Prescott H.C.,United Road Services |
Prescott H.C.,University of Michigan
Annals of the American Thoracic Society | Year: 2017
Rationale: Rehospitalization is common after sepsis, but little is known about the variation in readmission patterns across patient groups and care locations. Objectives: To examine the variation in postsepsis readmission rates and diagnoses by patient age, nursing facility use, admission year, and hospital among U.S. Veterans Affairs (VA) beneficiaries. Methods: Observational cohort study of VA beneficiaries who survived a sepsis hospitalization (2009-2011) at 114 VA hospitals, stratified by age (,65 vs. >65 yr), nursing home usage (none, chronic, or acute), year of admission (2009, 2010, 2011), and hospital. In the primary analysis, sepsis hospitalizations were identified using a previously validated method. Sensitivity analyses were performed using alternative definitions with explicit International Classification of Diseases, Ninth Revision, Clinical Modification, codes for sepsis, and separately for severe sepsis and septic shock. Measurements and Main Results: The primary outcomes were rate of 90-day all-cause hospital readmission after sepsis hospitalization and proportion of readmissions resulting from specific diagnoses, including the proportion of "potentially preventable" readmissions. Readmission diagnoseswere similar from2009 to 2011, with little variation in readmission rates across hospitals. The top six readmission diagnoses (heart failure, pneumonia, sepsis, urinary tract infection, acute renal failure, and chronic obstructive pulmonary disease) accounted for 30% of all readmissions. Although about one in five readmissions had a principal diagnosis for infection, 58% of all readmissions received early systemic antibiotics. Infection accounted for a greater proportion of readmissions among patients discharged to nursing facilities compared with patients discharged to home (25.0-27.1% vs. 16.8%) and among older vs. younger patients (22.2%vs.15.8%).Potentially preventable readmissions accounted foraquarterof readmissionsoverallandweremorecommonamongolder patients and patients discharged to nursing facilities. Conclusions: Hospital readmission rates after sepsis were similar by site and admission year. Heart failure, pneumonia, sepsis, and urinary tract infection were common readmission diagnoses across all patient groups. Readmission for infection and potentially preventable diagnoses were more common in older patients and patients discharged to nursing facilities. © Copyright 2017 by the American Thoracic Society.
News Article | November 24, 2016
DETROIT, MI--(Marketwired - November 24, 2016) - The Michigan job market is revitalized and thousands of employers are hiring in Metro Detroit cities. Join us at the Wayne County Job Revival meet with over 50 employers ready to hire top notch candidates on Wednesday, November 30, 2016 at the Sheraton Hotel in Romulus, Michigan. JobFairGiant.com, producer of Detroit Job Revival has partnered with Sion Recruitment and GetHiredinDetroit.com to connect area employers with experienced candidates, veterans, interns, blue-collar workers, college graduates and entry-level job seekers. Hiring employers included the following: Goodman Manufacturing/Daikin, Quicken Loans, Formel D, Metro Machine Works Inc, MacDermott Roofing, Eby-Brown, World Duty Free / Hudson Group, Compact Power Equipment, Impact Management, ASIG, Universal Truckload, Executive Car Rental, Global Information Technology, AT&T / DIRECTV Installation, International Trucking School, New Horizon Computer Learning, Sion Recruitment, Michigan State Police, Michigan Department of Corrections, Michigan Civil Service Commission, Midwest Mobility Services, Trinity Services Group, U.S. Army Recruiting, Goodman Networks, PSCU, Securitas Security USA, IMPACT Management, Indian Trails, Walgreens, United Road Services, Colonial Life, Datamatics Global Services, Village Green, Trinity Transportation, Arrow Strategies, Life Center, Maratha T. Berry Medical Care Facility, Foundation Systems of Michigan, Rainbow Rehabilitation Center, Sweetland Transport, Advanced Staffing Solutions, Workbox Staffing, MPS Group, Advanced Home Care, NITS Solutions, Tri-County Breast Cervical Cancer Control Program, NAPA Auto Parts, Paradies Lagardere. And many other companies... Targeted career fields: Engineering, Information Technology, Skilled Trades, Manufacturing, Blue-collar Labor, Production, Industrial, General Labor, Customer Services, Retail, Management, Restaurant, Accounting, Banking, Office Support, Clerical, Seasonal, Holiday Jobs, Data Entry, Call Center, Installation, Technical, Machining, Electrical, Mortgage, Financial Planning, Insurance, Education, Truck Driving, Real Estate, Nursing, Rehabilitation, Human Services, and other career fields. Candidates should prepare to interview with recruiters onsite, bring 50 resume copies and dress for success. The Wayne County Job Revival is "free" for all job seekers to attend, bring plenty of resumes and dress for success. Several job workshops will take place throughout the day for job seekers that need assistance finding jobs. For information visit our website at www.detroitjobrevival.com Workshops Include: 10:15 AM - 10:30 AM, How To Get The Job You Want, Even When No One's Hiring 2:00 PM - 2:15 PM, How To Discover Transferable Job Skills 2:15 PM - 2:30 PM, Mystery Shopping the New Part-time Career.
