Juvenile Probation Officers Call for a New Response to Teen Drug and Alcohol Use and Dependency

Shares lessons learned from RWJF's Reclaiming Futures initiative from a juvenile justice practitioner's perspective. Discusses the need to reform the system's treatment services, the challenges faced at the ten project sites, and recommendations

Comparison of Sequential Three-Drug Regimens as Initial Therapy for HIV-1 Infection

BACKGROUND The optimal sequencing ofantiretroviral regimens for the treatment of infection with human immunodeficiency virus type 1 (HIV-1) is unknown. We compared several different antiretroviral treatment strategies. METHODS This multicenter, randomized, partially double-blind trial used a factorial design to compare pairs of sequential three-drug regimens, starting with a regimen including zidovudine and lamivudine or a regimen including didanosine and stavudine in combination with either nelfinavir or efavirenz. The primary end point was the length of time to the failure ofthe second three-drug regimen. RESULTS A total of 620 subjects who had not previously received antiretroviral therapy were followed for a median of 2. 3 years. Starting with a three-drug regimen containing efavirenz combined with zidovudine and lamivudine (but not efavirenz combined with didanosine and stavudine) appeared to delay the failure ofthe second regimen, as compared with starting with a regimen containing nelfinavir (hazard ratio for failure ofthe second regimen, 0.71; 95 percent confidence interval, 0.48 to 1.06), as well as to delay the second virologic failure (hazard ratio, 0.56; 95 percent confidence interval, 0.29 to 1.09), and significantly delayed the failure ofthe first regimen (hazard ratio, 0.39) and the firstvirologic failure (hazard ratio, 0.34). Starting with zidovudine and lamivudine combined with efavirenz (but not zidovudine and lamivudine combined with nelfinavir) appeared to delay the failure of the second regimen, as compared with starting with didanosine and stavudine (hazard ratio, 0.68), and significantly delayed both the first and the second virologic failures (hazard ratio for the firstvirologic failure, 0.39; hazard ratio for the second virologic failure, 0.47), as well as the failure ofthe first regimen (hazard ratio, 0.35). The initial use of zidovudine, lamivudine, and efavirenz resulted in a shorter time to viral suppression. CONCLUSIONS The efficacy ofantiretroviral drugs depends on how they are combined. The combination of zidovudine, lamivudine, and efavirenz is superior to the other antiretroviral regimens used as initial therapy in this study

HIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg, Russian Federation

We examined the prevalence of HIV disclosure to sexual partners by HIV-positive drug injectors (IDUs) in St. Petersburg, Russia and compared the magnitude and direction of associations of condom use with awareness of one’s HIV infection and disclosure to partners. Among 157 HIV-infected participants, awareness of infection at time of last intercourse was associated with condom use with partners perceived to be HIV-negative (aOR 6.68, 95% CI 1.60–27.88). Among the 70 participants aware of their infection prior to enrolment, disclosure to potentially uninfected sexual partners was independently and negatively associated with condom use (aOR 0.13, 95% CI 0.02–0.66). Disclosure was independently associated with having injected ≥9 years (aOR 6.04, 95% CI 1.53–23.77) and partnership with another IDU (aOR 3.61, 95% CI 1.44–9.06) or HIV-seropositive (aOR 45.12, 95% CI 2.79–730.46). Scaling up HIV testing services and interventions that increase the likelihood of individuals receiving their test results is recommended

Oxidative Desulfurization of Middle-Distillate Fuels Using Activated Carbon and Power Ultrasound

The oxidative desulfurization (ODS) of jet and diesel fuels was studied using hydrogen peroxide plus formic acid as the oxidant, activated carbon as a reaction enhancer, and power ultrasound for phase dispersion. When the ODS treatment is followed by an activated alumina post-processing step, overall sulfur removal performance was 98% for JP-8 (at pH 1.4), 94% for diesel (at pH 1.5), and >88% for ultralow-sulfur diesel (at pH 1.5). The ODS treatment converts sulfur compounds to sulfones/sulfoxides, and activated alumina removes the oxidized sulfur compounds to yield a low-sulfur fuel. Control tests reveal that removal of any of the four reaction components (ultrasound, carbon, hydrogen peroxide, and formic acid) reduces the ODS removal performance, with hydrogen peroxide being the most crucial. The response of ODS removal performance to initial oxidant concentrations is consistent with performic acid, formed in situ from hydrogen peroxide and formic acid, being the active oxidizing species. Power ultrasound promotes dispersion of the three immiscible phases (fuel, water, and carbon), accelerates interfacial mass transfer, and may also accelerate the reaction via the sonochemical effect. Activated carbon increases the ODS reaction rate up to 12-fold. Rate data for different benzothiophene compounds show no evidence of steric hindrances, either in the presence or in the absence of carbon. Two types of activated carbon were tested as ODS enhancers: a phosphoric acid treated, wood-based activated carbon material and a thermally activated peat-based carbon material. Both carbon materials improved ODS reaction rates relative to the uncatalyzed control, but the wood-based carbon was superior to the peat-based carbon for all monitored sulfur compounds. The wood-based carbon had greater surface area, pore volume, and surface acidity than the peat-based carbon, making it difficult to attribute the enhancement effect to any single characteristic. Chemical analysis of the treated fuel revealed that <1% of the fuel hydrocarbon compounds was oxidized during the ODS treatment and that aromatic compounds were the most likely to be oxidized

