Implementation of a severe sepsis bundle using a quality improvement feedback to modify physician behavior in the emergency department setting was feasible and was associated with decreased in-hospital mortality.

There exists a wide spectrum of injuries from snowboarding, ranging from common extremity injuries to potentially life-threatening nonorthopedic trauma.

By their own report, EMS providers encounter a substantial amount of violence and injury due to assault on the job. Formal training and protocols to provide a standardized safe approach for such encounters are lacking. Although the limitations of survey data are recognized, further research characterizing the level of violence and potential interventions seems warranted.

Emergency medical services providers in some areas are at substantial risk for encountering violence in the prehospital setting. Certain situational factors may be used to predict the risk of encountering violence. Training, protocols, and protective gear for dealing with violent situations should be encouraged for all prehospital personnel.

Effects of a diet high in fat on body weight, adiposity, and energy expenditure were investigated. Male rats were fed 8% (control) or 50% fat (by weight) for 6 mo. The high-fat group increased body weight (+26%), adipocyte size (+61%), and adipocyte number (+48%). However, food intake and resting oxygen consumption, although higher in absolute amount, were normal in that both were commensurate with the greater body mass the rats maintained. When body weight and adipocyte size were reduced by caloric restriction, the high-fat group displayed the same adaptive adjustments in resting oxygen consumption as controls. We conclude that rats fed high-fat diets for prolonged periods 1) have energy intakes and expenditures appropriate for the greater tissue mass and adipocyte number they maintain, and 2) show adaptive reductions in energy expenditure when food is restricted, which provide further evidence that the regulated level of body weight can be altered by such diets.

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