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Presents information on a study designed to demonstrate how the energy mix consumed in the United States could be chosen given a national goal to reduce the risks to the domestic macroeconomy of unanticipated energy price shocks. Methodology used on the study; Estimation and results; Policy recommendations.

Background: In 2007 new World Health Organization (WHO) growth references for children aged 5-19 y were introduced to replace the National Center for Health Statistics (NCHS) references., Objective: This study aimed to compare the prevalence of stunting, wasting, and thinness estimated by the NCHS and WHO growth references., Design: NCHS and WHO height-for-age z scores were calculated with the use of cross-sectional data from 20,605 schoolchildren aged 5-17 y in 11 low-income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. The z scores of body mass index-for-age and weight-for-height were calculated with the use of the WHO and NCHS references, respectively, to compare differences in the prevalence of thinness and wasting., Results: No systematic differences in mean z scores of height-for-age were observed between the WHO and NCHS growth references. However, z scores of height-for-age varied by sex and age, particularly during early adolescence. In children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys., Conclusions: In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with results shown when the NCHS references are used as well as a higher estimated prevalence of thinness than of wasting. An awareness of these differences is important for comparative studies or the evaluation of programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when such studies are undertaken.

Purpose of Review: Healthcare-associated or nosocomial infection (HCAI) is of increasing importance to healthcare providers and the public. Surveillance is crucial but must be adjusted for risk, especially when used for interhospital comparisons or for public reporting., Recent Findings: Surveillance data are increasingly adjusted for risk factors for HCAI if meaningful comparisons are made between institutions or across national boundaries. Postdischarge surveillance is important in detecting those infections that may not present to the institution in which the original procedure occurred. Caution is urged when comparing data from two sources, for example, an active surveillance program and administrative datasets. The public reporting of HCAI rates can assist in improving the quality of healthcare, but to date there is little evidence that this is happening. In the United States, a number of states have introduced mandatory reporting of HCAIs, but there is considerable variation in what data are released, how these are reported and the rigor of the validation of the dataset., Summary: The consumerization of healthcare requires a response from healthcare providers to engage with the public on how, when and what risk-adjusted surveillance data to release. Information campaigns are required to ensure the public understand any publicly released data and its limitations.

The incidence of infection in the intensive care unit (ICU) is one of the highest in the hospital and yet facilities to prevent infection are often inadequate in this important clinical area. Many antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA), Serratia marcescens and vancomycin-resistant enterococci (VRE), may survive and persist in the environment leading to recurrent outbreaks. A number of professional and scientific bodies in the UK, the USA and Europe have published guidelines on the design and layout of ICUs. All emphasize the importance of adequate isolation facilities (at least one cubicle for every six beds), sufficient space around each bed (20 m2), wash hand basins between every other bed, ventilation including positive and negative pressure ventilation for high risk patients and sufficient storage and utility space. Common sense and considerations of safety and comfort should guide decisions on floors, walls etc. Appropriate cleaning and disinfection programmes are essential to render the ICU relatively pathogen free and compliance with handwashing is imperative in minimizing infection in this high-risk area. Infection control teams should support ICU personnel in their efforts to upgrade facilities and help ensure that this is a priority when resources are limited.

Methicillin-resistant Staphylococcus aureus (MRSA) remains an important nosocomial pathogen and the number of affected patients is rising. Increasing numbers of patients at risk of acquisition, inadequate isolation facilities, problems in identifying the source of outbreaks and the perception amongst some clinical colleagues that control measures are too disruptive have contributed to the problems faced by infection control teams. Recent controlled studies indicate that MRSA is no less virulent than sensitive strains and emphasize the continuing need for control measures even where MRSA is endemic. Efforts to control spread should be targeted to key clinical areas, such as intensive care units, where the impact of infection is likely to be greatest, whilst general infection control measures should be strengthened throughout the hospital.