Procedural and shunt-related complications and mortality of the transjugular intrahepatic portosystemic shunt (TIPSS). 2015 63:743–752.īettinger D, Schultheiss M, Boettler T, Muljono M, Thimme R, Rössle M. Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. The MELD 3.0 was significantly superior to the MELD, MELD-Na and FIPS scores in predicting mortality in patients with cirrhosis after TIPS creation. The Child–Pugh score could stratify patients defined as low risk by MELD 3.0 (log-rank P < 0.001). The MELD 3.0 could stratify patients with Child–Pugh grade B (log-rank P < 0.001). A MELD 3.0 of 14 could be used as a cut-off point for discriminating between high- and low-risk patients. The Hosmer–Lemeshow test was used to test the goodness of fit of all models and the calibration plot was drawn. The prognostic value of the MELD 3.0, MELD, MELD-Na, Child–Pugh and FIPS score was assessed using Harrell’s C concordance index (c-index). MethodsĪ total of 855 consecutive patients with cirrhosis from December 2011 to October 2019 who underwent TIPS placement were retrospectively reviewed. To validate the Model for End-Stage Liver Disease (MELD) 3.0 in predicting mortality in patients with cirrhosis after TIPS creation. The selection of appropriate candidates for transjugular intrahepatic portosystemic shunt (TIPS) is important and challenging.
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Rahe and Holmes initially viewed the human subject as a passive recipient of stress, one who played no role in determining the degree, intensity, or valence of the stressor. There is a common threshold of adjustment beyond which illness will result.Life events demand the same levels of adjustment across the population.While some correlations emerged between SRRS scores and illness (Rahe, Mahan, & Arthur, 1970 Johnson & Sarason, 1979), there were problems with the stress as stimulus theory. Holmes and Rahe theorized that stress was an independent variable in the health-stress-coping equation - the cause of an experience rather than the experience itself. The theory of stress as a stimulus was introduced in the 1960s, and viewed stress as a significant life event or change that demands response, adjustment, or adaptation. Holmes and Rahe (1967) created the Social Readjustment Rating Scale (SRRS) consisting of 42 life events scored according to the estimated degree of adjustment they would each demand of the person experiencing them (e.g., marriage, divorce, relocation, change or loss of job, loss of loved one). As early as 1932, Walter Cannon described the notion of self-regulation in his work The Wisdom of the Body. Thus, along with the early conceptualization of stress as a physiological response, early research on coping was also born. The resistance response then initiates physiological systems with a fight or flight reaction to the stressor, returning the system to homeostasis, reducing harm, or more generally accommodating the stressor, which can lead to adaptive diseases such as sleep deprivation, mental illness, hypertension, or heart disease. When confronted with a negative stimulus, the alarm response initiates the sympathetic nervous system to combat or avoid the stressor (i.e., increased heart rate, temperature, adrenaline, and glucose levels). The idea of adaptation or coping is inherent to the GAS model at both the alarm and resistance stages. The response model of stress incorporates coping within the model itself. Figure 16.3 General Adaptation to Stress (GAS) Model. Gradually, other researchers expanded the thinking on stress to include and involve psychological concepts earlier in the stress model. However, Selye always considered stress to be a physiologically based construct or response. In this way, stress could be experienced as eustress (positive) or dystress (negative). Later, in The Stress Concept: Past, Present and Future (1983), Selye introduced the idea that the stress response could result in positive or negative outcomes based on cognitive interpretations of the physical symptoms or physiological experience (Figure 16.3, “The General Adaptation to Stress Model“). If the stress is prolonged or severe, it could result in diseases of adaptation or even death.Stress follows the three stages of alarm, resistance, and exhaustion.This model describes stress as a dependent variable and includes three concepts: Stress as a response model, initially introduced by Hans Selye (1956), describes stress as a physiological response pattern and was captured within his general adaptation syndrome (GAS) model (Figure 16.3). How an individual conceptualizes stress determines his or her response, adaptation, or coping strategies. Stress has been viewed as a response, a stimulus, and a transaction. In order to understand how people learn to cope with stress, it is important to first reflect on the different conceptualizations of stress and how the coping research has emerged alongside distinct approaches to stress.
