Lee S. Friedman

Social-environmental factors associated with elevated body mass index in a Ukrainian cohort of children

BACKGROUNDnWhile obesity is a growing epidemic in most developed countries, we still lack information on countries in economic transition. In this study, we evaluate the built environment, activity levels, economic status and dietary patterns associated with body mass index (BMI) greater than or equal to the 85th percentile among 3-year-old Ukrainian children living through the downturn in the economy during the mid-1990s.nnnMETHODSnWe evaluated 883 3-year-old children from the Ukraine ELSPAC cohort. Principal components analysis was used as a data reduction tool for dietary, built environment and activity variables. We evaluated predictors of elevated BMI (> or = 85th percentile) using a multivariable logistic regression model.nnnRESULTSnThe final multivariable model showed that for every kilogram increase in the mothers weight, there was a corresponding 2% increase in risk of a child having a BMI> or = 85th percentile (OR=1.02; 95% CI: 1.00-1.04). A higher social class and a friendly neighborhood were associated with higher BMI, whereas infrequent outings to places that require spending money was associated with lower BMI. Except for meat consumption, none of the dietary variables were associated with elevated BMI.nnnDISCUSSIONnThe picture in the Ukraine during the 1990s, a period of economic hardship, revealed that variables associated with higher standards of living were predictive of elevated BMI: higher social class, meat consumption and friendly neighborhoods. Variables associated with economic isolation were predictive of a lower risk of elevated BMI.

Dose–response relationship between in-hospital mortality and alcohol following acute injury

Although the relationship between alcohol and injury incidence is well researched, there continues to be dispute about the relationship between alcohol and mortality following an injury. Findings from past studies have varied primarily because of methodological issues and have failed to characterize the dose-response relationship. The main objective of this study was to evaluate the dose response relationship of in-hospital mortality and blood alcohol concentration (BAC). This study was a retrospective analysis of traumatic injuries occurring between 1995 and 2009 as reported by all level 1 and 2 trauma units in the State of Illinois. The study includes all patients with blood alcohol toxicological examination levels ranging from zero to 500xa0mg/dl (Nxa0=xa0190,612). The Illinois trauma registry includes all patients sustaining traumatic injuries and admitted to a trauma center for ≥12xa0h. A total of 6733 patients meeting the inclusion criteria died following admission. Patients that were dead on arrival and those that died during the initial assessment within the emergency room were excluded. In the adjusted multivariable model, a decrease in in-hospital mortality was strongly associated with an increase in blood alcohol concentration (adjusted ORxa0=xa00.83 per 100xa0mg/dl units change in BAC; CI 95%: 0.80, 0.85; pxa0<xa00.001). The direction of the dose response relationship was consistent across the stratified models, with the exception of patients suffering burns. The largest reduction of in-hospital case fatality rates by blood alcohol concentration was observed among patients suffering penetrating or severe injuries (Injury Severity Scorexa0≥xa016). In the clinical setting, it is important to understand not only how to recognize intoxicated patients, but also how alcohol may affect the course of treatment. The consistency of the findings across the multivariable models indicates that blood alcohol concentration is strongly associated with lower in-hospital mortality among those that survive long enough to receive treatment in specialized trauma units.

Characterizing the relationship between in-hospital measures and workers' compensation outcomes among severely injured construction workers using a data linkage strategy

BACKGROUNDnTo characterize the relationship between acute measures of severity and three important workers compensation outcomes associated with a workers ability to return to work and the cost of a work-related injury.nnnMETHODSnProbabilistic data linkage of workers compensation claims made by injured construction workers from 2000 to 2005 with two Illinois medical record registries. Multivariable robust regression models were built to assess the relationship between three in-hospital measures and three outcomes captured in the Workers Compensation data.nnnRESULTSnIn the final multivariable models, a categorical increase in injury severity was associated with an extra

Mortality in cancer patients after a fall-related injury: The impact of cancer spread and type

7,830 (95% CI:

Analysis of Suspected Suicides Using Poison Center Data

4,729-

Complications associated with blood alcohol concentration following injury

10,930) of monetary compensation awarded, though not with temporary total disability (TTD) or permanent partial disability (PPD). Our models also predicted that every extra day spent in the hospital results in an increase of 0.51 (95% CI: 0.23-0.80) weeks of TTD and an extra

A retrospective cohort study of suspected child maltreatment cases resulting in hospitalization

1,248 (95% CI:

Analysis of Hymenoptera Stings Reported to the Illinois Poison Center

810-

Using clinical signs of neglect to identify elder neglect cases

1,686) in monetary compensation. Discharge to an intermediate care facility following the initial hospitalization was associated with an increase of 8.15 (95% CI: 4.03-12.28) weeks of TTD and an increase of

Death and Injury from Motor Vehicle Crashes A Tale of Two Countries

23,440 (95% CI: