We sought to determine if the number of hours elementary school students viewed television (TV) and video games is associated with substance use. We distributed the California Healthy Kids Survey Elementary School Questionnaire to elementary schools in Kentucky in 2006. A total of 4,691 students, primarily fourth and fifth graders, completed the survey. The students provided responses to questions on topics such as drug use, alcohol use, TV and video game viewing time, and their home life. We analyzed the survey using Chi-square tests and logistic regression. Approximately one-third of respondents indicated substance use, which was defined as alcohol use, illegal drug use, smoking/tobacco use, or sniffing solvents. Significantly more children (28% of those watching ≥3 hours of TV/video games compared with 20% of those watching greater than zero but ≤2 hours of TV/video games) reported alcohol use (p<0.05). Similar results were seen for sniffing solvents, with 9% of those watching ≥3 hours of TV/video games reporting they sniffed solvents compared with 4% who watched TV/video games for greater than zero but ≤2 hours (p<0.05). The results of the logistic regression indicated that the odds of drinking alcohol (odds ratio [OR] = 1.48, 95% confidence interval [CI] 1.23, 1.79) and sniffing solvents (OR=1.97, 95% CI 1.42, 2.75) were significantly higher for those watching ≥3 hours of TV/video games compared with those who watched TV/video games for greater than zero but ≤2 hours. The hours of TV and video games viewed were associated with alcohol use and sniffing solvents for our sample. However, limitations exist due to the inability to separate TV viewing from video game viewing.

Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur. Since 2000 in the District of Columbia (DC), SEP operations have been subject to the 1000 Foot Rule (§48–1121), a policy that prohibits the distribution of “any needle or syringe for the hypodermic injection of any illegal drug in any area of the District of Columbia which is within 1000 feet of a public or private elementary or secondary school (including a public charter school).” The 1000 Foot Rule may impede SEP services in areas that are in urgent need for harm reduction services, such as locations where injections are happening in “real time” or where drugs are purchased or exchanged. We examined the effects of the 1000 Foot Rule on SEP operational space in injection drug use (IDU)-related crime (i.e., heroin possession or distribution) hot spots from 2000 to 2010. Data from the DC Metropolitan Police Department were used to identify IDU-related crime hot spots. School operation data were matched to a dataset that described the approximate physical property boundaries of land parcels. A 1000-ft buffer was applied to all school property boundaries. The overlap between the IDU-related crime hot spots and the school buffer zones was calculated by academic year. When overlaying the land space associated with IDU-related crime hot spots on the maps of school boundaries per the 1000-ft buffer zone stipulation, we found that the majority of land space in these locations was ineligible for legal SEP operations. More specifically, the ineligible space in the identified hot spots in each academic year ranged from 51.93 to 88.29 % of the total hot spot area. The removal of the 1000 Foot Rule could significantly improve the public health of PWID via increased access to harm reduction services. Buffer zone policies that restrict SEP operational space negatively affect the provision of harm reduction services to PWID.

This study quantifies the transmission potential of SARS-CoV-2 across public health districts in Georgia, USA, and tests if per capita cumulative case count varies across counties. To estimate the time-varying reproduction number, R_t of SARS-CoV-2 in Georgia and its 18 public health districts, we apply the R package ‘EpiEstim’ to the time series of historical daily incidence of confirmed cases, 2 March–15 December 2020. The epidemic curve is shifted backward by nine days to account for the incubation period and delay to testing. Linear regression is performed between log₁₀-transformed per capita cumulative case count and log₁₀-transformed population size. We observe R_t fluctuations as state and countywide policies are implemented. Policy changes are associated with increases or decreases at different time points. R_t increases, following the reopening of schools for in-person instruction in August. Evidence suggests that counties with lower population size had a higher per capita cumulative case count on June 15 (slope = −0.10, p = 0.04) and October 15 (slope = −0.05, p = 0.03), but not on August 15 (slope = −0.04, p = 0.09), nor December 15 (slope = −0.02, p = 0.41). We found extensive community transmission of SARS-CoV-2 across all 18 health districts in Georgia with median 7-day-sliding window R_t estimates between 1 and 1.4 after March 2020.

Objective: U.S. pedestrian fatalities increased by 25% between 2010 and 2015. Risk factors include distractions, the built environment, urbanization, economic variables, and weather conditions. Of interest is the role of alcohol and drugs in premature death among pedestrians. This study sought to explore the prevalence of substance use screenings among pedestrian fatalities in the United States between 2014 and 2016. Methods: Data were collected from the Fatality Analysis Reporting System provided by the NHTSA. Pedestrian crash variables included demographics as well as information regarding alcohol or drug testing status. Frequency and cross-tabulation tables were constructed to assess the prevalence of screening by person, place, and time. Log-linear analyses were completed to explore age, race, and sex differences. A 3-year examination period was used to control for yearly fluctuations and to incorporate an increasing trend in cases. Results: Pedestrian fatalities accounted for 84% of all deaths among vulnerable road users during the examination period. Those most at risk were white males between the ages of 45 and 64. Over all states, 74.7% of fatalities were tested for alcohol and 67.1% were tested for drugs; further, 66.5% of cases were tested for both alcohol and drugs and 24.8% were tested for neither substance. Cases screened for both alcohol and drugs ranged from 2.9% in North Carolina to 95.7% in Nevada and those testing for neither substance ranged from a high of 68.9% in Indiana to a low of 1.1% in Maryland. Log-linear regression revealed significant differences in alcohol screening by age and race but not by sex. Differences in drug screening were not identified for any demographic variable. Fatalities tested for alcohol were significantly more likely to be tested for drugs; only 8.2% were screened solely for alcohol and 0.05% were screened for drugs alone. Conclusions: Preventive strategies become more important as pedestrian crashes and fatalities increase. Risk reduction in the form of policy change, alterations to the built environment, or interdisciplinary approaches to injury prevention is dependent upon best evidence supported in part by more deliberate and consistent screening.