Science.gov

Sample records for based stockpile stewardship

  1. Accelerator Based Tools of Stockpile Stewardship

    NASA Astrophysics Data System (ADS)

    Seestrom, Susan

    2017-01-01

    The Manhattan Project had to solve difficult challenges in physics and materials science. During the cold war a large nuclear stockpile was developed. In both cases, the approach was largely empirical. Today that stockpile must be certified without nuclear testing, a task that becomes more difficult as the stockpile ages. I will discuss the role of modern accelerator based experiments, such as x-ray radiography, proton radiography, neutron and nuclear physics experiments, in stockpile stewardship. These new tools provide data of exceptional sensitivity and are answering questions about the stockpile, improving our scientific understanding, and providing validation for the computer simulations that are relied upon to certify todays' stockpile.

  2. Science-based stockpile stewardship at LANSCE

    SciTech Connect

    Browne, J.

    1995-10-01

    Let me tell you a little about the Los Alamos Neutron Science Center (LANSCE) and how some of the examples you heard about from Sig Hecker and John Immele fit together in this view of a different world in the future where defense, basic and industrial research overlap. I am going to talk about science-based stockpile stewardship at LANSCE; the accelerator production of tritium (APT), which I think has a real bearing on the neutron road map; the world-class neutron science user facility, for which I will provide some examples so you can see the connection with defense science; and lastly, testing concepts for a high-power spallation neutron target and waste transmutation.

  3. Science Based Stockpile Stewardship and RIA

    SciTech Connect

    Ahle, L E; Bernstein, L A; Hausmann, M; Vieira, D J

    2003-06-09

    One aspect of Science Based Stockpile Stewardship (SBSS) is to improve the quality of neutron cross section data for certain isotopes. The isotopes of interest are used to monitor neutron and charged particle fluxes in environments of brief, intense neutron fluxes. The accuracy of flux determination is dependent on the accuracy of cross section data for the stable isotopes loaded into the system and the unstable isotopes produced when the neutrons are incident on the monitor. For isotopes with a half-life greater than one day it is possible, given the production rates of RIA, to make radioactive targets for neutron irradiation. This would require the ability to harvest isotopes at RIA, an onsite radiochemistry facility for processing the harvested material into a target, and an onsite neutron source facility. The radiochemistry facility will need to handle activity levels on the order of 100's of Curie's while the neutron source facility will need to provide high intensity ''monoenergetic'' neutrons from 10's keV to 20 MeV. For isotopes with a half-life much less than one day, only indirect methods can be used to get information on the neutron cross sections because of the lack of a target. Both experimental techniques will be discussed with their impact on the infrastructure at RIA, as well as the general case for the interest of SBSS in RIA.

  4. Stockpile Stewardship: Los Alamos

    ScienceCinema

    McMillan, Charlie; Morgan, Nathanial; Goorley, Tom; Merrill, Frank; Funk, Dave; Korzekwa, Deniece; Laintz, Ken

    2016-07-12

    "Heritage of Science" is a short video that highlights the Stockpile Stewardship program at Los Alamos National Laboratory. Stockpile Stewardship was conceived in the early 1990s as a national science-based program that could assure the safety, security, and effectiveness of the U.S. nuclear deterrent without the need for full-scale underground nuclear testing. This video was produced by Los Alamos National Laboratory for screening at the Lab's Bradbury Science Museum in Los Alamos, NM and is narrated by science correspondent Miles O'Brien.

  5. Stockpile Stewardship: Los Alamos

    SciTech Connect

    McMillan, Charlie; Morgan, Nathanial; Goorley, Tom; Merrill, Frank; Funk, Dave; Korzekwa, Deniece; Laintz, Ken

    2012-01-26

    "Heritage of Science" is a short video that highlights the Stockpile Stewardship program at Los Alamos National Laboratory. Stockpile Stewardship was conceived in the early 1990s as a national science-based program that could assure the safety, security, and effectiveness of the U.S. nuclear deterrent without the need for full-scale underground nuclear testing. This video was produced by Los Alamos National Laboratory for screening at the Lab's Bradbury Science Museum in Los Alamos, NM and is narrated by science correspondent Miles O'Brien.

  6. Science-based stockpile stewardship at Los Alamos National Laboratory

    SciTech Connect

    Immele, J.

    1995-10-01

    I would like to start by working from Vic Reis`s total quality management diagram in which he began with the strategy and then worked through the customer requirements-what the Department of Defense (DoD) is hoping for from the science-based stockpile stewardship program. Maybe our customer`s requirements will help guide some of the issues that we should be working on. ONe quick answer to {open_quotes}why have we adopted a science-based strategy{close_quotes} is that nuclear weapons are a 50-year responsibility, not just a 5-year responsibility, and stewardship without testing is a grand challenge. While we can do engineering maintenance and turn over and remake a few things on the short time scale, without nuclear testing, without new weapons development, and without much of the manufacturing base that we had in the past, we need to learn better just how these weapons are actually working.

  7. Stockpile Stewardship at Los Alamos(U)

    SciTech Connect

    Webster, Robert B.

    2012-06-29

    Stockpile stewardship is the retention of nuclear weapons in the stockpile beyond their original design life. These older weapons have potential changes inconsistent with the original design intent and military specifications. The Stockpile Stewardship Program requires us to develop high-fidelity, physics-based capabilities to predict, assess, certify and design nuclear weapons without conducting a nuclear test. Each year, the Lab Directors are required to provide an assessment of the safety, security, and reliability our stockpile to the President of the United States. This includes assessing whether a need to return to testing exists. This is a talk to provide an overview of Stockpile Stewardship's scientific requirements and how stewardship has changed in the absence of nuclear testing. The talk is adapted from an HQ talk to the War college, and historical unclassified talks on weapon's physics.

  8. Defense Experimentation and Stockpile Stewardship

    ScienceCinema

    None

    2016-07-12

    A primary mission of the site is to help ensure that the nation's nuclear weapon stockpile remains safe, secure and reliable. The stockpile stewardship program, working with the national weapons laboratories conducts a wide range of experiments using advanced diagnostic technologies, many of which were developed right here at the NNSS.

  9. Defense Experimentation and Stockpile Stewardship

    SciTech Connect

    2014-10-28

    A primary mission of the site is to help ensure that the nation's nuclear weapon stockpile remains safe, secure and reliable. The stockpile stewardship program, working with the national weapons laboratories conducts a wide range of experiments using advanced diagnostic technologies, many of which were developed right here at the NNSS.

  10. Proposed Laser-Based HED physics experiments for Stockpile Stewardship

    SciTech Connect

    Benage, John F.; Albright, Brian J.; Fernandez, Juan C.

    2012-09-04

    An analysis of the scientific areas in High Energy Density (HED) physics that underpin the enduring LANL mission in Stockpile Stewardship (SS) has identified important research needs that are not being met. That analysis has included the work done as part of defining the mission need for the High Intensity Laser Laboratory (HILL) LANL proposal to NNSA, LDRD DR proposal evaluations, and consideration of the Predictive Capability Framework and LANL NNSA milestones. From that evaluation, we have identified several specific and scientifically-exciting experimental concepts to address those needs. These experiments are particularly responsive to physics issues in Campaigns 1 and 10. These experiments are best done initially at the LANL Trident facility, often relying on the unique capabilities available there, although there are typically meritorious extensions envisioned at future facilities such as HILL, or the NIF once the ARC short-pulse laser is available at sufficient laser intensity. As the focus of the LANL HEDP effort broadens from ICF ignition of the point design at the conclusion of the National Ignition Campaign, into a more SS-centric effort, it is useful to consider these experiments, which address well-defined issues, with specific scientific hypothesis to test or models to validate or disprove, via unit-physics experiments. These experiments are in turn representative of a possible broad experimental portfolio to elucidate the physics of interest to these campaigns. These experiments, described below, include: (1) First direct measurement of the evolution of particulates in isochorically heated dense plasma; (2) Temperature relaxation measurements in a strongly-coupled plasma; (3) Viscosity measurements in a dense plasma; and (4) Ionic structure factors in a dense plasma. All these experiments address scientific topics of importance to our sponsors, involve excellent science at the boundaries of traditional fields, utilize unique capabilities at LANL

  11. Stockpile Stewardship's 20th Anniversary

    SciTech Connect

    Hecker, Siegfried; Gottemoeller, Rose; Reis, Victor H.; McMillan, Charles; Rohlfing, Joan; Hurricane, Omar; Hagengruber, Roger; Taylor, John

    2015-10-22

    A short oral history of the NNSA's Stockpile Stewardship Program, produced in association with the 20th anniversary of the program. It features Siegfried Hecker, Rose Gottemoeller, Victor Reis, Charles McMillan, Joan Rohlfing, Omar Hurricane, Roger Hagengruber, and John Taylor.

  12. Stockpile Stewardship's 20th Anniversary

    ScienceCinema

    Hecker, Siegfried; Gottemoeller, Rose; Reis, Victor H.; McMillan, Charles; Rohlfing, Joan; Hurricane, Omar; Hagengruber, Roger; Taylor, John

    2016-07-12

    A short oral history of the NNSA's Stockpile Stewardship Program, produced in association with the 20th anniversary of the program. It features Siegfried Hecker, Rose Gottemoeller, Victor Reis, Charles McMillan, Joan Rohlfing, Omar Hurricane, Roger Hagengruber, and John Taylor.

  13. Science Based Stockpile Stewardship, Uncertainty Quantification, and Surrogate Reactions

    SciTech Connect

    Stoyer, M A; McNabb, D P; Burke, J T; Bernstein, L A

    2009-08-06

    Stewardship of this nation's nuclear weapons is predicated on developing a fundamental scientific understanding of the physics and chemistry required to describe weapon performance without the need to resort to underground nuclear testing and to predict expected future performance as a result of intended or unintended modifications. In order to construct more reliable models, underground nuclear test data is being reanalyzed in novel ways. To improve the interpretation of these experiments with quantified uncertainties, improved nuclear data is required. As an example, the thermonuclear yield of a device was often inferred through the use of radiochemical detectors. Conversion of the detector activations observed to thermonuclear yield was accomplished through explosion code calculations (models) and a good set of nuclear reaction cross-sections. Because of the unique high-fluence environment of an exploding nuclear weapon, many reactions occurred on radioactive nuclides, for which only theoretically calculated cross-sections are available. Surrogate nuclear reactions at STARS/LIBERACE offer the opportunity to measure cross-sections on unstable nuclei and thus improve the quality of the nuclear reaction cross-section sets. One radiochemical detector that was loaded in devices was mono-isotopic yttrium ({sup 89}Y). Nuclear reactions produced {sup 87}Y and {sup 88}Y which could be quantified post-shot as a ratio of {sup 87}Y/{sup 88}Y. The yttrium cross-section set from 1988 is shown in Figure 1(a) and contains approximately 62 cross-sections interconnecting the yttrium nuclides. The 6 experimentally measured cross-sections are shown in Figure 1(b). Any measurement of cross-sections on {sup 87}Y or {sup 88}Y would improve the quality of the cross-section set. A recent re-evaluation of the yttrium cross-section set was performed with many more calculated reaction cross-sections included.

  14. FY 2015 - Stockpile Stewardship and Management Plan

    SciTech Connect

    2014-04-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  15. FY 2016 - Stockpile Stewardship and Management Plan

    SciTech Connect

    2015-03-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  16. Stockpile stewardship past, present, and future

    SciTech Connect

    Adams, Marvin L.

    2014-05-09

    The U.S. National Academies released a report in 2012 on technical issues related to the Comprehensive Test Ban Treaty. One important question addressed therein is whether the U.S. could maintain a safe, secure, and reliable nuclear-weapons stockpile in the absence of nuclear-explosion testing. Here we discuss two main conclusions from the 2012 Academies report, which we paraphrase as follows: 1) Provided that sufficient resources and a national commitment to stockpile stewardship are in place, the U.S. has the technical capabilities to maintain a safe, secure, and reliable stockpile of nuclear weapons into the foreseeable future without nuclear-explosion testing. 2) Doing this would require: a) a strong weapons science and engineering program that addresses gaps in understanding; b) an outstanding workforce that applies deep and broad weapons expertise to deliver solutions to stockpile problems; c) a vigorous, stable surveillance program that delivers the requisite data; d) production facilities that meet stewardship needs. We emphasize that these conclusions are independent of CTBT ratification-they apply provided only that the U.S. continues its nuclear-explosion moratorium.

  17. Stockpile stewardship past, present, and future

    NASA Astrophysics Data System (ADS)

    Adams, Marvin L.

    2014-05-01

    The U.S. National Academies released a report in 2012 on technical issues related to the Comprehensive Test Ban Treaty. One important question addressed therein is whether the U.S. could maintain a safe, secure, and reliable nuclear-weapons stockpile in the absence of nuclear-explosion testing. Here we discuss two main conclusions from the 2012 Academies report, which we paraphrase as follows: 1) Provided that sufficient resources and a national commitment to stockpile stewardship are in place, the U.S. has the technical capabilities to maintain a safe, secure, and reliable stockpile of nuclear weapons into the foreseeable future without nuclear-explosion testing. 2) Doing this would require: a) a strong weapons science and engineering program that addresses gaps in understanding; b) an outstanding workforce that applies deep and broad weapons expertise to deliver solutions to stockpile problems; c) a vigorous, stable surveillance program that delivers the requisite data; d) production facilities that meet stewardship needs. We emphasize that these conclusions are independent of CTBT ratification-they apply provided only that the U.S. continues its nuclear-explosion moratorium.

  18. FY 2014 - Stockpile and Stewardship and Management Plan

    SciTech Connect

    2013-06-01

    This Department of Energy’s (DOE) National Nuclear Security Administration (NNSA) Fiscal Year Stockpile Stewardship and Management Plan (SSMP) is a key planning document for the nuclear security enterprise.

  19. Without Testing: Stockpile Stewardship in the Second Nuclear Age

    SciTech Connect

    Martz, Joseph C.

    2014-01-07

    Stockpile stewardship is a topic dear to my heart. I’ve been fascinated by it, and I’ve lived it—mostly on the technical side but also on the policy side from 2009 to 2010 at Stanford University as a visiting scholar and the inaugural William J. Perry Fellow. At Stanford I worked with Perry, former secretary of defense, and Sig Hecker, former Los Alamos Lab director (1986–1997), looking at nuclear deterrence, nuclear policy, and stockpile stewardship and at where all this was headed.

  20. Science Based Stockpile Stewardship

    DTIC Science & Technology

    1994-11-01

    that would provide up to six temporal images and six spatial views per shot . The scientific work in hydrotests is largely classified and will properly...help dispel concern that the NIF is being used to support advanced weapons development efforts. The limited shot rates, small tritium inventory, and...of a primary. Pin shots (thin conducting needles through which an induced current flow measures implosion velocities), and optical diagnostics

  1. The Big Science of stockpile stewardship

    SciTech Connect

    Reis, Victor H.; Hanrahan, Robert J.; Levedahl, W. Kirk

    2016-08-15

    In the quarter century since the US last exploded a nuclear weapon, an extensive research enterprise has maintained the resources and know-how needed to preserve confidence in the country’s stockpile.

  2. FY 2017 Stockpile Stewardship and Management Plan - Biennial Plan Summary

    SciTech Connect

    None, None

    2016-03-01

    This year’s summary report updates the Fiscal Year 2016 Stockpile Stewardship and Management Plan (FY 2016 SSMP), the 25-year strategic program of record that captures the plans developed across numerous NNSA programs and organizations to maintain and modernize the scientific tools, capabilities, and infrastructure necessary to ensure the success of NNSA’s nuclear weapons mission. The SSMP is a companion to the Prevent, Counter, and Respond: A Strategic Plan to Reduce Global Nuclear Threats (FY 2017-2021) report, the planning document for NNSA’s nuclear threat reduction mission. New versions of both reports are published each year in response to new requirements and challenges. Much was accomplished in FY 2015 as part of the program of record described in this year’s SSMP. The science-based Stockpile Stewardship Program allowed the Secretaries of Energy and Defense to certify for the twentieth time that the stockpile remains safe, secure, and effective without the need for underground nuclear explosive testing. The talented scientists, engineers, and technicians at the three national security laboratories, the four nuclear weapons production plants, and the national security site are primarily responsible for this continued success. Research, development, test, and evaluation programs have advanced NNSA’s understanding of weapons physics, component aging, and material properties through first-of-a-kind shock physics experiments, along with numerous other critical experiments conducted throughout the nuclear security enterprise. The multiple life extension programs (LEPs) that are under way made progress toward their first production unit dates. The W76-1 LEP is past the halfway point in total production, and the B61-12 completed three development flight tests. Critical to this success is the budget. The Administration’s budget request for NNSA’s Weapons Activities has increased for all but one of the past seven years, resulting in a total increase of

  3. Stockpile Stewardship: How we Ensure the Nuclear Deterrent without Testing

    SciTech Connect

    2014-09-04

    In the 1990s, the U.S. nuclear weapons program shifted emphasis from developing new designs to dismantling thousands of existing weapons and maintaining a much smaller enduring stockpile. The United States ceased underground nuclear testing, and the Department of Energy created the Stockpile Stewardship Program to maintain the safety, security, and reliability of the U.S. nuclear deterrent without full-scale testing. This video gives a behind the scenes look at a set of unique capabilities at Lawrence Livermore that are indispensable to the Stockpile Stewardship Program: high performance computing, the Superblock category II nuclear facility, the JASPER a two stage gas gun, the High Explosive Applications Facility (HEAF), the National Ignition Facility (NIF), and the Site 300 contained firing facility.

  4. Stockpile Stewardship: How we Ensure the Nuclear Deterrent without Testing

    ScienceCinema

    None

    2016-07-12

    In the 1990s, the U.S. nuclear weapons program shifted emphasis from developing new designs to dismantling thousands of existing weapons and maintaining a much smaller enduring stockpile. The United States ceased underground nuclear testing, and the Department of Energy created the Stockpile Stewardship Program to maintain the safety, security, and reliability of the U.S. nuclear deterrent without full-scale testing. This video gives a behind the scenes look at a set of unique capabilities at Lawrence Livermore that are indispensable to the Stockpile Stewardship Program: high performance computing, the Superblock category II nuclear facility, the JASPER a two stage gas gun, the High Explosive Applications Facility (HEAF), the National Ignition Facility (NIF), and the Site 300 contained firing facility.

  5. Stockpile Stewardship and the National Ignition Facility

    SciTech Connect

    Moses, E

    2012-01-04

    The National Ignition Facility (NIF), the world's most energetic laser system, is operational at Lawrence Livermore National Laboratory (LLNL). Since the completion of the construction project in March 2009, NIF has completed nearly 150 target experiments for the National Ignition Campaign (NIC), High Energy Density Stewardship Science (HEDSS) in the areas of radiation transport, material dynamics at high pressure in the solid state, as well as fundamental science and other national security missions. NIF capabilities and infrastructure are in place to support all of its missions with over 50 X-ray, optical and nuclear diagnostic systems and the ability to shoot cryogenic targets and DT layered capsules. NIF is now qualified for use of tritium and other special materials as well as to perform high yield experiments and classified experiments. DT implosions with record indirect-drive neutron yield of 4.5 x 10{sup 14} neutrons have been achieved. A series of 43 experiments were successfully executed over a 27-day period, demonstrating the ability to perform precise experiments in new regimes of interest to HEDSS. This talk will provide an update of the progress on the NIF capabilities, NIC accomplishments, as well as HEDSS and fundamental science experimental results and an update of the experimental plans for the coming year.

  6. Science and technology in the stockpile stewardship program, S & TR reprints

    SciTech Connect

    Storm, E

    1998-04-08

    This document reports on these topics: Computer Simulations in Support of National Security; Enhanced Surveillance of Aging Weapons; A New Precision Cutting Tool: The Femtosecond Laser; Superlasers as a Tool of Stockpile Stewardship; Nova Laser Experiments and Stockpile Stewardship; Transforming Explosive Art into Science; Better Flash Radiography Using the FXR; Preserving Nuclear Weapons Information; Site 300Õs New Contained Firing Facility; The Linear Electric Motor: Instability at 1,000 gÕs; A Powerful New Tool to Detect Clandestine Nuclear Tests; High Explosives in Stockpile Surveillance Indicate Constancy; Addressing a Cold War Legacy with a New Way to Produce TATB; JumpinÕ Jupiter! Metallic Hydrogen; Keeping the Nuclear Stockpile Safe, Secure, and Reliable; The Multibeam FabryÐPerot Velocimeter: Efficient Measurements of High Velocities; Theory and Modeling in Material Science; The Diamond Anvil Cell; Gamma-Ray Imaging Spectrometry; X-Ray Lasers and High-Density Plasma

  7. Development of Designer Diamond Technology for High Pressure High Temperature Experiments in Support of Stockpile Stewardship Program

    SciTech Connect

    Vohra, Yogesh, K.

    2009-10-28

    The role of nitrogen in the fabrication of designer diamond was systematically investigated by adding controlled amount of nitrogen in hydrogen/methane/oxygen plasma. This has led to a successful recipe for reproducible fabrication of designer diamond anvils for high-pressure high-temperature research in support of stockpile stewardship program. In the three-year support period, several designer diamonds fabricated with this new growth chemistry were utilized in high-pressure experiments at UAB and Lawrence Livermore National Laboratory. The designer diamond anvils were utilized in high-pressure studies on heavy rare earth metals, high pressure melting studies on metals, and electrical resistance measurements on iron-based layered superconductors under high pressures. The growth chemistry developed under NNSA support can be adapted for commercial production of designer diamonds.

  8. Use of hazard assessments to achieve risk reduction in the USDOE Stockpile Stewardship (SS-21) Program

    SciTech Connect

    Fischer, S.R.; Konkel, H.; Bott, T.; Eisenhawer, S.W.; DeYoung, L.; Hockert, J.

    1995-07-01

    This paper summarizes the nuclear explosive hazard assessment activities performed to support US Department of Energy (DOE) Stockpile Stewardship Demonstration Project SS-21, better known as the ``Seamless Safety`` program. Past practice within the DOE Complex has dictated the use of a significant number of post-design/fabrication safety reviews to analyze the safety associated with operations on nuclear explosives and to answer safety questions. These practices have focused on reviewing-in or auditing-in safety vs incorporating safety in the design process. SS-21 was proposed by the DOE as an avenue to develop a program to ``integrate established, recognized, verifiable safety criteria into the process at the design stage rather than continuing the reliance on reviews, evaluations and audits.`` The entire Seamless Safety design and development process is verified by a concurrent hazard assessment (HA). The primary purpose of the SS-21 Demonstration Project HA was to demonstrate the feasibility of performing concurrent HAs as part of an engineering design and development effort and then to evaluate the use of the HA to provide an indication in the risk reduction or gain in safety achieved. To accomplish this objective, HAs were performed on both baseline (i.e., old) and new (i.e. SS-21) B61-0 Center Case Section disassembly processes. These HAs were used to support the identification and documentation of weapon- and process-specific hazards and safety-critical operating steps. Both HAs focused on identifying accidents that had the potential for worker injury, public health effects, facility damage, toxic gas release, and dispersal of radioactive materials. A comparison of the baseline and SS-21 process risks provided a semi-quantitative estimate of the risk reduction gained via the Seamless Safety process.

  9. Draft Supplemental Programmatic Environmental Impact Statement on Stockpile Stewardship and Management for a Modern Pit Facility

    SciTech Connect

    N /A

    2003-06-06

    The U.S. Department of Energy's (DOE) National Nuclear Security Administration (NNSA) is responsible for the safety and reliability of the U.S. nuclear weapons stockpile, including production readiness required to maintain that stockpile. Since 1989, DOE has been without the capability to produce stockpile certified plutonium pits, which are an essential component of nuclear weapons. NNSA, the Department of Defense (DOD), and Congress have highlighted the lack of long-term pit production capability as a national security issue requiring timely resolution. While a small interim capacity is currently being established at the Los Alamos National Laboratory (LANL), classified analyses indicate projected capacity requirements (number of pits to be produced over a period of time), and agility (ability to rapidly change from production of one pit type to another, ability to simultaneously produce multiple pit types, or the flexibility to produce pits of a new design in a timely manner) necessary for long-term support of the stockpile will require a long-term pit production capability. In particular, identification of a systemic problem associated with an existing pit type, class of pits, or aging phenomenon cannot be adequately responded to today, nor could it be with the small capability being established at LANL (see Section S.2 for a more detailed discussion regarding the purpose and need for a Modern Pit Facility [MPF]).

  10. Advances and Challenges In Uncertainty Quantification with Application to Climate Prediction, ICF design and Science Stockpile Stewardship

    NASA Astrophysics Data System (ADS)

    Klein, R.; Woodward, C. S.; Johannesson, G.; Domyancic, D.; Covey, C. C.; Lucas, D. D.

    2012-12-01

    Uncertainty Quantification (UQ) is a critical field within 21st century simulation science that resides at the very center of the web of emerging predictive capabilities. The science of UQ holds the promise of giving much greater meaning to the results of complex large-scale simulations, allowing for quantifying and bounding uncertainties. This powerful capability will yield new insights into scientific predictions (e.g. Climate) of great impact on both national and international arenas, allow informed decisions on the design of critical experiments (e.g. ICF capsule design, MFE, NE) in many scientific fields, and assign confidence bounds to scientifically predictable outcomes (e.g. nuclear weapons design). In this talk I will discuss a major new strategic initiative (SI) we have developed at Lawrence Livermore National Laboratory to advance the science of Uncertainty Quantification at LLNL focusing in particular on (a) the research and development of new algorithms and methodologies of UQ as applied to multi-physics multi-scale codes, (b) incorporation of these advancements into a global UQ Pipeline (i.e. a computational superstructure) that will simplify user access to sophisticated tools for UQ studies as well as act as a self-guided, self-adapting UQ engine for UQ studies on extreme computing platforms and (c) use laboratory applications as a test bed for new algorithms and methodologies. The initial SI focus has been on applications for the quantification of uncertainty associated with Climate prediction, but the validated UQ methodologies we have developed are now being fed back into Science Based Stockpile Stewardship (SSS) and ICF UQ efforts. To make advancements in several of these UQ grand challenges, I will focus in talk on the following three research areas in our Strategic Initiative: Error Estimation in multi-physics and multi-scale codes ; Tackling the "Curse of High Dimensionality"; and development of an advanced UQ Computational Pipeline to enable

  11. Nuclear stockpile stewardship and Bayesian image analysis (DARHT and the BIE)

    SciTech Connect

    Carroll, James L

    2011-01-11

    Since the end of nuclear testing, the reliability of our nation's nuclear weapon stockpile has been performed using sub-critical hydrodynamic testing. These tests involve some pretty 'extreme' radiography. We will be discussing the challenges and solutions to these problems provided by DARHT (the world's premiere hydrodynamic testing facility) and the BIE or Bayesian Inference Engine (a powerful radiography analysis software tool). We will discuss the application of Bayesian image analysis techniques to this important and difficult problem.

  12. 2015 Stewardship Science Academic Programs Annual

    SciTech Connect

    Stone, Terri; Mischo, Millicent

    2015-02-01

    The Stockpile Stewardship Academic Programs (SSAP) are essential to maintaining a pipeline of professionals to support the technical capabilities that reside at the National Nuclear Security Administration (NNSA) national laboratories, sites, and plants. Since 1992, the United States has observed the moratorium on nuclear testing while significantly decreasing the nuclear arsenal. To accomplish this without nuclear testing, NNSA and its laboratories developed a science-based Stockpile Stewardship Program to maintain and enhance the experimental and computational tools required to ensure the continued safety, security, and reliability of the stockpile. NNSA launched its academic program portfolio more than a decade ago to engage students skilled in specific technical areas of relevance to stockpile stewardship. The success of this program is reflected by the large number of SSAP students choosing to begin their careers at NNSA national laboratories.

  13. Draft Site-wide Environmental Impact Statement for Continued Operation of Lawrence Livermore National Laboratory and Supplemental Stockpile Stewardship and Management Programmatic Environmental Impact Statement

    SciTech Connect

    N /A

    2004-02-27

    This ''Site-wide Environmental Impact Statement for Continued Operation of Lawrence Livermore National Laboratory and Supplemental Stockpile Stewardship and Management Programmatic Environmental Impact Statement'' (LLNL SW/SPEIS) describes the purpose and need for agency action for the continued operation of LLNL and analyzes the environmental impacts of these operations. The primary purpose of continuing operation of LLNL is to provide support for the National Nuclear Security Administration's (NNSA's) nuclear weapons stockpile stewardship missions. LLNL, located about 40 miles east of San Francisco, California, is also needed to support other U.S. Department of Energy (DOE) programs and Federal agencies such as the U.S. Department of Defense, Nuclear Regulatory Commission, U.S. Environmental Protection Agency (EPA), and the newly established U.S. Department of Homeland Security. This LLNL SW/SPEIS analyzes the environmental impacts of reasonable alternatives for ongoing and foreseeable future operations, facilities, and activities at LLNL. The reasonable alternatives include the No Action Alternative, Proposed Action, and the Reduced Operation Alternative. The major decision to be made by DOE/NNSA is to select one of the alternatives for the continued operation of the LLNL. As part of the Proposed Action, DOE/NNSA is considering: using additional materials including plutonium on the National Ignition Facility (NIF); increasing the administrative limit for plutonium in the Superblock, which includes the Plutonium Facility, the Tritium Facility, and the Hardened Engineering Test Building; conducting the Integrated Technology Project, using laser isotope separation to provide material for Stockpile Stewardship experiments, in the Plutonium Facility; increasing the material-at-risk limit for the Plutonium Facility; and increasing the Tritium Facility material-at-risk. A discussion of these issues is presented in Section S.5.2, Proposed Action. The ''National

  14. Double-shell target design for the NIF: Noncryogenic ignition and nonlinear mix studies for Stockpile Stewardship

    SciTech Connect

    Amendt, P

    2004-02-10

    Double-shell ignition is complementary to the baseline approach by virtue of not requiring: (1) cryogenic preparation and fielding, (2) high-contrast pulse-shaping for shock-timing, and (3) demanding x-ray flux symmetry control. The use of simpler low-contrast pulse-shaping potentially allows more benign hohlraum conditions by reducing the risk of laser backscatter. In addition, the associated higher laser fluence threshold for optics damage initiation allows the possibility of more routine high-fluence shots with 2{omega} on the NIF. Based on LDRD-sponsored research in FY01-03 on NIF double-shell ignition target designs, the feasibility of this approach was advanced through both a highly successful implosion campaign on the Omega laser facility and a variety of design improvements for mitigating instability. The double-shell implosion campaign on Omega achieved the important milestone of repeatably demonstrating dominant primary (2.45 MeV) neutron production from the mix-susceptible compressional phase of a double-shell implosion, using fall-line design optimization and exacting fabrication standards. Showing effective control of fuel-pusher mix during final compression is an essential element for achieving ignition. In our studies to control mix by reducing hydrodynamic instability a new pathway for destructive Rayleigh-Taylor growth on the outer surface of the inner shell at ignition scales was identified. However, highly resolved multi-mode simulations showed that with use of a graded dopant in the inner shell and material-matching with an exterior metallic foam, this instability was significantly reduced. In addition, the resulting density-gradient stabilization was seen to quench small-wavelength growth, thereby avoiding the computationally challenging turbulent regime. A major goal of future research for realizing double-shell ignition on the NIF is experimental validation of this instability mitigation approach using the Omega laser facility.

  15. Stewarding a Reduced Stockpile

    SciTech Connect

    Goodwin, B T; Mara, G

    2008-04-18

    The future of the US nuclear arsenal continues to be guided by two distinct drivers: the preservation of world peace and the prevention of further proliferation through our extended deterrent umbrella. Timely implementation of US nuclear policy decisions depends, in part, on the current state of stockpile weapons, their delivery systems, and the supporting infrastructure within the Department of Defense (DoD) and the Department of Energy's National Nuclear Security Administration (NNSA). In turn, the present is a product of past choices and world events. Now more than ever, the nuclear weapons program must respond to the changing global security environment and to increasing budget pressures with innovation and sound investments. As the nation transitions to a reduced stockpile, the successes of the Stockpile Stewardship Program (SSP) present options to transition to a sustainable complex better suited to stockpile size, national strategic goals and budgetary realities. Under any stockpile size, we must maintain essential human capital, forefront capabilities, and have a right-sized effective production capacity. We present new concepts for maintaining high confidence at low stockpile numbers and to effectively eliminate the reserve weapons within an optimized complex. We, as a nation, have choices to make on how we will achieve a credible 21st century deterrent.

  16. Internet-based monitoring and prediction system of coal stockpile behaviors under atmospheric conditions.

    PubMed

    Yilmaz, Nihat; Ozdeniz, A Hadi

    2010-03-01

    Spontaneous combustion on industrial-scale stockpiles causes environmental problems and economic losses for the companies consuming large amounts of coal. In this study, an effective monitoring and prediction system based on internet was developed and implemented to prevent losses and environmental problems. The system was performed in a coal stockpile with 5 m width, 10 m length, 3 m height, and having 120 t of weight. The inner temperature data of the stockpile was recorded by 17 temperature sensors placed inside the stockpile at certain points. Additionally, the data relating to the air temperature, air humidity, atmospheric pressure, wind velocity, and wind direction that are the parameters affecting the coal stockpile were also recorded. The recorded values were analyzed with artificial neural network and Statistical modeling methods for prediction of spontaneous combustion. Real-time measurement values and model outputs were published with a web page on internet. The internet-based system can also provide real-time monitoring (combustion alarms, system status) and tele-controlling (Parameter adjusting, system control) through internet exclusively with a standard web browser without the need of any additional software.

  17. Stewardship mapping and assessment project: a framework for understanding community-based environmental stewardship

    Treesearch

    Erika S. Svendsen; Lindsay K. Campbell; Dana R. Fisher; James J.T. Connolly; Michelle L. Johnson; Nancy Falxa Sonti; Dexter H. Locke; Lynne M. Westphal; Cherie LeBlanc Fisher; Morgan Grove; Michele Romolini; Dale J. Blahna; Kathleen L. Wolf

    2016-01-01

    The Stewardship Mapping and Assessment Project (STEW-MAP) is designed to answer who, where, why and how environmental stewardship groups are caring for our urbanized landscapes. This report is intended to be a guide for those who wish to start STEW-MAP in their own city. It contains step-by-step directions for how to plan and implement a STEW-MAP project. STEW-MAP is...

  18. Investigation of High Energy Density Matter for Science-Based Stockpile Stewardship

    SciTech Connect

    Bauer, B.

    1998-11-20

    The statement of work for this contract is to activate the Nevada Terawatt Facility (NTF). Experimentally investigate z-pinch physics, in collaboration with SNL, LANL, and LLNL. Develop x-ray and laser diagnostics for the NTF, SNL-Z, and LANL-ATLAS. Refine atomic and radiation physics calculations and data to meet the challenges of EUV and x-ray diagnostic development. Progress to date is reported.

  19. Urban ecological stewardship: understanding the structure, function and network of community-based urban land management

    Treesearch

    Erika s. Svendsen; Lindsay K. Campbell

    2008-01-01

    Urban environmental stewardship activities are on the rise in cities throughout the Northeast. Groups participating in stewardship activities range in age, size, and geography and represent an increasingly complex and dynamic arrangement of civil society, government and business sectors. To better understand the structure, function and network of these community-based...