Medication-Assisted Treatment in Criminal Justice Agencies Affiliated with the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS): Availability, Barriers, and Intentions

Medication-assisted treatment (MAT) is underutilized in the treatment of drug-dependent, criminal justice populations. This study surveyed criminal justice agencies affiliated with the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) to assess use of MAT and factors influencing use of MAT. A convenience sample (N = 50) of criminal justice agency respondents (e.g., jails, prisons, parole/probation, and drug courts) completed a survey on MAT practices and attitudes. Pregnant women and individuals experiencing withdrawal were most likely to receive MAT for opiate dependence in jail or prison, whereas those reentering the community from jail or prison were the least likely to receive MAT. Factors influencing use of MAT included criminal justice preferences for drug-free treatment, limited knowledge of the benefits of MAT, security concerns, regulations prohibiting use of MAT for certain agencies, and lack of qualified medical staff. Differences across agency type in the factors influencing use and perceptions of MAT were also examined. MAT use is largely limited to detoxification and maintenance of pregnant women in criminal justice settings. Use of MAT during the community reentry period is minimal. Addressing inadequate knowledge and negative attitudes about MAT may increase its adoption, but better linkages to community pharmacotherapy during the reentry period might overcome other issues, including security, liability, staffing, and regulatory concerns. The CJ-DATS collaborative MAT implementation study to address inadequate knowledge, attitudes, and linkage will be described

Investigation of Water Interactions with Petroleum-Derived and Synthetic Aviation Turbine Fuels

While undesirable in aviation fuel systems, water is both ubiquitous and tenacious; thus, interactions between water and aviation turbine fuel occur regularly. From a fuel user perspective, it is important to know, understand, and be able to predict such fuel–water interactions, e.g., water solubility, water settling rate, and interfacial tension, for proper mitigation. We explore these interactions as well as surface tension of both petroleum-derived and alternative jet fuels to compare potential differences between product compositions on these physical interactions. Observations indicate a positive, nonlinear correlation between water solubility and both aromatic content and temperature (from 0 to 50 °C). Water settling rates appear to follow a Stokes’ law model; therefore, bulk chemical composition indirectly influences settling rates via density and viscosity. Finally, surface tension appears positively correlated to sample density, while interfacial tension is correlated to both surface tension and fuel aromatic content

Medication-assisted treatment in criminal justice agencies affiliated with the criminal justice-drug abuse treatment studies (CJ-DATS): availability, barriers, and intentions.

Medication-assisted treatment (MAT) is underutilized in the treatment of drug-dependent, criminal justice populations. This study surveyed criminal justice agencies affiliated with the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) to assess use of MAT and factors influencing use of MAT. A convenience sample (N = 50) of criminal justice agency respondents (e.g., jails, prisons, parole/probation, and drug courts) completed a survey on MAT practices and attitudes. Pregnant women and individuals experiencing withdrawal were most likely to receive MAT for opiate dependence in jail or prison, whereas those reentering the community from jail or prison were the least likely to receive MAT. Factors influencing use of MAT included criminal justice preferences for drug-free treatment, limited knowledge of the benefits of MAT, security concerns, regulations prohibiting use of MAT for certain agencies, and lack of qualified medical staff. Differences across agency type in the factors influencing use and perceptions of MAT were also examined. MAT use is largely limited to detoxification and maintenance of pregnant women in criminal justice settings. Use of MAT during the community reentry period is minimal. Addressing inadequate knowledge and negative attitudes about MAT may increase its adoption, but better linkages to community pharmacotherapy during the reentry period might overcome other issues, including security, liability, staffing, and regulatory concerns. The CJ-DATS collaborative MAT implementation study to address inadequate knowledge, attitudes, and linkage will be described