Objective-To evaluate a text message (SMS) program as a booster to an in-person alcohol intervention with mandated college students.Participants-Undergraduates (n=224; 46% female) who violated an on-campus alcohol policy over a 2 semester period in 2014.Methods-The SMS program sent drinking-related queries each Thursday and Sunday and provided tailored feedback for 6 weeks. We examined response rates to SMS drinking-related queries and the associations between weekend drinking plans, drinking-limit goal commitment and alcohol consumption. Gender differences were explored.Results-90% of SMS queries were completed. Weekend binge drinking decreased over 6 weeks, and drinking-limit goal commitment was associated with less alcohol consumption. Compared with women, men had greater reductions in alcohol consumption when they committed to a drinking-limit goal.Conclusions-Preliminary evidence suggests that an SMS program could be useful as a booster for helping mandated students reduce weekend binge drinking. Keywordsalcohol; text message; college student; mandated Alcohol use is a major contributor to student morbidity and mortality 1 and there are thousands of alcohol policy violations per year on college campuses. 2,3 College students who violate campus alcohol policies have been shown to drink at higher quantities than general college populations, 4 and are therefore an important sub-population to target for interventions aimed at reducing consumption. 5 Individual-level interventions have been Corresponding Author Contact: Brian Suffoletto. Iroquois Building, Suite 400A; 3600 Forbes Avenue; Pittsburgh, PA 15261. HHS Public AccessAuthor manuscript J Am Coll Health. Author manuscript; available in PMC 2017 August 01. Author Manuscript Author ManuscriptAuthor Manuscript Author Manuscriptshown to produce small reductions in alcohol consumption and alcohol-related problems in general college student populations, 6 but exhibit diminished effects over time and may be less effective for mandated college students. 7In non-college settings, investigators have attempted to boost the effects of in-person alcohol interventions by incorporating booster sessions, either through letters, 8 face-to-face sessions, 9 or over the phone. 10,11,12 There have also been in-person boosters added to alcohol interventions in college settings, but little evidence of effect. 13 One potential explanation for sub-optimal effects may be the relatively low frequency of booster delivery. 14 A communication modality that may help boost effects of interventions for mandated students is mobile phone text messaging (e.g. short message service: SMS). SMS programs have been shown to be effective at reducing hazardous alcohol use in young adult emergency department populations as a stand-alone intervention, 15,16 and are beginning to be explored in college students. 17,18 To our knowledge, no study has reported on the implementation of an SMS program with college students who violate a campus alcohol policy.The present study analyzes anonymous da...
A multiscreen serum analysis program has been developed that permits a determination of antibody specificity for the vast majority of highly sensitized patients awaiting transplantation. This program is based on a 2 x 2 table analysis of correlations between serum reactivity with an HLA-typed cell panel and incorporates two modifications. One implements the concept of public HLA determinants based on the serologic crossreactivity among class I HLA antigens. The other modification derives from the premise that most highly sensitized patients maintain the same PRA and antibody profiles over many months and even years. Monthly screening results for patients with persistent PRA values can therefore be combined for analysis. For 132 of 150 highly sensitized patients with greater than 50% PRA, this multiscreen serum analysis program yielded information about antibody specificity toward public and private class I HLA determinants. The vast majority of patients (108 of 112) with PRA values between 50 and 89% showed antibody specificity generally toward one, two, or three public markers and/or the more common private HLA-A,B antigens. For 24 of 38 patients with greater than 90% PRA, it was possible to define one or few HLA-specific antibodies. The primary objective of the multiscreen program was to develop an algorithm about computer-predicted acceptable and unacceptable donor HLA-A,B antigens for patients with preformed antibodies. A retrospective analysis of kidney transplants into 89 highly sensitized patients has demonstrated that allografts with unacceptable HLA-A,B mismatches had significantly lower actuarial survival rates than those with acceptable mismatches (P = 0.01). This was shown for both groups of 32 primary transplants (44% vs. 67% after 1 year) and 60 retransplants (50% vs. 68%). Also, serum creatinine levels were significantly higher in patients with unacceptable class I mismatches (3.0 vs. 8.4 mg% [P = 0.007] after 2 weeks; 3.9 vs. 9.1 mg% [P = 0.014] after 4 weeks). Histopathologic analysis of allograft tissue specimens from 47 transplant recipients revealed a significantly higher incidence of humoral rejection (P = 0.02), but not cellular rejection, in the unacceptable mismatch group. These results suggest that the multiscreen program can establish which donor HLA-A,B mismatches must be avoided in kidney transplantation for most highly sensitized patients. For 18 of 150 high PRA renal dialysis patients, the multiscreen program could not define HLA-specific antibody. Most patients had greater than 90% PRA, and many of their sera appeared to contain IgM type nonspecific lymphocytotoxins that could be inactivated by dithioerythreitol (DTE).(ABSTRACT TRUNCATED AT 400 WORDS)
Limitations in timely testing for SARS-CoV-2 drive the need for new approaches in suspected COVID-19 disease. We queried whether viral load (VL) in the upper airways at presentation could improve the management and diagnosis of patients. This study was conducted in a 9 hospital system in Allegheny County, Pennsylvania between March 1-August 31 2020. Viral load was determined by PCR assays for patients presenting to the Emergency Departments (ED), community pediatrics practices and college health service. We found that for the ED patients, VL did not vary substantially between those admitted and not. VL was relatively equivalent across ages, except for the under 25 age groups that tended to present with higher loads. To determine if rapid antigen testing (RAT) could aid diagnosis in certain populations, we compared BD Veritor and Quidel Sofia to SOC PCR-based tests. The antigen assay provided a disease-detection sensitivity of >90% in a selection of 32 positive students and was modeled to have an 80% sensitivity in all positive students. In the outpatient pediatric population, the antigen assay detected 70% of PCR-positives. Extrapolating these findings to viral loads in older hospitalized patients, a minority would be detected by RAT (40%). Higher loads did correlate with death, though the prognostic value was marginal (ROC AUC of only 0.66). VL did not distinguish between those needing mechanical ventilation and routine inpatients. We conclude that VL in upper airways, while not prognostic for disease management, may aid in selecting proper testing methodologies for certain patient populations.
A 55-year-old man comes to you for a routine physical examination. He is a nonsmoker who takes no medications and has no signs of acute or chronic disease, and he has not seen a doctor in years. What blood work should you order for this patient? The authors of this article help you answer this question in light of recent advances in technology, restrictions in healthcare reimbursement, and increased sophistication in cost-benefit analysis for laboratory testing.
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