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"Holmes, Mark"
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Transportation Barriers to Health Care in the United States: Findings From the National Health Interview Survey, 1997–2017
Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations. Methods. We used data from the National Health Interview Survey (1997–2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017. Results. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics. Conclusions. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology.
Journal Article
Impacts of Employee Empowerment and Organizational Commitment on Workforce Sustainability
Building and maintaining a sustainable workforce in the hospitality sector, where demand for talent consistently exceeds supply across the globe, has only been exacerbated by COVID-19. The need to sustain this workforce behooves the industry to unpack core drivers of employee commitment in order to retain top talent. This paper explores how dimensions of employee empowerment increase organizational commitment and, in turn, reduce turnover intention—leading to a more sustained workforce. Drawing on the results of 346 surveys within the Canadian lodging industry, structural equation modeling was undertaken to examine the influence of empowerment on organizational commitment and organizational commitments influence on turnover intention. Findings suggest that the development of meaning through employee empowerment, particularly when the ideals and standards between workers and their organization are aligned, creates a strong emotional commitment which appears to strongly reduce an employee’s intention to leave. Feelings of emotional connection or duty towards an organization show clear positive relationships with reduced intentions to leave. For an industry struggling with higher-than-average turnover intention and labour costs, focusing on creating work with meaning, and instilling a sense of belonging in the workforce will enable organizations to reduce their employee’s turnover intentions.
Journal Article
How to grill everything : simple recipes for great flame-cooked food
Here's how to grill absolutely everything-- from the perfect steak to cedar-plank salmon to pizza-- explained in Bittman's straightforward style. With practical advice on all the grilling basics, this book is an exploration of the grill's nearly endless possibilities. Discover just how simple-- and versatile-- grilling can be.
Book
Emergence of methicillin resistance predates the clinical use of antibiotics
The discovery of antibiotics more than 80 years ago has led to considerable improvements in human and animal health. Although antibiotic resistance in environmental bacteria is ancient, resistance in human pathogens is thought to be a modern phenomenon that is driven by the clinical use of antibiotics
1
. Here we show that particular lineages of methicillin-resistant
Staphylococcus aureus
—a notorious human pathogen—appeared in European hedgehogs in the pre-antibiotic era. Subsequently, these lineages spread within the local hedgehog populations and between hedgehogs and secondary hosts, including livestock and humans. We also demonstrate that the hedgehog dermatophyte
Trichophyton erinacei
produces two β-lactam antibiotics that provide a natural selective environment in which methicillin-resistant
S. aureus
isolates have an advantage over susceptible isolates. Together, these results suggest that methicillin resistance emerged in the pre-antibiotic era as a co-evolutionary adaptation of
S. aureus
to the colonization of dermatophyte-infected hedgehogs. The evolution of clinically relevant antibiotic-resistance genes in wild animals and the connectivity of natural, agricultural and human ecosystems demonstrate that the use of a One Health approach is critical for our understanding and management of antibiotic resistance, which is one of the biggest threats to global health, food security and development.
Methicillin-resistant strains of
Staphylococcus aureus
appeared in European hedgehogs in the pre-antibiotic era as a co-evolutionary adaptation to antibiotic-producing dermatophytes and have spread within the local hedgehog populations and between hedgehogs and secondary hosts.
Journal Article
Revenge
Murder. Former SAS soldier David Shelley was part of the most covert operations team in the special forces, along with the woman he went on to marry. Now settling down to civilian life in London, they have plans to set up a private security company and enjoy a safer and more stable existence. But the shocking death of a young woman Shelley once helped protect puts those plans on hold. Betrayal. The police rule the death a suicide but the grieving parents can't accept their beloved daughter would take her own life. They need to find out what really happened, and they turn to their former bodyguard, Shelley, for help. Revenge. When the parents discover that their daughter had fallen into a dark and seedy world of drugs and online pornography, the father demands retribution against those responsible. But his desire for revenge will make enemies of people that even Shelley may not be able to protect them from, and take them into a war from which there may be no escape.
Invariance properties for the error function used for multilinear regression
The connections between the error function used in multilinear regression and the expected, or assumed, properties of the data are investigated. It is shown that two of the most basic properties often required in data analysis, scale and rotational invariance, are incompatible. With this, it is established that multilinear regression using an error function derived from a geometric mean is both scale and reflectively invariant. The resulting error function is also shown to have the property that its minimizer, under certain conditions, is well approximated using the centroid of the error simplex. It is then applied to several multidimensional real world data sets, and compared to other regression methods.
Journal Article
Don't be afraid of the dark
Sally Hurst is going to Rhode Island to live with her father Alex and his new girlfriend Kim in the nineteenth-century mansion they are restoring. While exploring the estate, Sally finds a hidden basement and accidentally lets loose a race of ancient, dark-dwelling creatures who conspire to drag her down into the mysterious house's bottomless depths. Before the evil lurking in the dark consumes them all, Sally must convince Alex and Kim that it's not a fantasy.
DVD
Global emergence of a hypervirulent carbapenem-resistant Escherichia coli ST410 clone
Carbapenem-resistant
Escherichia coli
(CREC) ST410 has recently emerged as a major global health problem. Here, we report a shift in CREC prevalence in Chinese hospitals between 2017 and 2021 with ST410 becoming the most commonly isolated sequence type. Genomic analysis identifies a hypervirulent CREC ST410 clone, B5/H24RxC, which caused two separate outbreaks in a children’s hospital. It may have emerged from the previously characterised B4/H24RxC in 2006 and has been isolated in ten other countries from 2015 to 2021. Compared with B4/H24RxC, B5/H24RxC lacks the
bla
OXA-181
-bearing X3 plasmid, but carries a F-type plasmid containing
bla
NDM-5
. Most of B5/H24RxC also carry a high pathogenicity island and a novel O-antigen gene cluster. We find that B5/H24RxC grew faster in vitro and is more virulent in vivo. The identification of this newly emerged but already globally disseminated hypervirulent CREC clone, highlights the ongoing evolution of ST410 towards increased resistance and virulence.
In this work, the authors identified a hypervirulent carbapenem-resistant
Escherichia coli
ST410 clone which carries a high pathogenicity island and an O-antigen gene cluster. The findings highlight the ongoing evolution of ST410 towards increased resistance and virulence.
Journal Article