Jeanne Beauchamp Hewitt

Environment and obesity in the National Children's Study.

Objective In this review we describe the approach taken by the National Children’s Study (NCS), a 21-year prospective study of 100,000 American children, to understanding the role of environmental factors in the development of obesity. Data sources and extraction We review the literature with regard to the two core hypotheses in the NCS that relate to environmental origins of obesity and describe strategies that will be used to test each hypothesis. Data synthesis Although it is clear that obesity in an individual results from an imbalance between energy intake and expenditure, control of the obesity epidemic will require understanding of factors in the modern built environment and chemical exposures that may have the capacity to disrupt the link between energy intake and expenditure. The NCS is the largest prospective birth cohort study ever undertaken in the United States that is explicitly designed to seek information on the environmental causes of pediatric disease. Conclusions Through its embrace of the life-course approach to epidemiology, the NCS will be able to study the origins of obesity from preconception through late adolescence, including factors ranging from genetic inheritance to individual behaviors to the social, built, and natural environment and chemical exposures. It will have sufficient statistical power to examine interactions among these multiple influences, including gene–environment and gene–obesity interactions. A major secondary benefit will derive from the banking of specimens for future analysis.

Violence in the workplace.

This integrative review of research on workplace violence in Canada and the United States showed that risk factors for homicide and nonfatal assault injuries differed significantly. In 1993, there were 1,063 work-related homicides in the United States (Bureau of Labor Statistics, 1994). Workplace homicide was the second leading cause of fatal occupational injuries overall, but the primary cause for women. The highest risk for workplace homicide was observed among males, the self-employed, and those employed in grocery stores, eating and drinking establishments, gas service stations, taxicab services, and government service, including law enforcement. The majority of workplace homicides occurred during robberies. Unlike workplace homicide, the majority of nonfatal assaults that involved lost work time occurred to women, primarily employed in health care or other service sector work. The assault rates for residential care and nursing and personal care workers were more than ten times that of private non-health care industries. Minimal intervention research has been reported. In recent years, some governmental agencies and professional organizations have begun to address policy issues related to workplace violence.

Assault of long-term care personnel.

The purpose of this study was to explore contributing factors, consequences, and solutions to assault of long-term care personnel. The study sample consisted of three focus groups composed of certified nursing assistants and administrators employed in long-term care facilities within a large Midwestern city. Using content analysis methodology, multiple themes emerged: worker attitude, vulnerability, work culture, job tasks, training, working short-staffed, financial concerns, changes in social values and health care, community crime, substance abuse, accepting assaults, coworker threats, issues of retaliation, professional withdrawal, and inability to share experiences. Preventive measures suggested by the participants are consistent with those recommended by the Occupational Safety and Health Administration. Implications for staff and administrators include both personal and workplace strategies. Recommendations include implementing more comprehensive violence prevention programs that includes conflict management and training tailored to the type of residents.

Length of stay and charges associated with health care-acquired bloodstream infections

BACKGROUND Although many studies have examined outcomes of health care-associated bloodstream infections (HCABSIs), population-based estimates of length of stay (LOS) and costs have seldom been reported. OBJECTIVES Our objective was to generate US national estimates of LOS and costs associated with HCABSIs using the 2003 National Inpatient Sample (NIS). METHODS This study utilized a matched case-control design to estimate LOS and costs associated with HCABSIs based on the 2003 (NIS). A special set of ICD-9-CM codes was used to identify cases. A 1:1 matching procedure was used in which HCABSIs in patients were matched with uninfected patients based on age, sex, and admission diagnosis. We performed weighted analysis to construct population estimates and their standard deviations for LOS and total charges. RESULTS After applying the case finding criteria, 113,436 HCABSI cases were identified. The weighted mean LOS for HCABSIs cases was 16.0 days compared with 5.4 days for the control group (P < .001). The weighted mean total charges for patients with HCABSIs were

Workplace homicides in Chicago. Risk factors from 1965 to 1990.

85,813 (

RISK OF ADVERSE OUTCOMES IN PREGNANT WOMEN EXPOSED TO SOLVENTS

110,183 US in 2010) compared with

Environment and Obesity in the National Children's Study

22,821 (

Workplace violence: female occupational homicides in metropolitan Chicago.

29,302 US in 2010) for uninfected patients (P < .001). We estimated that, in 2003, HCABSIs potentially cost the US economy nearly

Use of Electronic Health-Related Datasets in Nursing and Health-Related Research

29 billion (

Laboratory confirmed health care-associated bloodstream infections: A Jordanian study

37.24 billion US in 2010). CONCLUSION This study estimated the economic burden of HCABSIs on the US national economy. With some modifications, the annually published NIS data could be useful as a national surveillance tool for health care adverse events including HCABSIs.