  20. An Introduction to Risk with a Focus on Design Diversity in the Stockpile

    SciTech Connect

    Noone, Bailey C

    2012-08-13

    The maintenance and security of nuclear weapons in the stockpile involves decisions based on risk analysis and quantitative measures of risk. Risk is a factor in all decisions, a particularly important factor in decisions of a large scale. One example of high-risk decisions we will discuss is the risk involved in design diversity within the stockpile of nuclear weapons arsenal. Risk is defined as 'possibility of loss or injury' and the 'degree of probability of such loss' (Kaplan and Garrick 12). To introduce the risk involved with maintaining the weapons stockpile we will draw a parallel to the design and maintenance of Southwest Airlines fleet of Boeing 737 planes. The clear benefits for cost savings in maintenance of having a uniform fleet are what historically drove Southwest to have only Boeing 737s in their fleet. Less money and resources are need for maintenance, training, and materials. Naturally, risk accompanies those benefits. A defect in a part of the plane indicates a potential defect in that same part in all the planes of the fleet. As a result, safety, business, and credibility are at risk. How much variety or diversity does the fleet need to mitigate that risk? With that question in mind, a balance is needed to accommodate the different risks and benefits of the situation. In a similar way, risk is analyzed for the design and maintenance of nuclear weapons in the stockpile. In conclusion, risk must be as low as possible when it comes to the nuclear weapons stockpile. Design and care to keep the stockpile healthy involves all aspects of risk management. Design diversity is a method that helps to mitigate risk, and to help balance options in stockpile stewardship.

  1. Place-Based Stewardship Education: Nurturing Aspirations to Protect the Rural Commons

    ERIC Educational Resources Information Center

    Gallay, Erin; Marckini-Polk, Lisa; Schroeder, Brandon; Flanagan, Constance

    2016-01-01

    In this mixed-methods study, we examine the potential of place-based stewardship education (PBSE) for nurturing rural students' community attachment and aspirations to contribute to the preservation of the environmental "commons." Analyzing pre- and post-experience surveys (n = 240) and open-ended responses (n = 275) collected from…

  2. Place-Based Stewardship Education: Nurturing Aspirations to Protect the Rural Commons

    ERIC Educational Resources Information Center

    Gallay, Erin; Marckini-Polk, Lisa; Schroeder, Brandon; Flanagan, Constance

    2016-01-01

    In this mixed-methods study, we examine the potential of place-based stewardship education (PBSE) for nurturing rural students' community attachment and aspirations to contribute to the preservation of the environmental "commons." Analyzing pre- and post-experience surveys (n = 240) and open-ended responses (n = 275) collected from…

  3. Applications of Nuclear Science for Stewardship Science

    NASA Astrophysics Data System (ADS)

    Cizewski, Jolie A.

    2013-03-01

    Stewardship science is research important to national security interests that include stockpile stewardship science, homeland security, nuclear forensics, and non-proliferation. To help address challenges in stewardship science and workforce development, the Stewardship Science Academic Alliances (SSAA) was inaugurated ten years ago by the National Nuclear Security Administration of the U. S. Department of Energy. The goal was to enhance connections between NNSA laboratories and the activities of university scientists and their students in research areas important to NNSA, including low-energy nuclear science. This paper presents an overview of recent research in low-energy nuclear science supported by the Stewardship Science Academic Alliances and the applications of this research to stewardship science.

  4. Antimicrobial Stewardship

    PubMed Central

    Doron, Shira; Davidson, Lisa E.

    2011-01-01

    Antimicrobial resistance is increasing; however, antimicrobial drug development is slowing. Now more than ever before, antimicrobial stewardship is of the utmost importance as a way to optimize the use of antimicrobials to prevent the development of resistance and improve patient outcomes. This review describes the why, what, who, how, when, and where of antimicrobial stewardship. Techniques of stewardship are summarized, and a plan for implementation of a stewardship program is outlined. PMID:22033257

  5. Thorium Nitrate Stockpile--From Here to Eternity

    SciTech Connect

    Hermes, W. H.; Hylton, T. D.; Mattus, C.H.; Storch, S. N.; Singley, P.S.; Terry. J. W.; Pecullan, M.; Reilly, F. K.

    2003-02-26

    The Defense National Stockpile Center (DNSC), a field level activity of the Defense Logistics Agency (DLA) has stewardship of a stockpile of thorium nitrate that has been in storage for decades. The stockpile is made up of approximately 3.2 million kg (7 million lb) of thorium nitrate crystals (hydrate form) stored at two depot locations in the United States. DNSC sought technical assistance from Oak Ridge National Laboratory (ORNL) to define and quantify the management options for the thorium nitrate stockpile. This paper describes methodologies and results comprising the work in Phase 1 and Phase 2. The results allow the DNSC to structure and schedule needed tasks to ensure continued safe long-term storage and/or phased disposal of the stockpile.

  6. [Antibiotic Stewardship].

    PubMed

    Lanckohr, Christian; Ellger, Björn

    2016-02-01

    The adequate management of infections is an important task in critical care medicine which has an effect on patient outcome. As a result, the prevalence of antiinfective therapy is high in intensive care units. In the face of an unsettling development of worldwide microbial resistance, an optimization and reduction of antiinfective therapy is necessary. Antibiotic stewardship tries to improve antiinfective therapy with an interdisciplinary approach. One overall objective of antibiotic stewardship is the reduction of resistance induction in order to preserve the therapeutic efficiency of antibiotics. Intensive care units are important fields of action for antibiotic stewardship interventions. This article reviews available evidence and some practical aspects for antibiotic stewardship.

  7. Stockpiling Ventilators for Influenza Pandemics

    PubMed Central

    Araz, Ozgur M.; Morton, David P.; Johnson, Gregory P.; Damien, Paul; Clements, Bruce; Meyers, Lauren Ancel

    2017-01-01

    In preparing for influenza pandemics, public health agencies stockpile critical medical resources. Determining appropriate quantities and locations for such resources can be challenging, given the considerable uncertainty in the timing and severity of future pandemics. We introduce a method for optimizing stockpiles of mechanical ventilators, which are critical for treating hospitalized influenza patients in respiratory failure. As a case study, we consider the US state of Texas during mild, moderate, and severe pandemics. Optimal allocations prioritize local over central storage, even though the latter can be deployed adaptively, on the basis of real-time needs. This prioritization stems from high geographic correlations and the slightly lower treatment success assumed for centrally stockpiled ventilators. We developed our model and analysis in collaboration with academic researchers and a state public health agency and incorporated it into a Web-based decision-support tool for pandemic preparedness and response. PMID:28518041

  8. Antimicrobial stewardship

    PubMed Central

    Chung, Gladys W.; Wu, Jia En; Yeo, Chay Leng; Chan, Douglas; Hsu, Li Yang

    2013-01-01

    Antimicrobial stewardship is an emerging field currently defined by a series of strategies and interventions aimed toward improving appropriate prescription of antibiotics in humans in all healthcare settings. The ultimate goal is the preservation of current and future antibiotics against the threat of antimicrobial resistance, although improving patient safety and reducing healthcare costs are important concurrent aims. Prospective audit and feedback interventions are probably the most widely practiced of all antimicrobial stewardship strategies. Although labor-intensive, they are more easily accepted by physicians compared with formulary restriction and preauthorization strategies and have a higher potential for educational opportunities. Objective evaluation of antimicrobial stewardship is critical for determining the success of such programs. Nonetheless, there is controversy over which outcomes to measure and there is a pressing need for novel study designs that can objectively assess antimicrobial stewardship interventions despite the limitations inherent in the structure of most such programs. PMID:23302793

  9. Facilitating Stewardship of scientific data through standards based workflows

    NASA Astrophysics Data System (ADS)

    Bastrakova, I.; Kemp, C.; Potter, A. K.

    2013-12-01

    scientific data acquisition and analysis requirements and effective interoperable data management and delivery. This includes participating in national and international dialogue on development of standards, embedding data management activities in business processes, and developing scientific staff as effective data stewards. Similar approach is applied to the geophysical data. By ensuring the geophysical datasets at GA strictly follow metadata and industry standards we are able to implement a provenance based workflow where the data is easily discoverable, geophysical processing can be applied to it and results can be stored. The provenance based workflow enables metadata records for the results to be produced automatically from the input dataset metadata.

  10. Earth Stewardship Science: International Research Networks based in Africa (Invited)

    NASA Astrophysics Data System (ADS)

    Gaines, S. M.

    2010-12-01

    The role of networking in student and early career years is critical in the development of international interdisciplinary earth system science. These networks - both peer and mentor-based - can build community, foster enthusiasm and further research applications in addition to the traditional goal of identifying and obtaining work. UNESCO has nearly 40 years of experience in building international research teams through the International Geoscience Program (IGCP) and has recently focused their attention on the status of the earth sciences in Africa. UNESCO’s Earth Science Education Initiative in Africa ran a series of regional scoping workshops around the continent in order to develop an integrated status report on the earth sciences in Africa. The results, which are globally relevant, indicate that the field is limited by the level of basic science education of incoming students and restricted laboratory facilities, but also by a lack of connectedness. This isolation relates both to the interaction between researchers within countries and around the world but also the divide between Universities and Industry and the failure of the field to communicate its relevance to the public. In a context where livelihood opportunities are the driver of study and the earth sciences provide a major source of income, practical academic ties to industry are an essential element of the attractiveness of the field to students. Actions and ideas for addressing this situation will be presented to reinforce the role of the earth sciences in improving human and environmental well-being.

  11. Handling leachate from glass cullet stockpiles.

    PubMed

    Tsai, C L; Krogmann, U; Strom, P F

    2009-04-01

    Mixed glass cullet (crushed recycled glass containers) is stockpiled uncovered before use as roadway construction aggregate or daily cover in landfills. Rainwater that leaches through the stockpiles dissolves and suspends contaminants such as those from food residuals and paper labels. The objective of this study was to determine leachate quantity and quality from cullet stockpiles as a basis for development of Best Management Practices (BMPs). Four 35-tonne field stockpiles were set up for leachate analysis and to determine the effects of mechanical turning treatment on the leachate. Field-collected leachate and laboratory-generated washwater of cullet (water:cullet=3:1 by weight) were both analyzed for basic wastewater parameters, which showed pollutant levels comparable to or higher than those of untreated domestic wastewater or urban stormwater. While organic contamination decreased substantially (e.g., washwater BOD>95% reduction), TKN and total-phosphorus levels in leachate ranged between 11.6-154mgL(-1) and 1.6-12.0mgL(-1), respectively, and remained comparable to levels found in untreated domestic wastewater after four months. Turning enhanced the degradation of the organic constituents inside the stockpiles, which was confirmed by elevated temperatures. Based on this study, leachate from glass cullet stockpiles should not be released to surface water. For leachate from long-term cullet stockpiles, release to groundwater should be only done after treatment to reduce nitrogen levels.

  12. The Stockpile Monitor Program

    SciTech Connect

    Buntain, G.A.; Fletcher, M.; Rabie, R.

    1994-07-01

    Recent political changes have led to drastic reductions in the number of nuclear warheads in stockpile, as well as increased expectations for warhead-service lives. In order to support and maintain a shrinking and aging nuclear stockpile, weapon scientists and engineers need detailed information describing the environments experienced by weapons in the field. Hence, the Stockpile Monitor Program was initiated in 1991 to develop a comprehensive and accurate database of temperature and humidity conditions experienced by nuclear warheads both in storage and on-alert.

  13. Development of an Antimicrobial Stewardship-based Infectious Diseases Elective that Incorporates Human Patient Simulation Technology

    PubMed Central

    Meyer, Susan M.

    2014-01-01

    Objective. To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. Design. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Assessment. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. Conclusion. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs. PMID:25386016

  14. Antimicrobial stewardship.

    PubMed

    Allerberger, F; Mittermayer, H

    2008-03-01

    The aim of antimicrobial management or stewardship programmes is to ensure proper use of antimicrobial agents in order to provide the best treatment outcomes, to lessen the risk of adverse effects (including antimicrobial resistance), and to promote cost-effectiveness. Increasingly, long-term sustainability is found to be the major focus of antimicrobial stewardship. Implementing structural measures in healthcare institutions is therefore a major, but not the sole, focus of attention in promoting prudent use of antibiotics. The problem of antimicrobial resistance requires common strategies at all levels--for the prescribers and at ward, departmental, hospital, national and international levels.

  15. Stockpile surveillance: Past and future

    SciTech Connect

    Johnson, K.; Keller, J.; Ekdahl, C.; Krajcik, R.; Salazar, L.; Kelly, E.; Paulsen, R.

    1996-01-01

    The US nuclear weapon stockpile is entering a different era. Continuous introduction of new weapons into the stockpile, a large production capacity, and underground nuclear testing played important roles in how the nuclear weapons stockpile was managed in the past. These are no longer elements of the nuclear weapons program. Adjustments need to be made to compensate for the loss of these elements. The history of the stockpile indicates that problems have been found in both nuclear and nonnuclear components through a variety of methods including the Stockpile Evaluation Program, stockpile management activities, underground nuclear tests, and research activities. Changes have been made to the stockpile when necessary to assure safety, performance, and reliability. There have been problems found in each of the weapon types expected to be in the stockpile in the year 2000. It is reasonable to expect problems will continue to arise in the stockpile as it ages beyond the original design expectations.

  16. The pediatric vaccine stockpiling problem.

    PubMed

    Truong, Van-Anh

    2012-09-21

    The U.S. has experienced many major interruptions of its pediatric vaccine production in the past decade. The Centers for Disease Control and Prevention (CDC) copes with these shortages by building a national stockpile of pediatric vaccines, which it makes accessible to the public in the event of a shortage. The management of this stockpile is difficult due to limited production capacity and long and unpredictable production interruptions. In this paper, we address policies for managing the stockpile. We provide sufficient conditions for the optimal policy to be a modified state-dependent base-stock policy, with the base-stock level decreasing in the pipeline inventory. Since the optimal policy is in general difficult to evaluate, we derive bounds on the optimal decision in each period. We develop an efficient policy that performs on average within 1% of optimality in simulations. We show that stocking the same supply of vaccine of every type can be over-conservative in some cases, and inadequate in others by large factors. We also quantify the substantial reduction in inventory level that can be achieved when there are multiple suppliers in the market. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Chemical Stockpile Disposal Program

    SciTech Connect

    Krummel, J.R.; Policastro, A.J.; Olshansky, S.J.; McGinnis, L.D.

    1990-10-01

    As part of the Chemical Stockpile Disposal Program mandated by Public Law 99--145 (Department of Defense Authorization Act), an independent review is presented of the US Army Phase I environmental report for the disposal program at the Pine Bluff Arsenal (PBA) in Arkansas. The Phase I report addressed new and additional concerns not incorporated in the final programmatic environmental impact statement (FPEIS). Those concerns were addressed by examining site-specific data for the PBA and by recommending the scope and content of a more detailed site- specific study. This dependent review evaluates whether the new site-specific data presented in the Phase I report would alter the decision in favor of on-site disposal that was reached in the FPEIS, and whether the recommendations for the scope and content of the site-specific study are adequate. Based on the methods and assumptions presented in the FPEIS, the inclusion of more detailed site-specific data in the Phase I report does not change the decision reached in the FPEIS (which favored on-site disposal at PBA). It is recommended that alternative assumptions about meteorological conditions be considered and that site-specific data on water, ecological, socioeconomic, and cultural resources, and emergency planning and preparedness be considered explicitly in the site-specific EIS decision-making process. 13 refs., 1 fig.

  18. Chemical Stockpile Disposal Program

    SciTech Connect

    Krummel, J.R.; Policastro, A.J.; Olshansky, S.J.; McGinnis, L.D.

    1990-10-01

    As part of the Chemical Stockpile Disposal Program mandated by Public Law 99--145 (Department of Defense Authorization Act), an independent review is presented of the US Army Phase I environmental report for the disposal program at the Umatilla Depot Activity (UMDA) in Hermiston, Oregon. The Phase I report addressed new and additional concerns not incorporated in the final programmatic environmental impact statement (FPEIS). Those concerns were addressed by examining site-specific data for the Umatilla Depot Activity and by recommending the scope and content of a more detailed site-specific study. This independent review evaluates whether the new site-specific data presented in the Phase I report would alter the decision in favor of on-site disposal that was reached in the FPEIS, and whether the recommendations for the scope and content of the site-specific study are adequate. Based on the methods and assumptions presented in the FPEIS, the inclusion of more detailed site-specific data in the Phase I report does not change the decision reached in the FPEIS (which favored on-site disposal at UMDA). It is recommended that alternative assumptions about meteorological conditions be considered and that site-specific data on water, ecological, socioeconomic, and cultural resources; seismicity; and emergency planning and preparedness be considered explicitly in the site-specific EIS decision-making process. 7 refs., 1 fig.

  19. Risk in the Weapons Stockpile

    SciTech Connect

    Noone, Bailey C

    2012-08-14

    When it comes to the nuclear weapons stockpile, risk must be as low as possible. Design and care to keep the stockpile healthy involves all aspects of risk management. Design diversity is a method that helps to mitigate risk.

  20. Wetlands stewardship

    SciTech Connect

    Whelan, J.M.

    1992-04-01

    Wetlands have important ecological values and functions. It is estimated that 80 percent of the Nation's coastal fisheries are dependent on wetlands for spawning, nursery areas, and food sources. Both coastal and inland wetlands provide essential breeding, nesting, feeding, and predator escape habitats for millions of waterfowl, other birds, mammals, and reptiles. Well over one-third of the 564 plant and animal species listed as threatened or endangered in the United States utilize wetland habitats during some portion of their life cycle. Wetlands Stewardship is intended as a resource for everyone interested in wetlands protection.

  1. Analytical Characterization of the Thorium Nitrate Stockpile

    SciTech Connect

    Mattus, CH

    2003-12-30

    For several years, Oak Ridge National Laboratory (ORNL) has been supporting the Defense Logistics Agency-Defense National Stockpile Center with stewardship of a thorium nitrate (ThN) stockpile. The effort for fiscal year 2002 was to prepare a sampling and analysis plan and to use the activities developed in the plan to characterize the ThN stockpile. The sampling was performed in June and July 2002 by RWE NUKEM with oversight by ORNL personnel. The analysis was performed by Southwest Research Institute of San Antonio, Texas, and data validation was performed by NFT, Inc., of Oak Ridge, Tennessee. Of the {approx} 21,000 drums in the stockpile, 99 were sampled and 53 were analyzed for total metals composition, radiological constituents (using alpha and gamma spectrometry), and oxidizing characteristics. Each lot at the Curtis Bay Depot was sampled. Several of the samples were also analyzed for density. The average density of the domestic ThN was found to be 1.89 {+-} 0.08 g/cm{sup 3}. The oxidizer test was performed following procedures issued by the United Nations in 1999. Test results indicated that none of the samples tested was a Division 5.1 oxidizer per Department of Transportation definition. The samples were analyzed for total metals following the U.S. Environmental Protection Agency methods SW-846-6010B and 6020 (EPA 2003) using a combination of inductively coupled plasma--atomic emission spectroscopy and inductively coupled plasma--mass spectroscopy techniques. The results were used to compare the composition of the eight Resource Conservation and Recovery Act metals present in the sample (arsenic, barium, cadmium, chromium, lead, mercury, selenium, and silver) to regulatory limits. None of the samples was found to be hazardous for toxicity characteristics. The radiological analyses confirmed, when possible, the results obtained by the inductively coupled plasma analyses. These results--combined with the historical process knowledge acquired on the material

  2. Los Alamos Explosives Performance Key to Stockpile Stewardship

    SciTech Connect

    Dattelbaum, Dana

    2014-11-03

    As the U.S. Nuclear Deterrent ages, one essential factor in making sure that the weapons will continue to perform as designed is understanding the fundamental properties of the high explosives that are part of a nuclear weapons system. As nuclear weapons go through life extension programs, some changes may be advantageous, particularly through the addition of what are known as "insensitive" high explosives that are much less likely to accidentally detonate than the already very safe "conventional" high explosives that are used in most weapons. At Los Alamos National Laboratory explosives research includes a wide variety of both large- and small-scale experiments that include small contained detonations, gas and powder gun firings, larger outdoor detonations, large-scale hydrodynamic tests, and at the Nevada Nuclear Security Site, underground sub-critical experiments.

  3. Neutron Capture Reactions for Stockpile Stewardship and Basic Science

    SciTech Connect

    Parker, W; Agvaanluvsan, U; Becker, J; Wilk, P; Wu, C; Bredeweg, T; Couture, A; Haight, R; Jandel, M; O'Donnell, J; Reifarth, R; Rundberg, R; Ullmann, J; Vieira, D; Wouters, J; Sheets, S; Mitchell, G; Becvar, F; Krticka, M

    2007-08-04

    The capture process is a nuclear reaction in which a target atom captures an incident projectile, e.g. a neutron. The excited-state compound nucleus de-excites by emitting photons. This process creates an atom that has one more neutron than the target atom, so it is a different isotope of the same element. With low energy (slow) neutron projectiles, capture is the dominant reaction, other than elastic scattering. However, with very heavy nuclei, fission competes with capture as a method of de-excitation of the compound nucleus. With higher energy (faster) incident neutrons, additional reactions are also possible, such as emission of protons or emission of multiple neutrons. The probability of a particular reaction occurring (such as capture) is referred to as the cross section for that reaction. Cross sections are very dependent on the incoming neutron's energy. Capture reactions can be studied either using monoenergetic neutron sources or 'white' neutron sources. A 'white' neutron source has a wide range of neutron energies in one neutron beam. The advantage to the white neutron source is that it allows the study of cross sections as they depend on neutron energies. The Los Alamos Neutron Science Center, located at Los Alamos National Laboratory, provides an intense white neutron source. Neutrons there are created by a high-energy proton beam from a linear accelerator striking a heavy metal (tungsten) target. The neutrons range in energy from subthermal up to very fast - over 100 MeV in energy. Low-energy neutron reaction cross sections fluctuate dramatically from one target to another, and they are very difficult to predict by theoretical modeling. The cross sections for particular capture reactions are important for defense sciences, advanced reactor concepts, transmutation of radioactive wastes and nuclear astrophysics. We now have a strong collaboration between Lawrence Livermore National Laboratory, Los Alamos National Laboratory, North Carolina State University and Charles University in Prague. In this paper, we report neutron capture studies that are of particular interest to Lawrence Livermore National Laboratory. In addition to determining neutron capture cross sections, we are also interested in the nuclear properties of the excited state compound nuclei created in the capture reactions. One model that describes the behavior of the nucleus is the statistical model. Our statistical studies included measuring the photon strength function, resonance parameters, level density and gamma-ray ({gamma}-ray) cascade multiplicity. The DANCE array allows the separation of cascades by the number of transitions (multiplicity) in the cascade, and this makes it possible to study detailed properties of the statistical cascade such as the relationship between multiplicity and energy distributions. The work reported here includes reaction on molybdenum targets, europium targets, gadolinium targets and the first americium-242m target. Our goal is to improve the accuracy and provide new measurements for stable and radioactive targets. We are especially interested in energy-dependent neutron capture cross sections. In all of our experiments, the photons emitted in the capture reactions are gamma rays, and they are detected by the barium fluoride crystal array named the Detector for Advanced Neutron Capture Experiments (DANCE) shown in Fig. 1. The detector array is made of 160 crystals arranged in a sphere around the target. There are four different crystal shapes, each of which covers an equal solid angle. This array was specifically designed to measure neutron capture cross sections with targets that were milligram sized or smaller, including radioactive targets. The barium fluoride crystals are scintillation (light generating) detectors with very fast response time, and are therefore suitable for high count rate experiments. Actual neutron capture events must be reliably distinguished from background {gamma}-rays, which are always present in neutron induced reactions. To reduce the background of scattered neutrons, a lithium hydride shell is placed inside the array. The purpose of using the spherical array of detectors is to cover all possible directions of emitted {gamma} rays, so we will come as close as possible to complete detection of all the prompt {gamma}-ray cascades emitted in a capture reaction. The sum of the energy of the {gamma} cascades is a measure of the binding energy of the capture neutron. The binding energy is the energy required to remove a bound neutron from the nucleus. The measured mass of the nucleus is smaller than the masses of the target nucleus plus the captured neutron, and the difference (converted to energy) is the binding energy of the capture neutron. Because the detector is segmented into a large number of independent detectors, additional information on event multiplicities (number of {gamma} rays emitted) and other properties can be determined.

  4. Los Alamos Explosives Performance Key to Stockpile Stewardship

    ScienceCinema

    Dattelbaum, Dana

    2016-07-12

    As the U.S. Nuclear Deterrent ages, one essential factor in making sure that the weapons will continue to perform as designed is understanding the fundamental properties of the high explosives that are part of a nuclear weapons system. As nuclear weapons go through life extension programs, some changes may be advantageous, particularly through the addition of what are known as "insensitive" high explosives that are much less likely to accidentally detonate than the already very safe "conventional" high explosives that are used in most weapons. At Los Alamos National Laboratory explosives research includes a wide variety of both large- and small-scale experiments that include small contained detonations, gas and powder gun firings, larger outdoor detonations, large-scale hydrodynamic tests, and at the Nevada Nuclear Security Site, underground sub-critical experiments.

  5. [Antibiotic stewardship].

    PubMed

    Kerwat, Klaus; Wulf, Hinnerk

    2014-09-01

    Resistance against antibiotics is continuously increasing throughout the world and has become a very serious problem. For just this reason "Antibiotic Stewardship Programs" have been developed. These programs are intended to lead to a sustained improvement in the situation and to assure a rational practice for the prescription of anti-infective agents in medical facilities. The aim is to prescribe the correct antibiotic therapy to the right patient at the most appropriate point in time. An AWMF S3 guideline on this topic published by the German Society for Infectiology (S3-Leitlinie StrategienzurSicherungrationalerAntibiotika-AnwendungimKrankenhaus.AWMF-Registernummer 092/001 - S3 Guideline on Strategies for the Rational Use of Antibiotics in Hospitals. AWMF - Registry Number 092/001) has been available since the end of 2013. An essential aspect therein is the expert interdisciplinary cooperation of a team comprising a clinically experienced infectiologist, a hospital pharmacist and a consultant for microbiology.

  6. 16 CFR 1210.20 - Stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARD FOR CIGARETTE LIGHTERS Stockpiling § 1210.20 Stockpiling. (a) Definition. Stockpiling means to... cigarette lighters shall not manufacture or import lighters that do not comply with the requirements of this...

  7. 16 CFR 1210.20 - Stockpiling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARD FOR CIGARETTE LIGHTERS Stockpiling § 1210.20 Stockpiling. (a) Definition. Stockpiling means to... cigarette lighters shall not manufacture or import lighters that do not comply with the requirements of this...

  8. 16 CFR 1210.20 - Stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARD FOR CIGARETTE LIGHTERS Stockpiling § 1210.20 Stockpiling. (a) Definition. Stockpiling means to... cigarette lighters shall not manufacture or import lighters that do not comply with the requirements of...

  9. 16 CFR 1210.20 - Stockpiling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARD FOR CIGARETTE LIGHTERS Stockpiling § 1210.20 Stockpiling. (a) Definition. Stockpiling means to... cigarette lighters shall not manufacture or import lighters that do not comply with the requirements of...

  10. Potential Radon-222 Emissions from the Thorium Nitrate Stockpile

    SciTech Connect

    Terry, J.W.

    2003-09-04

    The Defense National Stockpile Center (DNSC), a field level activity of the Defense Logistics Agency, has stewardship of a stockpile of thorium nitrate that has been in storage for decades. The thorium nitrate stockpile was produced from 1959 to 1964 for the Atomic Energy Commission and previously has been under the control of several federal agencies. The stockpile consists of approximately 7 million pounds of thorium nitrate crystals (hydrate form) stored at two depot locations in the United States (75% by weight at Curtis Bay, Maryland, and 25% by weight at Hammond, Indiana). The material is stored in several configurations in over 21,000 drums. The U.S. Congress has declared the entire DNSC thorium nitrate stockpile to be in excess of the needs of the Department of Defense. Part of DNSC's mission is to safely manage the continued storage, future sales, and/or disposition of the thorium nitrate stockpile. Historically, DNSC has sold surplus thorium nitrate to domestic and foreign companies, but there is no demand currently for this material. Analyses conducted by Oak Ridge National Laboratory (ORNL) in 2001 demonstrated that disposition of the thorium nitrate inventory as a containerized waste, without processing, is the least complex and lowest-cost option for disposition. A characterization study was conducted in 2002 by ORNL, and it was determined that the thorium nitrate stockpile may be disposed of as low-level waste. The Nevada Test Site (NTS) was used as a case study for the disposal alternative, and special radiological analyses and waste acceptance requirements were documented. Among the special radiological considerations is the emission of {sup 220}Rn and {sup 222}Rn from buried material. NTS has a performance objective on the emissions of radon: 20 pCi m{sup -2} sec{sup -1} at the surface of the disposal facility. The radon emissions from the buried thorium nitrate stockpile have been modeled. This paper presents background information and summarizes

  11. Market stabilization and the strategic stockpile. [Economic stockpiling mostly ineffective

    SciTech Connect

    Gauntt, G.E.

    1980-01-01

    The evidence in this article indicates that the United States has in the past operated economic stockpiles for market-stabilization purposes for lead, zinc, and tin, though those stockpiles were established solely for strategic purposes and their use for economic purposes has never been officially authorized. This fact has, ironically, often been overlooked in the recent debate in the US over the desirability of creating economic stockpiles. A closeook at the efforts to use government stocks to stabilize the lead, zinc, and tin markets also suggests they have not been very successful. They may contribute temporarily to stability, but in the process they affect decisions regarding material substitution and capacity, and shift the short-run supply and demand curves in a manner that often is ultimately destabilizing. The reason these efforts have been unsuccessful is that pressure to maintain the stockpiles at militarily acceptable levels, as well as the possible need to intervene in the market on an extended basis, prevents the government from carrying out economic stockpiling for more than several years. This suggests that economic stockpiling, in order to stabilize effectively mineral markets, may have to be quite large, separate, and distinct from military stockpiles, and require extended periods of disposals or purchases to counteract successfully market trends. 10 references, 8 figures.

  12. Reliability Degradation Due to Stockpile Aging

    SciTech Connect

    Robinson, David G.

    1999-04-01

    The objective of this reseach is the investigation of alternative methods for characterizing the reliability of systems with time dependent failure modes associated with stockpile aging. Reference to 'reliability degradation' has, unfortunately, come to be associated with all types of aging analyes: both deterministic and stochastic. In this research, in keeping with the true theoretical definition, reliability is defined as a probabilistic description of system performance as a funtion of time. Traditional reliability methods used to characterize stockpile reliability depend on the collection of a large number of samples or observations. Clearly, after the experiments have been performed and the data has been collected, critical performance problems can be identified. A Major goal of this research is to identify existing methods and/or develop new mathematical techniques and computer analysis tools to anticipate stockpile problems before they become critical issues. One of the most popular methods for characterizing the reliability of components, particularly electronic components, assumes that failures occur in a completely random fashion, i.e. uniformly across time. This method is based primarily on the use of constant failure rates for the various elements that constitute the weapon system, i.e. the systems do not degrade while in storage. Experience has shown that predictions based upon this approach should be regarded with great skepticism since the relationship between the life predicted and the observed life has been difficult to validate. In addition to this fundamental problem, the approach does not recognize that there are time dependent material properties and variations associated with the manufacturing process and the operational environment. To appreciate the uncertainties in predicting system reliability a number of alternative methods are explored in this report. All of the methods are very different from those currently used to assess stockpile

  13. Assessing Environmental Stewardship Motivation

    ERIC Educational Resources Information Center

    Bramston, Paul; Pretty, Grace; Zammit, Charlie

    2011-01-01

    Environmental stewardship networks flourish across Australia. Although the environment benefits, this article looks to identify what volunteers draw from their stewardship. The authors adapted 16 questions that purportedly tap environmental stewardship motivation and administered them to a convenience sample of 318 university students and then to…

  14. Steering through Stewardship

    ERIC Educational Resources Information Center

    Emlen, Julia S.

    2010-01-01

    A cornerstone of intentional stewardship is measuring outcomes--essentially keeping track of the changing behavior of donors. Evaluating stewardship outcomes may require a considerable amount of work in determining cause-and-effect relationships between stewardship actions and donor behaviors, but a few tests can be revelatory. For instance, it…

  15. Temperature profiles of coal stockpiles

    SciTech Connect

    Sensogut, C.; Ozdeniz, A.H.; Gundogdu, I.B.

    2008-07-01

    Excess of produced coals should be kept in the stockyards of the collieries. The longer the duration time for these coals, the greater possibility for spontaneous combustion to take place. Spontaneously burnt coals result in economical and environmental problems. Therefore, taking the necessary precautions before an outburst of the spontaneous combustion phenomenon is too important in terms of its severe results. In this study, a stockpile having industrial dimensions was formed in coal stockyard. The effective parameters on the stockpiles of coal such as temperature and humidity of the weather, time, and atmospheric pressure values were measured. The interior temperature variations of these stockpiles caused by the atmospheric conditions were also measured. The interior temperature distribution maps of the stockpile together with maximum and minimum temperature values were expressed visually and numerically by the assistance of obtained data.

  16. Technical basis for chemical stockpile emergency planning

    SciTech Connect

    Newsom, D.E.; Madore, M.A.; Paddock, R.A.; Absil, M.J.G.

    1995-12-31

    As part of the Chemical Stockpile Emergency Preparedness Program, an Accident Planning Base Review Group (APBRG) was convened in December 1992. The APBRG`s mission was to update the accident basis for protective action strategy planning in the vicinity of eight US chemical agent stockpile sites. The results of the APBRG`s work are being issued as site-specific Emergency Planning Guides (EPGs). The EPGs give emergency planners -- Army, State, and local -- an updated assessment of the chemical hazard and guidance on how to plan for a broad range of accidents by planning for a manageable number of accident categories. This paper addresses: the rationale for updating the accident planning base, the modeling methodology used to assess the chemical hazard, and strategies that are advocated in the EPGs for the use of models by planners.

  17. Technical basis for chemical stockpile emergency planning

    SciTech Connect

    Newsom, D.E.; Madore, M.A.; Paddock, R.A.; Absil, M.J.G.

    1995-06-01

    As part of the Chemical Stockpile Emergency Preparedness Program, an Accident Planning Base Review Group (APBRG) was convened in December 1992. The APBRG`s mission was to update the accident basis for protective action strategy planning in the vicinity of eight US chemical agent stockpile sites. The results of the APBRG`s work are being issued as site-specific Emergency Planning Guides (EPGs). The EPGs give emergency planners--Army, State, and local--updated assessment of the chemical hazard and guidance on how to plan for a broad range of accidents by planning for a manageable number of accident categories. This paper addresses: (1) the rationale for updating the accident planning base; (2) the modeling methodology used to assess the chemical hazard; and (3) strategies that are advocated in the EPGs for the use of models by planners.

  18. 20 Years of Success: Science, Technology, and the Nuclear Weapons Stockpile

    SciTech Connect

    None, None

    2015-10-22

    On Oct. 22, 2015, NNSA celebrated the proven success of the Stockpile Stewardship Program at a half-day public event featuring remarks by Secretary of Energy Ernest Moniz, Secretary of State John Kerry, and Under Secretary for Nuclear Security and NNSA Administrator Lt. Gen. (retired) Frank G. Klotz. The event also featured remarks by Deputy Secretary of Energy Elizabeth Sherwood-Randall and NNSA Principal Deputy Administrator Madelyn Creedon.

  19. Stewardship as an Environmental Ethic.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

    The stewardship model of environmental ethics, based on ancient Greek and Judeo-Christian doctrines, has failed to protect the earth. This model is committed to human superiority and detachment from nature and lacks the teeth of accountability for faithless stewards. An alternative model must recognize the biosphere's intrinsic values. (SV)

  20. 16 CFR 1201.6 - Prohibited stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR ARCHITECTURAL GLAZING MATERIALS The Standard § 1201.6 Prohibited stockpiling. (a) Stockpiling. For the purposes of this section, the term stockpiling means manufacturing or importing the...

  1. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ....7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling. (a) Stockpiling. Stockpiling means manufacturing or importing a product which is the subject of a consumer product...

  2. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling. (a) Stockpiling. Stockpiling means manufacturing or importing a product which is the subject of a consumer product...

