An overview of the Salmonella enteritidis risk assessment for shell eggs and egg products.

This article summarizes a quantitative microbial risk assessment designed to characterize the public health impact of consumption of shell eggs and egg products contaminated with Salmonella Enteritidis (SE). This risk assessment's objectives were to: (1) establish the baseline risk of foodborne illness from SE, (2) identify and evaluate potential risk mitigation strategies, and (3) identify data gaps related to future research efforts. The risk assessment model has five modules. The Egg Production module estimates the number of eggs produced that are SE-contaminated. Shell Egg Processing, Egg Products Processing, and Preparation & Consumption modules estimate the increase or decrease in the numbers of SE organisms in eggs or egg products as they pass through storage, transportation, processing, and preparation. A Public Health Outcomes module then calculates the incidence of illnesses and four clinical outcomes, as well as the cases of reactive arthritis associated with SE infection following consumption. The baseline model estimates an average production of 2.3 million SE-contaminated shell eggs/year of the estimated 69 billion produced annually and predicts an average of 661,633, human illnesses per year from consumption of these eggs. The model estimates approximately 94% of these cases recover without medical care, 5% visit a physician, an additional 0.5% are hospitalized, and 0.05% result in death. The contribution of SE from commercially pasteurized egg products was estimated to be negligible. Five mitigation scenarios were selected for comparison of their individual and combined effects on the number of human illnesses. Results suggest that mitigation in only one segment of the farm-to-table continuum will be less effective than several applied in different segments. Key data gaps and areas for future research include the epidemiology of SE on farms, the bacteriology of SE in eggs, human behavior in food handling and preparation, and human responses to SE exposure.     

QALYs versus WTP.

Quality adjusted life years (QALYs) and willingness to pay (WTP) are alternative measures of the value of reductions in health risk that are often used in evaluating environmental, health, and safety practices. Although both methods are based on individual preferences, the underlying assumptions differ. The different bases yield systematically different conclusions about the relative value of reducing health and mortality risks to individuals that differ in age, preexisting health conditions, income, and other factors. The choice of which method to use depends on judgments about what constraints should be placed on individual preferences and what factors should be considered in aggregating preferences across people.     

Stalking perpetrators and psychological maltreatment of partners: anger-jealousy, attachment insecurity, need for control, and break-up context

Two studies of the correlates of self-reported courtship persistence, stalking-like behaviors following a relationship break-up, and psychological maltreatment of partners were conducted in samples of male (N = 46 and 93) and female (N = 123 and 110) college students. Approximately 40% (38.5% and 44.6%) engaged in at least one stalking behavior following a break-up. A total of 10.7% (study 1) and 7.6% (study 2) engaged in 6 or more stalking behaviors. Stalking was significantly related to psychological maltreatment of the partner (PMP) prior to the break-up. Being the recipient of the breakup was associated with feelings of anger, jealousy and obsessiveness and with higher levels of courtship persistence, and stalking. A replicated path model showed that anxious attachment and need for control were related to PMP and that need for control had a direct contribution to stalking. For anxious attachment, its connection to stalking was indirect, mediated by the degree of anger-jealousy over the break-up.     

Research on stalking: what do we know and where do we go?

Findings of the article in this two-volume series on stalking are reviewed. Building on the findings of the National Violence Against Women Survey (Tjaden & Thoennes, 1998), this series of studies adds to the literature in defining and measuring stalking behaviors. Repeated stalking victimization is reported by up to 62% of young adults, although frequencies depend on the sample and the precise definition used. Self-definitions of stalking victimization may be quite different from legal definitions. Although the majority of legally defined stalkers (where victim fear is a key component) are men stalking women, studies utilizing other definitions find many more women as stalkers, with no significant gender differences in many studies. In many cases, it does appear that stalking is one part of a larger pattern of relationship physical and psychological abuse. Data on emotional reactions and coping strategies of victims are also reviewed, along with findings on characteristics of stalkers.     

Wife killing: risk to women as a function of age

Younger women, relative to older women, incur elevated risk of uxoricide-being murdered by their husbands. Some evolutionary theorists attribute this pattern to men's evolved sexual proprietariness, which inclines them to use violence to control women, especially those high in reproductive value. Other evolutionary theorists propose an evolved homicide module for wife killing. An alternative to both explanations is that young women experience elevated uxoricide risk as an incidental byproduct of marriage to younger men who commit the majority of acts of violence. We used a sample of 13,670 uxoricides to test these alternative explanations. Findings show that (a) reproductive-age women incur an elevated risk of uxoricide relative to older women; (b) younger men are overrepresented among uxoricide perpetrators; and (c) younger women, even when married to older men, still incur excess risk of uxoricide. Discussion examines competing explanations for uxoricide in light of these findings.     

Psychiatric hospitalization and process description: what will nursing add?

1. Inpatient treatment programs operating in the managed care environment must clearly articulate their treatment outcomes and the processes of care that are connected to these outcomes. 2. The work of inpatient psychiatric nurses can be organized and articulated through the therapeutic processes of the Four S Model: Safety, Structure, Support, and Symptom Management. 3. Nurses are vital contributors to the inpatient treatment process, but will be marginalized if they are unable to articulate how their interventions contribute to the positive treatment outcomes.     

A campus-community coalition to control alcohol-related problems off campus: an environmental management case study

The authors report on the effects of a university and community coalition in preventing problems related to college students' off-campus drinking. The Albany, New York, Committee on University and Community Relations used strategies based on an environmental-management approach that focuses on changing the environment in which individuals make decisions about alcohol consumption and related behaviors. Committee initiatives included improving enforcement of local laws and ordinances, creating a safety-awareness campaign for off-campus students, and developing a comprehensive advertising and beverage-service agreement with local tavern owners. The initiatives were associated with a decline in the number of alcohol-related problems in the community, as indicated by decreases in the number of off-campus noise ordinance reports filed by police and the number of calls to a university-maintained hotline for reporting off-campus problems. An environmental management approach, the authors suggest, has promise as an effective means of preventing alcohol-related problems among college students.     

The ideal physician entrepreneur

How does the sometimes elusive and high-stakes world of venture capital really work? How can physician executives with innovative ideas or new technologies approach venture capitalists to help them raise capital to form a start-up company? These important questions are explored in this new column on the physician as entrepreneur. The ideal physician executive is described as: (1) an expert in an area that Wall Street perceives as hot; (2) a public speaker who can enthusiastically communicate scientific and business plans to a variety of audiences; (3) a team leader who is willing to share equity in the company with other employees; (4) a recruiter and a motivator; (5) an implementer who can achieve milestones quickly that allow the company to go public as soon as possible; and (6) a realist who does not resent the terms of the typical deal. The lucrative world of the venture capitalists is foreign territory for physician executives and requires a great idea, charisma, risk-taking, connections, patience, and perseverance to navigate it successfully.