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The article presents a discussion on the problem of obesity in young children in the United States. The epidemic of childhood obesity in the United States is the critical health issue of this decade. Childhood obesity is now prevalent among infants, toddlers, and preschoolers. Early childhood educators and families need to address this issue in the classroom and at home. The dramatic increase in obesity among children in the United States parallels the increase in adult obesity. In adults, overweight and obese are defined by body mass index (BMI), a measure of weight for height. In children, BMI should be calculated yearly by a health care provider to identify children who are gaining excessive weight compared to their growth in height. Childhood obesity increases the chances that children will suffer health risks commonly seen in obese adults. These risks include high blood pressure; elevated cholesterol levels; increased heart rate; joint and skeletal abnormalities including osteoarthritis; insulin and others. It also causes significant negative effects on physical, orthopedic, and skeletal health. INSET: Healthy Snacks and Meals at the Center..

Examines the impact of Sesame Street on the academic skills and social behavior of preschool children based on 30 years of research in the United States. Influence of Sesame Street on school readiness; Process of creating Sesame Street co-productions in countries other than the US; Modeling of the children on the cooperative behavior presented in the series.

Examines the difference between permanent and transitory residence in nursing homes in the United States. Relationship between the length of a patient's stay and the availability of informal help in the community; Long stays and short stays in nursing homes; Effects of family helpers and living arrangements on the risk of long nursing home stays.

Examines the extent to which the characteristics of caregivers or recipients determine the probability that caregivers stop being caregivers. Caregiving in the United States; Information on National Long-Term Care Survey; Specification of determinants of caregiver attrition; Estimation of the characteristics of both caregivers and recipients which affect the probability of caregivers quit; Findings of the study and its implications for public policy.

Background & Aims: Gastrointestinal (GI) diseases account for substantial morbidity, mortality, and cost. Statistical analyses of the most recent data are necessary to guide GI research, education, and clinical practice. We estimate the burden of GI disease in the United States. Methods: We collected information on the epidemiology of GI diseases (including cancers) and symptoms, along with data on resource utilization, quality of life, impairments to work and activity, morbidity, and mortality. These data were obtained from the National Ambulatory Medical Care Survey; National Health and Wellness Survey; Nationwide Inpatient Sample; Surveillance, Epidemiology, and End Results Program; National Vital Statistics System; Thompson Reuters MarketScan; Medicare; Medicaid; and the Clinical Outcomes Research Initiative''s National Endoscopic Database. We estimated endoscopic use and costs and examined trends in endoscopic procedure. Results: Abdominal pain was the most common GI symptom that prompted a clinic visit (15.9 million visits). Gastroesophageal reflux was the most common GI diagnosis (8.9 million visits). Hospitalizations and mortality from Clostridium difficile infection have doubled in the last 10 years. Acute pancreatitis was the most common reason for hospitalization (274,119 discharges). Colorectal cancer accounted for more than half of all GI cancers and was the leading cause of GI-related mortality (52,394 deaths). There were 6.9 million upper, 11.5 million lower, and 228,000 biliary endoscopies performed in 2009. The total cost for outpatient GI endoscopy examinations was $32.4 billion. Conclusions: GI diseases are a source of substantial morbidity, mortality, and cost in the United States. [Copyright &y& Elsevier]

The female athlete triad (Triad) refers to the interrelationships among energy availability, menstrual function, and bone mineral density, which may have clinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. With proper nutrition, these same relationships promote robust health. Athletes are distributed along a spectrum between health and disease, and those at the pathological end may not exhibit all these clinical conditions simultaneously. Energy availability is defined as dietary energy intake minus exercise energy expenditure. Low energy availability appears to be the factor that impairs reproductive and skeletal health in the Triad, and it may be inadvertent, intentional, or psychopathological. Most effects appear to occur below an energy availability of 30 kcal.kg(-1) of fat-free mass per day. Restrictive eating behaviors practiced by girls and women in sports or physical activities that emphasize leanness are of special concern. For prevention and early intervention, education of athletes, parents, coaches, trainers, judges, and administrators is a priority. Athletes should be assessed for the Triad at the preparticipation physical and/or annual health screening exam, and whenever an athlete presents with any of the Triad's clinical conditions. Sport administrators should also consider rule changes to discourage unhealthy weight loss practices. A multidisciplinary treatment team should include a physician or other health-care professional, a registered dietitian, and, for athletes with eating disorders, a mental health practitioner. Additional valuable team members may include a certified athletic trainer, an exercise physiologist, and the athlete's coach, parents and other family members. The first aim of treatment for any Triad component is to increase energy availability by increasing energy intake and/or reducing exercise energy expenditure. Nutrition counseling and monitoring are sufficient interventions for many athletes, but eating disorders warrant psychotherapy. Athletes with eating disorders should be required to meet established criteria to continue exercising, and their training and competition may need to be modified. No pharmacological agent adequately restores bone loss or corrects metabolic abnormalities that impair health and performance in athletes with functional hypothalamic amenorrhea.

At a time when nurses identify educational opportunities as an essential element of the health-care work environment, becoming an on-site evaluator for the accreditation process of the Commission on Collegiate Nursing Education (CCNE) offers unique opportunities for professional development. Nurses who are on-site evaluators bring first-hand practice experience as well as knowledge of evolving health-care and organizational trends to the accreditation process. In return, they find positive learning experiences, acquire insight into academic nursing education, and develop enthusiasm for academic teaching-a winning combination in this era of national nursing faculty shortage. This article describes the CCNE's process for incorporating nurses from clinical practice into accreditation activities and discusses the potential benefit of the process to the CCNE, nurses, and academic nursing programs.

Academic, business, and government organizations are increasingly looking to distance education to meet workforce learning needs. This modality differs from classroom education, however, and simply transferring content from a traditional classroom to a distance learning application can result in poor outcomes. The Department of Veterans Affairs and the Uniformed Services University of the Health Sciences Graduate School of Nursing implemented a program preparing adult nurse practitioners solely through the medium of distance education, with no university "in-residence" requirement. Lessons learned from this success can prove useful to organizations that are planning distance education initiatives.

Experts in creative management recommend that managers routinely explore the practices of other disciplines to develop innovative strategies for their organizations. The author examines the provisions of the Sarbanes-Oxley Corporate Responsibility Act of 2002, designed to ensure sound corporate fiscal practices, and proposes a model using the same actions to radically transform the nursing work environment.