  3. The development of global vaccine stockpiles

    PubMed Central

    Yen, Catherine; Hyde, Terri B; Costa, Alejandro J; Fernandez, Katya; Tam, John S; Hugonnet, Stéphane; Huvos, Anne M; Duclos, Philippe; Dietz, Vance J; Burkholder, Brenton T

    2016-01-01

    Global vaccine stockpiles, in which vaccines are reserved for use when needed for emergencies or supply shortages, have effectively provided countries with the capacity for rapid response to emergency situations, such as outbreaks of yellow fever and meningococcal meningitis. The high cost and insufficient supply of many vaccines, including oral cholera vaccine and pandemic influenza vaccine, have prompted discussion on expansion of the use of vaccine stockpiles to address a wider range of emerging and re-emerging diseases. However, the decision to establish and maintain a vaccine stockpile is complex and must take account of disease and vaccine characteristics, stockpile management, funding, and ethical concerns, such as equity. Past experience with global vaccine stockpiles provide valuable information about the processes for their establishment and maintenance. In this Review we explored existing literature and stockpile data to discuss the lessons learned and to inform the development of future vaccine stockpiles. PMID:25661473

  4. Detectors for Accelerator-Based Security Applications

    NASA Astrophysics Data System (ADS)

    Warren, Glen A.; Stave, Sean C.; Miller, Erin A.

    We present a review of detector systems used in accelerator-based security applications. The applications discussed span stockpile stewardship, material interdiction, treaty verification, and spent nuclear fuel assay. The challenge for detectors in accelerator-based applications is the separation of the desired signal from the background, frequently during high input count rates. Typical techniques to address the background challenge include shielding, timing, selection of sensitive materials, and choice of accelerator.

  5. Detectors for Accelerator-Based Security Applications

    NASA Astrophysics Data System (ADS)

    Warren, Glen A.; Stave, Sean C.; Miller, Erin A.

    We present a review of detector systems used in accelerator-based security applications. The applications discussed span stockpile stewardship, material interdiction, treaty verification, and spent nuclear fuel assay. The challenge for detectors in accelerator-based applications is the separation of the desired signal from the background, frequently during high input count rates. Typical techniques to address the background challenge include shielding, timing, selection of sensitive materials, and choice of accelerator.

  6. U.S. Nuclear Weapons Modernization - the Stockpile Life Extension Program

    NASA Astrophysics Data System (ADS)

    Cook, Donald

    2016-03-01

    Underground nuclear testing of U.S. nuclear weapons was halted by President George H.W. Bush in 1992 when he announced a moratorium. In 1993, the moratorium was extended by President Bill Clinton and, in 1995, a program of Stockpile Stewardship was put in its place. In 1996, President Clinton signed the Comprehensive Nuclear Test Ban Treaty (CTBT). Twenty years have passed since then. Over the same time, the average age of a nuclear weapon in the stockpile has increased from 6 years (1992) to nearly 29 years (2015). At its inception, achievement of the objectives of the Stockpile Stewardship Program (SSP) appeared possible but very difficult. The cost to design and construct several large facilities for precision experimentation in hydrodynamics and high energy density physics was large. The practical steps needed to move from computational platforms of less than 100 Mflops/sec to 10 Teraflops/sec and beyond were unknown. Today, most of the required facilities for SSP are in place and computational speed has been increased by more than six orders of magnitude. These, and the physicists and engineers in the complex of labs and plants within the National Nuclear Security Administration (NNSA) who put them in place, have been the basis for underpinning an annual decision, made by the weapons lab directors for each of the past 20 years, that resort to underground nuclear testing is not needed for maintaining confidence in the safety and reliability of the U.S stockpile. A key part of that decision has been annual assessment of the physical changes in stockpiled weapons. These weapons, quite simply, are systems that invariably and unstoppably age in the internal weapon environment of radioactive materials and complex interfaces of highly dissimilar organic and inorganic materials. Without an ongoing program to rebuild some components and replace other components to increase safety or security, i.e., life extending these weapons, either underground testing would again be

  7. The concept of stewardship in health policy.

    PubMed Central

    Saltman, R. B.; Ferroussier-Davis, O.

    2000-01-01

    There is widespread agreement that both the configuration and the application of state authority in the health sector should be realigned in the interest of achieving agreed policy objectives. The desired outcome is frequently characterized as a search for good governance serving the public interest. The present paper examines the proposal in The World Health Report 2000 that the concept of stewardship offers the appropriate basis for reconfiguration. We trace the development of stewardship from its initial religious formulation to more recent ecological and sociological permutations. Consideration is given to the potential of stewardship for encouraging state decision-making that is both normatively based and economically efficient. Various dilemmas that could impede or preclude such a shift in state behaviour are examined. We conclude that the concept of stewardship holds substantial promise if adequately developed and effectively implemented. PMID:10916910

  8. Biosolid stockpiles are a significant point source for greenhouse gas emissions.

    PubMed

    Majumder, Ramaprasad; Livesley, Stephen J; Gregory, David; Arndt, Stefan K

    2014-10-01

    The wastewater treatment process generates large amounts of sewage sludge that are dried and then often stored in biosolid stockpiles in treatment plants. Because the biosolids are rich in decomposable organic matter they could be a significant source for greenhouse gas (GHG) emissions, yet there are no direct measurements of GHG from stockpiles. We therefore measured the direct emissions of methane (CH4), nitrous oxide (N2O) and carbon dioxide (CO2) on a monthly basis from three different age classes of biosolid stockpiles at the Western Treatment Plant (WTP), Melbourne, Australia, from December 2009 to November 2011 using manual static chambers. All biosolid stockpiles were a significant point source for CH4 and N2O emissions. The youngest biosolids (<1 year old) had the greatest CH4 and N2O emissions of 60.2 kg of CO2-e per Mg of biosolid per year. Stockpiles that were between 1 and 3 years old emitted less overall GHG (∼29 kg CO2-e Mg(-1) yr(-1)) and the oldest stockpiles emitted the least GHG (∼10 kg CO2-e Mg(-1) yr(-1)). Methane emissions were negligible in all stockpiles but the relative contribution of N2O and CO2 changed with stockpile age. The youngest stockpile emitted two thirds of the GHG emission as N2O, while the 1-3 year old stockpile emitted an equal amount of N2O and CO2 and in the oldest stockpile CO2 emissions dominated. We did not detect any seasonal variability of GHG emissions and did not observe a correlation between GHG flux and environmental variables such as biosolid temperature, moisture content or nitrate and ammonium concentration. We also modeled CH4 emissions based on a first order decay model and the model based estimated annual CH4 emissions were higher as compared to the direct field based estimated annual CH4 emissions. Our results indicate that labile organic material in stockpiles is decomposed over time and that nitrogen decomposition processes lead to significant N2O emissions. Carbon decomposition favors CO2 over

  9. Stockpile Dismantlement Database Training Materials

    SciTech Connect

    Not Available

    1993-11-01

    This document, the Stockpile Dismantlement Database (SDDB) training materials is designed to familiarize the user with the SDDB windowing system and the data entry steps for Component Characterization for Disposition. The foundation of information required for every part is depicted by using numbered graphic and text steps. The individual entering data is lead step by step through generic and specific examples. These training materials are intended to be supplements to individual on-the-job training.

  10. Real-world performance of a microarray-based rapid diagnostic for Gram-positive bloodstream infections and potential utility for antimicrobial stewardship.

    PubMed

    Aitken, Samuel L; Hemmige, Vagish S; Koo, Hoonmo L; Vuong, Nancy N; Lasco, Todd M; Garey, Kevin W

    2015-01-01

    The Verigene Gram-positive blood culture assay (BC-GP) is a microarray-based rapid diagnostic test, which includes targets for 12 bacterial species and 3 resistance determinants. We prospectively compared the diagnostic accuracy of the BC-GP to routine microbiologic methods and evaluated the potential of the BC-GP for antimicrobial stewardship programs. A total of 143 consecutive patients with Gram-positive bacteremia were included in the analysis. BC-GP correctly identified 127/128 (99.2%) of organisms from monomicrobial blood cultures and 9/14 (64.3%) from polymicrobial, including all methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci. Stewardship interventions were possible in 51.0% of patients, most commonly stopping or preventing unnecessary vancomycin or starting a targeted therapy. In Monte Carlo simulations, unnecessary antibiotics could be stopped at least 24 hours earlier in 65.6% of cases, and targeted therapy could be started at least 24 hours earlier in 81.2%. BC-GP is a potentially useful test for antibiotic stewardship in patients with Gram-positive bacteremia.

  11. Best Practices for Healthcare Facility and Regional Stockpile Maintenance and Sustainment: A Literature Review.

    PubMed

    Rebmann, Terri; McPhee, Kyle; Osborne, Leslie; Gillen, Daniel P; Haas, Gabriel A

    Preparing for mass casualty incidents is essential to maximizing community resilience. Many US-based organizations and regions have developed stockpiles of medications, supplies, and equipment for mass casualty incident preparedness. The Centers for Disease Control and Prevention (CDC) assess and manage federally stockpiled materials, but hospitals, healthcare systems, and regional organizations are responsible for maintaining locally owned caches. The CDC has protocols for assessing and managing the Strategic National Stockpile, but no such guidance exists for local or geographical/regional stockpiles. This article outlines best practices and recommendations identified in the literature related to maintaining and sustaining a local or regional stockpile. Recommendations are provided on the timing and procedures for assessing, inventorying, storing, managing, tracking, and deploying materials stockpiled on site, in a trailer, or in a warehouse. In addition, alternative approaches for maintaining a local or regional cache, such as vendor- or user-managed inventory methods, are addressed. Management of local or regional caches requires an investment in infrastructure and training but is necessary to ensure the integrity of stockpiled medication and supplies and to enable rapid and appropriate activation during a mass casualty incident. Hospitals, healthcare systems, businesses, academic institutions, public health agencies, organizations, and regions can use the recommendations here to develop protocols or policies to properly manage their existing stockpiles, which should minimize costs related to damaged supplies.

  12. Generic Unclassified Stockpile Sizing Module (SSM) Training and Testing for the National Defense Stockpile (NDS) 2015

    DTIC Science & Technology

    2014-11-01

    Generic Unclassified Stockpile Sizing Module (SSM) Training and Testing for the National Defense Stockpile (NDS) 2015 Robert J. Atwell Eleanor L...REPORT DATE NOV 2014 2. REPORT TYPE 3. DATES COVERED 4. TITLE AND SUBTITLE Generic Unclassified Stockpile Sizing Module (SSM) Training and...SUPPLEMENTARY NOTES 14. ABSTRACT The Stockpile Sizing Module (SSM) is a modeling tool used to estimate U.S. shortfalls of strategic and critical

  13. Aging and Radiation Effects in Stockpile Electronics

    SciTech Connect

    Hartman, E.F.

    1999-03-25

    It is likely that aging is affecting the radiation hardness of stockpile electronics, and we have seen apparent examples of aging that affects the electronic radiation hardness. It is also possible that low-level intrinsic radiation that is inherent during stockpile life will damage or in a sense age electronic components. Both aging and low level radiation effects on radiation hardness and stockpile reliability need to be further investigated by using both test and modeling strategies that include appropriate testing of electronic components withdrawn from the stockpile.

  14. Revaluation of stockpile amount of PFOS-containing aqueous film-forming foam in Japan: gaps and pitfalls in the stockpile survey.

    PubMed

    Zushi, Yasuyuki; Yamamoto, Atsushi; Tsunemi, Kiyotaka; Masunaga, Shigeki

    2017-03-01

    Stockpiles of perfluoro-octane sulfonic acid (PFOS) containing aqueous film-forming foam (AFFF) have the potential to be emitted by leaching, spills, and during use in fire response and other processes. Several studies have discussed the high levels of stockpiled PFOS-containing AFFF and the risk they pose to the environment; however, there are large gaps in the amounts in Japan compared with other countries. For example, 300 tons are stockpiled in Canada, 2200-2600 tons in Switzerland, 1400 tons in Norway, and 19,000 tons in Japan from their reports for publication. The gap is considered to be a result of lack of surveys of several important sources. In this study, we revaluated the stockpile of AFFF in Japan to verify the reported value and identify the source of this gap based on information available in peer-reviewed papers, governmental reports, and business reports. The major reason for the gap between Japan and other countries was considered to be the survey of stockpiles in car-parking facilities, which accounted for 46.7% of the total amounts in Japan, but were not considered in other countries. These stockpiles indicate a high potential for accidental leaching or spilling of the AFFF by careless storage. Therefore, it is recommended that continual surveys of the AFFF stockpile in car-parking facilities be conducted in the rest of the world.

  15. Benefits of Adding a Rapid PCR-Based Blood Culture Identification Panel to an Established Antimicrobial Stewardship Program

    PubMed Central

    2016-01-01

    Studies have demonstrated that the combination of antimicrobial stewardship programs (ASP) and rapid organism identification improves outcomes in bloodstream infections (BSI) but have not controlled for the incremental contribution of the individual components. Hospitalized adult patients with blood culture pathogens on a rapid, multiplex PCR-based blood culture identification panel (BCID) that included 19 bacterial species, 5 Candida spp., and 4 antimicrobial resistance genes were studied over sequential time periods in a pre-post quasiexperimental study in 3 groups in the following categories: conventional organism identification (controls), conventional organism identification with ASP (AS), and BCID with ASP (BCID). Clinical and economic outcomes were compared between groups. There were 783 patients with positive blood cultures; of those patients, 364 (115 control, 104 AS, and 145 BCID) met inclusion criteria. The time from blood culture collection to organism identification was shorter in the BCID group (17 h; P < 0.001) than in the control group (57 h) or the AS group (54 h). The BCID group had a shorter time to effective therapy (5 h; P < 0.001) than the control group (15 h) or AS group (13 h). The AS (57%) and BCID (52%) groups had higher rates of antimicrobial de-escalation than the control group (34%), with de-escalation occurring sooner in the BCID group (48 h; P = 0.034) than in the AS group (61 h) or the control group (63 h). No difference between the control group, AS group, and BCID group was seen with respect to mortality, 30-day readmission, intensive care unit length of stay (LOS), postculture LOS, or costs. In patients with BSI, ASP alone improved antimicrobial utilization. Addition of BCID to an established ASP shortened the time to effective therapy and further improved antimicrobial use compared to ASP alone, even in a setting of low antimicrobial resistance rates. PMID:27487951

  16. Stockpile tritium production from fusion

    SciTech Connect

    Lokke, W.A.; Fowler, T.K.

    1986-03-21

    A fusion breeder holds the promise of a new capability - ''dialable'' reserve capacity at little additional cost - that offers stockpile planners a new way to deal with today's uncertainties in forecasting long range needs. Though still in the research stage, fusion can be developed in time to meet future military requirements. Much of the necessary technology will be developed by the ongoing magnetic fusion energy program. However, a specific program to develop the nuclear technology required for materials production is needed if fusion is to become a viable option for a new production complex around the turn of the century.

  17. 16 CFR 1207.12 - Stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... STANDARD FOR SWIMMING POOL SLIDES § 1207.12 Stockpiling. (a) Definitions. As used in this section: (1) Stockpiling means manufacturing or importing swimming pool slides between the date of promulgation of part... importation) means the total number of swimming pool slides manufactured (or imported) during a stated time...

  18. 16 CFR 1207.12 - Stockpiling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... STANDARD FOR SWIMMING POOL SLIDES § 1207.12 Stockpiling. (a) Definitions. As used in this section: (1) Stockpiling means manufacturing or importing swimming pool slides between the date of promulgation of part... importation) means the total number of swimming pool slides manufactured (or imported) during a stated...

  19. 16 CFR 1207.12 - Stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... STANDARD FOR SWIMMING POOL SLIDES § 1207.12 Stockpiling. (a) Definitions. As used in this section: (1) Stockpiling means manufacturing or importing swimming pool slides between the date of promulgation of part... importation) means the total number of swimming pool slides manufactured (or imported) during a stated...

  20. 16 CFR 1207.12 - Stockpiling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... STANDARD FOR SWIMMING POOL SLIDES § 1207.12 Stockpiling. (a) Definitions. As used in this section: (1) Stockpiling means manufacturing or importing swimming pool slides between the date of promulgation of part... importation) means the total number of swimming pool slides manufactured (or imported) during a stated...

  1. 16 CFR 1207.12 - Stockpiling.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... STANDARD FOR SWIMMING POOL SLIDES § 1207.12 Stockpiling. (a) Definitions. As used in this section: (1) Stockpiling means manufacturing or importing swimming pool slides between the date of promulgation of part... importation) means the total number of swimming pool slides manufactured (or imported) during a stated...

  2. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Prohibited stockpiling. 1205.7 Section 1205.7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling....

  3. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Prohibited stockpiling. 1205.7 Section 1205.7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling....

  4. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Prohibited stockpiling. 1205.7 Section 1205.7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling....

  5. The United States pediatric vaccine stockpile program.

    PubMed

    Lane, Kimberly S; Chu, Susan Y; Santoli, Jeanne M

    2006-03-01

    The initial goal of the national vaccine stockpile program was to establish a 6-month supply of all recommended childhood vaccines, to meet national demands if a manufacturing process was interrupted. When the first vaccine stockpiles were created in 1983, the childhood immunization schedule was much less complicated than it is today, and the first stockpiles included only measles-mumps-rubella, poliovirus, and pertussis vaccines, as well as diphtheria and tetanus toxoids. However, today's vaccine needs are much greater, and current stockpiles do not include all recommended childhood vaccines, partially because inclusion of vaccines that are universally recommended, fully implemented, and produced by a single manufacturer has been made a priority. Future planning must also consider substantially higher vaccine costs, the development of new combination vaccines, a wide range of production times, and changes in immunization recommendations. Expansion and strengthening of the national vaccine stockpile program are critical to protect against future disruptions in vaccine supply.

  6. Experience With Rapid Microarray-Based Diagnostic Technology and Antimicrobial Stewardship for Patients With Gram-Positive Bacteremia.

    PubMed

    Neuner, Elizabeth A; Pallotta, Andrea M; Lam, Simon W; Stowe, David; Gordon, Steven M; Procop, Gary W; Richter, Sandra S

    2016-11-01

    OBJECTIVE To describe the impact of rapid diagnostic microarray technology and antimicrobial stewardship for patients with Gram-positive blood cultures. DESIGN Retrospective pre-intervention/post-intervention study. SETTING A 1,200-bed academic medical center. PATIENTS Inpatients with blood cultures positive for Staphylococcus aureus, Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, S. pyogenes, S. agalactiae, S. anginosus, Streptococcus spp., and Listeria monocytogenes during the 6 months before and after implementation of Verigene Gram-positive blood culture microarray (BC-GP) with an antimicrobial stewardship intervention. METHODS Before the intervention, no rapid diagnostic technology was used or antimicrobial stewardship intervention was undertaken, except for the use of peptide nucleic acid fluorescent in situ hybridization and MRSA agar to identify staphylococcal isolates. After the intervention, all Gram-positive blood cultures underwent BC-GP microarray and the antimicrobial stewardship intervention consisting of real-time notification and pharmacist review. RESULTS In total, 513 patients with bacteremia were included in this study: 280 patients with S. aureus, 150 patients with enterococci, 82 patients with stretococci, and 1 patient with L. monocytogenes. The number of antimicrobial switches was similar in the pre-BC-GP (52%; 155 of 300) and post-BC-GP (50%; 107 of 213) periods. The time to antimicrobial switch was significantly shorter in the post-BC-GP group than in the pre-BC-GP group: 48±41 hours versus 75±46 hours, respectively (P<.001). The most common antimicrobial switch was de-escalation and time to de-escalation, was significantly shorter in the post-BC-GP group than in the pre-BC-GP group: 53±41 hours versus 82±48 hours, respectively (P<.001). There was no difference in mortality or hospital length of stay as a result of the intervention. CONCLUSIONS The combination of a rapid microarray diagnostic test with an antimicrobial

  7. Environmental Management Welcomes a New Face and Reinforces Its Focus on Science-Based Stewardship

    SciTech Connect

    Dale, Virginia H

    2010-06-01

    ENVIRONMENTAL MANAGEMENT is pleased to announce that Rebecca Efroymson will join Virginia Dale as Co-Editors-in-Chief of the journal. Dr. Efroymson brings extensive expertise in risk assessment and environmental toxicology. Her work has focused on land management, natural resources, water quality, and rare species, with recent work on benefits and risks of energy alternatives. ENVIRONMENTAL MANAGEMENT has been publishing research on the management and conservation of natural resources and habitats since 1976. Articles discuss implications for an international audience and examine a scientific or management hypothesis. As a premier scientific journal in applied and cross-cutting areas, articles come from a variety of disciplines including biology, botany, climatology, earth sciences, ecology, ecological economics, environmental engineering, fisheries, forest sciences, geography, information science, law, management science, politics, public affairs, social sciences, and zoology, most often in combinations determined by the interdisciplinary topic of the study. The journal strives to improve cross-disciplinary communication by making ideas and results available to environmental practitioners from other backgrounds. The goal of ENVIRONMENTAL MANAGEMENT is to present a wide spectrum of viewpoints and approaches, and to this end the journal consists of four main sections. Forum contains addresses, editorials, comments, and opinions about environmental matters. Articles in the Profile section describe and evaluate particular case histories, events, policies, problems, or organizations and their work. Papers in the Research section present the methods and findings from empirical and model-based scientific studies. The section on Environmental Assessment is for articles that cover methods of appraisal, measurement, and comparison. Generally, the debates published in the journal's Forum help construct better environmental research or policies; Research and Assessment

  8. Evaluating ecological monitoring of civic environmental stewardship in the Green-Duwamish watershed, Washington

    Treesearch

    Jacob C. Sheppard; Clare M. Ryan; Dale J. Blahna

    2017-01-01

    The ecological outcomes of civic environmental stewardship are poorly understood, especially at scales larger than individual sites. In this study we characterized civic environmental stewardship programs in the Green-Duwamish watershed in King County, WA, and evaluated the extent to which stewardship outcomes were monitored. We developed a four-step process based on...

  9. Point-of-Prescription Interventions to Improve Antimicrobial Stewardship

    PubMed Central

    Hamilton, Keith W.; Gerber, Jeffrey S.; Moehring, Rebekah; Anderson, Deverick J.; Calderwood, Michael S.; Han, Jennifer H.; Mehta, Jimish M.; Pollack, Lori A.; Zaoutis, Theoklis; Srinivasan, Arjun; Camins, Bernard C.; Schwartz, David N.; Lautenbach, Ebbing

    2015-01-01

    Antimicrobial stewardship is pivotal to improving patient outcomes, reducing adverse events, decreasing healthcare costs, and preventing further emergence of antimicrobial resistance. In an era in which antimicrobial resistance is increasing, judicious antimicrobial use is the responsibility of every healthcare provider. Antimicrobial stewardship programs (ASPs) have made headway in improving antimicrobial prescribing using such “top-down” methods as formulary restriction and prospective audit with feedback; however, engagement of prescribers has not been fully explored. Strategies that include frontline prescribers and other unit-based healthcare providers have the potential to expand stewardship, both to augment existing centralized ASPs and to provide alternative approaches to perform stewardship at healthcare facilities with limited resources. This review discusses interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship. PMID:25595748

  10. Planning guidance for the Chemical Stockpile Emergency Preparedness Program

    SciTech Connect

    Shumpert, B.L.; Watson, A.P.; Sorensen, J.H.

    1995-02-01

    This planning guide was developed under the direction of the U.S. Army and the Federal Emergency Management Agency (FEMA) which jointly coordinate and direct the development of the Chemical Stockpile Emergency Preparedness Program (CSEPP). It was produced to assist state, local, and Army installation planners in formulating and coordinating plans for chemical events that may occur at the chemical agent stockpile storage locations in the continental United States. This document provides broad planning guidance for use by both on-post and off-post agencies and organizations in the development of a coordinated plan for responding to chemical events. It contains checklists to assist in assuring that all important aspects are included in the plans and procedures developed at each Chemical Stockpile Disposal Program (CSDP) location. The checklists are supplemented by planning guidelines in the appendices which provide more detailed guidance regarding some issues. The planning guidance contained in this document will help ensure that adequate coordination between on-post and off-post planners occurs during the planning process. This planning guide broadly describes an adequate emergency planning base that assures that critical planning decisions will be made consistently at every chemical agent stockpile location. This planning guide includes material drawn from other documents developed by the FEMA, the Army, and other federal agencies with emergency preparedness program responsibilities. Some of this material has been developed specifically to meet the unique requirements of the CSEPP. In addition to this guidance, other location-specific documents, technical studies, and support studies should be used as needed to assist in the planning at each of the chemical agent stockpile locations to address the specific hazards and conditions at each location.

  11. Antimicrobial Stewardship in the Management of Sepsis.

    PubMed

    Pulia, Michael S; Redwood, Robert; Sharp, Brian

    2017-02-01

    Sepsis represents a unique clinical dilemma with regard to antimicrobial stewardship. The standard approach to suspected sepsis in the emergency department centers on fluid resuscitation and timely broad-spectrum antimicrobials. The lack of gold standard diagnostics and evolving definitions for sepsis introduce a significant degree of diagnostic uncertainty that may raise the potential for inappropriate antimicrobial prescribing. Intervention bundles that combine traditional quality improvement strategies with emerging electronic health record-based clinical decision support tools and rapid molecular diagnostics represent the most promising approach to enhancing antimicrobial stewardship in the management of suspected sepsis in the emergency department.

  12. Pediatric Antimicrobial Stewardship Programs

    PubMed Central

    Nichols, Kristen; Stoffella, Sylvia; Meyers, Rachel; Girotto, Jennifer

    2017-01-01

    The frequent use of antimicrobials in pediatric patients has led to a significant increase in multidrug-resistant bacterial infections among children. Antimicrobial stewardship programs have been created in many hospitals in an effort to curtail and optimize the use of antibiotics. Pediatric-focused programs are necessary because of the differences in antimicrobial need and use among this patient population, unique considerations and dosing, vulnerability for resistance due to a lifetime of antibiotic exposure, and the increased risk of adverse events. This paper serves as a position statement of the Pediatric Pharmacy Advocacy Group (PPAG) who supports the implementation of antimicrobial stewardship programs for all pediatric patients. PPAG also believes that a pediatric pharmacy specialist should be included as part of that program and that services be covered by managed care organizations and government insurance entities. PPAG also recommends that states create legislation similar to that in existence in California and Missouri and that a federal Task Force for Combating Antibiotic-Resistant Bacteria be permanently established. PPAG also supports post-doctoral pharmacy training programs in antibiotic stewardship.

  13. Ecosystem stewardship: good idea, but how?

    USDA-ARS?s Scientific Manuscript database

    Ecosystem stewardship and resilience-based management are admirable concepts that remain largely conceptual. Beyond a suite of general ideas, including linkages among ecological models, monitoring, stakeholder engagement, and social learning, there is not a replicable method to use the ideas in the ...

  14. Modeling the national pediatric vaccine stockpile: supply shortages, health impacts and cost consequences.

    PubMed

    Shrestha, Sundar S; Wallace, Gregory S; Meltzer, Martin I

    2010-08-31

    Pediatric vaccine stockpiles have been in place in the U.S. since 1983 to address the potential disruption in supply of routine pediatric vaccines. Increases in the number of vaccines recommended for pediatric and adolescent patients have increased the cost of stocking and maintaining the stockpile. Based on a spreadsheet-based model (VacStockpile) we developed, we estimated potential supply shortages of 14 stockpiled vaccines as of August 1, 2008 and its health and financial impacts under various shortage and stockpile scenarios. To illustrate the implications of policy options, we compared "high" to "low" stockpile scenarios. The high stockpile scenario ensures a 6-month vaccine supply to vaccinate all children according to recommended schedules. The low scenario comprised of 50% of the high scenario or existing stocks, whichever is smaller. For each vaccine, we used a weighted average of five shortage scenarios ranging from 0% to 100%, in 25% increments. Demand for each vaccine was based on current distribution or birth cohort size. The probabilities of shortages were based on number of manufacturers, market stability, history of manufacturing problems, and production complexity. CDC contract prices were used to estimate costs. Expert opinion and literature provided estimates of health impacts due to shortages. Applying the probabilities of shortages to all vaccines in a single year, the "low" scenario could cost $600 million, with 376,000 vaccine-preventable cases occurring and 1774 deaths. The "high" scenario could cost $2 billion, with an additional $1.6 billion initial stocking, and result in 7100 vaccine-preventable cases occurring and 508 deaths. Based on the assumptions in the model, there is the potential for large differences in outcomes between the scenarios although some outcomes could potentially be averted with measures such as catch-up campaigns after shortages. Using the VacStockpile policy makers can readily evaluate the implications of

  15. A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

    PubMed

    Agwu, Allison L; Lee, Carlton K K; Jain, Sanjay K; Murray, Kara L; Topolski, Jason; Miller, Robert E; Townsend, Timothy; Lehmann, Christoph U

    2008-09-15

    Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World

  16. Stockpile reliability program for special purpose strap. Technical report

    SciTech Connect

    Mayfield, N.A.

    1993-06-01

    Since 1962, web strap tie-down assemblies have been used to secure nuclear weapon containers on tactical vehicles. In 1968, a 36 month useful life (in use) requirement was placed on the straps used to secure war reserve nuclear weapons containers on vehicles. This means that no matter what condition the straps were in, after 36 months they could no longer be used. Due to the numerous problems with the straps for different reasons throughout the years, in 1986 the US Army Armament Research, Development and Engineering Center was tasked to design a new special purpose strap. The US Armament, Munition and Chemical Command, Rock Island, was assigned to be the item manager and to procure the new design straps. Also, at that time, it was agreed that instead of placing the 36 month useful life requirement on the new straps, a stockpile reliability program would be established. This program was to determine whether real usage of tie-down strap could justify either the establishment of a 36 month useful life requirement or have no requirement at all and reject straps based on their condition as determined by inspections only. This report reflects the results, conclusions, and recommendations based on a 5 year stockpile reliability program.... Web strap tie-down assemblies, Stockpile Reliability Program(SPR), In-field use environment, Control storage sample, Base line, Ultimate load, Failure.

  17. DEM Simulation of Particle Stratification and Segregation in Stockpile Formation

    NASA Astrophysics Data System (ADS)

    Zhang, Dizhe; Zhou, Zongyan; Pinson, David

    2017-06-01

    Granular stockpiles are commonly observed in nature and industry, and their formation has been extensively investigated experimentally and mathematically in the literature. One of the striking features affecting properties of stockpiles are the internal patterns formed by the stratification and segregation processes. In this work, we conduct a numerical study based on DEM (discrete element method) model to study the influencing factors and triggering mechanisms of these two phenomena. With the use of a previously developed mixing index, the effects of parameters including size ratio, injection height and mass ratio are investigated. We found that it is a void-filling mechanism that differentiates the motions of particles with different sizes. This mechanism drives the large particles to flow over the pile surface and segregate at the pile bottom, while it also pushes small particles to fill the voids between large particles, giving rise to separate layers. Consequently, this difference in motion will result in the observed stratification and segregation phenomena.

  18. Long-term environmental stewardship.

    SciTech Connect

    Nagy, Michael David

    2010-08-01

    The purpose of this Supplemental Information Source Document is to effectively describe Long-Term Environmental Stewardship (LTES) at Sandia National Laboratories/New Mexico (SNL/NM). More specifically, this document describes the LTES and Long-Term Stewardship (LTS) Programs, distinguishes between the LTES and LTS Programs, and summarizes the current status of the Environmental Restoration (ER) Project.

  19. Antibiotic stewardship implementation in the EU: the way forward.

    PubMed

    Allerberger, Franz; Gareis, Roland; Jindrák, Vlastimil; Struelens, Marc J

    2009-12-01

    There is an urgent need for an agreement on the principles and key components of antibiotic stewardship to support the EU member states in developing their national or regional programs. A proposal for a conceptual framework was drafted during an international expert workshop on hospital antibiotic stewardship organized under the Czech presidency in Prague on 15 April 2009. This document aims at defining structural and organizational requirements to optimize antibiotic use for hospitalized patients. Optimization should aim at improving patient outcomes, ensuring cost-effective therapy, and reducing the adverse health and ecological effects of antimicrobial use, including drug resistance. Antibiotic stewardship is of relevance to hospital as well as community care. To progress on antibiotic stewardship implementation in the EU, we suggest that three issues need to be addressed: the need for further research on the comparative effectiveness and cost-effectiveness of antibiotic stewardship strategies and interventions in different healthcare settings, the development of expert consensus on key elements of evidence-based best practice in hospital and community antibiotic stewardship, and strengthening the legal basis and core funding of antibiotic stewardship programs as integral components of quality and efficiency of care promotion initiatives.

  20. Evaluation of gas emissions from coal stockpile.

    PubMed

    Kozinc, J; Zupancic-Kralj, L; Zapusek, A

    2004-05-01

    Gas emissions of carbon dioxide, methane, dimethylsulfide, carbon monoxide and oxygen from a coal stockpile in Velenje were determined. Gases from the coal stockpile were collected in Alltech Standard sampling bags and then analysed using a capillary gas chromatograph and electrochemical sensors. A flame ionisation detector equipped with a Zr/Ni catalytic reactor was used for the determination of methane and carbon dioxide. Dimethylsulfide was detected with a flame photometric detector, and the concentrations of carbon monoxide and oxygen were determined by use of electrochemical sensors. The results showed that the main influence on gas emissions is related to the ambient temperature. Emissions of carbon dioxide during summer 2001 (average temperature during sampling period was 24 degrees C) were approximately 30-times higher than during winter 2002 (average temperature during sampling period was -2 degrees C) and were also influenced by the oxygen concentration. Carbon dioxide is mainly formed by oxidation of coal. Methane and dimethylsulfide are desorbed from coal, and are present in higher concentrations in stockpile emissions when stockpiles are renewed. The dimethylsulfide concentration, in contrast to laboratory experiments in stockpile emissions, falls immediately due to photo-degradation.

  1. Strategic national stockpile: overview and ventilator assets.

    PubMed

    Malatino, Eileen M

    2008-01-01

    Acquiring a resupply of critical medical assets following a national emergency will be crucial to saving lives. The Strategic National Stockpile is a national repository of various medications, vaccines, antidotes, and medical/surgical equipment that would be used to augment federal, state, and local public health agencies in the event of a terrorist attack or other public health emergency. Portable ventilators are included in the stockpile Managed Inventory. These ventilators and the ancillary equipment needed for one adult or one pediatric patient are kitted in a durable case that is staged and ready for deployment. A state that requires these assets initiates a request for federal assistance through established guidelines. This paper provides an overview of the Strategic National Stockpile, the types of ventilators and ancillary equipment currently available, and the process for requesting these assets.

  2. Pharmaceuticals and the strategic national stockpile program.

    PubMed

    Stewart, Amy; Cordell, Geoffrey A

    2007-10-01

    This article discusses current stockpile practices after exploring a history of the use of biologic agents as weapons, the preventive measures that the federal government has used in the past, and the establishment of a Strategic National Stockpile Program in 2003. The article also describes the additional medical supplies from the managed inventory and the federal medical stations. The issues (financial burden, personnel, and materiel selection) for local asset development are also discussed. Critical is the cost to local communities of the development and maintenance of a therapeutic agent stockpile and the need for personnel to staff clinics and medical stations. Finally, the important role of the dental profession for dispensing medication and providing mass immunization in the event of a disaster is described.