Song G.-L.,General Motors |
Xu Z.,United Road Services
Corrosion Science | Year: 2012
In this study, scanning Kelvin probe, in situ scanning vibrating electrode technique and micro-electrochemical electrolyte cell are employed to investigate the corrosion of polycrystalline pure Mg. It is found that differently oriented Mg grains have different electrochemical activities and corrosion behavior. The grain with a basal orientation is more stable and corrosion resistant, exhibiting a more positive corrosion potential, lower anodic polarization current density, larger impedance, and thinner surface film than the grain with a non-basal orientation. A corrosion model is proposed to explain the differences in electrochemical corrosion performance between these grains. © 2012 Elsevier Ltd.
Kirsh K.,United Road Services
Journal of pain & palliative care pharmacotherapy | Year: 2012
Prescription opioids are prescribed increasingly for the management of chronic pain, and this has been accompanied by a dramatic rise in opioid-related abuse, addiction, and overdose deaths. Reports of abuse involving nonoral administration (e.g., snorting, injecting) of prescription opioids are increasing, although the epidemiology of oral versus nonoral abuse is not well understood. Available data indicate that oral abuse is far more common,with 72% to 97% of opioid abusers perferring oral administration. Factors associated with nonoral administration include longer duration of opioid abuse, male gender, and rural setting. Extended-release opioids, because of their relatively high drug load, may be attractive to experienced abusers seeking to manipulate the formulation to facilitate a rapid onset of effect. Putative abuse-deterrent formulations have been developed to decrease the likelihood or consequences of nonoral abuse. In addition, Risk Evaluation and Mitigation Strategies (REMS) are now required for prescribed extended-release/long-acting opioids by the US Food and Drug Administration, although their effectiveness in reducing the risk of abuse, addiction, and overdose has not been evaluated. Physicians should remain vigilant when prescribing opioids and should exercise appropriate patient selection, perform risk analysis and stratification, and maintain continuous patient monitoring to ensure the benefits outweigh these important risks.
Williams W.W.,United Road Services
MMWR. Morbidity and mortality weekly report | Year: 2012
In the United States, annual influenza epidemics typically occur during the late fall through early spring. During these epidemics, rates of serious illness and death are highest among adults aged ≥65 years, children aged <2 years, and persons of any age who have medical conditions that increase their risk for complications from influenza. Adults aged 50-64 years who have underlying medical conditions have a substantially increased risk for hospitalization during the influenza season. Influenza illness among healthy adults aged 18-64 years typically is not as severe as the illness among adults aged ≥65 years, pregnant women, or persons with chronic medical conditions and less frequently results in hospitalization. However, influenza among healthy adults aged 18-49 years is an important cause of outpatient medical visits and worker absenteeism. An economic analysis estimated an annual average of approximately 5 million illnesses, 2.4 million outpatient visits, 32,000 hospitalizations, and 680 deaths from influenza among adults aged 18-49 years who did not have a medical condition that increased their risk for influenza complications. In this analysis, adults aged 18-49 years accounted for 10% of the total economic cost from influenza, or approximately $8.7 billion.
