Pervasive misinformation about climate change might be reduced if colleges were to include the topic within general education curriculum. This paper analyzes the general education (or “core”) ...curriculum in the top 100 universities and liberal-arts colleges in the U.S. to assess the proportion of core courses that highlight climate change or climate science. The probability that a student takes at least one climate-change course via the core curriculum is estimated at 0.17 across all schools. The probability is higher at research universities than at liberal arts colleges, in core programs that have more science and social science courses, and at public universities in states with a Democrat-controlled legislature than in states with a Republican-controlled or split legislature. Drawing on cases of best practices in the U.S. identified from the data set, the authors discuss strategies that could ensure a higher likelihood that the core curriculum includes education on climate science and climate change. The study advances the broader research literature on sustainability in higher education programs by bringing it into conversation with research on the college core curriculum and by focusing both on the specific issue of climate-change education.
•The proportion of required courses about climate change in the college core in the U.S. is low.•Public universities in states with conservative governments have lower levels of required courses.•Research universities in the U.S. have higher levels of required climate-related courses than liberal arts colleges.•There are multiple models for improving the chances that the college education includes climate change.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
OBJECTIVES:To evaluate the clinical safety of daily tenofovir disoproxil fumarate (TDF) among HIV-negative men who have sex with men.
DESIGN:Randomized, double-blind, placebo-controlled trial. ...Participants were randomized 1:1:1:1 to immediate or delayed study drug (TDF, 300 mg orally per day, or placebo).
METHODS:Four hundred healthy HIV-uninfected men who have sex with men reporting anal sex with another man within the previous 12 months enrolled in Atlanta, Boston, and San Francisco. HIV serostatus, clinical and laboratory adverse events (AEs), adherence (pill count, Medication Event Monitoring System, and self-report), and sexual and other sociobehavioral data were assessed at 3-month intervals for 24 months. Primary outcomes were clinical safety, assessed by incidence of AEs and laboratory abnormalities.
RESULTS:Study drug was initiated by 373 (93%) participants (186 TDF and 187 placebo), of whom 325 (87%) completed the final study visit. Of 2428 AEs reported among 334 (90%) participants, 2366 (97%) were mild or moderate in severity. Frequencies of commonly reported AEs did not differ significantly between TDF and placebo arms. In multivariable analyses, back pain was more likely among TDF recipients (P = 0.04); these reports were not associated with documented fractures or other objective findings. There were no grade ≥3 creatinine elevations; grades 1 and 2 creatinine increases were not associated with TDF receipt. Estimated percentage of study drug doses taken was 92% by pill count and 77% by Medication Event Monitoring System. Seven seroconversions occurred4 on placebo and 3 among delayed arm participants not yet on study drug.
CONCLUSIONS:Daily oral TDF was well tolerated, with reasonable adherence. No significant renal concerns were identified.
Abstract
Recycling of effluent water from urban water-supply systems is often a more sustainable water source than increased use of surface sources, groundwater sources, and desalination. However, ...water-supply organizations (WSOs) often do not take full advantage of recycled water. Although recycling water for direct potable use is efficient, public concern with safety has tended to cause WSOs to favor other uses for recycled water. This study examines patterns in the degree of utilization of two main indirect uses of recycled water: dual-reticulation systems and groundwater recharge. Drawing on case studies of four U.S. cities that are leaders in the use of recycled water, the study identifies conditions that favor the choice of one option over the other. Where cities are concerned with groundwater recharge of potable water supplies, they tend to prefer non-recycled water if available for recharge projects. However, where non-recycled water supplies are limited, recycled water may be prioritized for aquifer recharge. Otherwise, the preference is for use by large industrial partners such as power plants or for exchanges for higher-quality potable water resources with rural systems. In contrast, dual-reticulation (purple-pipe) systems for direct nonpotable recycling face steep economic and technical challenges.
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CEKLJ, NUK, ODKLJ, UL, UM, UPUK
OBJECTIVE:To evaluate for changes in sexual behaviors associated with daily pill use among men who have sex with men (MSM) participating in a preexposure prophylaxis trial.