  3. 30 CFR 56.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Trimming stockpile and muckpile faces. 56.9314 Section 56.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 56.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  4. 30 CFR 56.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Trimming stockpile and muckpile faces. 56.9314 Section 56.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 56.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  5. 30 CFR 57.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Trimming stockpile and muckpile faces. 57.9314 Section 57.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 57.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  6. 30 CFR 56.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Trimming stockpile and muckpile faces. 56.9314 Section 56.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 56.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  7. 30 CFR 57.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Trimming stockpile and muckpile faces. 57.9314 Section 57.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 57.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  8. 30 CFR 57.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Trimming stockpile and muckpile faces. 57.9314 Section 57.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 57.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  9. 30 CFR 56.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Trimming stockpile and muckpile faces. 56.9314 Section 56.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 56.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  10. 30 CFR 56.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Trimming stockpile and muckpile faces. 56.9314 Section 56.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 56.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  11. 30 CFR 57.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Trimming stockpile and muckpile faces. 57.9314 Section 57.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 57.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  12. 30 CFR 57.9314 - Trimming stockpile and muckpile faces.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Trimming stockpile and muckpile faces. 57.9314 Section 57.9314 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Dumping Sites § 57.9314 Trimming stockpile and muckpile faces. Stockpile and muckpile faces shall be...

  13. Nuclear materials stewardship: Our enduring mission

    SciTech Connect

    Isaacs, T.H.

    1998-12-31

    The US Department of Energy (DOE) and its predecessors have handled a remarkably wide variety of nuclear materials over the past 50 yr. Two fundamental changes have occurred that shape the current landscape regarding nuclear materials. If one recognizes the implications and opportunities, one sees that the stewardship of nuclear materials will be a fundamental and important job of the DOE for the foreseeable future. The first change--the breakup of the Soviet Union and the resulting end to the nuclear arms race--altered US objectives. Previously, the focus was on materials production, weapon design, nuclear testing, and stockpile enhancements. Now the attention is on dismantlement of weapons, excess special nuclear material inventories, accompanying increased concern over the protection afforded to such materials; new arms control measures; and importantly, maintenance of the safety and reliability of the remaining arsenal without testing. The second change was the raised consciousness and sense of responsibility for dealing with the environmental legacies of past nuclear arms programs. Recognition of the need to clean up radioactive contamination, manage the wastes, conduct current operations responsibly, and restore the environment have led to the establishment of what is now the largest program in the DOE. Two additional features add to the challenge and drive the need for recognition of nuclear materials stewardship as a fundamental, enduring, and compelling mission of the DOE. The first is the extraordinary time frames. No matter what the future of nuclear weapons and no matter what the future of nuclear power, the DOE will be responsible for most of the country`s nuclear materials and wastes for generations. Even if the Yucca Mountain program is successful and on schedule, it will last more than 100 yr. Second, the use, management, and disposition of nuclear materials and wastes affect a variety of nationally important and diverse objectives, from national

  14. The Strategic National Stockpile: roles and responsibilities of health care professionals for receiving the stockpile assets.

    PubMed

    Esbitt, Debraelee

    2003-01-01

    In 1999, the US Congress created the National Pharmaceutical Stockpile Program (NPS) under the management of the Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services. On March 1, 2003, the National Pharmaceutical Stockpile Program became known as the Strategic National Stockpile (SNS) Program under the new Department of Homeland Security. The purpose of the SNS Program is to maintain a stockpile of pharmaceutical agents, vaccines, medical supplies, and equipment to augment state and local resources during a large-scale disaster or bioterrorism event. Upon request, the SNS Program will deliver materials anywhere in the United States within 12 or fewer hours. A brief overview of the SNS Program and the role of local and state health care providers for receiving the SNS assets are reviewed.

  15. Stewardship and leadership in nursing.

    PubMed

    Milton, Constance L

    2014-04-01

    The concept or metaphor of stewardship is important to the future of the discipline of nursing. Nurse leaders and scholars of the discipline are entrusted to preserve and hold in trust the value priorities of the discipline as well as the value priorities of others who are living health. The author here offers a discussion of possible meanings and ethical implications for enhancing the discipline's potential obligations of leadership and stewardship as a basic human science discipline.

  16. Sinclair Stockpiles CFCs for Future Use.

    ERIC Educational Resources Information Center

    George, Stephen C.

    1996-01-01

    A Dayton (Ohio) community college's 21 buildings were cooled by a network of 5 chillers, all of which used soon-to-be-banned chlorofluorocarbons (CFCs). A reclamation program provides the college with reusable refrigerant and eliminates chiller replacement costs. Refrigerant from three of the old units is stockpiled for use in the two other…

  17. Sinclair Stockpiles CFCs for Future Use.

    ERIC Educational Resources Information Center

    George, Stephen C.

    1996-01-01

    A Dayton (Ohio) community college's 21 buildings were cooled by a network of 5 chillers, all of which used soon-to-be-banned chlorofluorocarbons (CFCs). A reclamation program provides the college with reusable refrigerant and eliminates chiller replacement costs. Refrigerant from three of the old units is stockpiled for use in the two other…

  18. 16 CFR 1202.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ....7 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR MATCHBOOKS § 1202.7 Prohibited stockpiling. Section 9(d)(2) of the Consumer Product Safety Act (15 U.S.C. 2058(d)(2)) authorizes the Commission to prohibit manufacturers and importers from...

  19. Assuring Essential Industrial Base Requirements for Strategic & Critical Materials

    DTIC Science & Technology

    2012-05-23

    pilot project to reclaim rhenium containing super alloys from jet engines • Viewed as a method to offset substantial reliance on foreign sources of...be candidates for National Defense Stockpile inventory Rhenium Upgrade 13 WARFIGHTER SUPPORT ENHANCEMENT STEWARDSHIP

  20. An Evidence-Based Antimicrobial Stewardship Smartphone App for Hospital Outpatients: Survey-based Needs Assessment Among Patients

    PubMed Central

    McLeod, Monsey; Castro-Sánchez, Enrique; Gharbi, Myriam; Charani, Esmita; Moore, Luke SP; Gilchrist, Mark; Husson, Fran; Costelloe, Ceire; Holmes, Alison H

    2016-01-01

    Background Current advances in modern technology have enabled the development and utilization of electronic medical software apps for both mobile and desktop computing devices. A range of apps on a large variety of clinical conditions for patients and the public are available, but very few target antimicrobials or infections. Objective We sought to explore the use of different antimicrobial information resources with a focus on electronic platforms, including apps for portable devices, by outpatients at two large, geographically distinct National Health Service (NHS) teaching hospital trusts in England. We wanted to determine whether there is demand for an evidence-based app for patients, to garner their perceptions around infections/antimicrobial prescribing, and to describe patients’ experiences of their interactions with health care professionals in relation to this topic. Methods A cross-sectional survey design was used to investigate aspects of antimicrobial prescribing and electronic devices experienced by patients at four hospitals in London and a teaching hospital in the East of England. Results A total of 99 surveys were completed and analyzed. A total of 82% (80/98) of respondents had recently been prescribed antimicrobials; 87% (85/98) of respondents were prescribed an antimicrobial by a hospital doctor or through their general practitioner (GP) in primary care. Respondents wanted information on the etiology (42/65, 65%) and prevention and/or management (32/65, 49%) of their infections, with the infections reported being upper and lower respiratory tract, urinary tract, oral, and skin and soft tissue infections. All patients (92/92, 100%) desired specific information on the antimicrobial prescribed. Approximately half (52/95, 55%) stated it was “fine” for doctors to use a mobile phone/tablet computer during the consultation while 13% (12/95) did not support the idea of doctors accessing health care information in this way. Although only 30% (27

  1. The Aging Arsenal: The Stockpile Stewardship Program and Long Term Challenges to Viable Deterrence

    DTIC Science & Technology

    2010-03-01

    certainly been great advances in testing, simulation, and sustainment efforts. One example of this investment is the National Ignition Facility ( NIF ) where...test. In essence, the NIF will create a small nuclear explosion with most of the corresponding characteristics except the total explosive energy yield...proper conditions for a supercritical reaction. The NIF and DARHT facilities provide a CTBT compliant capability to test existing warheads and

  2. Article on Trident Laser Facility for NA-11 Stockpile Stewardship Quarterly

    SciTech Connect

    Barnes, Cris W.

    2012-08-13

    The Trident Intermediate-Scale Laser Facility at Los Alamos National Laboratory is an extremely versatile Nd:glass laser system dedicated to high energy density laboratory physics and weapons physics research and fundamental laser-matter interactions. Trident is a three-beam, 200 J/beam at the second harmonic for glass (527 nm wavelength), facility with tremendous flexibility and high beam quality. Pulse durations varying over 6 orders of magnitude, from 0.5 picoseconds to 1.0 microsecs, can be directed to either of two different target chambers with changeable illumination geometries, including the ability to achieve near-diffraction limited focus. This provides a unique range of capability at one facility from sub-picosecond pulses (and high-intensity laser science) to nanosecond pulses (and LPI physics relevant to ICF) to microsecond pulses (and driving flyer plates for supported shock dynamic materials science.) When in short-pulse mode (less than picosecond pulse), a single beam can provide up to 200 TW of power with uniquely controllable and measured pre-pulse contrast of 10 orders of magnitude. A recent external capability review at Los Alamos concluded that 'Trident is generating excellent, cutting edge science and is a leading intermediate scale laser system worldwide.'

  3. Stockpile Model of Personal Protective Equipment in Taiwan.

    PubMed

    Chen, Yu-Ju; Chiang, Po-Jung; Cheng, Yu-Hsin; Huang, Chun-Wei; Kao, Hui-Yun; Chang, Chih-Kai; Huang, Hsun-Miao; Liu, Pei-Yin; Wang, Jen-Hsin; Chih, Yi-Chien; Chou, Shu-Mei; Yang, Chin-Hui; Chen, Chang-Hsun

    The Taiwan Centers for Disease Control (Taiwan CDC) has established a 3-tier personal protective equipment (PPE) stockpiling framework that could maintain a minimum stockpile for the surge demand of PPE in the early stage of a pandemic. However, PPE stockpiling efforts must contend with increasing storage fees and expiration problems. In 2011, the Taiwan CDC initiated a stockpile replacement model in order to optimize the PPE stockpiling efficiency, ensure a minimum stockpile, use the government's limited funds more effectively, and achieve the goal of sustainable management. This stockpile replacement model employs a first-in-first-out principle in which the oldest stock in the central government stockpile is regularly replaced and replenished with the same amount of new and qualified products, ensuring the availability and maintenance of the minimum stockpiles. In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. In this article, we describe the PPE stockpile model in Taiwan, including the 3-tier stockpiling framework, the operational model, the components of the replacement system, implementation outcomes, epidemic supports, and the challenges and prospects of this model.

  4. Stockpile Model of Personal Protective Equipment in Taiwan

    PubMed Central

    Chen, Yu-Ju; Cheng, Yu-Hsin; Huang, Chun-Wei; Kao, Hui-Yun; Chang, Chih-Kai; Huang, Hsun-Miao; Liu, Pei-Yin; Wang, Jen-Hsin; Chih, Yi-Chien; Chou, Shu-Mei; Yang, Chin-Hui; Chen, Chang-Hsun

    2017-01-01

    The Taiwan Centers for Disease Control (Taiwan CDC) has established a 3-tier personal protective equipment (PPE) stockpiling framework that could maintain a minimum stockpile for the surge demand of PPE in the early stage of a pandemic. However, PPE stockpiling efforts must contend with increasing storage fees and expiration problems. In 2011, the Taiwan CDC initiated a stockpile replacement model in order to optimize the PPE stockpiling efficiency, ensure a minimum stockpile, use the government's limited funds more effectively, and achieve the goal of sustainable management. This stockpile replacement model employs a first-in-first-out principle in which the oldest stock in the central government stockpile is regularly replaced and replenished with the same amount of new and qualified products, ensuring the availability and maintenance of the minimum stockpiles. In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. In this article, we describe the PPE stockpile model in Taiwan, including the 3-tier stockpiling framework, the operational model, the components of the replacement system, implementation outcomes, epidemic supports, and the challenges and prospects of this model. PMID:28418743

  5. Evidence-based knowledge versus negotiated indicators for assessment of ecological sustainability: the Swedish Forest Stewardship Council standard as a case study.

    PubMed

    Angelstam, Per; Roberge, Jean-Michel; Axelsson, Robert; Elbakidze, Marine; Bergman, Karl-Olof; Dahlberg, Anders; Degerman, Erik; Eggers, Sönke; Esseen, Per-Anders; Hjältén, Joakim; Johansson, Therese; Müller, Jörg; Paltto, Heidi; Snäll, Tord; Soloviy, Ihor; Törnblom, Johan

    2013-03-01

    Assessing ecological sustainability involves monitoring of indicators and comparison of their states with performance targets that are deemed sustainable. First, a normative model was developed centered on evidence-based knowledge about (a) forest composition, structure, and function at multiple scales, and (b) performance targets derived by quantifying the habitat amount in naturally dynamic forests, and as required for presence of populations of specialized focal species. Second, we compared the Forest Stewardship Council (FSC) certification standards' ecological indicators from 1998 and 2010 in Sweden to the normative model using a Specific, Measurable, Accurate, Realistic, and Timebound (SMART) indicator approach. Indicator variables and targets for riparian and aquatic ecosystems were clearly under-represented compared to terrestrial ones. FSC's ecological indicators expanded over time from composition and structure towards function, and from finer to coarser spatial scales. However, SMART indicators were few. Moreover, they poorly reflected quantitative evidence-based knowledge, a consequence of the fact that forest certification mirrors the outcome of a complex social negotiation process.

  6. Fluorescent lamp recycling initiatives in the United States and a recycling proposal based on extended producer responsibility and product stewardship concepts.

    PubMed

    Silveira, Geraldo Tr; Chang, Shoou-Yuh

    2011-06-01

    This paper presents an overview of mercury-containing lamp (MCL) recycling initiatives currently available in the world, especially in the United States. The majority of MCLs contain mercury which is a neurotoxin, a persistent pollutant in the environment, and can bioaccumulate in the food chain. Although there are some recycling options in the United States, collection rates are still at 23% of all potential used MCLs. This shows that citizens are either indifferent to or unaware of the recycling alternatives. On the other hand, MCL recycling seems not to be a cost-effective process and, for this reason, in the United States, take-back programmes are still sponsored only by consumers or municipalities. A few retailers have recently initiated limited take-back alternatives and manufacturers have not yet supported financially any consistent recycling alternative in the country. Considering successful experiences, this paper makes a suggestion for an MCL recycling system based on the concepts of extended producer responsibility and product stewardship. A manufacturer-importer advance recycling fee is proposed to finance the collection and recycling system while a MCL-energy recycling fee supported by the energy sector creates a lamp refund process. 'PRO Lamp', a producer responsibility organization, will manage the entire system through a widespread public-private agreement.

  7. Antimicrobial stewardship: philosophy versus practice.

    PubMed

    Dodds Ashley, Elizabeth S; Kaye, Keith S; DePestel, Daryl D; Hermsen, Elizabeth D

    2014-10-15

    To promote the judicious use of antimicrobials and preserve their usefulness in the setting of growing resistance, a number of policy-making bodies and professional societies have advocated the development of antimicrobial stewardship programs. Although these programs have been implemented at many institutions in the United States, their impact has been difficult to measure. Current recommendations advocate the use of both outcome and process measures as metrics for antimicrobial stewardship. Although patient outcome metrics have the greatest impact on the quality of care, the literature shows that antimicrobial use and costs are the indicators measured most frequently by institutions to justify the effectiveness of antimicrobial stewardship programs. The measurement of more meaningful outcomes has been constrained by difficulties inherent to these measures, lack of funding and resources, and inadequate study designs. Antimicrobial stewardship can be made more credible by refocusing the antimicrobial review process to target specific disease states, reassessing the usefulness of current metrics, and integrating antimicrobial stewardship program initiatives into institutional quality and safety efforts. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Product stewardship in the composites industry

    NASA Technical Reports Server (NTRS)

    Aldrich, Donald C.; Merriman, Edmund A.

    1994-01-01

    The definition and purpose of Product Stewardship is discussed. Its' impact in the composites industry is stated. The report also outlines 12 ways that Product Stewardship can be utilized by consumers.

  9. Treatment-donation-stockpile dynamics in ebola convalescent blood transfusion therapy.

    PubMed

    Huo, Xi; Sun, Xiaodan; Lan, Kunquan; Wu, Jianhong

    2016-03-07

    The interim guidance issued by the World Health Organization during the West Africa 2014 Ebola outbreak provides guidelines on the use of convalescent blood from Ebola survivors for transfusion therapy. Here we develop a novel mathematical model, based on the interim guidance, to examine the nonlinear transmission-treatment-donation-stockpile dynamics during an Ebola outbreak and with a large scale use of the transfusion therapy in the population. We estimate the reduction of case fatality ratio by introducing convalescent blood transfusion as a therapy, and inform optimal treatment-donation-stockpile strategies to balance the treatment need for case fatality ratio reduction and the strategic need of maintaining a minimal blood bank stockpile for other control priorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Update on the Stockpile Monitor Program

    SciTech Connect

    Rivera, T.; Harry, H.H.

    1999-04-01

    In 1991 the Los Alamos National Laboratory (LANL) launched a program to develop a comprehensive database of warhead storage conditions. Because of the extended lifetimes expected of the Stockpile, it became desirable to obtain as much detailed information on the storage environments as possible. Temperature and relative humidity at various facilities capable of storing and/or handling nuclear weapons were used as monitoring locations. The Stockpile Monitor Program (SMP) was implemented in a variety of locations as illustrated in a figure. Probably the most useful data come from the most extreme conditions monitored. The hottest outside temperatures and relative humidities come from Barksdale, while some of the lowest relative humidity values come from Nellis, which continue to be monitored. The coldest conditions come from Grand Forks, Griffiss, and KI Sawyer, none of which are presently being monitored. For this reason, the authors would like to begin monitoring Minot, ND. The outside extreme temperatures are ameliorated by the structures to a significant degree. For example, the hottest outside temperature (120 F) is contrasted by the corresponding cooler inside temperature (85 F), and the coldest outside temperature ({minus}35 F) is contrasted by the corresponding warmer inside temperature (+25 F). These data have become useful for calculations related to stockpile-to-target sequence (STS) and other analyses. SMP information has been provided to a number of outside agencies.

  11. Longitudinal evaluation of a World Wide Web-based antimicrobial stewardship program: assessing factors associated with approval patterns and trends over time.

    PubMed

    Venugopal, Vidya; Lehmann, Christoph U; Diener-West, Marie; Agwu, Allison L

    2014-02-01

    The Johns Hopkins Children's Medical and Surgery Center developed a Web-based Antimicrobial Stewardship Program (ASP) in 2005. The present study aimed to assess longitudinal antimicrobial request and approval patterns for this ASP. We analyzed a total of 16,229 antimicrobial requests for 3,542 patients between June 1, 2005, and June 30, 2009. Antimicrobial approval was the outcome of interest. We assessed gaming by studying trends in automatically approved requests. Nonparametric tests for trend were performed to detect changes in approval patterns. Multiple logistic regression was used to identify factors associated with approval. The vast majority (91.3%) of antimicrobial requests were approved, with an increase of 6.1% over time (P < .01). Renewal requests were more likely than primary requests (adjusted odds ratio [aOR], 1.72; 95% confidence interval [CI], 1.45-2.04) to be approved. Antiviral requests had higher odds of approval than antibiotic requests (aOR, 1.27; 95% CI, 1.04-1.56). Compared with requests by medical services, requests by surgical services had lower odds of approval (aOR, 0.70; 95% CI, 0.59-0.83), whereas pediatric intensive care requests had higher odds of approval (aOR, 1.18; 95% CI, 1.00-1.40). The number of auto-approved requests remained consistent. The Web-based ASP allows management of a large number of antimicrobial requests, without apparent gaming. Observed differences in approval patterns based on patient, requestor, and antimicrobial factors may inform the development of ASPs and evaluation of provider education and training. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  12. The organisational structure of urban environmental stewardship

    Treesearch

    Dana R. Fisher; Lindsay Campbell; Erika S. Svendsen

    2012-01-01

    How is the organisational structure of urban environmental stewardship groups related to the diverse ways that civic stewardship is taking place in urban settings? The findings of the limited number of studies that have explored the organisational structure of civic environmentalism are combined with the research on civic stewardship to answer this question. By...

  13. Cost-Minimization Model of a Multidisciplinary Antibiotic Stewardship Team Based on a Successful Implementation on a Urology Ward of an Academic Hospital

    PubMed Central

    Dik, Jan-Willem H.; Hendrix, Ron; Friedrich, Alex W.; Luttjeboer, Jos; Nannan Panday, Prashant; Wilting, Kasper R.; Lo-Ten-Foe, Jerome R.; Postma, Maarten J.; Sinha, Bhanu

    2015-01-01

    Background In order to stimulate appropriate antimicrobial use and thereby lower the chances of resistance development, an Antibiotic Stewardship Team (A-Team) has been implemented at the University Medical Center Groningen, the Netherlands. Focus of the A-Team was a pro-active day 2 case-audit, which was financially evaluated here to calculate the return on investment from a hospital perspective. Methods Effects were evaluated by comparing audited patients with a historic cohort with the same diagnosis-related groups. Based upon this evaluation a cost-minimization model was created that can be used to predict the financial effects of a day 2 case-audit. Sensitivity analyses were performed to deal with uncertainties. Finally, the model was used to financially evaluate the A-Team. Results One whole year including 114 patients was evaluated. Implementation costs were calculated to be €17,732, which represent total costs spent to implement this A-Team. For this specific patient group admitted to a urology ward and consulted on day 2 by the A-Team, the model estimated total savings of €60,306 after one year for this single department, leading to a return on investment of 5.9. Conclusions The implemented multi-disciplinary A-Team performing a day 2 case-audit in the hospital had a positive return on investment caused by a reduced length of stay due to a more appropriate antibiotic therapy. Based on the extensive data analysis, a model of this intervention could be constructed. This model could be used by other institutions, using their own data to estimate the effects of a day 2 case-audit in their hospital. PMID:25955494

  14. Cost-minimization model of a multidisciplinary antibiotic stewardship team based on a successful implementation on a urology ward of an academic hospital.

    PubMed

    Dik, Jan-Willem H; Hendrix, Ron; Friedrich, Alex W; Luttjeboer, Jos; Panday, Prashant Nannan; Wilting, Kasper R; Lo-Ten-Foe, Jerome R; Postma, Maarten J; Sinha, Bhanu

    2015-01-01

    In order to stimulate appropriate antimicrobial use and thereby lower the chances of resistance development, an Antibiotic Stewardship Team (A-Team) has been implemented at the University Medical Center Groningen, the Netherlands. Focus of the A-Team was a pro-active day 2 case-audit, which was financially evaluated here to calculate the return on investment from a hospital perspective. Effects were evaluated by comparing audited patients with a historic cohort with the same diagnosis-related groups. Based upon this evaluation a cost-minimization model was created that can be used to predict the financial effects of a day 2 case-audit. Sensitivity analyses were performed to deal with uncertainties. Finally, the model was used to financially evaluate the A-Team. One whole year including 114 patients was evaluated. Implementation costs were calculated to be €17,732, which represent total costs spent to implement this A-Team. For this specific patient group admitted to a urology ward and consulted on day 2 by the A-Team, the model estimated total savings of €60,306 after one year for this single department, leading to a return on investment of 5.9. The implemented multi-disciplinary A-Team performing a day 2 case-audit in the hospital had a positive return on investment caused by a reduced length of stay due to a more appropriate antibiotic therapy. Based on the extensive data analysis, a model of this intervention could be constructed. This model could be used by other institutions, using their own data to estimate the effects of a day 2 case-audit in their hospital.

  15. Point-of-prescription interventions to improve antimicrobial stewardship.

    PubMed

    Hamilton, Keith W; Gerber, Jeffrey S; Moehring, Rebekah; Anderson, Deverick J; Calderwood, Michael S; Han, Jennifer H; Mehta, Jimish M; Pollack, Lori A; Zaoutis, Theoklis; Srinivasan, Arjun; Camins, Bernard C; Schwartz, David N; Lautenbach, Ebbing

    2015-04-15

    Antimicrobial stewardship is pivotal to improving patient outcomes, reducing adverse events, decreasing healthcare costs, and preventing further emergence of antimicrobial resistance. In an era in which antimicrobial resistance is increasing, judicious antimicrobial use is the responsibility of every healthcare provider. Antimicrobial stewardship programs (ASPs) have made headway in improving antimicrobial prescribing using such "top-down" methods as formulary restriction and prospective audit with feedback; however, engagement of prescribers has not been fully explored. Strategies that include frontline prescribers and other unit-based healthcare providers have the potential to expand stewardship, both to augment existing centralized ASPs and to provide alternative approaches to perform stewardship at healthcare facilities with limited resources. This review discusses interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  16. Modeling of coal stockpiles using a finite elements method

    SciTech Connect

    Ozdeniz, A.H.; Sensogut, C.

    2008-07-01

    In the case of coal stockpiles finding suitable environmental conditions, spontaneous combustion phenomenon will be unavoidable. In this study, an industrial-sized stockpile having a shape of triangle prism was constituted in a coal stockyard of Western Lignite Corporation (WLC), Turkey. The parameters of time, humidity and temperature of air, atmospheric pressure, velocity and direction of wind values that are effective on coal stockpile were measured in a continuous manner. These experimental works were transferred into a computer media in order to obtain similar outcomes by carrying out 2-dimensional analysis of the stockpile with Finite Elements Method (FEM). The performed experimental studies and obtained results were then compared.

  17. The challenge of wilderness stewardship

    Treesearch

    David J. Parsons; David N. Cole

    2003-01-01

    The 1964 Wilderness Act and subsequent wilderness legislation have resulted in the designation of over 106 million acres of the United States as wilderness. Charged with the responsibility of protecting a significant portion of federal lands as wilderness, the federal land management agencies with responsibility for wilderness stewardship (Bureau of Land Management,...

  18. What is urban environmental stewardship? Constructing a practitioner-derived framework

    Treesearch

    M. Romolini; W. Brinkley; K.L. Wolf

    2012-01-01

    Agencies and organizations deploy various strategies in response to environmental challenges, including the formulation of policy, programs, and regulations. Citizen-based environmental stewardship is increasingly seen as an innovative and important approach to improving and conserving landscape health. A new research focus on the stewardship of urban natural resources...

  19. Antibiotic stewardship in orthopaedic surgery: principles and practice.

    PubMed

    Campbell, Kirk A; Stein, Spencer; Looze, Christopher; Bosco, Joseph A

    2014-12-01

    A thorough knowledge of the principles of antibiotic stewardship is a crucial part of high-quality orthopaedic surgical care. These principles include (1) determining appropriate indications for antibiotic administration, (2) choosing the correct antibiotic based on known or expected pathogens, (3) determining the correct dosage, and (4) determining the appropriate duration of treatment. Antibiotic stewardship programs have a multidisciplinary staff that can help guide antibiotic selection and dosage. These programs also perform active surveillance of antimicrobial use and may reduce Clostridium difficile and other drug-resistant bacterial infections by providing expert guidance on judicious antibiotic usage. The emergence of antibiotic-resistant pathogens, the geographical diversity of these infecting pathogens, and the changing patient population require customization of prophylactic regimens to reduce infectious complications. A multidisciplinary approach to antibiotic stewardship can lead to improved patient outcomes and cost-effective medical care.

  20. An Audit-Based, Infectious Disease Specialist-Guided Antimicrobial Stewardship Program Profoundly Reduced Antibiotic Use Without Negatively Affecting Patient Outcomes

    PubMed Central

    Nilholm, Hannah; Holmstrand, Linnea; Ahl, Jonas; Månsson, Fredrik; Odenholt, Inga; Tham, Johan; Melander, Eva; Resman, Fredrik

    2015-01-01

    Background. Antimicrobial stewardship programs are increasingly implemented in hospital care. They aim to simultaneously optimize outcomes for individual patients with infections and reduce financial and health-associated costs of overuse of antibiotics. Few studies have examined the effects of antimicrobial stewardship programs in settings with low proportions of antimicrobial resistance, such as in Sweden. Methods. An antimicrobial stewardship program was introduced during 5 months of 2013 in a department of internal medicine in southern Sweden. The intervention consisted of audits twice weekly on all patients given antibiotic treatment. The intervention period was compared with a historical control consisting of patients treated with antibiotics in the same wards in 2012. Studied outcome variables included 28-day mortality and readmission, length of hospital stay, and use of antibiotics. Results. A reduction of 27% in total antibiotic use (2387 days of any antibiotic) was observed in the intervention period compared with the control period. The reduction was due to fewer patients started on antibiotics as well as to significantly shorter durations of antibiotic courses (P < .001). An earlier switch to oral therapy and a specific reduction in use of third-generation cephalosporins and fluoroquinolones was also evident. Mortality, total readmissions, and lengths of stay in hospital were unchanged compared with the control period, whereas readmissions due to a nonresolved infection were fewer during the intervention of 2013. Conclusions. This study demonstrates that an infectious disease specialist-guided antimicrobial stewardship program can profoundly reduce antibiotic use in a low-resistance setting with no negative effect on patient outcome. PMID:26380341

  1. Fostering science literacy, environmental stewardship, and collaboration: Assessing a garden-based approach to teaching life science

    NASA Astrophysics Data System (ADS)

    Fisher-Maltese, Carley B.

    Recently, schools nationwide have expressed a renewed interest in school gardens (California School Garden Network, 2010), viewing them as innovative educational tools. Most of the scant studies on these settings investigate the health/nutritional impacts, environmental attitudes, or emotional dispositions of students. However, few studies examine the science learning potential of a school garden from an informal learning perspective. Those studies that do examine learning emphasize individual learning of traditional school content (math, science, etc.) (Blaire, 2009; Dirks & Orvis, 2005; Klemmer, Waliczek & Zajicek, 2005a & b; Smith & Mostenbocker, 2005). My study sought to demonstrate the value of school garden learning through a focus on measures of learning typically associated with traditional learning environments, as well as informal learning environments. Grounded in situated, experiential, and contextual model of learning theories, the purpose of this case study was to examine the impacts of a school garden program at a K-3 elementary school. Results from pre/post tests, pre/post surveys, interviews, recorded student conversations, and student work reveal a number of affordances, including science learning, cross-curricular lessons in an authentic setting, a sense of school community, and positive shifts in attitude toward nature and working collaboratively with other students. I also analyzed this garden-based unit as a type curriculum reform in one school in an effort to explore issues of implementing effective practices in schools. Facilitators and barriers to implementing a garden-based science curriculum at a K-3 elementary school are discussed. Participants reported a number of implementation processes necessary for success: leadership, vision, and material, human, and social resources. However, in spite of facilitators, teachers reported barriers to implementing the garden-based curriculum, specifically lack of time and content knowledge.

  2. 30 CFR 702.16 - Stockpiling of minerals.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Stockpiling of minerals. 702.16 Section 702.16 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR GENERAL EXEMPTION FOR COAL EXTRACTION INCIDENTAL TO THE EXTRACTION OF OTHER MINERALS § 702.16 Stockpiling...

  3. 30 CFR 702.16 - Stockpiling of minerals.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Stockpiling of minerals. 702.16 Section 702.16 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR GENERAL EXEMPTION FOR COAL EXTRACTION INCIDENTAL TO THE EXTRACTION OF OTHER MINERALS § 702.16 Stockpiling...

  4. 30 CFR 702.16 - Stockpiling of minerals.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Stockpiling of minerals. 702.16 Section 702.16 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR GENERAL EXEMPTION FOR COAL EXTRACTION INCIDENTAL TO THE EXTRACTION OF OTHER MINERALS § 702.16 Stockpiling...

  5. 30 CFR 702.16 - Stockpiling of minerals.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Stockpiling of minerals. 702.16 Section 702.16 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR GENERAL EXEMPTION FOR COAL EXTRACTION INCIDENTAL TO THE EXTRACTION OF OTHER MINERALS § 702.16 Stockpiling...

  6. 30 CFR 702.16 - Stockpiling of minerals.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Stockpiling of minerals. 702.16 Section 702.16 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT, DEPARTMENT OF THE INTERIOR GENERAL EXEMPTION FOR COAL EXTRACTION INCIDENTAL TO THE EXTRACTION OF OTHER MINERALS § 702.16 Stockpiling...

  7. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Soil removal and stockpiling. 823.12 Section... ON PRIME FARMLAND § 823.12 Soil removal and stockpiling. (a) Prime farmland soils shall be removed from the areas to be disturbed before drilling, blasting, or mining. (b) The minimum depth of soil...

  8. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Soil removal and stockpiling. 823.12 Section... ON PRIME FARMLAND § 823.12 Soil removal and stockpiling. (a) Prime farmland soils shall be removed from the areas to be disturbed before drilling, blasting, or mining. (b) The minimum depth of soil...

  9. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Soil removal and stockpiling. 823.12 Section... ON PRIME FARMLAND § 823.12 Soil removal and stockpiling. (a) Prime farmland soils shall be removed from the areas to be disturbed before drilling, blasting, or mining. (b) The minimum depth of soil...

  10. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ON PRIME FARMLAND § 823.12 Soil removal and stockpiling. (a) Prime farmland soils shall be removed... soil materials to be removed and stored for use in the reconstruction of prime farmland shall be sufficient to meet the requirements of § 823.14(b). (c) Soil removal and stockpiling operations on prime...

  11. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... ON PRIME FARMLAND § 823.12 Soil removal and stockpiling. (a) Prime farmland soils shall be removed... soil materials to be removed and stored for use in the reconstruction of prime farmland shall be sufficient to meet the requirements of § 823.14(b). (c) Soil removal and stockpiling operations on prime...

  12. Dust emission modelling around a stockpile by using computational fluid dynamics and discrete element method

    NASA Astrophysics Data System (ADS)

    Derakhshani, S. M.; Schott, D. L.; Lodewijks, G.

    2013-06-01

    Dust emissions can have significant effects on the human health, environment and industry equipment. Understanding the dust generation process helps to select a suitable dust preventing approach and also is useful to evaluate the environmental impact of dust emission. To describe these processes, numerical methods such as Computational Fluid Dynamics (CFD) are widely used, however nowadays particle based methods like Discrete Element Method (DEM) allow researchers to model interaction between particles and fluid flow. In this study, air flow over a stockpile, dust emission, erosion and surface deformation of granular material in the form of stockpile are studied by using DEM and CFD as a coupled method. Two and three dimensional simulations are respectively developed for CFD and DEM methods to minimize CPU time. The standard κ-ɛ turbulence model is used in a fully developed turbulent flow. The continuous gas phase and the discrete particle phase link to each other through gas-particle void fractions and momentum transfer. In addition to stockpile deformation, dust dispersion is studied and finally the accuracy of stockpile deformation results obtained by CFD-DEM modelling will be validated by the agreement with the existing experimental data.

  13. Antibiotic stewardship: a focus on ambulatory care.

    PubMed

    Gangat, M Azhar; Hsu, Jennifer L

    2015-01-01

    Antibiotic resistance is one of the major health threats facing modern medicine. While there are many tactics to address this issue, antibiotic stewardship has been shown effective in reducing antimicrobial resistance, adverse drug effects, mortality and health care cost. Most antibiotic stewardship programs have evolved within acute care settings where the bulk of resistant infections are identified. Unfortunately, hospitals are just the tip of the iceberg in terms of overall antibiotic use. The vast majority of the antibiotic prescriptions are dispensed in ambulatory care settings, making this a critical target for stewardship programs. This article discusses the global need for antibiotic stewardship, highlights the importance of outpatient stewardship, and discusses strategies and challenges for implementation of stewardship in community settings.

  14. Characteristics of stewardship in the Chicago Wilderness Region

    Treesearch

    Lynne M. Westphal; Amelie Y. Davis; Cindy Copp; Laurel M. Ross; Mark J. Bouman; Cherie L. Fisher; Mark K. Johnston

    2014-01-01

    We report on the early results of a survey-based assessment of stewardship activities within the Chicago Wilderness region, work conducted as a part of the Chicago ULTRA-Ex project. Chicago Wilderness is a 270 member alliance focused on preserving and enhancing biodiversity throughout northern Illinois and parts of Wisconsin, Indiana and Michigan (USA). The results...

