To determine how many steps·day(-1) equate to current moderate-to-vigorous physical activity (MVPA) guidelines in a population from the Lower Mississippi Delta (LMD) of the United States, 58 overweight adults wore an Actigraph accelerometer (GT3X) for up to 2 weeks. Min·day(-1) in MVPA was a good predictor of steps·day(-1) (r(2) = 0.62; p < 0.001; linear regression), such that 30 min of daily MVPA equated to 9154 steps·day(-1) (mixed-model approach). Using receiver operating characteristic analysis, sensitivity and specificity were optimized at 8357 steps·day(-1). Results indicate that overweight residents of the LMD should be accumulating at least 8300-9100 steps·day(-1) to meet the recommendation of 30 min·day(-1) MVPA.

OBJECTIVE: The objectives of the present study were to evaluate diet quality among Lower Mississippi Delta (LMD) residents using the Healthy Eating Index-2005 (HEI-2005) and to identify the top five dietary sources contributing to HEI-2005 components. Demographic differences in HEI-2005 scores were also explored.
METHODS: Diet quality was evaluated using HEI-2005. Demographic differences in HEI-2005 scores were investigated using multivariable regression models adjusting for multiple comparisons. The top five dietary sources contributing to HEI-2005 components were identified by estimating and ranking mean MyPyramid equivalents overall and by demographic characteristics.
METHODS: Dietary data, based on a single 24 h recall, from the Foods of Our Delta Study 2000 (FOODS 2000) were used in the analyses.
METHODS: FOODS 2000 adult participants 18 years of age or older.
RESULTS: Younger age was the largest determinant of low diet quality in the LMD with HEI-2005 total and seven component scores declining with decreasing age. Income was not a significant factor for HEI-2005 total or component scores. The top five dietary sources differed by all five of the demographic variables, particularly for total vegetables and energy from solid fats, alcoholic beverages and added sugars (SoFAAS). Soft drinks were the leading source of SoFAAS energy intake for all demographic groups.
CONCLUSIONS: The assessment of diet quality and identification of top dietary sources revealed the presence of demographic differences for selected HEI-2005 components. These findings allow identification of food patterns and culturally appropriate messaging and highlight the difficulties of treating this region as a homogeneous population.

BACKGROUND: End-stage renal disease is epidemic within the United States among certain high-risk groups. The National Kidney Disease Education Program examined the awareness of chronic kidney disease (CKD) risk factors among primary care physicians who treat high-risk populations, such as African Americans, persons with diabetes, persons with hypertension, and family members of dialysis patients.
METHODS: We conducted a survey of 465 primary care physicians in 4 communities with high-risk populations. Respondents were asked to score 9 potential CKD risk factors on a 4-point scale graded from \"Does not increase risk at all\" to \"Increases risk greatly.\" Potential risk factors included African-American race, diabetes, hypertension, and family history of CKD.
RESULTS: Respondents saw a mean of 414 +/- 222 (SD) patients/mo. Primary care physicians were more likely to report that diabetes and hypertension were significant risk factors for CKD. Conversely, 34.4% did not consider family history of kidney disease to increase the risk for CKD, and 22% of respondents did not consider African-American race a CKD risk factor.
CONCLUSIONS: Primary care physicians need targeted education to increase awareness of populations at high risk for CKD.

A U.S. Magistrate Judge ordered the Mississippi Department of Corrections (DOC) to comply with the National Institutes of Health\'s (NIH) guidelines for the standard of care for HIV-positive individuals. Current treatment of HIV-positive inmates in Mississippi was characterized as \"abysmal\" by the American Civil Liberties Union (ACLU), but defended as undergoing improvements, by a state medical expert. Despite NIH recommendations for antiretroviral treatment comprised of a protease inhibitor and two other drugs, inmates were only given a two-drug regimen. A protease inhibitor was added only after prisoners proved adherence for at least 6 months. The prison also failed to provide routine viral load testing. The terms of the injunction require the DOC to complete viral load tests for prisoners who have not begun triple drug therapy, and to write a protocol establishing standards of HIV care.

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OBJECTIVE: Assess the effect and use of resources associated with implementation of a program for the systematic follow-up of positive blood cultures.
METHODS: Prospective epidemiologic study.
METHODS: Tertiary-care military medical center.
METHODS: All positive blood cultures (BC) were reported via E-mail to an infectious disease specialist as soon as growth was noted. This individual reviewed all Gram stains, clinical data, and antibiotic information on these patients.
RESULTS: From June 26, 1994, through January 25, 1995, there were 3,121 BCs drawn, of which 199 (6.4%) were positive from 145 episodes. Sixty-three episodes involved probable contaminants, and 82 episodes were considered true bacteremias. Six patients with true bacteremia died, two were transferred, and three were discharged within 24 hours of drawing the positive BC. Of the remaining 71 true bacteremias, 9 patients were on inadequate empiric therapy, as judged by the final organism susceptibilities. Changes in empiric therapy were recommended for five of the nine episodes and were implemented by the primary physicians in each case. Each of the changes resulted in improved coverage (as judged by the final identification and susceptibilities).
CONCLUSIONS: This program has improved the quality of care at Keesler Medical Center at the cost of one additional hour of consultant time per week.

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