The band moved to California and worked with producer Alex da Kid on two more EPs: Continued Silence and Hear Me. It broke out in 2011 with the single “It’s Time”, which led them to sign with Interscope Records. Over the next two years, Imagine Dragons followed up with two EPs, Imagine Dragons and Hell and Silence. As a last-minute replacement, Imagine Dragons’ first major gig before an audience of 26,000. It is on 16 Mile Road east of Schoenherr Road.The band’s first big break came in 2009 at the Bite of Las Vegas Festival when Train frontman Pat Monahan fell ill. “It’s such an honor to have this wall here recognizing the men and women who are top-notch skilled trades workers and to be able to showcase their work and honor them,” she said.Ĭommunity supporters in the creation of the monument include: DTE Energy, Operating Engineers Michigan 324, Lear Corporation, Michigan Lottery, SVS Vision, UAW Ford, Lutz Roofing, Carpenters Union, Signal Restoration, Teamsters, Roncelli Inc., Bricklayers Union IBEW-NECA, Motor City Harley Davidson and Luna Entertainment.įreedom Hill Amphitheatre, which seats about 7,200, is known for hosting summer concerts and festivals. Lane called the honor “very long overdue.” “Southeast Michigan has the best labor force in the country.” “I think it’s a special honor to be recognized,” said Moore, of Dearborn Heights. Marilyn Lane (D-Fraser), was seen taking pictures in front of the wall with Kevin Moore, president of Teamsters Local 299. The wall quickly drew an audience prior to the Four Tops/Beach Boys concert on Aug. Macomb County Executive Mark Hackel reminded the crowd that Freedom Hill once was a solid waste landfill that was renovated into a concert facility, and said the idea to honor workers was long overdue. Nick Contesti of Roncelli said the wall honors all workers and “praises their past and future accomplishments.” Celain said he has other improvements in mind including heating elements for cooler nights in the fall. The wall, located in the concourse, includes a video screen centerpiece that will present live footage of the concerts taking place next year. A number of labor unions and companies donated services for the $250,000 project. Clair and constructed by Sterling Heights-based Roncelli Inc., the general contractor. The 60-foot-wide, 25-foot-tall wall in the venue’s concourse was designed by Infuz Ltd. The ceremony was held in the MGM Grand Detroit VIP Club as a storm was moving into the area. The naming rights announcement came at the end of a ceremony to dedicate the “Tribute to American Workforce” wall. He is a former investor of Motor City Hotel Casino.įreedom Hill, which has made about $2 million in improvements to the property, in 2015 announced it reached an agreement with Palace Sports and Entertainment of Auburn Hills to manage the facility. Celani also is owner of Motor City Power Sports in Bloomfield Township and Motor City Harley-Davidson of Farmington Hills. In addition to adding the Michigan Lottery logo to the marquee on 16 Mile Road, the reworked logo will be added to the venue’s marketing materials and tickets in the new year.įreedom Hill is owned by Celani, through his company Luna Entertainment of Novi, and Joseph Vicari, founder of Andiamo Restaurant Group. Holyfield said he does not yet know whether a permanent sales site will be added. The Michigan Lottery currently has mobile sites that sells tickets at select Freedom Hill shows. It’s the first naming rights the Lottery has been involved with, said Jeffrey Holyfield, public relations director for the Lottery. There are two three-year renewal options built into the contract, with payment terms to be negotiated, Lottery officials said. Under terms of the agreement, the Michigan Lottery has a three-year agreement that pays Freedom Hill’s owners $300,000 a year. “With the additional revenue from this agreement, we will be able to attract even bigger and better acts,” Celani said. A new sign and logo will be designed over the winter, according to state Lottery officials. 1, the entertainment facility will be called the Michigan Lottery Theater at Freedom Hill. 20 by amphitheatre co-owner Tom Celani during a dedication ceremony at the venue for a special wall that honors the labor movement titled “Tribute to the American Workforce.” The Michigan Lottery has purchased naming rights to Freedom Hill Amphitheatre in Sterling Heights for at least the next three years in a move that will bring the outdoor concert venue $900,000 in revenue. These eye-catching designs are great for smaller spaces and for anyone who wants to get extra close to nature. Use rectangular planters or a row of pots to divide your spacious deck into separate areas for entertaining, relaxation, dining, etc.įor a multifunctional moment, try outdoor seating with planters built right in. Have one whole pallet make up the back portion to add height, and fashion a container for the front out of one or two other pallets that can house vining clematis or dracaena. Build a wooden planter using old box pallets. Here’s an inexpensive DIY project that will add privacy to your deck or large backyard. Choose plants that produce thick and wide leaves to ensure full coverage, and make sure the garden is secured to an existing structure like a pergola, fence, or the side of your house. Vertical gardens are worth exploring if you want to add solitude to your outdoor space. Style a small plant container on your outdoor kitchen counter so you can keep fresh herbs handy whenever you’re cooking alfresco.įill planter boxes with lavender, mint, and marigolds, and place them around the perimeter of your outdoor dining area to repel mosquitos and other annoying insects. If a pergola or gazebo covers your deck, place a container garden with a trellis at one side and let climbing plants wind their way to the top. Install eye hooks in the overhead joists or beams on your deck’s ceiling so you can put up hanging planters and take your plantscaping to new heights. Here are some great ways to incorporate planters into any deck design. Here’s a list of different types of plants and which containers they thrive in: Some ornamental grasses start small but get HUGE as time passes, and Dracaena plants can grow up to 10 feet tall. Size and growth habits: Do your research to find plants that won’t outgrow your pots.Aesthetic: Whether you’re going for a meadow-like feel or a tropical theme, there are plants out there that will blend beautifully with your preferred style.Maintenance level: How much work are you willing to put in to maintain your plantscaping? If your schedule leaves you with little free time, choose low-maintenance plants that don’t need constant attention.Climate and hardiness zone: The best plants to use are those local to your region and hardiness zone.Pick foliage that needs full sun if your deck sees sunshine all day. If tall trees shroud your space, look for varieties that thrive in the shade. Sun exposure: The amount of sunlight that shines on your deck, patio, or porch dictates the quality of life for your plants.Keep these points in mind while searching for the perfect plants. Materials: Look for planters built from durable materials that can withstand outdoor elements while supporting plant life.Utility: Think about your plantscaping goals and plan your purchases and layout around them.Architectural features: Pergolas, railings, built-in benches, and other features can impact the types of planters you can have.Budget: Setting a budget helps manage expectations and prevents overspending.We highly recommend taking deck measurements before buying anything.
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