  15. Improving antibiotic stewardship by involving nurses.

    PubMed

    Gillespie, Elizabeth; Rodrigues, Anne; Wright, Louise; Williams, Natalie; Stuart, Rhonda L

    2013-04-01

    Antimicrobial stewardship programs are important preventative strategies to reduce hospital-acquired infection, typically involving medical and pharmacy staff. Because nurses are pivotal in administering medication prescribed by medical staff and filled by pharmacy staff, we assessed nursing attitudes and antimicrobial stewardship knowledge before and after an education intervention that focused on nursing involvement in antimicrobial management. This study supports involving nurses as a means of improving antibiotic stewardship.

  16. Smallpox vaccine and its stockpile in 2005.

    PubMed

    Arita, Isao

    2005-10-01

    Smallpox vaccine was the most important tool in the successful eradication of smallpox. In 1980, this achievement made it possible for all nations to cease smallpox vaccination. However, the threat of smallpox bioterrorism has made it necessary to reconsider the need for vaccination. Over the past 3 years, many nations have set up action plans for use in the event of such an attack. The setting up of these plans was not simple. Several factors needed to be considered, including the judgement of risk, vaccine complications, conventional vaccines versus new vaccines, optimal stockpile of smallpox vaccine, and its use for different target populations in different emergency situations. Here, I review measures taken by the USA, Japan, and other nations, and discuss likely national and global efforts in 2005 and subsequently, in view of the fact that half of the world's population is now apparently unvaccinated and that this proportion will increase with time.

  17. NASA Earth Science Data Stewardship

    NASA Astrophysics Data System (ADS)

    Moses, J. F.; Ramapriyan, H. K.

    2009-12-01

    The Earth Science Data and Information System (ESDIS) Project at NASA Goddard Space Flight Center was established in the early 1990s to develop and maintain a core collection of NASA’s critical earth science data. Its mission was to provide an archive and distribution system for the huge volume of data and products from the major EOS missions. We have encountered and addressed engineering, scientific and organizational challenges that show stewardship is more than preserving the bits. Engineering - including petabyte scale archives that appeared daunting when we got started, but not so anymore, thanks to advances in hardware and information systems technology. Scientific - having knowledgeable people familiar with data being archived responsible for data in their respective disciplines; understanding what needs to be preserved; defining appropriate metadata; preserving usability; determining active research period vs. “inactive” preservation for potential future use, and the value of peer review processes. Organizational - setting up DAACs, getting them to work together, interoperability, enforcing standards and the producer’s point view as well as the end users’ point of view. This presentation will highlight organizational and technical aspects of being good data stewards for the data and information from the EOS missions. A timeline of key events, activities and accomplishments illustrate the fundamental elements of Earth science data stewardship over the course of the 15 year program. These range from the backup of raw instrument datasets at the onset to extending a common data model across a broad and diverse Earth science community. The relative advantages of standard and unique data formats, standard and extended metadata and data representation, and documentation continue to be specific to each Earth science discipline community practices. Best practices for sizing and technology refresh vary by data center but have application in planning future

  18. NOAA's Scientific Data Stewardship Program

    NASA Astrophysics Data System (ADS)

    Bates, J. J.

    2004-12-01

    The NOAA mission is to understand and predict changes in the Earth's environment and conserve and manage coastal and marine resources to meet the Nation's economic, social and environmental needs. NOAA has responsibility for long-term archiving of the United States environmental data and has recently integrated several data management functions into a concept called Scientific Data Stewardship. Scientific Data Stewardship a new paradigm in data management consisting of an integrated suite of functions to preserve and exploit the full scientific value of NOAA's, and the world's, environmental data These functions include careful monitoring of observing system performance for long-term applications, the generation of authoritative long-term climate records from multiple observing platforms, and the proper archival of and timely access to data and metadata. NOAA has developed a conceptual framework to implement the functions of scientific data stewardship. This framework has five objectives: 1) develop real-time monitoring of all satellite observing systems for climate applications, 2) process large volumes of satellite data extending up to decades in length to account for systematic errors and to eliminate artifacts in the raw data (referred to as fundamental climate data records, FCDRs), 3) generate retrieved geophysical parameters from the FCDRs (referred to as thematic climate data records TCDRs) including combining observations from all sources, 4) conduct monitoring and research by analyzing data sets to uncover climate trends and to provide evaluation and feedback for steps 2) and 3), and 5) provide archives of metadata, FCDRs, and TCDRs, and facilitate distribution of these data to the user community. The term `climate data record' and related terms, such as climate data set, have been used for some time, but the climate community has yet to settle on a concensus definition. A recent United States National Academy of Sciences report recommends using the

  19. Idaho National Laboratory Site Long-Term Stewardship Implementation Plan

    SciTech Connect

    B. E. Olaveson

    2006-07-27

    The U.S. Department of Energy has established long-term stewardship programs to protect human health and the environment at sites where residual contamination remains after site cleanup. At the Idaho National Laboratory Site, Comprehensive Environmental Response, Compensation, and Liability Act (CERLA) long-term stewardship activities performed under the aegis of regulatory agreements, the Federal Facility Agreement and Consent Order for the Idaho National Laboratory, and state and federal requirements are administered primarily under the direction of the Idaho Cleanup Project. It represents a subset of all on-going environmental activity at the Idaho National Laboratory Site. This plan provides a listing of applicable CERCLA long-term stewardship requirements and their planned and completed implementation goals. It proffers the Long-Term Stewardship Environmental Data Warehouse for Sitewide management of environmental data. This plan will be updated as needed over time, based on input from the U.S. Department of Energy, its cognizant subcontractors, and other local and regional stakeholders.

  20. 75 FR 31609 - Conservation Stewardship Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-03

    ... Agriculture Commodity Credit Corporation 7 CFR Part 1470 Conservation Stewardship Program; Final Rule #0;#0... OF AGRICULTURE Commodity Credit Corporation 7 CFR Part 1470 RIN 0578-AA43 Conservation Stewardship... Department of Agriculture. ACTION: Final rule. SUMMARY: Section 2301 of the Food, Conservation, and...

  1. The Six Principles of Facilities Stewardship

    ERIC Educational Resources Information Center

    Kaiser, Harvey H.; Klein, Eva

    2010-01-01

    Facilities stewardship means high-level and pervasive commitment to optimize capital investments, in order to achieve a high-functioning and attractive campus. It includes a major commitment to capital asset preservation and quality. Stewardship is about the long view of an institution's past and future. It ultimately forms the backdrop for…

  2. Preserving Open Space via Community Stewardship.

    ERIC Educational Resources Information Center

    Lopez, Stephen

    1983-01-01

    When community groups assume stewardship of underused properties and turn them into recreational spaces, park agencies can save money on overhead and construction. Three stewardship projects in New York State, involving a playing field, gardening areas, and a historical restoration, are described. Criteria for successful projects are included. (PP)

  3. Preserving Open Space via Community Stewardship.

    ERIC Educational Resources Information Center

    Lopez, Stephen

    1983-01-01

    When community groups assume stewardship of underused properties and turn them into recreational spaces, park agencies can save money on overhead and construction. Three stewardship projects in New York State, involving a playing field, gardening areas, and a historical restoration, are described. Criteria for successful projects are included. (PP)

  4. Systematic Review and Meta-analysis of Clinical and Economic Outcomes from the Implementation of Hospital-Based Antimicrobial Stewardship Programs

    PubMed Central

    Karanika, Styliani; Paudel, Suresh; Grigoras, Christos; Kalbasi, Alireza

    2016-01-01

    The implementation of antimicrobial stewardship programs (ASPs) is a promising strategy to help address the problem of antimicrobial resistance. We sought to determine the efficacy of ASPs and their effect on clinical and economic parameters. We searched PubMed, EMBASE, and Google Scholar looking for studies on the efficacy of ASPs in hospitals. Based on 26 studies (extracted from 24,917 citations) with pre- and postimplementation periods from 6 months to 3 years, the pooled percentage change of total antimicrobial consumption after the implementation of ASPs was −19.1% (95% confidence interval [CI] = −30.1 to −7.5), and the use of restricted antimicrobial agents decreased by −26.6% (95% CI = −52.3 to −0.8). Interestingly, in intensive care units, the decrease in antimicrobial consumption was −39.5% (95% CI = −72.5 to −6.4). The use of broad-spectrum antibiotics (−18.5% [95% CI = −32 to −5.0] for carbapenems and −14.7% [95% CI = −27.7 to −1.7] for glycopeptides), the overall antimicrobial cost (−33.9% [95% CI = −42.0 to −25.9]), and the hospital length of stay (−8.9% [95% CI = −12.8 to −5]) decreased. Among hospital pathogens, the implementation of ASPs was associated with a decrease in infections due to methicillin-resistant Staphylococcus aureus (risk difference [RD] = −0.017 [95% CI = −0.029 to −0.005]), imipenem-resistant Pseudomonas aeruginosa (RD = −0.079 [95% CI = −0.114 to −0.040]), and extended-spectrum beta-lactamase Klebsiella spp. (RD = −0.104 [95% CI = −0.153 to −0.055]). Notably, these improvements were not associated with adverse outcomes, since the all-cause, infection-related 30-day mortality and infection rates were not significantly different after implementation of an ASP (RD = −0.001 [95% CI = −0.009 to 0.006], RD = −0.005 [95% CI = −0.016 to 0.007], and RD = −0.045% [95% CI = −0.241 to 0.150], respectively). Hospital ASPs result in significant decreases in antimicrobial

  5. Prevention of Airborne Dust from Petroleum Coke Stockpiles

    NASA Astrophysics Data System (ADS)

    Kozicki, Robert; Wrightson, George

    To prevent airborne dust from Petroleum Coke stockpiles, there must be an understanding of all the variables. The first variable is the particle size of the material in the stockpile. The USDA has defined silt as material with a particle size smaller than 200 mesh. The US EPA has adopted this definition in their regulations (EPA Appendix C.2). The second variable is moisture. It is common for stockpiles of petroleum coke to have water or some other dust suppressant applied to them to prevent airborne dust. This technique is only effective if the suppressant can impact the moisture of the -200 mesh material. This study will provide data on the relationship between moisture and particle size as it applies to the prevention of airborne dust from petroleum coke stockpiles.

  6. Antibiotic stewardship in the intensive care unit.

    PubMed

    Luyt, Charles-Edouard; Bréchot, Nicolas; Trouillet, Jean-Louis; Chastre, Jean

    2014-08-13

    The rapid emergence and dissemination of antimicrobial-resistant microorganisms in ICUs worldwide constitute a problem of crisis dimensions. The root causes of this problem are multifactorial, but the core issues are clear. The emergence of antibiotic resistance is highly correlated with selective pressure resulting from inappropriate use of these drugs. Appropriate antibiotic stewardship in ICUs includes not only rapid identification and optimal treatment of bacterial infections in these critically ill patients, based on pharmacokinetic-pharmacodynamic characteristics, but also improving our ability to avoid administering unnecessary broad-spectrum antibiotics, shortening the duration of their administration, and reducing the numbers of patients receiving undue antibiotic therapy. Either we will be able to implement such a policy or we and our patients will face an uncontrollable surge of very difficult-to-treat pathogens.

  7. Stockpile levels for pediatric vaccines: how much is enough?

    PubMed

    Jacobson, Sheldon H; Sewell, Edward C; Proano, Ruben A; Jokela, Janet A

    2006-04-24

    In recent years, several factors have led to pediatric vaccine manufacturers experiencing vaccine production interruptions that resulted in vaccine supply shortages. One unfortunate consequence of such events is that not all children in the United States could be vaccinated on time, as set forth by the Recommended Childhood Immunization Schedule, and hence, created the potential for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention (CDC) have responded to such events by releasing vaccine supplies from the national pediatric vaccine stockpiles, which were designed to mitigate the impact of vaccine production interruptions. This paper analyzes the CDC-proposed vaccine stockpile levels using a stochastic inventory model. The results from this analysis examine the adequacy of the proposed pediatric vaccine stockpile levels, as well as provide insights into what the appropriate pediatric vaccine stockpile levels should be to achieve prespecified vaccination coverage rates. Given that the average pediatric vaccine production interruption has lasted more than 1 year, the model is used to compute appropriate pediatric vaccine stockpile levels sufficient to absorb the effect of such vaccine production interruptions. The level of funding needed to create such pediatric vaccine stockpile levels is also reported.

  8. Antibiotic Stewardship: New Frontier, Familiar Journey.

    PubMed

    Martin, Caren McHenry

    2017-03-01

    Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts.

  9. National Certification Methodology for the Nuclear Weapons Stockpile

    SciTech Connect

    Goodwin, B T; Juzaitis, R J

    2006-08-07

    and December of 2001 and continued in 2002 have proven useful in developing the methodology, and future workshops should prove useful in further refining this framework. Each laboratory developed an approach to certification with some differences in detailed implementation. The general methodology introduces specific quantitative indicators for assessing confidence in our nuclear weapon stockpile. The quantitative indicators are based upon performance margins for key operating characteristics and components of the system, and these are compared to uncertainties in these factors. These criteria can be summarized in a quantitative metric (for each such characteristic) expressed as: (i.e., confidence in warhead performance depends upon CR significantly exceeding unity for all these characteristics). These Confidence Ratios are proposed as a basis for guiding technical and programmatic decisions on stockpile actions. This methodology already has been deployed in certifying weapons undergoing current life extension programs or component remanufacture. The overall approach is an adaptation of standard engineering practice and lends itself to rigorous, quantitative, and explicit criteria for judging the robustness of weapon system and component performance at a detailed level. There are, of course, a number of approaches for assessing these Confidence Ratios. The general certification methodology was publicly presented for the first time to a meeting of Strategic Command SAG in January 2002 and met with general approval. At that meeting, the Laboratories committed to further refine and develop the methodology through the implementation process. This paper reflects the refinement and additional development to date. There will be even further refinement at a joint laboratory workshop later in FY03. A common certification methodology enables us to engage in peer reviews and evaluate nuclear weapon systems on the basis of explicit and objective metrics. The clarity provided by

  10. Pesticide Environmental Stewardship Program Member Handbook

    EPA Pesticide Factsheets

    This Pesticide Environmental Stewardship Program (PESP) handbook is a resource with information to help prospective members to learn about PESP, to understand how the program works, and to assist in applying for membership.

  11. Taimi Lynne Hoag Award for Environmental Stewardship

    EPA Pesticide Factsheets

    The Region 5 Tribal Operation Committee established this Award in the name of Taimi Hoag to recognize significant contributions in environmental management and/or environmental stewardship by a tribal government leader, program manager, or staff person.

  12. Compilation of demographic data for the chemical stockpile emergency preparedness program

    SciTech Connect

    Vogt, B.; Sorensen, J.; Coomer, C.; Shumpert, B.; Hardee, H.

    1998-01-01

    There are eight installations in the continental US where lethal unitary chemical agents and munitions have been stored since the late 1950`s. In December, 1985, Congress directed the Department of Defense (DOD) to destroy these stockpiles of aging chemical warfare weapons. The destruction was to take place in such a manner as to provide: (1) maximum protection of the environment, the general public, and the personnel involved in the destruction, (2) adequate and safe facilities designed solely for the destruction of the stockpile, and (3) clean-up dismantling, and disposal of the facilities when the disposal program was complete. To help communities develop emergency response capabilities, the Army established the Chemical Stockpile Emergency Preparedness Program or CSEPP based on principals established in the Emergency Response Concept Plan (ERCP). The Army and the Federal Emergency Management Agency (FEMA) jointly oversee the CSEPP. An important part of the ERCP guidance was establishing cooperative interaction between local, state, and federal agencies and the development of emergency planning zones (EPZs) to support the emergency response concept. The purpose of this document is to describe how the population figures were derived for the population estimates for both the Chemical Stockpile Disposal Program and the CSEPP analyses. Most of the data is derived from the US Census 1990 population figures. However, the Census only counts residential populations and does not attempt to document daytime populations within commercial or residential facilities. One conclusion from this review is that there is a need for better and more consistent population data in the Emergency Planning Guides.

  13. Evaluation of environmental effect of coal stockpile in Muara Telang, Banyuasin, Indonesia

    NASA Astrophysics Data System (ADS)

    Rusdianasari; Arita, Susila; Ibrahim, Eddy; Ngudiantoro

    2013-04-01

    Stockpile commonly serves as a temporary dump before the coal is transported through the waterways. This study investigated the effects of coal stockpiles on the surrounding environment: air, water, and soil. The location of the study is in the estuary of Telang, South-Sumatra, Indonesia, which is located at the edge of the river of Telang and close to the residential community. The monitoring of the environmental impact from the stockpile is intended to conduct an environmental assessment owing the existence and operations of coal accumulation. Enviromental impact analysis was conducted based on the value of the effluent, air pollution (dust), soil and water by determining the parameters of the coal wastewater pH, total suspended solid, ferrous dan ferrous metals contents. The results indicate that the total suspended particulate, total suspended solids, noise level, ferrous metal and manganese metal were 10-14 μg/Nm3 249-355 mg/L, 41.3 to 50.3 dBA, 6.074 to7.579 mg/L, and 1.987 to 2.678 mg/L, respectively. Meanwhile the pH of water and soil were 3 to 4 and 2.83 to 4.02 respectively. It is concluded that the pH value are beyond the threshold standard.

  14. Cost-effectiveness of Antiviral Stockpiling and Near-Patient Testing for Potential Influenza Pandemic

    PubMed Central

    Edmunds, W. John

    2008-01-01

    A decision analytical model was developed to investigate the cost-effectiveness of stockpiling antiviral (AV) drugs for a potential influenza pandemic in the United Kingdom and the possible role of near-patient testing in conserving AV drug stocks. Under base-case assumptions (including a fixed stockpile that was smaller than the clinical attack rate), the treat-only option (treating all symptomatic patients with AV drugs) would be considered cost-effective (£1,900–£13,700 per quality-adjusted life year [QALY] gained, depending on the fatality scenario), compared with no intervention (nonintervention but management of cases as they arise). The test-treat option (testing all symptomatic patients but treating those with positive tests results only) would result in moderate gains in QALYs over the treat-only option but at relatively large additional costs. Stockpiling sufficient AV drugs (but not near-patient tests) to treat all patients with clinical cases would be cost-effective, provided AV drugs are effective at preventing deaths from pandemic influenza. PMID:18258120

  15. Pandemics, antiviral stockpiles and biosecurity in Australia: what about the generic option?

    PubMed

    Lokuge, Buddhima; Drahos, Peter; Neville, Warwick

    2006-01-02

    In view of the possibility of a human pandemic of avian influenza, a first-line strategy for many countries is stockpiling of antiviral neuraminidase inhibitors (oseltamivir [Tamiflu] and zanamivir [Relenza]), which can reduce mortality, morbidity and influenza transmission. However, global supply of the antivirals is controlled by the European-based patent owners, Roche and GlaxoSmithKline. This prevents competition in the manufacturing and distribution of antivirals and has reduced global supply capacity and affordability. The Australian Government has acknowledged that, in the event of a pandemic, its own stockpile of antivirals will be limited and reserved for those on a confidential rationing list. Pharmacies are running out of stocks, limiting opportunities for individuals to secure supplies privately. Compulsory licensing provisions, permitted under domestic patent law, would allow Australian generic manufacturers to start producing antivirals locally or import them from generic producers at affordable prices. Australia also has an opportunity and a responsibility to promote compulsory licensing and generic antiviral production in the Asian region, to ensure our neighbours can establish pandemic stockpiles in a timely and affordable manner.

  16. Leveraging best practices to promote health, safety, sustainability, and stewardship.

    PubMed

    Weiss, Marjorie D

    2013-08-01

    Strategically leveraging health and safety initiatives with sustainability and stewardship helps organizations improve profitability and positively impact team member and customer attachment to the organization. Collective efficacy enhances the triple bottom line: healthy people, healthy planet, and healthy profits. The HS(3)™ Best Practice Exchanges group demonstrated that collective efficacy can leverage the social cohesion, communication channels, and activities within workplaces to promote a healthy, sustainable work culture. This in turn (1) protects the health and safety of workers, (2) preserves the natural environment, and (3) increases attachment to the organization. Community-based participatory research using the Attach21 survey assessed the progress of these companies in their efforts to integrate health, safety, sustainability, and stewardship. Monthly Best Practice Exchanges promoted collective efficacy by providing support, encouragement, and motivation to share and adopt new ideas.

  17. Materials and Sensor R&D to Transform the Nuclear Stockpile: Livermore?s Transformational Materials Initiative

    SciTech Connect

    Maxwell, R; Fried, L; Campbell, G; Saab, A; Kotovsky, J; Carter, C; Chang, J

    2009-10-11

    As the nation's nuclear weapons age and the demands placed on them change, significant challenges face the nuclear stockpile. Risks include material supply issues, ever-increasing lifecycle costs, and loss of technical expertise across the weapons complex. For example, non-nuclear materials are becoming increasingly difficult to replace because manufacturing methods and formulations have evolved in such a way as to render formerly available materials unprofitable, unsafe, or otherwise obsolete. Subtle formulation changes in available materials that occur without the knowledge of the weapons community for proprietary reasons have frequently affected the long-term performance of materials in the nuclear weapon environment. Significant improvements in performance, lifetime, or production cost can be realized with modern synthesis, modeling, and manufacturing methods. For example, there are currently supply and aging issues associated with the insensitive high explosive formulations LX-17 and PBX 9502 that are based on triaminotrinitrobenzene (TATB) and Kel-F, neither of which are commercially available today. Assuring the reliability of the stockpile through surveillance and regularly scheduled Life Extension Programs is an increasingly expensive endeavor. Transforming our current stockpile surveillance--a system based on destructive testing of increasingly valuable assets--to a system based on embedded sensors has a number of potential advantages that include long-term cost savings, reduced risk associated with asset transportation, state-of-health assessments in the field, and active management of the stockpile.

  18. Decrease of calorific value and particle size in coal stockpiles

    SciTech Connect

    Sensogut, C.; Ozdeniz, A.H.

    2008-07-01

    During storage of excess amount of coal, they lose both their economical value and cause environmental problems. In this work, two industrial-sized stockpiles were constituted at a coal stockyard of Western Lignite Corporation (WLC) in Tuncbilek, Turkey. The size of the stockpiles, formed as triangle prisms, was about 10 m x 5 m wide with a height of 3 m; each mass being approximately 120 tons of coal in total. Some of the parameters that were effective on the stockpiles were measured in a continuous manner during this experimental work. The calorific losses and the decreases that occurred in particle size due to atmospheric conditions were also examined and detailed as the result of this work.

  19. Characterization of outbreak response strategies and potential vaccine stockpile needs for the polio endgame.

    PubMed

    Duintjer Tebbens, Radboud J; Pallansch, Mark A; Wassilak, Steven G F; Cochi, Stephen L; Thompson, Kimberly M

    2016-03-24

    Following successful eradication of wild polioviruses and planned globally-coordinated cessation of oral poliovirus vaccine (OPV), national and global health leaders may need to respond to outbreaks from reintroduced live polioviruses, particularly vaccine-derived polioviruses (VDPVs). Preparing outbreak response plans and assessing potential vaccine needs from an emergency stockpile require consideration of the different national risks and conditions as they change with time after OPV cessation. We used an integrated global model to consider several key issues related to managing poliovirus risks and outbreak response, including the time interval during which monovalent OPV (mOPV) can be safely used following homotypic OPV cessation; the timing, quality, and quantity of rounds required to stop transmission; vaccine stockpile needs; and the impacts of vaccine choices and surveillance quality. We compare the base case scenario that assumes aggressive outbreak response and sufficient mOPV available from the stockpile for all outbreaks that occur in the model, with various scenarios that change the outbreak response strategies. Outbreak response after OPV cessation will require careful management, with some circumstances expected to require more and/or higher quality rounds to stop transmission than others. For outbreaks involving serotype 2, using trivalent OPV instead of mOPV2 following cessation of OPV serotype 2 but before cessation of OPV serotypes 1 and 3 would represent a good option if logistically feasible. Using mOPV for outbreak response can start new outbreaks if exported outside the outbreak population into populations with decreasing population immunity to transmission after OPV cessation, but failure to contain outbreaks resulting in exportation of the outbreak poliovirus may represent a greater risk. The possibility of mOPV use generating new long-term poliovirus excretors represents a real concern. Using the base case outbreak response assumptions, we

  20. Stockpile Management Program quarterly report. 2. quarter 1998

    SciTech Connect

    1998-11-01

    The objective of this program is to ensure the safety and reliability of the enduring nuclear weapons stockpile by: (1) maintaining robust nuclear facilities that comprise the infrastructure needed to conduct the various laboratory programs; (2) maintaining capabilities and qualified personnel needed to successfully implement the Program and ensure availability of competencies; (3) meeting present and future production and surveillance requirements to support the enduring stockpile and other programmatic deliverables; and (4) capturing and maintaining expertise and competency in the processes and technologies required to build a complete physics package. Summaries of accomplishments are presented for approximately 30 projects managed under this program.

  1. Preparing for pandemic influenza: should hospitals stockpile oseltamivir?

    PubMed

    Cinti, Sandro; Chenoweth, Carol; Monto, Arnold S

    2005-11-01

    The outbreak of H5N1 avian influenza in Asia has reignited concerns about an influenza pandemic. It is clear that influenza vaccine will be in short supply (or nonexistent) early in an influenza pandemic. Without vaccine, the role of antiviral agents, especially oseltamivir, in treatment and prophylaxis is of paramount importance. Unfortunately, the government cannot possibly stockpile enough oseltamivir to provide long-term prophylaxis or treatment for every healthcare worker in the United States. We think that hospitals should consider stockpiling oseltamivir, and we provide a strategy for doing so at a reasonable cost.

  2. Legally invisible: stewardship for Aboriginal and Torres Strait Islander health.

    PubMed

    Howse, Genevieve; Dwyer, Judith

    2016-04-01

    The need to improve access to good health care for Aboriginal and Torres Strait Islander people has been the subject of policy debate for decades, but progress is hampered by complex policy and administrative arrangements and lack of clarity about the responsibilities of governments. This study aimed to identify the current legal basis of those responsibilities and define options available to Australian governments to enact enduring responsibility for Aboriginal health care. This study used a framework for public health law research and conducted a mapping study to examine the current legal underpinnings for stewardship and governance for Aboriginal health and health care. More than 200 pieces of health legislation were analysed in the context of the common and statutory law and health policy goals. Very little specific recognition of the needs of Aboriginal people was found, and nothing that creates responsibility for stewardship and governance. The continuing absence of a legislative framework to address and protect Aboriginal health can be traced back to the founding doctrine of terra nullius (unoccupied land). We considered the results applying both a human rights perspective and the perspective of therapeutic jurisprudence. We suggest that national law for health stewardship would provide a strong foundation for progress, and should itself be based on recognition of Australia's First Peoples in the Australian Constitution, as is currently proposed. © 2015 The Authors.

  3. Legally invisible: stewardship for Aboriginal and Torres Strait Islander health

    PubMed Central

    Howse, Genevieve

    2015-01-01

    Abstract Objectives: The need to improve access to good health care for Aboriginal and Torres Strait Islander people has been the subject of policy debate for decades, but progress is hampered by complex policy and administrative arrangements and lack of clarity about the responsibilities of governments. This study aimed to identify the current legal basis of those responsibilities and define options available to Australian governments to enact enduring responsibility for Aboriginal health care. Methods: This study used a framework for public health law research and conducted a mapping study to examine the current legal underpinnings for stewardship and governance for Aboriginal health and health care. More than 200 pieces of health legislation were analysed in the context of the common and statutory law and health policy goals. Results: Very little specific recognition of the needs of Aboriginal people was found, and nothing that creates responsibility for stewardship and governance. The continuing absence of a legislative framework to address and protect Aboriginal health can be traced back to the founding doctrine of terra nullius (unoccupied land). Conclusions: We considered the results applying both a human rights perspective and the perspective of therapeutic jurisprudence. We suggest that national law for health stewardship would provide a strong foundation for progress, and should itself be based on recognition of Australia's First Peoples in the Australian Constitution, as is currently proposed. PMID:25903648

  4. NASA'S Earth Science Data Stewardship Activities

    NASA Technical Reports Server (NTRS)

    Lowe, Dawn R.; Murphy, Kevin J.; Ramapriyan, Hampapuram

    2015-01-01

    NASA has been collecting Earth observation data for over 50 years using instruments on board satellites, aircraft and ground-based systems. With the inception of the Earth Observing System (EOS) Program in 1990, NASA established the Earth Science Data and Information System (ESDIS) Project and initiated development of the Earth Observing System Data and Information System (EOSDIS). A set of Distributed Active Archive Centers (DAACs) was established at locations based on science discipline expertise. Today, EOSDIS consists of 12 DAACs and 12 Science Investigator-led Processing Systems (SIPS), processing data from the EOS missions, as well as the Suomi National Polar Orbiting Partnership mission, and other satellite and airborne missions. The DAACs archive and distribute the vast majority of data from NASA’s Earth science missions, with data holdings exceeding 12 petabytes The data held by EOSDIS are available to all users consistent with NASA’s free and open data policy, which has been in effect since 1990. The EOSDIS archives consist of raw instrument data counts (level 0 data), as well as higher level standard products (e.g., geophysical parameters, products mapped to standard spatio-temporal grids, results of Earth system models using multi-instrument observations, and long time series of Earth System Data Records resulting from multiple satellite observations of a given type of phenomenon). EOSDIS data stewardship responsibilities include ensuring that the data and information content are reliable, of high quality, easily accessible, and usable for as long as they are considered to be of value.

  5. Embedding Data Stewardship in Geoscience Australia

    NASA Astrophysics Data System (ADS)

    Bastrakova, I.; Fyfe, S.

    2013-12-01

    Ten years of technological innovation now enable vast amounts of data to be collected, managed, processed and shared. At the same time, organisations have witnessed government legislative and policy requirements for open access to public sector data, and a demand for flexibility in access to data by both machine-to-machine and human consumption. Geoscience Australia (GA) has adopted Data Stewardship as an organisation-wide initiative to improve the way we manage and share our data. The benefits to GA including: - Consolidated understanding of GA's data assets and their value to the Agency; - Recognition of the significant role of data custodianship and data management; - Well-defined governance, policies, standards, practices and accountabilities that promote the accessibility, quality and interoperability of GA's data; - Integration of disparate data sets into cohesive information products available online in real time and equally accessible to researchers, government, industry and the public. Although the theory behind data stewardship is well-defined and accepted and the benefits are generally well-understood, practical implementation requires an organisation to prepare for a long-term commitment of resources, both financial and human. Fundamentally this involves: 1. Raising awareness in the organisation of the need for data stewardship and the challenges this entails; 2. Establishing a data stewardship framework including a data governance office to set policy and drive organisational change; and 3. Embedding the functions and a culture of data stewardship into business as usual operations. GA holds a vast amount of data ranging from petabytes of Big Data to significant quantities of relatively small ';long tail' geoscientific observations and measurements. Over the past four years, GA has undertaken strategic activities that prepare us for Data Stewardship: - Organisation-wide audits of GA's data holdings and identification of custodians for each dataset

  6. Stockpiled Prairie Grass For Fall-Grazing Lambs

    USDA-ARS?s Scientific Manuscript database

    New varieties of prairiegrass (Bromus catharticus Vahl. = B. willdenowii Kunth.) exhibit improved persistence over 'Matua' under USA growing conditions, but animal performance data is lacking. Therefore, we evaluated performance of lambs grazing fall-stockpiled 'Dixon' prairiegrass on a West Virgin...

  7. Stockpiling and Comprehensive Utilization of Red Mud Research Progress

    PubMed Central

    Liu, Dong-Yan; Wu, Chuan-Sheng

    2012-01-01

    With increasing production of red mud, the environmental problems caused by it are increasingly serious, and thus the integrated treatment of red mud is imminent. This article provides an overview of the composition and the basic characteristics of red mud. The research progress of safe stockpiling and comprehensive utilization of red mud is summarized. The safe stockpiling of red mud can be divided into two aspects: the design and safe operation of the stocking yard. The comprehensive utilization of red mud can be further divided into three aspects: the effective recycling of components, resource utilization and application in the field of environmental protection. This paper points out that the main focus of previous studies on red mud stockpiling is cost reproduction and land tenure. The recovery of resources from red mud has a high value-added, but low level industrialization. The use of red mud as a building material and filler material is the most effective way to reduce the stockpiling of red mud. Red mud used for environmental remediation materials is a new hotspot and worth promoting for its simple processing and low cost.

  8. STOCKPILED PRAIRIEGRASS PROVIDES HIGH-QUALITY FALL GRAZING FOR LAMBS

    USDA-ARS?s Scientific Manuscript database

    New varieties of prairiegrass (Bromus catharticus Vahl. = B. willdenowii Kunth.) exhibit improved persistence over ‘Matua’ under USA growing conditions, but animal performance data is lacking. We evaluated performance of lambs grazing stockpiled ‘Dixon’ prairiegrass on West Virginia hill pasture in...

  9. Adventitious Agents and Smallpox Vaccine in Strategic National Stockpile

    PubMed Central

    Osburn, Bennie I.

    2005-01-01

    In keeping with current standards, we urge that old smallpox vaccines that were made in animal skin and are still a key part of our strategic national stockpile be tested for adventitious infectious agents. The advisory especially applies to viruses that have the potential for zoonotic transmission to human vaccine recipients. PMID:16022785

  10. Adventitious agents and smallpox vaccine in strategic national stockpile.

    PubMed

    Murphy, Frederick A; Osburn, Bennie I

    2005-07-01

    In keeping with current standards, we urge that old smallpox vaccines that were made in animal skin and are still a key part of our strategic national stockpile be tested for adventitious infectious agents. The advisory especially applies to viruses that have the potential for zoonotic transmission to human vaccine recipients.

  11. 3.5 D temperature model of a coal stockpile

    SciTech Connect

    Ozdeniz, A.H.; Corumluoglu, O.; Kalayci, I.; Sensogut, C.

    2008-07-01

    Overproduced coal mines that are not sold should remain in coal stock sites. If these coal stockpiles remain at the stock yards over a certain period of time, a spontaneous combustion can be started. Coal stocks under combustion threat can cost too much economically to coal companies. Therefore, it is important to take some precautions for saving the stockpiles from the spontaneous combustion. In this research, a coal stock which was 5 m wide, 10 m long, and 3 m in height, with a weight of 120 tons, was monitored to observe internal temperature changes with respect to time under normal atmospheric conditions. Internal temperature measurements were obtained at 20 points distributed all over the two layers in the stockpile. Temperatures measured by a specially designed mechanism were then stored into a computer every 3 h for a period of 3 months. Afterward, this dataset was used to delineate 3.5 D temporal temperature distribution models for these two levels, and they were used to analyze and interpret what was seen in these models to derive some conclusions. It was openly seen, followed, and analyzed that internal temperature changes in the stockpile went up to 31{sup o}C by 3.5 D models created for this research.

  12. Stewardship of very large digital data archives

    NASA Technical Reports Server (NTRS)

    Savage, Patric

    1991-01-01

    An archive is a permanent store. There are relatively few very large digital data archives in existence. Most business records are expired within five or ten years. Many kinds of business records that do have long lives are embedded in data bases that are continually updated and re-issued cyclically. Also, a great deal of permanent business records are actually archived as microfilm, fiche, or optical disk images - their digital version being an operational convenience rather than an archive. The problems forseen in stewarding the very large digital data archives that will accumulate during the mission of the Earth Observing System (EOS) are addressed. It focuses on the function of shepherding archived digital data into an endless future. Stewardship entails storing and protecting the archive and providing meaningful service to the community of users. The steward will (1) provide against loss due to physical phenomena; (2) assure that data is not lost due to storage technology obsolescence; and (3) maintain data in a current formatting methodology.

  13. Implementation of a cefazolin-based stewardship pathway for methicillin-susceptible Staphylococcus aureus bloodstream infections paired with infectious diseases consultation.

