between January 2009 and January 2016. After exclusions, 248 patients were included for analysis. After univariate analysis, logistic regression multivariate analysis was performed to adjust for any demographic, cardiovascular, and laboratory data variables found to be associated with GI bleeding post-LVAD.Results: Gastrointestinal bleeding occurred in 85 patients (35%) with 55% of GIBs due to arteriovenous malformations (AVMs). Of the total cohort, 105 patients received an SSRI or SNRI during LVAD support. Forty-four (44) SSRI/SNRI (41.9%) and 41 non-SSRI/SNRI (28.7%) patients had a GIB (RR 1.46, p = 0.03). Twenty-six (26) (24.8%) of the SSRI/SNRI patients had a GIB due to AVMs versus 21 (14.7%) of the non-SSRI/SNRI patients (RR 1.69, p = 0.05). In fully-adjusted multivariate regression analysis, SSRI/SNRI therapy was independently associated with GIB (OR 1.78, p = 0.045). For GIB, the number needed to harm (NNH) was 7.6.Conclusion: In conclusion, SSRI/SNRI therapy is independently associated with an increased risk of GIB in LVAD patients. [ABSTRACT FROM AUTHOR]

• Objective: To evaluate whether changing the seizure-free interval in Arizona from 12 months to 3 months affected the number of seizure-related motor vehicle crashes. • Methods: We performed a time trend study with analysis of motor vehicle crash reports in the state of Arizona 3 years before (1991-1993) and 3 years after (1994-1996) the seizure-free interval was decreased from 12 to 3 months. The number of motor vehicle crashes related to seizures, other medical conditions, and other nonmedical crashes was compared before and after the law changed. Other population trends, including population growth, registered vehicles, and registered drivers, are also reported. • Results: Seizure-related crashes increased from 125 to 136 for the 3 years before and 3 years after the law changed, respectively. The total rate of seizure-related crashes did not increase on the basis of an incidence rate difference of -0.03/10[sup 9] miles (95% confidence interval [CI], -0.30 to 0.24) and a relative risk of 0.98 (95% CI, 0.77 to 1.24). Over the same time interval, crashes related to other medical conditions increased from 288 to 310, respectively, for an incidence rate difference of -0.09/10[sup 9] miles (95% CI, -0.51 to 0.33) and a relative risk of 0.97 (95% CI, 0.82 to 1.13). Fatalities due to seizure-related crashes decreased during the same period, whereas the number of multiple vehicle crashes increased. • Conclusion: The rate of seizure-related crashes did not significantly increase in the state of Arizona after the seizure-free interval was reduced from 12 to 3 months. [ABSTRACT FROM AUTHOR]

Background: Randomized trials for percutaneous closure of patent foramen ovale (PFO) have demonstrated a lower rate of recurrent ischemic events compared with medical therapy. The aim of this long-term follow-up analysis was to validate the impact of PFO closure on recurrent ischemic events., Methods and Results: A total of 570 patients were enrolled. Patients were followed for recurrent ischemic events for a median of 7.2 years. Mean age at the time of procedure was 49.3 ± 13.1 years. PFO closure was performed with the Amplatzer occluder in 44.9% of patients and with BioStar, Cardia or Premere occluders in 55.1% of patients. Within 10 years of follow-up, recurrent ischemic stroke occurred in 5.1% of patients in the Amplatzer group vs 7.6% with the other occluders (log rank P=.61). There was no difference in the rate of recurrent transient ischemic attack (1.86% vs 1.51%; log rank P=.52) or all-cause mortality (2.9% vs 3.8%; log rank P=.84) between the two groups, in patients with or without an atrial septal aneurysm or with respect to grade of preprocedural shunt. Recurrent stroke was lower in patients <45 years old at the time of occluder implantation (hazard ratio, 4.14; 95% confidence interval, 0.94-18.8; log rank P=.05)., Conclusion: In this long-term follow-up after PFO closure, the rate of recurrent stroke was low. There were no significant differences in event rates between different occluder devices, the existence of an atrial septal aneurysm, or grade of preprocedural shunt at baseline. Patients <45 years old had lower rates of recurrent ischemic stroke.

Background: Previous reports have shown that prolonged duration of resuscitation efforts in out-of-hospital cardiac arrest (OHCA) is associated with poor neurologic outcome. This concept has recently been questioned with advancements in post-cardiac arrest care including the use of therapeutic hypothermia (TH). The aim of this study was to determine the rate of good neurologic outcome based on the duration of resuscitation efforts in OHCA patients treated with TH., Methods: This prospective, observational, study was conducted between January 2008 and September 2012. Inclusion criteria consisted of adult non-traumatic OHCA patients who were comatose after return of spontaneous circulation (ROSC) and received TH. The primary endpoint was good neurologic outcome defined as a cerebral performance category score of 1 or 2. Downtime was calculated as the length of time between the patient being recognized as pulseless and ROSC., Results: 105 patients were treated with TH and 19 were excluded due to unknown downtime, leaving 86 patients for analysis. The median downtime was 18.5 (10.0-32.3)min and 33 patients (38.0%) had a good neurologic outcome. When downtime was divided into four groups (≤10min, 11-20min, 21-30min, >30min), good neurologic outcomes were 62.5%, 37%, 25%, and 21.7%, respectively (p=0.02). However, even with downtime >20min, 22.9% had a good neurologic outcome, and this percentage increased to 37.5% in patients with an initial shockable rhythm., Conclusions: Although longer downtime is associated with worse outcome in OHCA patients, we found that comatose patients who have been successfully resuscitated and treated with TH have neurologically intact survival rates of 23% even with downtime >20min., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)