Watts N.B.,United Road Services
Endocrine Practice | Year: 2013
Objective: To review information pertinent to bone health and osteoporosis in men.Methods: A review of pertinent literature was conducted.Results: Osteoporosis affects approximately 2 million men in the US and accounts for an estimated 600,000 fractures each year. There are significant differences in skeletal size and structure between men and women that account for differences in fracture incidence, location, and outcomes. Bone density testing is appropriate for men age 70 and older and younger men (50-69) who have risk factors for osteoporosis. Lifestyle management, including adequate calcium and vitamin D intake, appropriate physical activity, and avoidance of tobacco and heavy alcohol use, is appropriate for all men. Pharmacologic therapy to reduce fracture risk is advisable for men with a clinical diagnosis of osteoporosis (a spine or hip fracture) or a T-score of -2.5 or below in the spine, femoral neck, total hip or 1/3 radius; however, the majority of men at high risk will only be identified using a fracture risk assessment tool, such as FRAX. Alendronate, risedronate, zoledronic acid, denosumab, and teriparatide are Food and Drug Administration (FDA)-approved therapeutic options.Conclusions: Osteoporosis in men presents an important public health problem with significant morbidity and mortality. There are recommended strategies for identifying men at high risk of fracture, and effective agents are available for treatment. © 2013 AACE.
Elder R.W.,United Road Services
American Journal of Preventive Medicine | Year: 2012
The Community Preventive Services Task Force recommends person-to-person interventions intended to modify adolescents' risk and protective behaviors by improving their caregivers' parenting skills, on the basis of sufficient evidence of effectiveness in reducing adolescent risk behaviors. These interventions, conducted face-to-face or by telephone, occur outside of clinical settings.
Delany J.R.,United Road Services
MMWR. Surveillance summaries : Morbidity and mortality weekly report. Surveillance summaries / CDC | Year: 2011
These guidelines for biosafety laboratory competency outline the essential skills, knowledge, and abilities required for working with biologic agents at the three highest biosafety levels (BSLs) (levels 2, 3, and 4). The competencies are tiered to a worker's experience at three levels: entry level, midlevel (experienced), and senior level (supervisory or managerial positions). These guidelines were developed on behalf of CDC and the Association of Public Health Laboratories (APHL) by an expert panel comprising 27 experts representing state and federal public health laboratories, private sector clinical and research laboratories, and academic centers. They were then reviewed by approximately 300 practitioners representing the relevant fields. The guidelines are intended for laboratorians working with hazardous biologic agents, obtained from either samples or specimens that are maintained and manipulated in clinical, environmental, public health, academic, and research laboratories.
Edwards T.A.,United Road Services
Veterinary Clinics of North America - Food Animal Practice | Year: 2010
Vaccines and antibiotics are still relied upon as the standard methods of bovine respiratory disease (BRD) prevention, control, and therapy. Success in building disease resistance begins with genetic selection and continues with colostrum management and reducing pathogen exposure. Purchasing single-source cattle with a history of pre- and post-weaning procedures will minimize pathogen exposure and enhance immunity. Using cattle-handling techniques and facilities that promote low stress will allow host immune defenses to remain effective against bacterial and viral colonization. Lastly, controlling BRD must be managed through a comprehensive herd health immunization and management program that effectively addresses disease challenges common to the operation. © 2010 Elsevier Inc.
Watts N.B.,United Road Services
Nature Reviews Endocrinology | Year: 2014
GLOW is an observational, longitudinal, practice-based cohort study of osteoporosis in 60,393 women aged ‰ 55 years in 10 countries on three continents. In this Review, we present insights from the first 3 years of the study. Despite cost analyses being frequently based on spine and hip fractures, we found that nonvertebral, nonhip fractures were around five times more common and doubled the use of health-care resources compared with hip and spine fractures combined. Fractures not at the four so-called major sites in FRAX ® (upper arm, forearm, hip and clinical vertebral fractures) account for >40% of all fractures. The risk of fracture is increased by various comorbidities, such as Parkinson disease, multiple sclerosis and lung and heart disease. Obesity, although thought to be protective against all fractures, substantially increased the risk of fractures in the ankle or lower leg. Simple assessment by age plus fracture history has good predictive value for all fractures, but risk profiles differ for first and subsequent fractures. Fractures diminish quality of life as much or more than diabetes mellitus, arthritis and lung disease, yet women substantially underestimate their own fracture risk. Treatment rates in patients at high risk of fracture are below those recommended but might be too frequent in women at low risk. Comorbidities and the limits of current therapeutic regimens jeopardize the efficacy of drugs; new regimens should be explored for severe cases. © 2014 Macmillan Publishers Limited.