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Tal Jasper R.,Tel Aviv University | Coyle J.R.,Bureau of Disease Control | Katz D.E.,Shaare Zedek Medical Center | Marchaim D.,Tel Aviv University | Marchaim D.,Assaf Harofeh Medical Center
Future Microbiology | Year: 2015

Antimicrobial resistance is a growing worldwide iatrogenic complication of modern medical care. Extended-spectrum β-lactamases have emerged as one of the most successful resistance mechanisms, limiting our therapeutic options to treat various human infections. The dissemination of these enzymes to the community probably signifies an irreversible step. This paper will review the evolution of human infections associated with extended-spectrum β-lactamase-producing organisms in the past 20 years, and will present and discuss the current challenges, controversies, debates and knowledge gaps in this research field. © 2015 Future Medicine Ltd. Source


Sacks J.J.,Sue Binder Consulting Inc. | Roeber J.,Substance Abuse Epidemiology Section | Bouchery E.E.,Mathematica Policy Research | Gonzales K.,Bureau of Disease Control | And 2 more authors.
American Journal of Preventive Medicine | Year: 2013

Background: Excessive alcohol consumption is responsible for an average of 80,000 deaths in the U.S. each year and cost $223.5 billion ($1.90/drink) in 2006. Comparable state estimates of this cost are needed to help inform prevention strategies. Purpose: The goal of the study was to estimate the economic cost of excessive drinking by state for 2006. Methods: From December 2011 to November 2012, an expert panel developed methods to allocate component costs from the 2006 national estimate to states for (1) total; (2) government; (3) binge drinking; and (4) underage drinking costs. Differences in average state wages were used to adjust productivity losses. Results: In 2006, the median state cost of excessive drinking was $2.9 billion (range: $31.9 billion [California] to $419.6 million [North Dakota]); the median cost per drink, $1.91 (range: $2.74 [Utah] to $0.88 [New Hampshire]); and the median per capita cost, $703 (range: $1662 [District of Columbia] to $578 [Utah]). A median of 42% of state costs were paid by government (range: 45.0% [Utah] to 37.0% [Mississippi]). Binge drinking was responsible for a median of 76.6% of state costs (range: 83.1% [Louisiana] to 71.6% [Massachusetts]); underage drinking, a median of 11.2% of state costs (range: 20.0% [Wyoming] to 5.5% [District of Columbia]). Conclusions: Excessive drinking cost states a median of $2.9 billion in 2006. Most of the costs were due to binge drinking and about $2 of every $5 were paid by government. The Guide to Community Preventive Services has recommended several evidence-based strategies - including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability - that can help reduce excessive alcohol use and the associated economic costs. © 2013 American Journal of Preventive Medicine. All rights reserved. Source


Sacks J.J.,Sue Binder Consulting Inc. | Gonzales K.R.,Bureau of Disease Control | Bouchery E.E.,Mathematica Policy ResearchWashington | Tomedi L.E.,Substance Abuse Epidemiology Section | Brewer R.D.,National Center for Chronic Disease Prevention and Health Promotion
American Journal of Preventive Medicine | Year: 2015

Introduction Excessive alcohol use cost the U.S. $223.5 billion in 2006. Given economic shifts in the U.S. since 2006, more-current estimates are needed to help inform the planning of prevention strategies. Methods From March 2012 to March 2014, the 26 cost components used to assess the cost of excessive drinking in 2006 were projected to 2010 based on incidence (e.g., change in number of alcohol-attributable deaths) and price (e.g., inflation rate in cost of medical care). The total cost, cost to government, and costs for binge drinking, underage drinking, and drinking while pregnant were estimated for the U.S. for 2010 and allocated to states. Results Excessive drinking cost the U.S. $249.0 billion in 2010, or about $2.05 per drink. Government paid for $100.7 billion (40.4%) of these costs. Binge drinking accounted for $191.1 billion (76.7%) of costs; underage drinking $24.3 billion (9.7%) of costs; and drinking while pregnant $5.5 billion (2.2%) of costs. The median cost per state was $3.5 billion. Binge drinking was responsible for >70% of these costs in all states, and >40% of the binge drinking-related costs were paid by government. Conclusions Excessive drinking cost the nation almost $250 billion in 2010. Two of every $5 of the total cost was paid by government, and three quarters of the costs were due to binge drinking. Several evidence-based strategies can help reduce excessive drinking and related costs, including increasing alcohol excise taxes, limiting alcohol outlet density, and commercial host liability. © 2015 American Journal of Preventive Medicine. Source


Largo T.W.,Bureau of Disease Control | Rosenman K.D.,Michigan State University
Occupational and Environmental Medicine | Year: 2015

Objectives An amputation is one of the most serious injuries an employee can sustain and may result in lost time from work and permanent limitations that restrict future activity. A multidata source system has been shown to identify twice as many acute traumatic fatalities as one relying only on employer reporting. This study demonstrates the value of a multidata source approach for non-fatal occupational injuries. Methods Data were abstracted from medical records of patients treated for work-related amputations at Michigan hospitals and emergency departments and were linked to workers' compensation claims data. Safety inspections were conducted by the Michigan Occupational Safety and Health Administration for selected cases. Results From 2006 through 2012, 4140 Michigan residents had a work-related amputation. In contrast, the Survey of Occupational Injury and Illness conducted by the Bureau of Labor Statistics (BLS) estimated that there were 1770 cases during this period. During the 7-year period, work-related amputation rates decreased by 26%. The work-related amputation rate for men was more than six times that for women. Industries with the highest workrelated amputation rates were Wood Product Manufacturing and Paper Manufacturing. Power saws and presses were the leading causes of injury. One hundred and seventy-three safety inspections were conducted as a result of referrals from the system. These inspections identified 1566 violations and assessed $652 755 in penalties. Conclusions The system was fairly simple to maintain, identified more than twice as many cases than either BLS or workers' compensation alone, and was useful for initiating inspection of high-risk worksites. Source


Largo T.,Bureau of Disease Control | Rosenman K.,Michigan State University
Journal of Occupational and Environmental Medicine | Year: 2013

BACKGROUND:: Michigan's work-related amputation surveillance system quantifies and characterizes occupational amputations and facilitates remediation of workplace hazards. OBJECTIVE:: To identify and mitigate the hazards that cause amputations, to facilitate workplace investigations, and, ultimately, to significantly reduce the incidence of serious injury. METHODS:: Data were abstracted from medical records of patients treated for work-related amputations at Michigan hospitals in 2008 and linked to workers' compensation claims data. Incidents occurring at specific high-risk industries were referred to the Michigan Occupational Safety and Health Administration for potential worksite inspection. RESULTS:: A total of 616 Michigan residents sustained a work-related amputation (13.6/100,000 workers). Rates were highest for men, workers aged 20 to 24 years, and those in paper and wood product manufacturing. The Michigan Occupational Safety and Health Administration conducted 39 enforcement inspections in response to specific amputations. CONCLUSIONS:: The surveillance system identified more than twice the number of work-related amputations as estimated by the Bureau of Labor Statistics (N = 250) in 2008 and was the impetus for many worksite inspections that otherwise may not have occurred. Copyright © 2013 Lippincott Williams & Wilkins. Source

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