DESIGN:Randomized, ...double-blind, placebo-controlled trial. Participants were randomized 1:1:1:1 to receive tenofovir disoproxil fumarate or placebo at enrollment or after a 9-month delay and followed for 24 months.
METHODS:Four hundred HIV-negative MSM reporting anal sex with a man in the past 12 months and meeting other eligibility criteria enrolled in San Francisco, Atlanta, and Boston. Sexual risk was assessed at baseline and quarterly visits using Audio Computer-Assisted Self-Interview. The association of pill taking with sexual behavior was evaluated using logistic and negative-binomial regressions for repeated measures.
RESULTS:Overall indices of behavioral risk declined or remained stable during follow-up. Mean number of partners and proportion reporting unprotected anal sex declined during follow-up (P < 0.05), and mean unprotected anal sex episodes remained stable. During the initial 9 months, changes in risk practices were similar in the group that began pills immediately vs. those in the delayed arm. These indices of risk did not differ significantly after initiation of pill use in the delayed arm or continuation of study medication in the immediate arm. Use of poppers, amphetamines, and sexual performance–enhancing drugs were independently associated with one or more indices of sexual risk.
CONCLUSIONS:There was no evidence of risk compensation among HIV-uninfected MSM in this clinical trial. Monitoring for risk compensation should continue now that preexposure prophylaxis has been shown to be efficacious in MSM and other populations and will be provided in open-label trials and other contexts.
Health-related Quality of Life (HRQL) measures are widely used in research settings, but integration of use in routine clinical care has been slow. In spite of an increased effort to show its ...usefulness in a clinical setting, there is still an inherent need to better understand what patient-centered constructs would be best suited for integration into standard clinical care to enhance the measurement of HRQL-particularly in a HIV/AIDS population. This is a secondary data analysis that used structural equation modeling (SEM) to assess the utility of the HIV Cost and Services Utilization (HCSUS) in predicting health related quality of life (HRQL) in an AIDS-infected population in care. A model of hypothesized relationships between constructs was proposed and tested using EQS (version 6.1). A parsimonious model was achieved. The direct predictors of HRQL included medication adherence (β= 3.396; p<.05) and utilization of services (β=-18.184; p<.05). The final model had an acceptable fit with the measured data (χ2=171.4, p<.001, RMSEA=.06; CFI=.645). The results provide important information on the role of patient-centered constructs in health status decision-making. The analysis indicates that integration of these constructs should be investigated further with an emphasis on medication adherence and the use of health care services and how these two factors build on the AIDS patient's self-efficacy.
In Dec 1999, the Centers for Disease Control & Prevention's (CDC's) Division of HIV/AIDS Prevention initiated a standardized evaluation system for CDC-funded health department HIV prevention ...programs. This evaluation guidance asks health departments to develop comprehensive evaluation plans & to submit aggregated data on such activities as intervention planning, process monitoring, & outcome evaluation. During the first year of this system, of 65 health departments, 62 submitted evaluation plans, 37 submitted intervention plan data, & 20 submitted process monitoring data. Major issues affecting implementation of a national evaluation system include varying levels of evaluation capacity among health departments, differences between the CDC's taxonomy for national data collection & local definitions, & limitations regarding use of first-year data. The CDC has learned that implementation of a standardized evaluation system takes considerable time & that stakeholder involvement & technical assistance & capacity building support are essential. 2 Tables, 10 References. Adapted from the source document.
In December 1999 the Centers for Disease Control and Prevention's (CDC's) Division of HIV/AIDS Prevention initiated a standardized evaluation system for CDC-funded health department HIV prevention ...programs. This health department evaluation guidance asks health departments to develop comprehensive evaluation plans and to submit aggregated data on such activities as intervention planning, process monitoring, and outcome evaluation. During the first year of this system, of 65 health departments, 62 submitted evaluation plans, 37 submitted intervention plan data, and 20 submitted process monitoring data. Major issues affecting implementation of a national evaluation system include varying levels of evaluation capacity among health departments, differences between the CDC's taxonomy for national data collection and local definitions, and limitations regarding use of 1st-year data. The CDC has learned that implementation of a standardized evaluation system takes considerable time and that stakeholder involvement and technical assistance and capacity building support are essential.
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