    PubMed

    Lee, Benjamin J; Rao, Sonia N; Wang, Sheila K; Lee, Jane Y; Lakada, Irfana Y; Gilbert, Elise M; Barr, Viktorija O; Postelnick, Michael J; Sutton, Sarah H; Zembower, Teresa R; Bolon, Maureen; Scheetz, Marc H; Rhodes, Nathaniel J

    2017-05-01

    Methicillin-susceptible Staphylococcus aureus (MSSA) infections have been successfully treated both with cefazolin and antistaphylococcal penicillins; cefazolin appears effective in MSSA bloodstream infections (BSIs). Thus, our antimicrobial stewardship programme (ASP) implemented a clinical pathway supporting cefazolin use in MSSA-BSIs and restricting oxacillin use to infectious diseases (ID) consultation due to cefazolin's lower cost and more convenient dosing. This before and after quasi-experimental study was conducted to describe the impact on outcomes and process of care measures associated with implementing this pathway among patients with MSSA-BSI. Definitive treatment with cefazolin increased over the study period from 17.3% to 69.8% post-implementation. Clinical failure (5.8% vs. 2.3%; P = 0.62) and in-hospital mortality (3.8% vs. 0%; P = 0.50) were rare pre- and post-implementation. Median hospital length of stay among survivors was similar between pre- and post-implementation periods (P = 0.31). Duration of bacteraemia [median (IQR) 3 (2-4) days vs. 2 (2-3) days; P = 0.002] and rates of re-infection after culture clearance (9.6% vs. 0%; P = 0.06) were reduced post-implementation. Frequency of source control (P = 0.71) and time to source control (P = 0.52) were similar between study periods. Significant increases in ID consultations (33.3% [3/9] vs. 73.3% [22/30]; P = 0.047) and median (IQR) 24-h daily doses [2 (1-3) g vs. 6 (3-6) g; P < 0.01] were seen for patients treated with cefazolin post-implementation. ASPs may find implementation of a similar pathway to be an effective means of improving the care of patients infected with MSSA. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  14. Outcomes of rapid identification for gram-positive bacteremia in combination with antibiotic stewardship at a community-based hospital system.

    PubMed

    Box, Maggie J; Sullivan, Eva L; Ortwine, Kristine N; Parmenter, Mark A; Quigley, Michael M; Aguilar-Higgins, Louise M; MacIntosh, Cynthia L; Goerke, Kristina F; Lim, Rachel A

    2015-03-01

    Rapid diagnostics for bloodstream infections have been shown to improve outcomes. Most studies have focused on rapid diagnostics for a single pathogen and have been conducted in academic medical centers. The Verigene Gram-Positive Blood Culture Test (BC-GP) identifies 12 gram-positive organisms and 3 genetic markers of antibiotic resistance from positive blood culture media in 2.5 hours. This study evaluates implementation of the Verigene BC-GP panel in combination with real-time support from the Antibiotic Stewardship Team (AST) in a community hospital system. This multicenter, pre-post, quasi-experimental study was conducted at the five hospitals that compose Scripps Healthcare. Rapid diagnostic testing was performed at a central laboratory from 7 a.m.-7 p.m. Pharmacists notified physicians of results and assisted with antibiotic modifications. The primary outcomes were average time to targeted antibiotic therapy and difference in antibiotic duration for contaminants. Secondary end points included hospital length of stay, mortality, pharmacy costs, and overall hospitalization costs. Adult patients with a gram-positive bacteremia admitted in 2011 (pre-rapid testing) were compared with those admitted in 2014 (post-rapid testing). There were 103 patients in the preintervention group and 64 patients in the intervention group. The optimized identification process, combined with AST intervention, improved mean time to targeted antibiotic therapy (61.1 vs 35.4 hrs, p<0.001) and decreased mean duration of antibiotic therapy for blood culture contaminants (42.3 vs 24.5 hrs, p=0.03). Median length of stay (9.1 vs 7.2 days, p=0.04) and overall median hospitalization costs ($17,530 vs $10,290, p=0.04) were lower in the intervention group. Mortality was similar between groups (9.1% vs 9.2%, p=0.98). Rapid identification of gram-positive blood cultures with AST intervention decreased time to targeted antibiotic therapy, length of unnecessary antibiotic therapy for blood

  15. Microbiological surveillance and antimicrobial stewardship minimise the need for ultrabroad-spectrum combination therapy for treatment of nosocomial infections in a trauma intensive care unit: an audit of an evidence-based empiric antimicrobial policy.

    PubMed

    Ramsamy, Yogandree; Muckart, David James Jackson; Han, Khine Swe Swe

    2013-03-15

    Nosocomial infections are a major cause of morbidity in the critically injured, and the incidence of resistant strains of bacteria is increasing. Management requires a strategy that achieves accurate empiric cover without antibiotic overuse - a goal that may be achieved by surveillance and antibiotic stewardship. With the aim of minimising the use of empirical ultrabroad-spectrum combination antimicrobial prescriptions and reducing bacterial resistance, the level I Trauma Intensive Care Unit (TICU) at Inkosi Albert Luthuli Central Hospital (IALCH) in Durban employs stewardship and an antimicrobial policy based on surveillance. This study was undertaken with three aims: (i) to describe the spectrum and sensitivities of nosocomial pathogens in a level I TICU; (ii) to ascertain, based on surveillance data, how frequently initial empiric choice of antimicrobials was correct; and (iii) to determine how frequently ultrabroad-spectrum antimicrobials were prescribed and were actually necessary. Over a 12-month period, all critically injured patients who underwent mechanical ventilation in the TICU were identified from a prospectively gathered database. Information regarding every specimen submitted to the National Health Laboratory Services (NHLS) situated at IALCH was extracted from the laboratory computer database. For each patient, bacterial isolates and antimicrobial susceptibility were identified using standard laboratory techniques. Empiric prescriptions for presumed nosocomial sepsis were identified from the hospital's computerised patient record system and compared with culture results. Acinetobacter species were regarded as colonisers and treatment not offered unless this was the sole isolate in the presence of signs of severe sepsis. Results. Of 227 patients, 106 (46.6%) had 136 culture-positive isolates with a total of 323 pathogens (201 Gram-negative, 119 Gram-positive, 3 Candida albicans). There were 19 species of Gram-negative pathogens, of which 56

  16. Antibiotic stewardship programmes and the surgeon's role.

    PubMed

    Çakmakçi, M

    2015-04-01

    Inappropriate antibiotic use is a frequent occurrence, especially in surgical units. Among the unnecessary costs of such usage are unfavourable outcomes for patients and the emergence and spread of resistant bacteria. Antibiotic stewardship programmes aim to limit the spread of antibiotic resistance by promoting thoughtful prescribing of antibiotics. Such programmes usually try to control inappropriate use of antibiotics; to optimize the choice of drug, dosing, route, and duration of therapy; to maximize clinical cure or prevention of infection; and to limit unwanted effects and excess cost. In this paper, I discuss the impact of improper use of antibiotics and outline why I believe that antibiotic stewardship is likely to be the best way of dealing with it. Engagement of surgeons in antibiotic stewardship programmes is crucial to their success.

  17. Promoting Data Stewardship Through Best Practices

    SciTech Connect

    Strasser, C.A.; Cook, Robert B; Michener, William; Budden, Amber; Koskela, Rebecca

    2011-01-01

    The ecological and environmental sciences are comprised of many different disciplines, each with their own methods, theories, and culture. A characteristic that most of these different disciplines share, however, is a lack of culture for good stewardship of data. Characteristics of good data stewardship include understanding the importance of data management, using best practices for managing data, and recognizing the value of data sharing and data reuse for the future of ecology and the environmental sciences. The Data Observation Network for Earth (DataONE) is actively developing a community database of best practices that can be easily accessed and adopted by scientists to promote good data stewardship practices and lead to high quality data products. Here we introduce DataONE s approach to developing the best practices database and provide a data management primer that contains examples relevant to all elements of the data life cycle.

  18. LX-17-1 Stockpile Returned Material Lot Comparison

    SciTech Connect

    Gagliardi, F.; Pease, S.; Willey, T.

    2015-02-18

    Many different lots of LX-17 have been produced over the years. Two varieties of LX-17, LX-17-0 and LX-17-1, have at one point or another been a part of the Livermore stockpile systems. LX-17-0 was made with dry-aminated TATB whereas LX-17-1 was made with wet-aminated TATB. Both versions have the same TATB to Kel-F 800 mass ratio of 92.5%/7.5%. Both kinds of LX-17 were formulated at Holston during the late 1970s or early to mid-1980s and were certified to have met the necessary specifications that cover the purity, particle size range, explosive to binder ratio, etc. In recent years, Trevor Willy and others have performed a detailed evaluation of solid parts made from each of the LX-17 lots manufactured at Holston. Using the Advanced Light Source at LBNL, Willey and his colleagues radiographed many samples from isostatic pressings using the same scanning conditions. In their investigation they identified that even though the bulk composition can be the same, there may exist a large spread in how smoothly the TATB and binder were distributed within the radiographed volume of different lots of material.1 Overall, the dry-aminated TATB-based material, LX-17-0, had a smooth TATB and binder distribution, whereas the wet-aminated TATB-based LX-17-1 showed a wide range of binder distributions. The results for five different LX-17-1 lots are shown in Figure 1. The wide variation in material distribution has raised the question about whether or not this sort variability will cause significant differences in mechanical behavior.

  19. New Horizons for Pediatric Antibiotic Stewardship.

    PubMed

    Goldman, Jennifer L; Newland, Jason G

    2015-09-01

    Antibiotic resistance remains a major health threat and the overuse of antimicrobials contributes to this serious problem. Antimicrobial stewardship programs (ASPs) are effective in decreasing the inappropriate use of antimicrobials. The development of pediatric ASPs is increasing and these programs have proven effective in optimizing antimicrobial use in children. The value of ASPs is gaining recognition and the expansion of stewardship into additional health care settings is expected. Collaborative efforts are underway among pediatric ASPs to enhance best practices and develop efficient and effective strategies to minimize unnecessary antimicrobial use in children.

  20. 36 CFR 230.6 - Landowner forest stewardship plan.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Landowner forest stewardship plan. 230.6 Section 230.6 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Stewardship Incentive Program § 230.6 Landowner forest stewardship...

  1. 36 CFR 230.6 - Landowner forest stewardship plan.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Landowner forest stewardship plan. 230.6 Section 230.6 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND PRIVATE FORESTRY ASSISTANCE Stewardship Incentive Program § 230.6 Landowner forest stewardship...

  2. Understanding social influences on wilderness fire stewardship decisions

    Treesearch

    Katie Knotek

    2006-01-01

    Federal land managers and the public engage in many decisions about stewardship of wilderness in the United States, including decisions about stewardship of fire. To date, social science research lacks a holistic examination of the decision-making context of managers and the public about stewardship of fire inside wilderness and across its boundaries. A conceptual...

  3. 7 CFR 1470.22 - Conservation stewardship plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Conservation stewardship plan. 1470.22 Section 1470..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments § 1470.22 Conservation stewardship plan. (a) NRCS will use the conservation...

  4. 7 CFR 1470.22 - Conservation stewardship plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Conservation stewardship plan. 1470.22 Section 1470..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments § 1470.22 Conservation stewardship plan. (a) NRCS will use the conservation...

  5. 7 CFR 1470.22 - Conservation stewardship plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Conservation stewardship plan. 1470.22 Section 1470..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments § 1470.22 Conservation stewardship plan. (a) NRCS will use the conservation...

  6. 7 CFR 1470.22 - Conservation stewardship plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Conservation stewardship plan. 1470.22 Section 1470..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments § 1470.22 Conservation stewardship plan. (a) NRCS will use the conservation...

  7. 7 CFR 1470.22 - Conservation stewardship plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Conservation stewardship plan. 1470.22 Section 1470..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments § 1470.22 Conservation stewardship plan. (a) NRCS will use the conservation...

  8. A global call from five countries to collaborate in antibiotic stewardship: united we succeed, divided we might fail.

    PubMed

    Goff, Debra A; Kullar, Ravina; Goldstein, Ellie J C; Gilchrist, Mark; Nathwani, Dilip; Cheng, Allen C; Cairns, Kelly A; Escandón-Vargas, Kevin; Villegas, Maria Virginia; Brink, Adrian; van den Bergh, Dena; Mendelson, Marc

    2017-02-01

    In February, 2016, WHO released a report for the development of national action plans to address the threat of antibiotic resistance, the catastrophic consequences of inaction, and the need for antibiotic stewardship. Antibiotic stewardship combined with infection prevention comprises a collaborative, multidisciplinary approach to optimise use of antibiotics. Efforts to mitigate overuse will be unsustainable without learning and coordinating activities globally. In this Personal View, we provide examples of international collaborations to address optimal prescribing, focusing on five countries that have developed different approaches to antibiotic stewardship-the USA, South Africa, Colombia, Australia, and the UK. Although each country's approach differed, when nurtured, individual efforts can positively affect local and national antimicrobial stewardship programmes. Government advocacy, national guidelines, collaborative research, online training programmes, mentoring programmes, and social media in stewardship all played a role. Personal relationships and willingness to learn from each other's successes and failures continues to foster collaboration. We recommend that antibiotic stewardship models need to evolve from infection specialist-based teams to develop and use cadres of health-care professionals, including pharmacists, nurses, and community health workers, to meet the needs of the global population. We also recommend that all health-care providers who prescribe antibiotics take ownership and understand the societal burden of suboptimal antibiotic use, providing examples of how countries can learn, act globally, and share best antibiotic stewardship practices. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Investigation of coal stockpiles of Tuncbilek thermal power plant with respect to time under atmospheric conditions

    SciTech Connect

    Ozdeniz, A.H.

    2009-07-01

    Thermal power plants have delayed the coal that they will use at stockpiles mandatorily. If these coal stockpiles remain at the stockyards over a certain period of time, a spontaneous combustion can be started itself. Coal stocks under combustion threat can cost too much economically to coal companies. Therefore, it is important to take some precautions for saving the stockpiles from the spontaneous combustion. In this research a coal stockpile at Tuncbilek Thermal Power Plant which was formed in 5 m wide, 10 m long, and 3 m height with a weight of 120 tons to observe internal temperature changes with respect to time under normal atmospheric conditions. Later, internal temperature measurements were obtained at 20 points distributed all over two layers in the stockpile. The parameters, such as air temperature, humidity, atmosphere pressure, wind speed and direction, which are effective on the stockpiles, were measured and used to obtain the graphs of stockpiles' internal temperature.

  10. Projection-aided videometric method for shape measurement of large-scale bulk material stockpile.

    PubMed

    Zhang, Xiaohu; Ou, Jianliang; Yuan, Yun; Shang, Yang; Yu, Qifeng

    2011-09-10

    Large-scale stockpiles are a common means for the storage of bulk material and their shape measurement is a prerequisite for effective transportation and logistics management. This paper proposes a projection-aided videometric method that is based on stereo vision and makes use of projections and epipolar geometry constraints to solve the correspondence problem. A prototype measuring system was developed that can work in real time and achieve measuring accuracy of 0.71 mm in terms of the flatness deviation and 0.54 mm in terms of the depth error, as proven by the experimental results.

  11. Stewardship, Learning, and Memory in Disaster Resilience

    ERIC Educational Resources Information Center

    Tidball, Keith G.; Krasny, Marianne E.; Svendsen, Erika; Campbell, Lindsay; Helphand, Kenneth

    2010-01-01

    In this contribution, we propose and explore the following hypothesis: civic ecology practices, including urban community forestry, community gardening, and other self-organized forms of stewardship of green spaces in cities, are manifestations of how memories of the role of greening in healing can be instrumentalized through social learning to…

  12. Of stewardship, motherhood and apple pie.

    PubMed

    Livermore, David M

    2014-04-01

    Antibiotic stewardship is universally agreed to be desirable, but optimal models for stewardship remain uncertain. UK stewardship targets the particular antibiotic families-cephalosporins and fluoroquinolones-blamed for the selection of Clostridium-difficile-associated disease. To balance this there have been dramatic increases in the use of penicillin-β-lactamase inhibitor combinations. By channelling selection pressure in this way, we hazard destroying the utility of these antibiotic classes in turn, as happened with gonorrhoea where penicillins, fluoroquinolones and cefixime were sequentially lost as therapies. Strikingly, in context, almost all carbapenemase-producers are highly resistant to penicillin-β-lactamase inhibitor combinations, which may select for them. There is an urgent need to explore an alternative stewardship model, seeking to limit total antibiotic use but to maintain heterogeneity in what is used, avoiding concentrated selection pressure. There is also a great need to improve and accelerate diagnostics for infection and resistance, reducing or removing the need for protracted empirical treatment with broad-spectrum agents.

  13. PFOA Stewardship Program Baseline Year Summary Report

    EPA Pesticide Factsheets

    In 2006, EPA and the eight major companies in the industry launched the 2010/15 PFOA Stewardship Program, in which companies committed to reduce global facility emissions and product content of PFOA and related chemicals by 95 percent by 2010, and to work

  14. Predicting volunteer commitment in environmental stewardship programmes

    Treesearch

    Robert L. Ryan; Rachel Kaplan; Robert E. Grese

    2001-01-01

    The natural environment benefits greatly from the work of volunteers in environmental stewardship programmes. However, little is known about volunteers' motivations for continued participation in these programmes. This study looked at the relationship between volunteer commitment and motivation, as well as the effect that volunteering has on participants'...

  15. Stewardship, learning, and memory in disaster resilience

    Treesearch

    Keith G. Tidball; Marianne E. Krasny; Erika Svendsen; Lindsay Campbell; Kenneth. Helphand

    2010-01-01

    In this contribution, we propose and explore the following hypothesis: civic ecology practices, including urban community forestry, community gardening, and other self-organized forms of stewardship of green spaces in cities, are manifestations of how memories of the role of greening in healing can be instrumentalized through social learning to foster social-ecological...

  16. Stewardship, Learning, and Memory in Disaster Resilience

    ERIC Educational Resources Information Center

    Tidball, Keith G.; Krasny, Marianne E.; Svendsen, Erika; Campbell, Lindsay; Helphand, Kenneth

    2010-01-01

    In this contribution, we propose and explore the following hypothesis: civic ecology practices, including urban community forestry, community gardening, and other self-organized forms of stewardship of green spaces in cities, are manifestations of how memories of the role of greening in healing can be instrumentalized through social learning to…

  17. 75 FR 34924 - Conservation Stewardship Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ...-12699, concerning the Conservation Stewardship Program, contained an error in the words of ``issuance..., June 3, 2010, the following correction is made: Words of Issuance (1) On page 31653, in the second column, the Words of Issuance that read ``For the reasons stated above, the CCC adds part 1470 of the CFR...

  18. Optimizing tactics for use of the U.S. antiviral strategic national stockpile for pandemic influenza.

    PubMed

    Dimitrov, Nedialko B; Goll, Sebastian; Hupert, Nathaniel; Pourbohloul, Babak; Meyers, Lauren Ancel

    2011-01-19

    In 2009, public health agencies across the globe worked to mitigate the impact of the swine-origin influenza A (pH1N1) virus. These efforts included intensified surveillance, social distancing, hygiene measures, and the targeted use of antiviral medications to prevent infection (prophylaxis). In addition, aggressive antiviral treatment was recommended for certain patient subgroups to reduce the severity and duration of symptoms. To assist States and other localities meet these needs, the U.S. Government distributed a quarter of the antiviral medications in the Strategic National Stockpile within weeks of the pandemic's start. However, there are no quantitative models guiding the geo-temporal distribution of the remainder of the Stockpile in relation to pandemic spread or severity. We present a tactical optimization model for distributing this stockpile for treatment of infected cases during the early stages of a pandemic like 2009 pH1N1, prior to the wide availability of a strain-specific vaccine. Our optimization method efficiently searches large sets of intervention strategies applied to a stochastic network model of pandemic influenza transmission within and among U.S. cities. The resulting optimized strategies depend on the transmissability of the virus and postulated rates of antiviral uptake and wastage (through misallocation or loss). Our results suggest that an aggressive community-based antiviral treatment strategy involving early, widespread, pro-rata distribution of antivirals to States can contribute to slowing the transmission of mildly transmissible strains, like pH1N1. For more highly transmissible strains, outcomes of antiviral use are more heavily impacted by choice of distribution intervals, quantities per shipment, and timing of shipments in relation to pandemic spread. This study supports previous modeling results suggesting that appropriate antiviral treatment may be an effective mitigation strategy during the early stages of future influenza

  19. Optimizing Tactics for Use of the U.S. Antiviral Strategic National Stockpile for Pandemic Influenza

    PubMed Central

    Dimitrov, Nedialko B.; Goll, Sebastian; Hupert, Nathaniel; Pourbohloul, Babak; Meyers, Lauren Ancel

    2011-01-01

    In 2009, public health agencies across the globe worked to mitigate the impact of the swine-origin influenza A (pH1N1) virus. These efforts included intensified surveillance, social distancing, hygiene measures, and the targeted use of antiviral medications to prevent infection (prophylaxis). In addition, aggressive antiviral treatment was recommended for certain patient subgroups to reduce the severity and duration of symptoms. To assist States and other localities meet these needs, the U.S. Government distributed a quarter of the antiviral medications in the Strategic National Stockpile within weeks of the pandemic's start. However, there are no quantitative models guiding the geo-temporal distribution of the remainder of the Stockpile in relation to pandemic spread or severity. We present a tactical optimization model for distributing this stockpile for treatment of infected cases during the early stages of a pandemic like 2009 pH1N1, prior to the wide availability of a strain-specific vaccine. Our optimization method efficiently searches large sets of intervention strategies applied to a stochastic network model of pandemic influenza transmission within and among U.S. cities. The resulting optimized strategies depend on the transmissability of the virus and postulated rates of antiviral uptake and wastage (through misallocation or loss). Our results suggest that an aggressive community-based antiviral treatment strategy involving early, widespread, pro-rata distribution of antivirals to States can contribute to slowing the transmission of mildly transmissible strains, like pH1N1. For more highly transmissible strains, outcomes of antiviral use are more heavily impacted by choice of distribution intervals, quantities per shipment, and timing of shipments in relation to pandemic spread. This study supports previous modeling results suggesting that appropriate antiviral treatment may be an effective mitigation strategy during the early stages of future influenza

  20. Integrating Information Networks for Collective Planetary Stewardship

    NASA Astrophysics Data System (ADS)

    Tiwari, A.

    2016-12-01

    Responsible behaviour resulting from climate literacy in global environmental movement is limited to policy and planning institutions in the Global South, while remaining absent for ends-user. Thus, planetary stewardship exists only at earth system boundaries where pressures sink to the local scale while ethics remains afloat. Existing citizen participation is restricted within policy spheres, appearing synonymous to enforcements in social psychology. Much, accounted reason is that existing information mechanisms operate mostly through linear exchanges between institutions and users, therefore reinforcing only hierarchical relationships. This study discloses such relationships that contribute to broad networking gaps through information demand assessment of stakeholders in a dozen development projects based in South Asia. Two parameters widely used for this purpose are: a. Feedback: Ends-user feedback to improve consumption literacy of climate sensitive resources (through consumption displays, billing, advisory services ecolabelling, sensors) and, b. Institutional Policy: Rewarding punishing to enforce desired behaviour (subsidies, taxation). Research answered: 1. Who gets the information (Equity in Information Distribution)? As existing information publishing mechanisms are designed by and for analysts, 2. How information translates to climate action Transparency of Execution)? Findings suggested that climate goals manifested in economic policy, than environmental policy, have potential clear short-term benefits and costs, and coincide with people's economic goals Also grassroots roles for responsible behaviour are empowered with presence of end user information. Barier free climate communication process and decision making is ensured among multiplicity of stakeholders with often conflicting perspectives. Research finds significance where collaboration among information networks can better translate regional policies into local action for climate adaptation and

  1. Relational responsibility, and not only stewardship, a Roman Catholic view on voluntary euthanasia for dying and non-dying patients.

    PubMed

    Schotsmans, Paul T

    2003-01-01

    The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called "stewardship argument": Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist--and even secular--debate on the legitimacy of euthanasia.

  2. 16 CFR 1202.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... manufacturing plant that it did not operate during the base period, or that it did not operate for an entire..., holidays, and vacations) for the part of the base period he did operate that plant, multiplied by 365 or...

  3. [Bedside consultation by a multidisciplinary antibiotics team: an Antibiotic Stewardship Programme at UMCG].

    PubMed

    Lo-Ten-Foe, Jerome R; Sinha, Bhanu; Wilting, Kasper R; Veenstra-Kyuchukova, Yanka; Panday, Prashant N; Hendrix, Ron

    2014-01-01

    In 2012, the Dutch Working Party on Antibiotic Policy (SWAB) published a vision document to counteract the rise in antibiotic use and resistance. An Antibiotic Stewardship Programme (ASP) will be implemented by a multidisciplinary antibiotics team (A-team). In 2012 University Medical Centre Groningen (UMCG) in the Netherlands started an Antibiotic Stewardship Programme (ASP) pilot project at the trauma surgery ward. The focus is on providing bedside consultation for patients based on the day 2 bundle. Implementation of the ASP on the basis of a day 2 bundle resulted in an intervention percentage of 75%. The pilot project was a success and will be extended to other wards.

  4. The GSFC Combined Approach of ODC Stockpiling and Tribological Testing to Mitigate the Risks of ODC Elimination

    NASA Technical Reports Server (NTRS)

    Predmore, Roamer; LeBoeuf, Claudia; Hovanec, Andrew

    1997-01-01

    In response to the elimination of production of several Ozone Depleting Chemicals (ODC's) which have been widely used in successful space flight mechanism cleaning and lubricating procedures, GSFC developed and implemented an overall philosophy of mitigating the risks to flight hardware during the transition phase to ODC-free cleaning procedures. The short term leg of the philosophy was the stockpiling of an appropriate amount of ODC solvents such that all short term GSFC missions will be able to stay with or revert to heritage cleaning and lubricating procedures in the face of life issues. The long-term leg of that philosophy was the initiation of a several tier testing program that will deliver increasing amounts of information over the next few years, starting with accelerated lubricant life tests that compare lubricant life on surfaces cleaned with ODC solvents with lubricant life on surfaces cleaned with ODC-free solvents. While tribological testing, mechanism life testing and space-flight experience will ultimately bring us into the 21st century with environmentally friendly means of cleaning long-life precision mechanism components, many satellites will be launched over the next few years before a number of important tribological questions can be answered. In order to prepare for this challenge, the Materials Engineering Branch in cooperation with the Electromechanical Branch launched an intensive review of all ongoing missions. The failure risk was determined for each long-life lubricated mechanism based on a number of parameters, including 4 comparison of flight solvents used to clean the heritage/life test hardware. Also studied was the ability of the mechanism manufacturers to stockpile ODC's based on state laws and company policies. A stockpiling strategy was constructed based on this information and subsequently implemented. This paper provides an overview of the GSFC ODC elimination risk mitigation philosophy as well as a detailed examination of the

  5. The GSFC Combined Approach of ODC Stockpiling and Tribological Testing to Mitigate the Risks of ODC Elimination

    NASA Technical Reports Server (NTRS)

    Predmore, Roamer; Woods, Claudia; Hovanec, Andrew

    1997-01-01

    In response to the elimination of production of several Ozone Depleting Chemicals (ODCs) which have been widely used in successful space flight mechanism cleaning and lubricating procedures, GSFC developed and implemented an overall philosophy of mitigating the risks to flight hardware during the transition phase to ODC-Free cleaning procedures. One leg of that philosophy is the initiation of a several tier testing program which will deliver increasing amounts of information over the next few years, starting with original surface analysis comparisons between ODC and various ODC-Free cleaning technologies. The other leg is the stockpiling of an appropriate amount of ODC solvents such that all short term GSFC missions will be able to stay with or revert to heritage cleaning and lubricating procedures in the face of life issues. While tribological testing, mechanism life testing and space-flight experience will ultimately bring us into the 21st century with environmentally friendly means of cleaning long-life precision mechanism components, many satellites will be launched over the next few years with a number of important tribological questions unanswered. In order to prepare for this challenge, the Materials Engineering Branch in cooperation with the Electromechanical Branch launched an intensive review of all ongoing missions. The failure risk was determined for each long-life mechanism based on a number of parameters, including a comparison of flight solvents used to clean the heritage/life test hardware. Also studied was the ability of the mechanism manufacturers to stockpile ODCs based on state laws and company policies. A stockpiling strategy was constructed based on this information and subsequently implemented. This paper provides an overview of the GSFC ODC elimination risk mitigation philosophy as well as a detailed examination of the development of the ODC stockpiling plan.

  6. Stockpiled forage or limit-fed corn as alternatives to hay for gestating and lactating beef cows.

    PubMed

    Schoonmaker, J P; Loerch, S C; Rossi, J E; Borger, M L

    2003-05-01

    In Exp. 1, 31, 24, and 17 mature, pregnant Simmental x Angus cows (initial BW = 662.0 +/- 10.4 kg) in each of 3 yr were used to determine the efficacy of stockpiled orchardgrass, limit-fed corn, or ad libitum hay for maintaining cows in mid- to late gestation, respectively. In Exp. 2, 24 mature, pregnant crossbred cows (initial BW = 677.7 +/- 9.4 kg) per treatment in each of 3 yr were used to determine the efficacy of stockpiled orchardgrass, limit-fed corn, or ad libitum hay for maintaining cows in late gestation and early lactation, respectively. Each year, cows were assigned to treatment by BW. From November to February or from January to April, respectively, nutritional needs for mid- to late gestation (Exp. 1) or late gestation and early lactation (Exp. 2) were met either by 1) rotating cows on approximately 15.2 or 21.7 ha of predominantly orchardgrass pasture, set aside and fertilized in late August, 2) limit-feeding approximately 5.8 kg of whole shelled corn, 1.1 kg of a pelleted supplement, and 1.2 kg of hay daily, or 3) ad libitum feeding of round-baled hay. During extreme weather conditions, cows grazing stockpiled orchardgrass were limit-fed a grain-based diet. Postcalving weight (P < 0.10) was greatest for limit-fed cows in Exp. 1 and lowest for cows grazed on stockpiled orchardgrass; cows given ad libitum access to hay were intermediate in weight and did not differ from cows limit-fed or cows grazed on stockpiled orchardgrass (641.8, 657.4, and 634.0 kg, respectively). Calving date, calf birth and weaning weight, and conception rate did not differ among treatments (P > 0.15) in Exp. 1. In Exp. 2, weight at weaning did not differ among treatments (P > 0.17); however, postcalving weight (P < 0.01) was greatest for cows given ad libitum access to hay, intermediate for limit-fed cows, and lowest for cows grazed on stockpiled orchardgrass (674.8, 652.4, and 624.5 kg). Body condition score at any time point did not differ among treatments (P > 0.38), nor

  7. Data Governance and Stewardship: Designing Data Stewardship Entities and Advancing Data Access

    PubMed Central

    Rosenbaum, Sara

    2010-01-01

    U.S. health policy is engaged in a struggle over access to health information, in particular, the conditions under which information should be accessible for research when appropriate privacy protections and security safeguards are in place. The expanded use of health information—an inevitable step in an information age—is widely considered be essential to health system reform. Models exist for the creation of data-sharing arrangements that promote proper use of information in a safe and secure environment and with attention to ethical standards. Data stewardship is a concept with deep roots in the science and practice of data collection, sharing, and analysis. Reflecting the values of fair information practice, data stewardship denotes an approach to the management of data, particularly data that can identify individuals. The concept of a data steward is intended to convey a fiduciary (or trust) level of responsibility toward the data. Data governance is the process by which responsibilities of stewardship are conceptualized and carried out. As the concept of health information data stewardship advances in a technology-enabled environment, the question is whether legal barriers to data access and use will begin to give way. One possible answer may lie in defining the public interest in certain data uses, tying provider participation in federal health programs to the release of all-payer data to recognized data stewardship entities for aggregation and management, and enabling such entities to foster and enable the creation of knowledge through research. PMID:21054365

  8. Scientific evidence and research in antimicrobial stewardship.

    PubMed

    Almirante, Benito; Garnacho-Montero, José; Pachón, Jerónimo; Pascual, Álvaro; Rodríguez-Baño, Jesús

    2013-09-01

    Evaluating the impact of antibiotic stewardship programs is challenging. There is evidence that they are effective in terms of reducing the consumption and cost of antibiotics, although establishing their impact on antimicrobial resistance (beyond restrictive policies in outbreaks caused by specific antimicrobial resistant organisms) and clinical outcomes is more difficult. Proper definitions of exposure and outcome variables, the use of advanced and appropriate statistical analyses and well-designed quasi-experimental studies would more accurately support the conclusions. Cluster randomized trials should be used whenever possible and appropriate, although the limitations of this approach should also be acknowledged. These issues are reviewed in this paper. We conclude that there are good research opportunities in the field of antibiotic stewardship. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  9. Initiatives and resources to promote antimicrobial stewardship.

    PubMed

    Paño-Pardo, José Ramón; Campos, José; Natera Kindelán, Clara; Ramos, Antonio

    2013-09-01

    The development of an antimicrobial stewardship program (ASP) requires institutional support. However, obtaining sufficient institutional support is often a complex task that requires convincing the hospital's managers of the benefits of these programs. Additionally, in the design and implementation of an ASP, antimicrobial stewardship (AS) leaders need tools for diverse purposes, such as measuring antimicrobial consumption, education and training and designing protocols. In this review we provide useful information for AS promoters to facilitate the task of designing and implementing an ASP. First, we summarize information about various institutions that promote AS and include evidence that supports the need for and benefits of these programs. Then, several campaigns promoting AS are described. Finally, online resources for professionals dealing with AS are briefly summarized. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. Multi-generational stewardship of plutonium

    SciTech Connect

    Pillay, K.K.S.

    1997-10-01

    The post-cold war era has greatly enhanced the interest in the long-term stewardship of plutonium. The management of excess plutonium from proposed nuclear weapons dismantlement has been the subject of numerous intellectual discussions during the past several years. In this context, issues relevant to long-term management of all plutonium as a valuable energy resource are also being examined. While there are differing views about the future role of plutonium in the economy, there is a recognition of the environmental and health related problems and proliferation potentials of weapons-grade plutonium. The long-term management of plutonium as an energy resource will require a new strategy to maintain stewardship for many generations to come.

  11. Stewardship of the Spanish national health system.

    PubMed

    Bankauskaite, Vaida; Novinskey, Christina M

    2010-01-01

    Along with resource generation, financing, and health service delivery, stewardship is a key health system function. However, very little empirical analysis has been carried out on it. This paper aims to fill this gap in the literature by assessing the Ministry of Health's (MoHs) role as a steward of the Spanish National Health System (NHS) after the 2001 decentralization reform of health care management to the Autonomous Communities. We use the following stewardship framework with six sub-functions for the analysis, looking at the MoH's ability to: (1) formulate strategic policy framework; 2) ensure a fit between policy objectives and organizational structure and culture; (3) ensure tools for implementation; (4) build coalitions and partnerships; (5) generate intelligence, and (6) ensure accountability. We describe the stewardship function, identify existing challenges and issues in the Spanish case, and reflect upon methodological aspects of this exercise. We use reports, documents, articles, and official statistics to complete the analysis. Overall, we find the MoH to give an average performance in its role as the steward of the health system. The MoH has progressed particularly well in generating intelligence as well as formulating a strategic policy framework over recent years. However, it lacks the appropriate authority to efficiently coordinate the health system and to ensure that the Autonomous Communities implement policies that are in-line with overall NHS objectives.

  12. Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis.

