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.     

Hybrid Processing of Stochastic and Subjective Uncertainty Data

Uncertainty analyses typically recognize separate stochastic and subjective sources of uncertainty, but do not systematically combine the two, although a large amount of data used in analyses is partly stochastic and partly subjective. We have developed methodology for mathematically combining stochastic and subjective sources of data uncertainty, based on new "hybrid number" approaches. The methodology can be utilized in conjunction with various traditional techniques, such as PRA (probabilistic risk assessment) and risk analysis decision support. Hybrid numbers have been previously examined as a potential method to represent combinations of stochastic and subjective information, but mathematical processing has been impeded by the requirements inherent in the structure of the numbers, e.g., there was no known way to multiply hybrids. In this paper, we will demonstrate methods for calculating with hybrid numbers that avoid the difficulties. By formulating a hybrid number as a probability distribution that is only fuzzily known, or alternatively as a random distribution of fuzzy numbers, methods are demonstrated for the full suite of arithmetic operations, permitting complex mathematical calculations. It will be shown how information about relative subjectivity (the ratio of subjective to stochastic knowledge about a particular datum) can be incorporated. Techniques are also developed for conveying uncertainty information visually, so that the stochastic and subjective components of the uncertainty, as well as the ratio of knowledge about the two, are readily apparent. The techniques demonstrated have the capability to process uncertainty information for independent, uncorrelated data, and for some types of dependent and correlated data. Example applications are suggested, illustrative problems are shown, and graphical results are given.     

Rehabilitation outlooks for rural Louisiana: educational developments,economic trends,and global perspectives

The objective of this article is to examine current medical, economic, and social trends affecting the provision of rehabilitation services for rural citizens with disabilities. While the population of interest is citizens of Louisiana, the concepts are applicable across all geographic boundaries. The article is a review of clinical practice, job placement alternatives, economic trends, and assessment of process applications. It is concluded numerous steps may be taken to enhance the availability and quality of services provided for rural citizens with disabilities: greater statistical inquiry into rural disability trends, increased incorporation of the Internet into all aspects of rural economic and educational developments, further development of distance learning, promotion of sensitivities towards rural cultures, and continued recruitment of rural allied and vocational rehabilitation professionals.     

How useful is the term "Cumulative Trauma Disorder"?

Cumulative trauma disorder is a widely accepted construct that refers to illnesses of the soft tissues which supposedly occur due to biomechanical workplace risk factors. However, is the term "cumulative trauma disorder" a useful term for describing the illness attributed to it? This paper will scrutinize this question by specifying the meaning of "cumulative trauma disorder" and examining this construct to see if the belief in it is justified, and if this belief is leading to the elucidation of the phenomenon it is purporting to notate. Anomalous findings will be identified and used to help evaluate the accuracy of the belief system currently surrounding the term. Finally the ability of the construct "cumulative trauma disorder" to provide an adequate foundation for research in this area will be explored. A model of alternate pathomechanisms for this illness is advanced to provide a method of studying the disorders associated with the term.     

Resources and strategies of interest groups and industry representatives involved in federal forest policy

This study analyzes the resources and strategies of public interest groups and industry representatives involved in federal forest policy in the state of Oregon during the early 1990s. While many studies have examined the role of interest groups in the policy process, few have compared empirically the resources available and strategies pursued by industry representatives and public interest groups in a particular policy domain. Utilizing survey data from 133 business representatives and 326 public interest groups involved in federal forest policy, the study argues that public interest group influence derives primarily from the ability to mobilize human resources; the financial resources of these groups tend to be modest. Industry and industry-supported groups, in contrast, possess considerable financial power while enjoying less support from the public. Consequently, industry interests tend to focus their efforts on more traditional forms of influence such as the persistent lobbying of natural resource agencies and elected officials. Public interest groups, in contrast, tend to devote considerable efforts to building public support in urban core areas to build the capacity to pressure governmental decision-makers.     

THE FAMILY FIRO MODEL: A MODEST PROPOSAL FOR ORGANIZING FAMILY TREATMENT

This paper presents a model for organizing family issues and family treatment. Schutz's FIRO model is offered as a framework for organizing family issues into inclusion, control and affection categories. Following Schutz's theory of group development, we propose that inclusion, control and affection constitute a logical hierarchy of core issues to be dealt with in treating multiproblem families-inclusion first, then control, and then affection (intimacy). Furthermore, we propose that the FIRO model can be used to organize theories of family therapy. We attempt to demonstrate that different family therapies are best suited for one of the three core issues of family interaction. We advocate an "intelligent eclecticism" based on the premise that when an issue is appropriately matched with a therapy, therapeutic effectiveness should be enhanced. We also discuss implications of our Family FIRO model for clinical practice.     

Family member response to violent infant kidnapping

All family members interviewed suffered from chronic posttraumatic stress disorder 5 or more years after an infant kidnapping. Psychiatric nurses should routinely assess for secondary victimization related to any type of traumatic stressor. Nurses should refer parents and families to materials available from the National Center for Missing and Exploited Children (NCMEC) (http://www.missingkids.com/).     

Demographic and situational factors affecting injury, resistance, completion, and charges brought in sexual assault cases: what is best for arrest?

This study examines demographic and situational factors in an effort to predict whether or not a complainant was injured, used resistance, experienced a completed assault, and whether charges were brought against the offender. If the accused had consumed alcohol or drugs, he was almost seven times more likely to be arrested. The complainant was six times more likely to report rape completion if she had consumed alcohol or drugs and if the complainant fell unconscious at any time during the attack she was significantly less likely to use a resistance strategy. The complainant's use of a compliance strategy at any time during the assault positively predicted not using a physical resistance strategy and sexual assault completion. The reporting of injury positively predicted use a physical resistance strategy and sexual assault completion. If the assault was completed, it was less likely that charges were pressed. Implications of these findings are discussed, and directions for future research are offered.