ABSTRACT
Although the rate of HIV infection among US prison inmates is considerably higher than that of the general population, little is known about age-related changes in HIV-infected inmates over the last decade. This study of the nation's largest state prison system examined (1) whether the mean age of the HIV-infected inmate increased over the last decade, and (2) whether the prevalence of HIV and associated comorbidities varied according to age. The study population included all 230,103 inmates incarcerated in the Texas prison system for any duration during 2014. A separate analysis was conducted on all HIV-infected inmates incarcerated between 2004 and 2014. Information on medical conditions and demographic factors was obtained from an institution-wide electronic medical record system. From 2004 to 2014, the mean age of HIV-infected inmates in the prison system increased from 39.3 to 42.5 years, compared to an increase of 36.1-37.9 for all Texas prison inmates. Multivariable logistic regression was used to assess the independent contributions of multiple demographic and clinical covariates in predicting the binary outcome, HIV infection. The model showed that, in 2014, HIV infection was elevated in inmates who were aged 40-49 years (OR = 3.1; 95% CI 2.7-3.3), aged 50-59 years (OR = 2.4; 95% CI 2.1-2.7), African American (OR = 3.0; 95% CI 2.8-3.3), and in those with several chronic diseases, including chronic obstructive pulmonary disease (OR = 1.7; 95% CI 1.5-1.9), hepatitis C (OR = 2.7; 95% CI 2.5-3.1), major depressive disorder (OR = 1.7; 95% CI 1.5-2.1), bipolar disorder (OR = 2.3; 95% CI 1.8-2.8), and schizophrenia (OR = 1.5; 95% CI 1.3-1.8). Among HIV-infected inmates (n = 2960), the percentage with comorbid disease increased in a linear fashion according to age (p < .01). Correctional health systems must adapt to address the evolving epidemiology of HIV among inmate populations.
Subject(s)
Chronic Disease/epidemiology , HIV Infections/epidemiology , Prisoners/statistics & numerical data , Prisons , Adolescent , Adult , Aged , Aged, 80 and over , Cohort Studies , Comorbidity , Criminal Law , Depressive Disorder, Major/epidemiology , Female , HIV Infections/psychology , Hepatitis C/epidemiology , Humans , Male , Middle Aged , Prevalence , Texas/epidemiology , Young AdultABSTRACT
OBJECTIVE: This study aimed to report on a toddler who presented with progressively worsening abdominal pain and obstructive uropathy 1 week after ureteral valve reimplantation. Acute renal failure resulted in critical hyperkalemia. METHODS: Chart review of presentation, physical examination, laboratory tests, and treatment. RESULTS: Initial potassium level was 10 mEq/L; ventricular tachycardia was observed and treated. CONCLUSIONS: More commonly, hyperkalemia results from overuse/overdose of supplementation or in patients with known renal failure. Although less common, obstructive uropathy should be considered in any patient with recent instrumentation of the urinary tract and coincident complications can be significant.
Subject(s)
Acute Kidney Injury/etiology , Hyperkalemia/etiology , Postoperative Complications/etiology , Tachycardia, Ventricular/etiology , Ureter/surgery , Ureteral Obstruction/etiology , Abdominal Pain/etiology , Acute Kidney Injury/blood , Ambulatory Surgical Procedures , Circumcision, Male , Emergencies , Fecal Impaction/etiology , Humans , Hydronephrosis/etiology , Hydronephrosis/therapy , Infant , Male , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Postoperative Nausea and Vomiting/etiology , Reoperation , Replantation , Ureteral Obstruction/blood , Urinary Catheterization , Vesico-Ureteral Reflux/surgeryABSTRACT
La alta diversidad de especies de carnívoros del Perú puede generar problemas al momento de decidir los taxa y temas sobre los que deben dirigirse los esfuerzos de investigación. En este trabajo se evalúa el esfuerzo de investigación en base al número de publicaciones realizadas para cada familia y especie de carnívoro en el Perú. Asimismo, se señalan los vacíos de información relevantes para la conservación de cada especie y se presenta la primera evaluación de las prioridades de investigación sobre este grupo animal en el Perú. Se registró 145 publicaciones sobre carnívoros peruanos realizadas desde el año 1943. El número de publicaciones presentó grandes diferencias entre taxa, entre temas estudiados y entre las ecorregiones en las que se realizaron las investigaciones. Según la escala de prioridades propuesta, la especie que debe ser estudiada con mayor prioridad es el coatí andino Nasua olivacea y la de menor prioridad es el ocelote Leopardus pardalis. Los resultados de nuestro trabajo resaltan la urgencia de realizar investigaciones sobre ciertas especies de carnívoros de las que existen pocos datos publicados, tanto a nivel local como global, y que se distribuyen en pocas ecorregiones del Perú. Tanto la escala de prioridades de investigación como la lista de vacíos de información serán de utilidad para guiar esfuerzos logísticos y financieros de investigadores particulares, instituciones privadas y gubernamentales.
The high diversity of Peruvian carnivore species may pose problems when deciding to which taxa and topics new research efforts should be directed. In this publication, we evaluated the research effort made on each taxa -by assessing the number of publications per species-, point out the knowledge gaps that are important to the conservation of each species and present the first evaluation of research priorities for this group of animals to the country. We registered 145 publications about Peruvian carnivores made since 1943. The number of publications is significantly different between taxa, between subjects and between ecoregions where the research was conducted. According to the proposed priority scale, the species to be studied with greater priority is Nasua olivacea and the lowest priority is for Leopardus pardalis. The results of our study highlight the urgent need to conduct research on certain species of carnivores about which there are few published data, locally and globally, and which occupy a low number of ecoregions in the country. Both the scale of research priorities and the list of knowledge gaps presented here will be useful to guide logistical and financial efforts, for individual researchers as well as for private or governmental institutions.
Subject(s)
Animals , Biodiversity , Carnivora , PeruABSTRACT
PURPOSE: All-terrain vehicle (ATV) injury is an increasingly serious problem, particularly among rural youth. There have been repeated calls for ATV safety education, but little study regarding optimal methods or content for such education. The purpose of this study was to determine if an ATV safety video was effective in increasing ATV safety knowledge when used in a community-based statewide hunter education program. METHODS: During the baseline phase, surveys focusing on ATV safety were distributed to students in the Arkansas hunter safety program in 2006. In the intervention phase a year later, an ATV safety video on DVD was provided for use in required hunter education courses across Arkansas. The same survey was administered to hunter education students before and after the course. FINDINGS: In the baseline phase, 1,641 precourse and 1,374 postcourse surveys were returned and analyzed. In the intervention phase, 708 precourse and 694 postcourse surveys were completed. Student knowledge of ATV safety after watching the video was higher than in preintervention classes. Knowledge of appropriate helmet usage increased from 95% to 98.8% (P < .0001). Awareness of the importance of not carrying a passenger behind the driver increased from 59.5% to 91.1% (P < .0001). Awareness of importance of hands-on ATV rider training increased from 82.1% to 92.4% (P < .0001). CONCLUSIONS: A brief ATV safety video used in a hunter education course increased ATV safety knowledge on most measures. A statewide hunter education program appears to be a useful venue for ATV safety education.