    PubMed

    Schuts, Emelie C; Hulscher, Marlies E J L; Mouton, Johan W; Verduin, Cees M; Stuart, James W T Cohen; Overdiek, Hans W P M; van der Linden, Paul D; Natsch, Stephanie; Hertogh, Cees M P M; Wolfs, Tom F W; Schouten, Jeroen A; Kullberg, Bart Jan; Prins, Jan M

    2016-07-01

    Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes, adverse events, costs, and bacterial resistance rates. We identified 14 stewardship objectives and did a separate systematic search for articles relating to each one in Embase, Ovid MEDLINE, and PubMed. Studies were included if they reported data on any of the four predefined outcomes in patients in whom the specific antimicrobial stewardship objective was assessed and compared the findings in patients in whom the objective was or was not met. We used a random-effects model to calculate relative risk reductions with relative risks and 95% CIs. We identified 145 unique studies with data on nine stewardship objectives. Overall, the quality of evidence was generally low and heterogeneity between studies was mostly moderate to high. For the objectives empirical therapy according to guidelines, de-escalation of therapy, switch from intravenous to oral treatment, therapeutic drug monitoring, use of a list of restricted antibiotics, and bedside consultation the overall evidence showed significant benefits for one or more of the four outcomes. Guideline-adherent empirical therapy was associated with a relative risk reduction for mortality of 35% (relative risk 0·65, 95% CI 0·54-0·80, p<0·0001) and for de-escalation of 56% (0·44, 0·30-0·66, p<0·0001). Evidence of effects was less clear for adjusting therapy according to renal function, discontinuing therapy based on lack of clinical or microbiological evidence of infection, and having a local antibiotic guide. We found no reports for the remaining five stewardship objectives or for long-term care facilities. Our findings of beneficial effects on outcomes with nine antimicrobial stewardship objectives suggest they can

  13. Wilderness stewardship in America today and what we can do to improve it

    Treesearch

    Ken Cordell; Chris Barns; David Brownlie; Tom Carlson; Chad Dawson; William Koch; Garry Oye; Chris Ryan

    2016-01-01

    The authors of this article are recently retired wilderness professionals from universities or federal agencies. We were asked to share our observations about how wilderness stewardship is being managed in America today. We based our observations on our many years of combined professional wilderness career experience as managers, trainers, scientists, educators, and...

  14. The Karuk tribe, planetary stewardship, and world renewal on the middle Klamath River, California

    Treesearch

    Frank K. Lake; William Tripp; R. Reed

    2010-01-01

    In the Karuk Tribe’s worldview, planetary stewardship is maintained through the place-based spiritual and cultural philosophy of World Renewal. A philosophy of Renewal reaffirms the responsibility of humans as stewards as well as a critical ecosystem component. The Tribe believes in renewal of the human-environment relationship that is compatible with ecological...

  15. A Survey of Antimicrobial Stewardship Programs in Korea, 2015.

    PubMed

    Kim, Bongyoung; Kim, Jieun; Kim, Shin Woo; Pai, Hyunjoo

    2016-10-01

    The study was conducted to evaluate the Antibiotic Stewardship Program (ASP) in Korean hospitals compared with the previous two surveys in 2006 and 2012. The information on ASPs was collected through an online-based survey sent by e-mail to 192 infectious diseases specialists in 101 Korean hospitals in September 2015. Fifty-four hospitals (53.5%, 54/101) responded to the online survey. One infectious diseases specialist was employed in 30 (55.6%) of the 54 hospitals, and they were in charge of ASPs in hospitals with the program. Fifty of the 54 hospitals (92.6%) had ASPs and the same number of hospitals was conducting a preauthorization-of-antibiotics-use program. Although most hospitals adopted preauthorization strategies for more antibiotics in 2015 than in 2012 (median 14 in 2015; 13 in 2012), a limited number of antibiotics were under control. The number of per oral and parenteral antibiotics available in hospitals in 2015 decreased compared to 2006 and 2012. The number of hospitals performing a retrospective or prospective qualitative drug use evaluation of antibiotic use increased from 2006 to 2015. Manpower in charge of antibiotic stewardship in most hospitals was still very limited and ASPs heavily depended on preauthorization-of-antibiotics-use programs in this survey. In conclusion, there leaves much to be desired in ASPs in Korea in 2015.

  16. A Survey of Antimicrobial Stewardship Programs in Korea, 2015

    PubMed Central

    2016-01-01

    The study was conducted to evaluate the Antibiotic Stewardship Program (ASP) in Korean hospitals compared with the previous two surveys in 2006 and 2012. The information on ASPs was collected through an online-based survey sent by e-mail to 192 infectious diseases specialists in 101 Korean hospitals in September 2015. Fifty-four hospitals (53.5%, 54/101) responded to the online survey. One infectious diseases specialist was employed in 30 (55.6%) of the 54 hospitals, and they were in charge of ASPs in hospitals with the program. Fifty of the 54 hospitals (92.6%) had ASPs and the same number of hospitals was conducting a preauthorization-of-antibiotics-use program. Although most hospitals adopted preauthorization strategies for more antibiotics in 2015 than in 2012 (median 14 in 2015; 13 in 2012), a limited number of antibiotics were under control. The number of per oral and parenteral antibiotics available in hospitals in 2015 decreased compared to 2006 and 2012. The number of hospitals performing a retrospective or prospective qualitative drug use evaluation of antibiotic use increased from 2006 to 2015. Manpower in charge of antibiotic stewardship in most hospitals was still very limited and ASPs heavily depended on preauthorization-of-antibiotics-use programs in this survey. In conclusion, there leaves much to be desired in ASPs in Korea in 2015. PMID:27550482

  17. Treating Wisely: The Surgeon's Role in Antibiotic Stewardship.

    PubMed

    Leeds, Ira L; Fabrizio, Anne; Cosgrove, Sara E; Wick, Elizabeth C

    2016-10-04

    Antibiotic resistance continues to receive national attention as a leading public health threat. In 2015, President Barack Obama proposed a National Action Plan to Combat Antibiotic-Resistant Bacteria to curb the rise of "superbugs," bacteria resistant to antibiotics of last resort. Whereas many antibiotics are prescribed appropriately to treat infections, there continue to be a large number of inappropriately prescribed antibiotics. Although much of the national attention with regards to stewardship has focused on primary care providers, there is a significant opportunity for surgeons to embrace this national imperative and improve our practices. Local quality improvement efforts suggest that antibiotic misuse for surgical disease is common. Opportunities exist as part of day-to-day surgical care as well as through surgeons' interactions with nonsurgeon colleagues and policy experts. This article discusses the scope of the antibiotic misuse in surgery for surgical patients, and provides immediate practice improvements and also advocacy efforts surgeons can take to address the threat. We believe that surgical antibiotic prescribing patterns frequently do not adhere to evidence-based practices; surgeons are in a position to mitigate their ill effects; and antibiotic stewardship should be a part of every surgeons' practice.

  18. The Antimicrobial Stewardship Approach to Combating Clostridium Difficile

    PubMed Central

    Wenzler, Eric; Mulugeta, Surafel G.; Danziger, Larry H.

    2015-01-01

    Clostridium difficile remains a major public health threat and continues to contribute to excess morbidity, mortality and healthcare costs. Antimicrobial stewardship programs have demonstrated success in combating C. difficile, primarily through antibiotic restrictive strategies. As the incidence and prevalence of C. difficile associate disease continues to increase both in the hospital and community setting, additional stewardship approaches are needed. This manuscript reviews stewardship interventions that have been successful against C. difficile associated disease and proposes future tactics that antimicrobial stewardship programs may employ to develop a more global approach to combat this difficult pathogen. PMID:27025621

  19. 77 FR 18879 - Meeting of the Regional Resource Stewardship Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    .... Introductions 2. Updates regarding TVA's Natural Resource Plan implementation and its River Operations essential stewardship functions, including management of the river system, dam safety, navigation, and flood control...

  20. A stewardship challenge: reconciling faith and finances.

    PubMed

    Kelly, M J

    1984-10-01

    As financial constraints have tightened in recent years, Catholic health care facilities have undergone the double pressure of having to safeguard the integrity of their Christian mission while maintaining economic viability. The conflict between faith and finances, however, represents a tension that has been felt since Biblical times. The dichotomy between ministry and money can be traced from Scripture's admonition that money is the root of all evil, through the Manichean heresy of the early Church, right up to the conflict that today's sponsoring congregations experience in seeking to reconcile multimillion-dollar budgets with their efforts to maintain a simple life-style and raise the existence level of the poor. Mission integrity and fiscal viability are not irreconcilable, however. Effective management can advance, not impede, the mission's cause. Sound business decisions need not exclude social or mission values. Indeed, ministry and management are united in the Gospel message of stewardship. The Gospel itself abounds in management lessons, perhaps the clearest of which is the parable of the talents, in which we are told to manage our gifts wisely so that they are actually increased and not just maintained. Numerous contemporary Church documents also suggest that the multimillion-dollar services that we have inherited and developed must continue to be managed well so that their yield, ministerial and financial, is increased. To resolve much of the misunderstanding within sponsorship groups and health care facilities, an action agenda is needed: The nature of work must be given prayerful reflection, so that it can be understood as a sharing in the creative act of God and as a part of each person's spirituality. Moreover, an institution should be viewed and managed as a positive power base and educational center for developing and advancing positions consistent with the Gospel. Institutional policies and procedures, of course, should be made to reflect this

  1. Evidence synthesis and decision modelling to support complex decisions: stockpiling neuraminidase inhibitors for pandemic influenza usage.

    PubMed

    Watson, Samuel I; Chen, Yen-Fu; Nguyen-Van-Tam, Jonathan S; Myles, Puja R; Venkatesan, Sudhir; Zambon, Maria; Uthman, Olalekan; Chilton, Peter J; Lilford, Richard J

    2016-01-01

    Objectives: The stockpiling of neuraminidase inhibitor (NAI) antivirals as a defence against pandemic influenza is a significant public health policy decision that must be made despite a lack of conclusive evidence from randomised controlled trials regarding the effectiveness of NAIs on important clinical end points such as mortality. The objective of this study was to determine whether NAIs should be stockpiled for treatment of pandemic influenza on the basis of current evidence. Methods: A decision model for stockpiling was designed. Data on previous pandemic influenza epidemiology was combined with data on the effectiveness of NAIs in reducing mortality obtained from a recent individual participant meta-analysis using observational data. Evidence synthesis techniques and a bias modelling method for observational data were used to incorporate the evidence into the model. The stockpiling decision was modelled for adults (≥16 years old) and the United Kingdom was used as an example. The main outcome was the expected net benefits of stockpiling in monetary terms. Health benefits were estimated from deaths averted through stockpiling. Results: After adjusting for biases in the estimated effectiveness of NAIs, the expected net benefit of stockpiling in the baseline analysis was £444 million, assuming a willingness to pay of £20,000/QALY ($31,000/QALY). The decision would therefore be to stockpile NAIs. There was a greater probability that the stockpile would not be utilised than utilised. However, the rare but catastrophic losses from a severe pandemic justified the decision to stockpile. Conclusions: Taking into account the available epidemiological data and evidence of effectiveness of NAIs in reducing mortality, including potential biases, a decision maker should stockpile anti-influenza medication in keeping with the postulated decision rule.

  2. Evidence synthesis and decision modelling to support complex decisions: stockpiling neuraminidase inhibitors for pandemic influenza usage

    PubMed Central

    Watson, Samuel I.; Chen, Yen-Fu; Nguyen-Van-Tam, Jonathan S.; Myles, Puja R.; Venkatesan, Sudhir; Zambon, Maria; Uthman, Olalekan; Chilton, Peter J.; Lilford, Richard J.

    2017-01-01

    Objectives: The stockpiling of neuraminidase inhibitor (NAI) antivirals as a defence against pandemic influenza is a significant public health policy decision that must be made despite a lack of conclusive evidence from randomised controlled trials regarding the effectiveness of NAIs on important clinical end points such as mortality. The objective of this study was to determine whether NAIs should be stockpiled for treatment of pandemic influenza on the basis of current evidence. Methods: A decision model for stockpiling was designed. Data on previous pandemic influenza epidemiology was combined with data on the effectiveness of NAIs in reducing mortality obtained from a recent individual participant meta-analysis using observational data. Evidence synthesis techniques and a bias modelling method for observational data were used to incorporate the evidence into the model. The stockpiling decision was modelled for adults (≥16 years old) and the United Kingdom was used as an example. The main outcome was the expected net benefits of stockpiling in monetary terms. Health benefits were estimated from deaths averted through stockpiling. Results: After adjusting for biases in the estimated effectiveness of NAIs, the expected net benefit of stockpiling in the baseline analysis was £444 million, assuming a willingness to pay of £20,000/QALY ($31,000/QALY). The decision would therefore be to stockpile NAIs. There was a greater probability that the stockpile would not be utilised than utilised. However, the rare but catastrophic losses from a severe pandemic justified the decision to stockpile. Conclusions: Taking into account the available epidemiological data and evidence of effectiveness of NAIs in reducing mortality, including potential biases, a decision maker should stockpile anti-influenza medication in keeping with the postulated decision rule. PMID:28413608

  3. Report: Ongoing Management Improvements and Further Evaluation Vital to EPA Stewardship and Voluntary Programs

    EPA Pesticide Factsheets

    Report #2005-P-00007, February 17, 2005. We asked stakeholders to define stewardship, list motivators and obstacles to participating in stewardship programs, and outline key roles for EPA to play to foster participating in environmental stewardship.

  4. 75 FR 54852 - National Defense Stockpile Market Impact Committee Request for Public Comments on the Potential...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Comments on the Potential Market Impact of Proposed Stockpile Disposals for Fiscal Year 2012 AGENCY: Bureau... Commerce and State, is seeking public comments on the potential market impact of the proposed disposal... economic effects of all acquisitions and disposals of materials from the stockpile * * * .'' The...

  5. 78 FR 68028 - National Defense Stockpile Market Impact Committee Request for Public Comments on the Potential...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-13

    ... foreign economic effects of all acquisitions and disposals involving the stockpile and related material... disposals of materials from the stockpile. . . .'' The Committee must also balance market impact concerns..., potential disposal, or potential upgrade) associated with each material in its proposed FY 2015...

  6. 13 CFR 121.512 - What is the size standard for stockpile purchases?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false What is the size standard for stockpile purchases? 121.512 Section 121.512 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... for Sales Or Lease of Government Property § 121.512 What is the size standard for stockpile purchases...

  7. 13 CFR 121.512 - What is the size standard for stockpile purchases?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false What is the size standard for stockpile purchases? 121.512 Section 121.512 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... for Sales Or Lease of Government Property § 121.512 What is the size standard for stockpile purchases...

  8. 13 CFR 121.512 - What is the size standard for stockpile purchases?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false What is the size standard for stockpile purchases? 121.512 Section 121.512 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... for Sales Or Lease of Government Property § 121.512 What is the size standard for stockpile purchases...

  9. 13 CFR 121.512 - What is the size standard for stockpile purchases?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is the size standard for stockpile purchases? 121.512 Section 121.512 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... for Sales Or Lease of Government Property § 121.512 What is the size standard for stockpile purchases...

  10. 13 CFR 121.512 - What is the size standard for stockpile purchases?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false What is the size standard for stockpile purchases? 121.512 Section 121.512 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION... for Sales Or Lease of Government Property § 121.512 What is the size standard for stockpile purchases...

  11. Risk communications and the Chemical Stockpile Emergency-Planning Program

    SciTech Connect

    Vogt, B.M.; Sorensen, J.H.

    1994-09-01

    The CSEPP (Chemical Stockpile Emergency Preparedness Program) was created to improve emergency planning and response capabilities at the eight sites around the country that store chemical weapons. These weapons are scheduled to be destroyed in the near future. In preparation of the Draft Programmatic Environmental Impact Statement (DPEIS) for the Chemical Stockpile Disposal Program (CSDP), it was proposed that the Army mitigate accidents through an enhanced community emergency preparedness program at the eight storage sites. In 1986, the Army initiated the development of an Emergency Response Concept Plan (ERCP) for the CSDP, one of 12 technical support studies conducted during preparation of the Final Programmatic Environmental Impact Statement (FPEIS). The purpose of this document is to provide a fairly comprehensive source book on risk, risk management, risk communication research and recommended risk communication practices. It does not merely summarize each publication in the risk communication literature, but attempts to synthesize them along the lines of a set of organizing principles. Furthermore, it is not intended to duplicate other guidance manuals (such as Covello et al.`s manual on risk comparison). The source book was developed for the CSEPP in support of the training module on risk communications. Although the examples provided are specific to CSEPP, its use goes beyond that of CSEPP as the findings apply to a broad spectrum of risk communication topics. While the emphasis is on communication in emergency preparedness and response specific to the CSEPP, the materials cover other non-emergency communication settings. 329 refs.

  12. Modeling the filtration ability of stockpiled filtering facepiece

    NASA Astrophysics Data System (ADS)

    Rottach, Dana R.

    2016-03-01

    Filtering facepiece respirators (FFR) are often stockpiled for use during public health emergencies such as an infectious disease outbreak or pandemic. While many stockpile administrators are aware of shelf life limitations, environmental conditions can lead to premature degradation. Filtration performance of a set of FFR retrieved from a storage room with failed environmental controls was measured. Though within the expected shelf life, the filtration ability of several respirators was degraded, allowing twice the penetration of fresh samples. The traditional picture of small particle capture by fibrous filter media qualitatively separates the effect of inertial impaction, interception from the streamline, diffusion, settling, and electrostatic attraction. Most of these mechanisms depend upon stable conformational properties. However, common FFR rely on electrets to achieve their high performance, and over time heat and humidity can cause the electrostatic media to degrade. An extension of the Langevin model with correlations to classical filtration concepts will be presented. The new computational model will be used to predict the change in filter effectiveness as the filter media changes with time.

  13. Monitoring and ANN modeling of coal stockpile behavior under different atmospheric conditions

    SciTech Connect

    Ozdeniz, A.H.; Ozbay, Y.; Yilmaz, N.; Sensogut, C.

    2008-07-01

    In this study, an industrial-sized stockpile of 5 m width, 4 m height, and 10 m length was built in a coal stock area to investigate coal stockpile behavior under different atmospheric conditions. The effective parameters on the coal stockpile that were time, weather temperature, atmospheric pressure, air humidity, velocity, and direction of wind values were automatically measured by means of a computer-aided measurement system to obtain Artificial Neural Network (ANN) input data. The coal stockpiles, which should be continuously observed, are capable of spontaneous combustion and then causing serious economical losses due to the mentioned parameters. Afterwards, these measurement values were used for training and testing of the ANN model. Comparison of the experimental and ANN results, accuracy rates of training, and testing were found as 98.6% and 98.7%, respectively. It is shown that possible coal stockpile behavior with this ANN model is powerfully estimated.

  14. Stewardship challenges abortion: A proposed means to mitigate abortion's social divisiveness

    PubMed Central

    Tardiff, Robert G.

    2015-01-01

    Since 1973 the legislated constitutional right to abortion has produced a political dichotomy (anti-abortion versus pro-abortion) within the United States, even while witnessing a gradual decline in the rate of abortions. A third paradigm, moral stewardship, is advanced as an effective means to ameliorate this social divisiveness. Incorporating the concept of stewardship into deliberations of pregnancy termination would require recognition, through fact-based education programs, of the life circumstances that prompt the consideration to terminate a pregnancy. Based on collective responsibility, policies, and programs are needed to foster social justice for parents and for the offspring brought to term, without creating excessive burdens on women faced with an unwanted pregnancy. Moral stewardship is perceived as humanitarian to family and community and advantageous to society overall. It also offers a serious opportunity to reshape our society from divisiveness to inclusiveness, and to guide science policy judgment that enhances and strengthens social justice. Lay summary: Differing opinions over the ethics of human abortion have been legion since Roe v. Wade (1973). The disputes between pro- and anti-abortion factions have segregated society with few improvements in social justice. This study offers an alternative approach, one capable of social assimilation and justice for unwanted offspring and pregnant mothers bearing them. It promotes moral stewardship toward the unborn whose humanity and personhood are recognized genetically and supported philosophically by long-standing ethical principles. Stewardship incorporates all people at all levels of society based on collective responsibility, supported by government policies, yet not restricting a mother's choices for the future of her unborn offspring. PMID:26912934

  15. Stewardship challenges abortion: A proposed means to mitigate abortion's social divisiveness.

    PubMed

    Tardiff, Robert G

    2015-08-01

    Since 1973 the legislated constitutional right to abortion has produced a political dichotomy (anti-abortion versus pro-abortion) within the United States, even while witnessing a gradual decline in the rate of abortions. A third paradigm, moral stewardship, is advanced as an effective means to ameliorate this social divisiveness. Incorporating the concept of stewardship into deliberations of pregnancy termination would require recognition, through fact-based education programs, of the life circumstances that prompt the consideration to terminate a pregnancy. Based on collective responsibility, policies, and programs are needed to foster social justice for parents and for the offspring brought to term, without creating excessive burdens on women faced with an unwanted pregnancy. Moral stewardship is perceived as humanitarian to family and community and advantageous to society overall. It also offers a serious opportunity to reshape our society from divisiveness to inclusiveness, and to guide science policy judgment that enhances and strengthens social justice. Lay summary: Differing opinions over the ethics of human abortion have been legion since Roe v. Wade (1973). The disputes between pro- and anti-abortion factions have segregated society with few improvements in social justice. This study offers an alternative approach, one capable of social assimilation and justice for unwanted offspring and pregnant mothers bearing them. It promotes moral stewardship toward the unborn whose humanity and personhood are recognized genetically and supported philosophically by long-standing ethical principles. Stewardship incorporates all people at all levels of society based on collective responsibility, supported by government policies, yet not restricting a mother's choices for the future of her unborn offspring.

  16. Understanding stewardship behaviour: factors facilitating and constraining private water well stewardship.

    PubMed

    Kreutzwiser, Reid; de Loë, Rob; Imgrund, Krystian; Conboy, Mary Jane; Simpson, Hugh; Plummer, Ryan

    2011-04-01

    Regulatory frameworks to ensure municipal drinking water safety exist in most North American jurisdictions. However, similar protection is rarely provided to people reliant on water provided from private wells. In Canada, approximately 4 million people depend on privately owned, domestic wells for their drinking water. Numerous studies have shown that people who rely on private wells for their water supplies are at risk from nitrate and bacterial contamination. Given the fact that regulations relating to private wells tend to be weak or poorly enforced, actions taken by well owners to protect their own drinking water safety are extremely important. Drawing on one of the largest and most comprehensive surveys of private well owners ever conducted in Canada or elsewhere, this paper explores factors that influence well owner stewardship behaviour. Key behaviours examined included annual testing of well water and inspection of wells, measures to protect water quality, and proper decommissioning of unused wells. A geographically-stratified survey, sent to 4950 well owners in Ontario, Canada, resulted in an effective response rate of 34% (n = 1567). Logistic regression analyses revealed that motivations for well stewardship behaviours included reassurance, the perception of problems, and knowledge of the environment. Knowing how to perform stewardship behaviours was an important antecedent to action. Barriers to stewardship included complacency, inconvenience, ignorance, cost, and privacy concerns. To promote stewardship, local initiatives, better educational materials, and enforcement through real estate laws are all required. Ultimately, drinking water safety for people reliant on private wells is shown to be a responsibility shared by governments and private well owners. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. After the Bell: Developing an Awareness of Pet Stewardship

    ERIC Educational Resources Information Center

    Farenga, Stephen J.; Ness, Daniel; Hutchinson, Michael

    2008-01-01

    Given the commonness of pets in communities throughout the United States, Canada, and Australia, among other countries, pet stewardship should be a natural topic of study for the integration of science, mathematics, and technology. Therefore, the term "stewardship" will be examined by applying observation and research to shape our…

  18. Family forest stewardship: do owners need a financial incentive?

    Treesearch

    Michael A. Kilgore; Stephanie Snyder; Steven Taff; Joseph Schertz

    2008-01-01

    This study assessed family forest owner interest in formally committing to the types of land use and management practices that characterize good stewardship if compensated for doing so, using Minnesota's Sustainable Forest Incentives Act (SFIA) as a proxy measure of forest stewardship. The SFIA provides an annual payment in return for obtaining and using a forest...

  19. Regional Stewardship and the Redefinition of Higher Education

    ERIC Educational Resources Information Center

    Simpson, Timothy Leahy

    2010-01-01

    Inspired by the late John Gardner, in May 2000 the "Alliance for Regional Stewardship" (ARS) was formed as a "peer-to-peer network of regional leaders working across boundaries to solve tough community problems." According to the ARS, regional stewardship is the leadership needed to address the complex problems of one's time.…

  20. After the Bell: Developing an Awareness of Pet Stewardship

    ERIC Educational Resources Information Center

    Farenga, Stephen J.; Ness, Daniel; Hutchinson, Michael

    2008-01-01

    Given the commonness of pets in communities throughout the United States, Canada, and Australia, among other countries, pet stewardship should be a natural topic of study for the integration of science, mathematics, and technology. Therefore, the term "stewardship" will be examined by applying observation and research to shape our…

  1. Branching Out: The North Carolina Forest Stewardship Activity Guide.

    ERIC Educational Resources Information Center

    Chesson, Gail

    Stewardship is the responsibility of individuals to maintain and improve their natural resources and surroundings. The Forest Stewardship Program (FSP) in North Carolina aims at enhancing the management of all forest resources on private lands. This activity guide is designed to help youth appreciate and understand forests and natural…

  2. 75 FR 12231 - NACEPT Subcommittee on Promoting Environmental Stewardship

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... Advisory Council for Environmental Policy and Technology (NACEPT) is to advise the U.S. Environmental Protection Agency on how to promote environmental stewardship practices that encompass all environmental... Subcommittee's potential recommendations to the Agency on how to promote environmental stewardship. DATES: The...

  3. Branching Out: The North Carolina Forest Stewardship Activity Guide.

    ERIC Educational Resources Information Center

    Chesson, Gail

    Stewardship is the responsibility of individuals to maintain and improve their natural resources and surroundings. The Forest Stewardship Program (FSP) in North Carolina aims at enhancing the management of all forest resources on private lands. This activity guide is designed to help youth appreciate and understand forests and natural…

  4. Intergenerational equity and long-term stewardship plans.

    SciTech Connect

    Hocking, E. K.

    2002-02-05

    For an untold number of contaminated sites throughout the world, stewardship will be inevitable. For many such sites, stewardship will be a reasonable approach because of the uncertainties associated with present and future site conditions and site contaminants, the limited performance of available technologies, the nonavailability of technologies, and the risk and cost associated with complete cleanup. Regardless of whether stewardship is a realistic approach to site situations or simply a convenient default, it could be required at most contaminated sites for multiple generations. Because the stewardship plan is required to protect the release of hazardous contaminants to the environment, some use restrictions will be put in place to provide that protection. These use restrictions will limit access to resources for as long as the protection is required. The intergenerational quality of long-term stewardship plans and their inherent limitations on resource use require that they be designed to achieve equity among the affected generations. Intergenerational equity, defined here as the fairness of access to resources across generations, could be achieved through a well-developed stewardship plan that provides future generations with the information they need to make wise decisions about resource use. Developing and implementing such a plan would take into account the failure mechanisms of the plan's components, feature short stewardship time blocks that would allow for periodic reassessments of the site and of the stewardship program's performance, and provide present and future generations with necessary site information.

  5. Environmental Management Long-Term Stewardship Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after the completion of facility cleanup. Long-term stewardship is administered and overseen by the U.S. Department of Energy Environmental Management Office of Science and Technology. This report describes the background of long-term stewardship and gives general guidance about considerations when ownership and/or responsibility of a site should be transferred to a long-term stewardship program. This guidance document will assist the U.S. Department of Energy in: (a) ensuring that the long-term stewardship program leads transition planning with respect to facility and site areas, and (b) describing the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete.

  6. Considerations for Future Climate Data Stewardship

    NASA Astrophysics Data System (ADS)

    Halem, M.; Nguyen, P. T.; Chapman, D. R.

    2009-12-01

    In this talk, we will describe the lessons learned based on processing and generating a decade of gridded AIRS and MODIS IR sounding data. We describe the challenges faced in accessing and sharing very large data sets, maintaining data provenance under evolving technologies, obtaining access to legacy calibration data and the permanent preservation of Earth science data records for on demand services. These lessons suggest a new approach to data stewardship will be required for the next decade of hyper spectral instruments combined with cloud resolving models. It will not be sufficient for stewards of future data centers to just provide the public with access to archived data but our experience indicates that data needs to reside close to computers with ultra large disc farms and tens of thousands of processors to deliver complex services on demand over very high speed networks much like the offerings of search engines today. Over the first decade of the 21st century, petabyte data records were acquired from the AIRS instrument on Aqua and the MODIS instrument on Aqua and Terra. NOAA data centers also maintain petabytes of operational IR sounders collected over the past four decades. The UMBC Multicore Computational Center (MC2) developed a Service Oriented Atmospheric Radiance gridding system (SOAR) to allow users to select IR sounding instruments from multiple archives and choose space-time- spectral periods of Level 1B data to download, grid, visualize and analyze on demand. Providing this service requires high data rate bandwidth access to the on line disks at Goddard. After 10 years, cost effective disk storage technology finally caught up with the MODIS data volume making it possible for Level 1B MODIS data to be available on line. However, 10Ge fiber optic networks to access large volumes of data are still not available from CSFC to serve the broader community. Data transfer rates are well below 10MB/s limiting their usefulness for climate studies. During

  7. Biologics industry challenges for developing diagnostic tests for the National Veterinary Stockpile.

    PubMed

    Hardham, J M; Lamichhane, C M

    2013-01-01

    Veterinary diagnostic products generated ~$3 billion US dollars in global sales in 2010. This industry is poised to undergo tremendous changes in the next decade as technological advances move diagnostic products from the traditional laboratory-based and handheld immunologic assays towards highly technical, point of care devices with increased sensitivity, specificity, and complexity. Despite these opportunities for advancing diagnostic products, the industry continues to face numerous challenges in developing diagnostic products for emerging and foreign animal diseases. Because of the need to deliver a return on the investment, research and development dollars continue to be focused on infectious diseases that have a negative impact on current domestic herd health, production systems, or companion animal health. Overcoming the administrative, legal, fiscal, and technological barriers to provide veterinary diagnostic products for the National Veterinary Stockpile will reduce the threat of natural or intentional spread of foreign diseases and increase the security of the food supply in the US.

  8. Antibiotic stewardship in perinatal and neonatal care.

    PubMed

    Ramasethu, Jayashree; Kawakita, Tetsuya

    2017-10-01

    The spread of antibiotic resistance due to the use and misuse of antibiotics around the world is now a major health crisis. Neonates are exposed to antibiotics both before and after birth, often empirically because of risk factors for infection, or for non-specific signs which may or may not indicate sepsis. There is increasing evidence that, apart from antibiotic resistance, the use of antibiotics in pregnancy and in the neonatal period alters the microbiome in the fetus and neonate with an increased risk of immediate and long-term adverse effects. Antibiotic stewardship is a co-ordinated program that promotes the appropriate use of antibiotics, improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. This review addresses some of the controversies in antibiotic use in the perinatal period, examines opportunities for reduction of unnecessary antibiotic exposure in neonates, and provides a framework for antibiotic stewardship in neonatal care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Antimicrobial Stewardship and Urinary Tract Infections

    PubMed Central

    Abbo, Lilian M.; Hooton, Thomas M.

    2014-01-01

    Urinary tract infections are the most common bacterial infections encountered in ambulatory and long-term care settings in the United States. Urine samples are the largest single category of specimens received by most microbiology laboratories and many such cultures are collected from patients who have no or questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed inappropriately in such patients. Antimicrobial use, whether appropriate or inappropriate, is associated with the selection for antimicrobial-resistant organisms colonizing or infecting the urinary tract. Infections caused by antimicrobial-resistant organisms are associated with higher rates of treatment failures, prolonged hospitalizations, increased costs and mortality. Antimicrobial stewardship consists of avoidance of antimicrobials when appropriate and, when antimicrobials are indicated, use of strategies to optimize the selection, dosing, route of administration, duration and timing of antimicrobial therapy to maximize clinical cure while limiting the unintended consequences of antimicrobial use, including toxicity and selection of resistant microorganisms. This article reviews successful antimicrobial stewardship strategies in the diagnosis and treatment of urinary tract infections. PMID:27025743

  10. Antimicrobial Stewardship Barriers and Goals in Pediatric Oncology and Bone Marrow Transplantation: A Survey of Antimicrobial Stewardship Practitioners.

    PubMed

    Wolf, Joshua; Sun, Yilun; Tang, Li; Newland, Jason G; Gerber, Jeffrey S; Van Dyke, Christie J; Hymes, Saul R; Yu, Diana; Carias, Delia C; Bryant, Penelope A

    2016-03-01

    We undertook a cross-sectional survey of antimicrobial stewardship clinicians in North America and Australasia regarding practices, goals, and barriers to implementation of stewardship for pediatric oncology patients. Goals and barriers were similar regardless of clinician or institutional characteristics and geographic location. Strategies addressing these factors could help optimize antimicrobial use.

  11. Medical table: A major tool for antimicrobial stewardship policy.

    PubMed

    Roger, P-M; Demonchy, E; Risso, K; Courjon, J; Leroux, S; Leroux, E; Cua, É

    2017-09-01

    Infectious diseases are unpredictable, with heterogeneous clinical presentations, diverse pathogens, and various susceptibility rates to anti-infective agents. These features lead to a wide variety of clinical practices, which in turn strongly limits their evaluation. We have been using a medical table since 2005 to monitor the medical activity in our department. The observation of heterogeneous therapeutic practices led to drafting up our own antibiotic guidelines and to implementing a continuous evaluation of their observance and impact on morbidity and mortality associated with infectious diseases, including adverse effects of antibiotics, duration of hospital stay, use of intensive care, and deaths. The 10-year analysis of medical practices using the medical table is based on more than 10,000 hospitalizations. It shows simplified antibiotic therapies and a reduction in infection-related morbidity and mortality. The medical table is a major tool for antimicrobial stewardship, leading to constant benefits for patients. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Intravenous Immune Globulin Stewardship Program at a Tertiary Academic Medical Center.

    PubMed

    Rocchio, Megan A; Schurr, James W; Hussey, Aaron P; Szumita, Paul M

    2017-02-01

    In October 2010, a pharmacist-driven stewardship program was implemented at the Brigham and Women's Hospital to ensure continued adherence to the prescribing guideline, focusing on indications for intravenous immune globulin (IVIG) use and dosing per ideal body weight. The primary objective was to describe an IVIG stewardship program at a tertiary academic medical center. This was a prospective, observational study from January 2013 through December 2014. All patients ordered to receive IVIG during the defined study period were included. The intervention assessed describes a pharmacist-driven IVIG stewardship program for medication approval. The primary end point was guideline compliance based on indication, dose, dosing weight, and frequency. Secondary end points included the number of patients receiving IVIG, indications, orders discontinued as a result of guideline nonadherence, and total amount dispensed. A total of 418 patients were identified during the study time frame. The top indications were: hypogammaglobulinemia in bone marrow transplantation and hematological malignancy (50.7%), acute solid organ rejection (11.8%), and immune thrombocytopenia with bleeding (10.1%). In all, 12 patients (2.9%) received IVIG for an indication nonadherent with the IVIG prescribing guideline; 9 patients (2.2%) and 2 patients (0.5%), respectively, received a different dose or frequency per the prescribed indication; and 12 orders (2.9%) for indications nonadherent to the guideline were discontinued. A total of 26 033 g of IVIG were dispensed during the study period. An IVIG stewardship program, including an institution-specific prescribing guideline and a pharmacist-driven stewardship program, may ensure guideline compliance for appropriateness of indication and dose at an academic medical center.

  13. Strategic National Stockpile program: implications for military medicine.

    PubMed

    Need, James T; Mothershead, Jerry L

    2006-08-01

    The Strategic National Stockpile (SNS) program, managed by the Centers for Disease Control and Prevention, Department of Health and Human Services, is designed to deliver critical medical resources to the site of a national emergency. A recent interagency agreement between the Department of Defense and the Department of Health and Human Services indicates that military medical treatment facility commanders should be actively engaged in cooperative planning with local and state public health officials, so that reception, storage, distribution, and dispensing of SNS materials as a consequence of an actual event could occur without disruption or delay. This article describes the SNS program and discusses issues of relevance to medical treatment facility commanders and Department of Defense medical planners and logisticians.

