Although recent increases in collegiate prescription drug misuse have generated a great deal of concern, there are few analyses available that examine the socio-cultural factors influencing these trends. This article attempts to address this gap in knowledge by providing an analysis of several socio-cultural factors influencing pharmaceutical misuse by college students. Prescription drugs are put to a number of different purposes in the collegiate setting, including self-medication, socio-recreation, and academic functioning. Such misuse is acceptable in a social context where individuals deliberately attempt to experiment with drugs. Widespread knowledge regarding effects, dosages, and compatibilities with other drugs, coupled with the extensive availability of pharmaceuticals in collegiate social circles, makes this class of drugs an attractive alternative to other psychoactive substances. These factors underscore several implications for substance abuse prevention efforts on college campuses and suggest a number of important issues for further research.

BACKGROUND Clinical teratology studies often rely on patient reports of medication use in pregnancy with or without other sources of information. Electronic medical records (EMRs), administrative databases, pharmacy dispensing records, drug registries, and patients' self-reports are all widely used sources of information to assess potential teratogenic effect of medications. The objective of this study was to assess comparability of self-reported and prescription medication data in EMRs for the most common therapeutic classes. METHODS The study population included 404 pregnant women prospectively recruited from five prenatal care clinics affiliated with the University of New Mexico. Self-reported information on prescription medications taken since the last menstrual period (LMP) was obtained by semistructured interviews in either English or Spanish. For validation purposes, EMRs were reviewed to abstract information on medications prescribed between the LMP and the date of the interview. Agreement was estimated by calculating a kappa (κ) coefficient, sensitivity, and specificity. RESULTS In this sample of socially-disadvantaged (i.e., 67.9% high school education or less, 48.5% no health insurance), predominantly Latina (80.4%) pregnant women, antibiotics and antidiabetic agents were the most prevalent therapeutic classes. The agreement between the two sources substantially varied by therapeutic class, with the highest level of agreement seen among antidiabetic and thyroid medications (κ ≥0.8) and the lowest among opioid analgesics (κ = 0.35). CONCLUSIONS Results indicate a high concordance between self-report and prescription data for therapeutic classes used chronically, while poor agreement was observed for medications used intermittently, on an 'as needed" basis, or in short courses.

Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross-sectional associations of 24-hour mean concentrations of personal and kitchen fine particulate matter (PM ), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner-burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24-hour PM concentrations of 126 μg/m (77) and 360 μg/m (374), while Justa stove users' exposures were 66 μg/m (38) and 137 μg/m (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7-4.3) per unit increase in natural log-transformed kitchen PM concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3-8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0-2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.

Pneumonia is a leading killer of children younger than 5 years despite high vaccination coverage, improved nutrition, and widespread implementation of the Integrated Management of Childhood Illnesses algorithm. Assessing the effect of interventions on childhood pneumonia is challenging because the choice of case definition and surveillance approach can affect the identification of pneumonia substantially. In anticipation of an intervention trial aimed to reduce childhood pneumonia by lowering household air pollution, we created a working group to provide recommendations regarding study design and implementation. We suggest to, first, select a standard case definition that combines acute (≤14 days) respiratory symptoms and signs and general danger signs with ancillary tests (such as chest imaging and pulse oximetry) to improve pneumonia identification; second, to prioritise active hospital-based pneumonia surveillance over passive case finding or home-based surveillance to reduce the risk of non-differential misclassification of pneumonia and, as a result, a reduced effect size in a randomised trial; and, lastly, to consider longitudinal follow-up of children younger than 1 year, as this age group has the highest incidence of severe pneumonia.

Authors' contributions SR performed the data collection, analyzed the data and wrote the manuscript. BNY performed the data collection and wrote the manuscript. MLC designed the study and revised the manuscript. MLBC performed the data collection and revised the manuscript. AMB designed the study and revised the manuscript. RDB designed the study and revised the manuscript. TLN revised the manuscript. JV supported the data collection and revised the manuscript. SJR revised the manuscript. CL supported the data collection and revised the manuscript. NG supported the data analysis and revised the manuscript. KK revised the manuscript. SA supported data collection and revised the manuscript. ABOP supported data collection and revised the manuscript. JLP designed the study and revised the manuscript. All authors read and approved the final manuscript.