  14. Should remaining stockpiles of smallpox virus (variola) be destroyed?

    PubMed

    Weinstein, Raymond S

    2011-04-01

    In 2011, the World Health Organization will recommend the fate of existing smallpox stockpiles, but circumstances have changed since the complete destruction of these cultures was first proposed. Recent studies suggest that variola and its experimental surrogate, vaccinia, have a remarkable ability to modify the human immune response through complex mechanisms that scientists are only just beginning to unravel. Further study that might require intact virus is essential. Moreover, modern science now has the capability to recreate smallpox or a smallpox-like organism in the laboratory in addition to the risk of nature re-creating it as it did once before. These factors strongly suggest that relegating smallpox to the autoclave of extinction would be ill advised.

  15. Chemical incident management: gaseous emissions from a stockpile of coal.

    PubMed

    Freudenstein, U; Crowley, D; Welch, F

    2000-01-01

    Spontaneous combustion of coal releases a wide range of airborne pollutants which, in high concentrations, may be hazardous to health. Little is known about how the effects on health change in relation to the release of multiple substances. This article reports an incident in which a stockpile of coal released potentially harmful gases into the environment. Although the resultant health effects reported were few, the co-ordinated response by local authorities and health authorities highlighted the advantage of a multidisciplinary approach. Public health departments need to be aware of major chemical hazards within their district. Prompt environmental monitoring and exposure measurement needs to be arranged as this is crucial to making an appropriate response. Updated registers are needed from private companies and public bodies; who can provide timely measurements of chemical hazards. Health districts with more than one local authority may benefit from pooling resources and knowledge in order to prepare for such an incident.

  16. Statistical modeling of spontaneous combustion in industrial-scale coal stockpiles

    SciTech Connect

    Ozdeniz, H

    2009-07-01

    Companies consuming large amounts of coal should work with coal stocks in order to not face problems due to production delays. The industrial-scale stockpiles formed for the aforementioned reasons cause environmental problems and economic losses for the companies. This study was performed in a coal stock area of a large company in Konya, which uses large amounts of coal in its manufacturing units. The coal stockpile with 5 m width, 10 m length, 3 m height, and having 120 tons of weight was formed in the coal stock area of the company. The inner temperature data of the stockpile was recorded by 17 temperature sensors placed inside the stockpile at certain points. Additionally, the data relating to the air temperature, air humidity, atmospheric pressure, wind velocity, and wind direction that are the parameters affecting the coal stockpile were also recorded. A statistical model applicable for a spontaneous combustion event was developed during this study after applying multi-regression analyses to the data recorded in the stockpile during the spontaneous combustion event. The correlation coefficients obtained by the developed statistical model were measured approximately at a 0.95 level. Thus, the prediction of temperature variations influential in the spontaneous combustion event of the industrial-scale coal stockpiles will be possible.

  17. Optimal vaccine stockpile design for an eradicated disease: application to polio.

    PubMed

    Tebbens, Radboud J Duintjer; Pallansch, Mark A; Alexander, James P; Thompson, Kimberly M

    2010-06-11

    Eradication of a disease promises significant health and financial benefits. Preserving those benefits, hopefully in perpetuity, requires preparing for the possibility that the causal agent could re-emerge (unintentionally or intentionally). In the case of a vaccine-preventable disease, creation and planning for the use of a vaccine stockpile becomes a primary concern. Doing so requires consideration of the dynamics at different levels, including the stockpile supply chain and transmission of the causal agent. This paper develops a mathematical framework for determining the optimal management of a vaccine stockpile over time. We apply the framework to the polio vaccine stockpile for the post-eradication era and present examples of solutions to one possible framing of the optimization problem. We use the framework to discuss issues relevant to the development and use of the polio vaccine stockpile, including capacity constraints, production and filling delays, risks associated with the stockpile, dynamics and uncertainty of vaccine needs, issues of funding, location, and serotype dependent behavior, and the implications of likely changes over time that might occur. This framework serves as a helpful context for discussions and analyses related to the process of designing and maintaining a stockpile for an eradicated disease. (c) 2010 Elsevier Ltd. All rights reserved.

  18. Assessing Stewardship Maturity: Use Case Results and Lessons Learned

    NASA Astrophysics Data System (ADS)

    Ritchey, N. A.; Peng, G.

    2015-12-01

    Assessing the current stewardship maturity state of datasets is an important part of ensuring and improving the way datasets are documented, preserved, stewarded, and disseminated to users. It is a critical step towards meeting U.S. federal regulations, organizational requirements, and user needs, especially in the area of data quality. Stewardship maturity assessment models provide a uniform framework for a consistent assessment within the context of data management in organizations and portfolios, and stewardship of individual datasets, respectively. A key component of dataset and stewardship models maturity is data quality and documentation of the quality. The Data Stewardship Maturity Matrix(DSMM) developed in partnership with NOAA's National Centers of Environmental Information (NCEI) and the Cooperative Institute for Climate and Satellites-North Carolina (CICS-NC) has been used to assess stewardship maturity of highly-utilized datasets within NCEI. Consistent application of the model across heterogenous data types (satellite, in situ, regional, global, etc.) and across multiple levels of stewardship support has proven beneficial but challenging.This presentation will demonstrate the utility of the DSMM through results from use case studies and its application for documenting data quality, indicate the challenges of consistent implementation and provide recommendations on improved application.

  19. Exploration of Antarctic Subglacial Aquatic Environments: Environmental and Scientific Stewardship

    NASA Astrophysics Data System (ADS)

    White, J. W.; Hobbie, J. E.; Baker, A.; Clarke, G.; Doran, P. T.; Karl, D.; Methe, B.; Miller, H.; Mukasa, S. B.; Race, M.; Vincent, W.; Walton, D.; Uhle, M.

    2007-12-01

    Antarctica is renowned for its extreme cold; yet surprisingly, there is liquid water at the base of the Antarctic ice sheet several kilometers beneath the surface. The exploration of these subglacial aquatic environments is in its initial stages, and many fundamental questions about these environments can only be answered by entering and sampling the water. Accordingly, the management of subglacial aquatic environments requires responsible environmental stewardship while allowing field research. As of early 2007, no one has yet drilled into a lake but entry within the next one or two years is likely. Thus, the challenge is to determine the best way of drilling into, extensively sampling, and monitoring these environments. While general guidelines for research in Antarctica are provided in the Antarctic Treaty, currently no clear protocols or standards for minimizing contamination have been established. At the request of the National Science Foundation (NSF), the National Research Council convened a committee to develop a set of environmental and scientific protection standards needed to responsibly explore the subglacial lake environments in Antarctica. Specifically, the committee was asked to define levels of cleanliness for equipment or devices entering subglacial aquatic environments, develop a sound scientific basis for contamination standards, and recommend the next steps needed to define an overall exploration strategy. This talk will present the findings of that committee. The committee included U.S. and international scientists, and gathered information from the global scientific community. Although a U.S. scientific advisory body produced this study, the committee hopes that its multinational makeup will be recognized and that the recommendations in this report will serve as a basis for broad international discussion about environmental stewardship for the exploration of subglacial aquatic environments.

  20. Evaluating environmental education, citizen science, and stewardship through naturalist programs.

    PubMed

    Merenlender, Adina M; Crall, Alycia W; Drill, Sabrina; Prysby, Michelle; Ballard, Heidi

    2016-12-01

    Amateur naturalists have played an important role in the study and conservation of nature since the 17th century. Today, naturalist groups make important contributions to bridge the gap between conservation science and practice around the world. We examined data from 2 regional naturalist programs to understand participant motivations, barriers, and perspectives as well as the actions they take to advance science, stewardship, and community engagement. These programs provide certification-based natural history and conservation science training for adults that is followed by volunteer service in citizen science, education, and stewardship. Studies in California and Virginia include quantitative and qualitative evaluation data collected through pre- and postcourse surveys, interviews, and long-term tracking of volunteer hours. Motivations of participants focused on learning about the local environment and plants and animals, connecting with nature, becoming certified, and spending time with people who have similar interests. Over half the participants surveyed were over 50 years old, two-thirds were women, and a majority reported household incomes of over $50,000 (60% in California, 85% in Virginia), and <20% of those surveyed in both states described themselves as nonwhite. Thus, these programs need to improve participation by a wider spectrum of the public. We interviewed younger and underrepresented adults to examine barriers to participation in citizen science. The primary barrier was lack of time due to the need to work and focus on career advancement. Survey data revealed that participants' ecological knowledge, scientific skills, and belief in their ability to address environmental issues increased after training. Documented conservation actions taken by the participants include invasive plant management, habitat restoration, and cleanups of natural areas and streams. Long-term data from Virginia on volunteer hours dedicated to environmental citizen science

  1. Antimicrobial stewardship programmes in Emilia-Romagna, Italy.

    PubMed

    Pan, Angelo; Gagliotti, Carlo; Resi, Davide; Moro, Maria Luisa

    2013-09-01

    The purpose of this study was to evaluate the state-of-the-art of antimicrobial stewardship programmes (ASPs) in Emilia-Romagna, Italy. A self-compiled, 23-question, multiple-choice questionnaire, divided into eight sections, focusing on Public Health Trust (PHT) characteristics, multidisciplinary team, formulary restrictions, education, guidelines and protocols, auditing, antimicrobial therapy management and consumption, and resistance surveillance, was sent to all 17 PHTs of Emilia-Romagna. The 'composite index of good antibiotic use' (ICATB) score, a French ASP process index based upon 12 different parameters, was calculated. All PHTs completed the survey. All PHTs had an antimicrobial control programme, although an antimicrobial stewardship team was present in 11/17 (65%) of trusts. The main results were (a) active antimicrobial committee, 47% of PHTs; (b) restricted formularies, 100%; (c) courses on surgical antimicrobial prophylaxis (SAP) and antimicrobial therapy, 56% of surgical specialties and 47% of PHTs, respectively; courses for new prescribers, nil; (d) guidelines on SAP and on antimicrobial therapy, 100% and 71% of PHTs, respectively; (e) antimicrobial prescribing audits, 71%; and (f) antibiotic consumption and antimicrobial resistance data periodically fed back to wards, 100% and 88% of PHTs, respectively. Low overall quality scores were observed for antibiotic committee, education and auditing activities. The mean ICATB score was 11.94 points, varying significantly among trusts (5.25-16.25 points). In conclusion, all PHTs have implemented an ASP, although significant differences exist between trusts. Antimicrobial committee organisation, education and auditing activities represent the most critical points and need to be addressed by regional programmes in order to harmonise the healthcare system. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  2. Revolutionising Bacteriology to Improve Treatment Outcomes and Antibiotic Stewardship

    PubMed Central

    Livermore, David M

    2013-01-01

    Laboratory investigation of bacterial infections generally takes two days: one to grow the bacteria and another to identify them and to test their susceptibility. Meanwhile the patient is treated empirically, based on likely pathogens and local resistance rates. Many patients are over-treated to prevent under-treatment of a few, compromising antibiotic stewardship. Molecular diagnostics have potential to improve this situation by accelerating precise diagnoses and the early refinement of antibiotic therapy. They include: (i) the use of 'biomarkers' to swiftly distinguish patients with bacterial infection, and (ii) molecular bacteriology to identify pathogens and their resistance genes in clinical specimens, without culture. Biomarker interest centres on procalcitonin, which has given good results particularly for pneumonias, though broader biomarker arrays may prove superior in the future. PCRs already are widely used to diagnose a few infections (e.g. tuberculosis) whilst multiplexes are becoming available for bacteraemia, pneumonia and gastrointestinal infection. These detect likely pathogens, but are not comprehensive, particularly for resistance genes; there is also the challenge of linking pathogens and resistance genes when multiple organisms are present in a sample. Next-generation sequencing offers more comprehensive profiling, but obstacles include sensitivity when the bacterial load is low, as in bacteraemia, and the imperfect correlation of genotype and phenotype. In short, rapid molecular bacteriology presents great potential to improve patient treatments and antibiotic stewardship but faces many technical challenges; moreover it runs counter to the current nostrum of defining resistance in pharmacodynamic terms, rather than by the presence of a mechanism, and the policy of centralising bacteriology services. PMID:24265945

  3. [Antibiotic stewardship and Staphylococcus aureus Bacteremia].

    PubMed

    Weis, S; Kimmig, A; Hagel, S; Pletz, M W

    2017-04-04

    Rates of antibiotic resistance are increasing worldwide and impact on the treatment of patients with bacterial infections. A broad and uncritical application in inpatient and outpatient settings as well as in agriculture has been recognized as the main driving force. Antibiotic stewardship (ABS) programs aim at countering this worrisome development using various direct interventions such as infectious disease counseling. Blood stream infections caused by Staphylococcus (S.) aureus are severe infections associated with high mortality rates. ABS interventions such as de-eskalation of the antibiotic regimen or application of narrow-spectrum beta-lactam antibiotics can significantly reduce mortality rates. In this review, we discuss the importance of ABS programs and infectious disease counseling for the treatment of S. aureus blood stream infection.

  4. Natural resources: stewardship of our public lands

    SciTech Connect

    Jackson, H.

    1982-06-01

    Senator Jackson notes that the Reagan administration's strategy of using budget cuts as a policy tool is evident in the area of natural resources, notably by the following: not including urban parks in the national park system; the low priority given to land acquisition; and the emphasis on resource development over conservation. Further, the administration has not requested funding for recreational grant programs, which are administered by the states and already incorporate the concepts of the new federalism. He feels that efforts to turn public lands over to the private sector bear watching because they seek a short-term gain at the expense of future public-land uses. He observes that Interior Secretary Watt's proposal to expedite land and offshore leasing has created a problem where none existed before. At issue in the Reagan initiatives is the proper stewardship of public lands, which should be a bipartisan effort. (DCK)

  5. The role of the microbiology laboratory in antimicrobial stewardship programs.

    PubMed

    Avdic, Edina; Carroll, Karen C

    2014-06-01

    One of the impediments to the success of antimicrobial stewardship is the lack of availability of rapid and sensitive laboratory tests. The last decade has seen an explosion in new technologies that permit, in less than 4 hours, the identification of organisms and their resistance markers. In addition, the use of biomarkers has been explored in algorithms to distinguish infections that require antimicrobial agents. Clinical microbiology laboratories also contribute to the success of stewardship programs through compilation of aggregate antimicrobial susceptibility data. This article reviews rapid diagnostics, the use of biomarkers, and antibiogram development to antimicrobial stewardship activities and the subsequent impact on patient outcomes.

  6. Strategy, demand, management, and costs of an international cholera vaccine stockpile.

    PubMed

    Maskery, Brian; DeRoeck, Denise; Levin, Ann; Kim, Young Eun; Wierzba, Thomas F; Clemens, John D

    2013-11-01

    In this article, we review the feasibility of mass vaccination against cholera and estimate the global population at risk for epidemic cholera. We then examine the cost of establishing and managing a cholera vaccine stockpile and summarize published mathematical models of the estimated impact of reactive vaccination campaigns developed for the current Haitian outbreak and a recent outbreak in Zimbabwe. On the basis of these evaluations, we recommend a stockpile that starts at 2 million doses, with an estimated annual cost of $5.5-$13.9 million in 2013, and grows to 10 million doses per year by 2017, with an annual cost of $27-$51 million. We believe that the stockpile can enhance efforts to mitigate future cholera outbreaks by guaranteeing the availability of cholera vaccines and, through use of the stockpile, by revealing knowledge about the efficient use of cholera vaccines during and after crises.

  7. Stockpiles of obsolete pesticides and cleanup priorities: A methodology and application for Tunisia.

    PubMed

    Dasgupta, Susmita; Meisner, Craig; Wheeler, David

    2010-01-01

    Obsolete pesticides have accumulated in almost every developing country or economy in transition over the past several decades. Concerned about the risks these chemicals pose to nearby residents, public health and environmental authorities are eager to reduce health threats by removing and decontaminating stockpile sites. However, there are many sites, cleanup can be costly, and public resources are scarce, so decision makers need to set priorities. Under these conditions, it seems sensible to develop a methodology for prioritizing sites and treating them sequentially, as budgetary resources permit. This paper presents a new methodology that develops a cleanup priority index for 1915 metric tons of obsolete pesticide formulations at 197 stockpile sites in Tunisia. The approach integrates information on populations at risk, their proximity to stockpiles, and the relative toxic hazards of the stockpiles. What emerges from the Tunisia results is a strategy for sequentially addressing all 197 sites to rapidly reduce potential health damage in a cost-effective way.

  8. Navigating the Web in search of resources on antimicrobial stewardship in health care institutions.

    PubMed

    Pagani, Leonardo; Gyssens, Inge C; Huttner, Benedikt; Nathwani, Dilip; Harbarth, Stephan

    2009-03-01

    Bacterial resistance to antimicrobials has become a public health threat for which coordinated action at the international, national, and local level is needed. Current recommendations for the control of antimicrobial overuse and resistance in hospitals recommend various strategies, including antimicrobial stewardship programs. Several of these integrated and multidisciplinary antimicrobial management programs provide detailed information and recommendations on the Web. We performed a search of the most relevant and authoritative Web sites in English that were available without need for special registration or cost. The search excluded community-based programs, and we present only established programs or those providing expert information useful for building a hospital-based antimicrobial stewardship program. The overview of these Web sites may be useful either for institutions or individuals planning to implement such programs in their own health care institution or for educational purposes targeted at different professionals involved in improving antimicrobial practice.

  9. Tri-State Synfuels Project Commercial Scale Coal Test: Volume 5. Kentucky stockpile tests. [Proposed Henderson, Kentucky coal to gasoline plant; coal stockpile study

    SciTech Connect

    Not Available

    1982-06-01

    This report focuses on the compacted coal stockpile built at Uniontown, Kentucky with a 200-ton sample representative of Camp 1 coal shipped to Sasolburg, Republic of South Africa. This stockpile program had several objectives: obtain information on the changes in quality of coal over a period of one year resulting from weatering and leaching. The weathering of coal may affect the physical and chemical properties, the gasification characteristics and oxygen consumption); obtain chemical composition of rainwater leached through the pile and collected over a period of one year to assist in the environmental design of water collection system; and demonstrate construction of a stockpile that is safe from spontaneous ignition. Conclusions and design recommendationa for the long term storage of compacted coal resulted from the program. Recommendations of interest include oxidation and weathering stability, minimal leaching due to rainwater, limited impact on gasification characteristics and effective method to minimize spontaneous ignition. The tests conducted on the compacted stockpile (Section 3.0) provided observations over the one-year period on spontaneous ignition, surface and weathering, oxidation as measured by chemical, physical and gasification property changes, size degradation, acid runoff, pH of rainwater and leachate and extent of leaching. Texas Gas was responsible for constructing, maintaining and collecting site data at the stockpile (Section 4.1.1). Paul Weir Company was responsible for sampling, screening, analytical testing program and the leaching program for the stockpile over regular intervals of one to two months (Section 4.2.1). Lurgi was requested to analyze samples (Section 4.2.2) corresponding to the samples analyzed by Commercial Testing and Engineering and report on the influence of weathering on the gasification characteristics.

  10. Promoting antimicrobial stewardship: using video tools for junior doctors' induction.

    PubMed

    Hadjiphilippou, Savvas; Odogwu, Sarah-Elizabeth; Jeyaratnam, Dakshika

    2014-02-01

    Antimicrobial prescribing is linked to key issues in infection control and patient safety. This article presents a novel video tool for junior doctors promoting antimicrobial stewardship, and thus safe antimicrobial prescribing, through improved awareness of local information technology systems.

  11. Antimicrobial Stewardship: How the Microbiology Laboratory Can Right the Ship.

    PubMed

    Morency-Potvin, Philippe; Schwartz, David N; Weinstein, Robert A

    2017-01-01

    SUMMARYAntimicrobial stewardship is a bundle of integrated interventions employed to optimize the use of antimicrobials in health care settings. While infectious-disease-trained physicians, with clinical pharmacists, are considered the main leaders of antimicrobial stewardship programs, clinical microbiologists can play a key role in these programs. This review is intended to provide a comprehensive discussion of the different components of antimicrobial stewardship in which microbiology laboratories and clinical microbiologists can make significant contributions, including cumulative antimicrobial susceptibility reports, enhanced culture and susceptibility reports, guidance in the preanalytic phase, rapid diagnostic test availability, provider education, and alert and surveillance systems. In reviewing this material, we emphasize how the rapid, and especially the recent, evolution of clinical microbiology has reinforced the importance of clinical microbiologists' collaboration with antimicrobial stewardship programs. Copyright © 2016 American Society for Microbiology.

  12. Using Watershed Stewardship to Build Sustainability and Resilience

    EPA Science Inventory

    This presentation is designed to help build understanding of how stewardship of water resources can help local communities develop sustainably and become more resilient; discuss how monitoring can engage communities and increase environmental awareness; and explore how monitoring...

  13. Oseltamivir for pandemic influenza preparation: Maximizing the use of an existing stockpile.

    PubMed

    Patel, Twisha S; Cinti, Sandro; Sun, Duxin; Li, Siwei; Luo, Ruijuan; Wen, Bo; Gallagher, Brian A; Stevenson, James G

    2017-03-01

    With the threat of significant morbidity and mortality following an influenza pandemic, stockpiling of antiviral agents such as oseltamivir is recommended. Shelf-life extension was explored to maximize use of an existing stockpile. This analysis demonstrated that oseltamivir retains potency defined by United States Pharmacopeia acceptance criteria beyond the labeled expiration date. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  14. Challenges associated with creating a pharmaceutical stockpile to respond to a terrorist event.

    PubMed

    Havlak, R; Gorman, S E; Adams, S A

    2002-08-01

    The Centers for Disease Control and Prevention (CDC) was called into action to develop a National Pharmaceutical Stockpile (NPS). The NPS was created to respond to terrorism events involving blast, chemical and biological agents. There are many challenges associated with creating, managing and using such an asset. This paper provides a helpful background for clinicians and those planning to develop pharmaceutical and/or medical materiel stockpiles for national use. It also describes major challenges and offers suggestions for meeting those challenges.

  15. Stockpiling anti-viral drugs for a pandemic: the role of Manufacturer Reserve Programs.

    PubMed

    Harrington, Joseph E; Hsu, Edbert B

    2010-05-01

    To promote stockpiling of anti-viral drugs by non-government organizations such as hospitals, drug manufacturers have introduced Manufacturer Reserve Programs which, for an annual fee, provide the right to buy in the event of a severe outbreak of influenza. We show that these programs enhance drug manufacturer profits but could either increase or decrease the amount of pre-pandemic stockpiling of anti-viral drugs.

  16. Leaching of nutrients and trace elements from stockpiled turkey litter into soil.

    PubMed

    Shah, Sanjay B; Hutchison, Kimberly J; Hesterberg, Dean L; Grabow, Garry L; Huffman, Rodney L; Hardy, David H; Parsons, James T

    2009-01-01

    In addition to nutrients, poultry are fed trace elements (e.g., As) for therapeutic purposes. Although a large proportion of the nutrients are assimilated by the birds, nearly all of the As is excreted. Hence, turkey litter constituents can leach into the soil and contaminate shallow ground water when it is stockpiled uncovered on bare soil. This study quantified the leaching of turkey litter constituents from uncovered stockpiles into the underlying soil. Four stockpiles were placed on Orangeburg loamy sand in summer 2004 for 162 d; 14 d after their removal, four stockpiles were created over the same footprints and left over winter for 162 d. Soil samples at depths of 7.6 to 30.5 cm and 30.5 to 61 cm adjacent to and beneath the stockpiles were compared for pH, electrical conductivity, total C, dissolved organic C, N species, P, water-extractable (WE)-P, As, WE-As, Cu, Mn, and Zn. All WE constituents affected the 7.6- to 30.5-cm layer, and some leached deeper; for example, NH(4)(+)-N concentrations were 184 and 62 times higher in the shallow and deep layers, respectively. During winter stockpiling, WE-As concentrations beneath the stockpiles tripled and doubled in the 7.6- to 30.5-cm and 30.5- to 61-cm layers, respectively, with WE-As being primarily as As(V). Heavy dissolved organic C and WE-P leaching likely increased solubilization of soil As, although WE-As concentrations were low due to the Al-rich soil and low-As litter. When used as drinking water, shallow ground water should be monitored on farms with a history of litter stockpiling on bare soil; high litter As; and high soil As, Fe, and Mn concentrations.

  17. Hedge math: Theoretical limits on minimum stockpile size across nuclear hedging strategies

    SciTech Connect

    Lafleur, Jarret Marshall; Roesler, Alexander W.

    2016-09-01

    In June 2013, the Department of Defense published a congressionally mandated, unclassified update on the U.S. Nuclear Employment Strategy. Among the many updates in this document are three key ground rules for guiding the sizing of the non-deployed U.S. nuclear stockpile. Furthermore, these ground rules form an important and objective set of criteria against which potential future stockpile hedging strategies can be evaluated.

  18. Vaccine shortages eliminate possibility for excess capacity in stockpiles.

    PubMed

    Congeni, Blaise L

    2004-09-01

    produced by three. It will take between 4 and 5 years to improve vaccine stockpiles to the desired levels. With fewer manufacturers, there is no possibility for "excess" capacity that may provide a cushion to augment stockpiles or address any unanticipated shortfalls in supply. In short, the potential for additional shortages remains substantial, and the ability to respond to shortages may actually have worsened. We must hope the return of widespread shortages or even outbreaks will not be necessary before real solutions are implemented.

  19. Long-Term Stewardship Baseline Report and Transition Guidance

    SciTech Connect

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  20. Strategies for antiviral stockpiling for future influenza pandemics: a global epidemic-economic perspective

    PubMed Central

    Carrasco, Luis R.; Lee, Vernon J.; Chen, Mark I.; Matchar, David B.; Thompson, James P.; Cook, Alex R.

    2011-01-01

    Influenza pandemics present a global threat owing to their potential mortality and substantial economic impacts. Stockpiling antiviral drugs to manage a pandemic is an effective strategy to offset their negative impacts; however, little is known about the long-term optimal size of the stockpile under uncertainty and the characteristics of different countries. Using an epidemic–economic model we studied the effect on total mortality and costs of antiviral stockpile sizes for Brazil, China, Guatemala, India, Indonesia, New Zealand, Singapore, the UK, the USA and Zimbabwe. In the model, antivirals stockpiling considerably reduced mortality. There was greater potential avoidance of expected costs in the higher resourced countries (e.g. from $55 billion to $27 billion over a 30 year time horizon for the USA) and large avoidance of fatalities in those less resourced (e.g. from 11.4 to 2.3 million in Indonesia). Under perfect allocation, higher resourced countries should aim to store antiviral stockpiles able to cover at least 15 per cent of their population, rising to 25 per cent with 30 per cent misallocation, to minimize fatalities and economic costs. Stockpiling is estimated not to be cost-effective for two-thirds of the world's population under current antivirals pricing. Lower prices and international cooperation are necessary to make the life-saving potential of antivirals cost-effective in resource-limited countries. PMID:21296791

  1. Between beneficence and justice: the ethics of stewardship in medicine.

    PubMed

    Jansen, Lynn A

    2013-02-01

    In an era of rapidly rising health care costs, physicians and policymakers are searching for new and effective ways to contain health care spending without sacrificing the quality of services provided. These proposals are increasingly articulated in terms of an ethical duty of stewardship. The duty of stewardship in medicine, however, is not at present well understood, and it is frequently conflated with other duties. This article presents a critical analysis of the notion of stewardship, which shows that it has an important and distinctive place in medical ethics. It claims that stewardship in medicine concerns the responsible use of a society's medical resources and it discusses the extent to which medical professionals are the proper stewards of these resources. The article argues that the duty of stewardship is best understood as a duty that applies in a space between the obligations of health care providers to provide beneficent care to their patients on the one hand and the obligations of citizens to bring about and support a just health care system on the other. Seen with clear eyes, stewardship in medicine is neither a consequence of beneficent medical care nor a substitute for justice.

  2. Saint Joseph's University Institute for Environmental Stewardship

    SciTech Connect

    McCann, Micahel P.; Springer, Clint J.

    2014-06-03

    Task A: Examination of the physiological, morphological, and reproductive responses of Panicum virgatum (switchgrass) cultivars identified as potential biofuel producing cultivars as well as naturally-occurring varieties of switchgrass to projected changes in climate for the central portion of the United States. This project was a multi-year project set in a field site located at the Konza Prairie Biological Station near Manhattan, KS USA. The major objective of the study was to understand the physiological and growth responses of the important biofuel grass species, Panicum virgatum (switch grass) to simulated changes in precipitation expected for the Central Plains region of the United States. Population level adaptation to broad-scale regional climates or within-population variation in genome size of this genetically and phenotypically diverse C4 grass species may influence the responses to future precipitation variability associated with climate change. Therefore, we investigated switchgrass responses to water variability between natural populations collected across latitudinal gradient and populations. P. virgatum plants from natural populations originating from Kansas, Oklahoma, and Texas received frequent, small precipitation events (“ambient’) or infrequent, large precipitation events (‘altered”) to simulate contrasting rainfall variability expected from this region. We measured leaf-level physiology, aboveground biomass varied significantly by population origin but did not differ by genome size. Our results suggest that trait variation in P. virgatum is primarily attributed to population-level adaptation across latitudinal gradient, not genome size, and that neither population-level adaptation nor genome size may be important predictors of P. virgatum responses to future climatic conditions. Based solely on the data presented here, the most important consideration when deciding what varieties of switchgrass to cultivate for biofuel feedstocks under

  3. Effects of fescue type and sampling date on the ruminal disappearance kinetics of autumn-stockpiled tall fescue.

    PubMed

    Flores, R; Coblentz, W K; Ogden, R K; Coffey, K P; Looper, M L; West, C P; Rosenkrans, C F

    2007-06-01

    Two tall fescue (Festuca arundinacea Schreb.) forages, one an experimental host plant/endophyte association containing a novel endophyte (HM4) that produces low or nil concentrations of ergot alkaloids, and the other a typical association of Kentucky 31 tall fescue and the wild-type endophyte (Neotyphodium coenophialum; E+), were autumn-stockpiled following late-summer clipping and fertilization with 56 kg/ha of N to assess the nutritive value and ruminal disappearance kinetics of autumn-stockpiled tall fescue forages. Beginning on December 4, 2003, sixteen 361 +/- 56.4-kg replacement dairy heifers were stratified by weight and breeding and assigned to one of four 1.6-ha pastures (2 each of E+ and HM4) that were strip-grazed throughout the winter. Pastures were sampled before grazing was initiated (December 4), each time heifers were allowed access to a fresh strip (December 26, January 15, and February 4), and when the study was terminated (February 26). For fiber components, there were no interactions between fescue type and sampling date for either pregrazed or postgrazed forages. Over sampling dates, neutral detergent fiber (NDF; 56.5 to 67.8%), acid detergent fiber (27.7 to 34.9%), hemicellulose (28.8 to 34.0%), cellulose (25.0 to 28.1%), and lignin (3.61 to 10.05%) varied with sampling date, but patterns were almost exclusively curvilinear with time. Ruminal disappearance rate of dry matter (DM) was not affected by any treatment factor (overall mean for both pregrazed and postgrazed forages = 0.050 h(- 1)); similar responses were observed for NDF disappearance (overall mean = 0.048 h(- 1)). Interactions of fescue type and sampling date were observed for both pregrazed and postgrazed forages with respect to effective ruminal disappearance of DM; however, estimates were relatively high for all forages (overall mean = 64.0%). Effective disappearance of NDF was relatively extensive for all forages (overall mean = 55.4% of NDF). Based on the results of this trial

  4. A Qualitative Analysis of Implementation of Antimicrobial Stewardship at 3 Academic Hospitals: Understanding the Key Influences on Success.

    PubMed

    Jeffs, Lianne; Thampi, Nisha; Maione, Maria; Steinberg, Marilyn; Morris, Andrew M; Bell, Chaim M

    2015-01-01

    Inappropriate use of antimicrobials is linked to the development and spread of drug-resistant pathogens and is associated with increased morbidity, mortality, lengths of hospital stay, and health care costs. "Antimicrobial stewardship" is the umbrella term for an evidence-based knowledge translation strategy involving comprehensive quality improvement activities to optimize the use of antimicrobials, improve patient outcomes, reduce the development of antimicrobial resistance and hospital-acquired infections such as Clostridium difficile, and decrease health care costs. To assess the perceptions and experiences of antimicrobial stewardship program leaders in terms of clinicians' attitudes toward and behaviours related to antimicrobial prescribing. In this qualitative study, semistructured interviews were conducted with 6 antimicrobial stewards (2 physicians and 4 pharmacists) at 3 academic hospitals between June and August 2013. The following 3 key themes emerged from the interviews: getting the right people on board, building collegial relationships, and rapidly establishing a track record. The study results elucidated the role and mechanisms that the program leader and other antimicrobial stewards used to influence other clinicians to engage in effective utilization of antimicrobials. The results also highlighted the methods employed by members of the antimicrobial stewardship team to tailor their strategies to the local context and to stakeholders of participating units; to gain credibility by demonstrating the impact of the antimicrobial stewardship program on clinical outcomes and cost; and to engage senior leaders to endorse and invest in the antimicrobial stewardship program, thereby adding to the antimicrobial stewards' credibility and their ability to influence the uptake of effective antimicrobial use. Collectively, these results offer insight into processes and mechanisms of influence employed by antimicrobial stewards to enhance antimicrobial use among

  5. Polymeric materials replacement issues for the LANL stockpile.

    SciTech Connect

    Sandoval, C. W.; Gladysz, G. M.; Stephens, T. S.; Gleiman, S. S.; Mendoza, D.; Baker, G. K.; Schoonover, J. R.; Schneider, Jim; Perry, B.; Lula, J. W.

    2002-01-01

    A number of materials in the LANL stockpile are no longer available due to lack of availability or environment, safety and health issues. Silastic S-5370 a polysiloxane foam used to manufacture multiple components in LANL systems has been discontinued by Dow Corning. Kerimid 601 is a polyimide resin used as the binder for the syntactic foam used as a support material in the W76. It contains MDA, which has been identified by OSHA as a carcinogen and is no longer used in the nuclear weapons complex. In addition, the Thornel carbon mat used in the syntactic foam formulation is no longer available. These issues have created major challenges in the effort to reestablish aft support production capability for the W76 LEP. Urethane Encapsulant 7200, an adhesive used to bond explosive booster pellets and detonator components, was originally manufactured by Hexcel Corporation and is no longer available. The details of the projects currently underway to provide replacements for these materials will be discussed.

  6. Impact of a reduced nuclear weapons stockpile on strategic stability

    SciTech Connect

    Chrzanowski, P.

    1991-03-20

    This presentation is to discuss the impact of a reduced nuclear weapons stockpile on the strategic stability. Methodologies used to study strategic stability issues include what are basically strategic-force exchange models. These models are used to simulate a massive nuclear exchange in which one side attacks and the other side retaliates. These models have been of interest to the Strategic Defense Initiative (SDI) program. Researchers have been looking at issues concerning the stability of the transition period, during which some defenses have been deployed and during which deterrence and war-fighting capability reply partly on defense and partly on offense. Also, more recently, with interest in the Strategic Arms Reduction Treaty (START) and force reductions beyond START, the same calculation engines have been used to examine the impact of reduced forces on strategic stability. For both the SDI and the START reduction cases, exchange models are able to address only a rather narrow class of strategic stability issues. Other broader stability questions that are unrelated to nuclear weapons or that relate to nuclear weapons but are not addressed by the calculational tools which are not included in this discussion. 6 refs., 1 fig., 1 tab. (BN)

  7. Ciliates expel environmental Legionella-laden pellets to stockpile food.

    PubMed

    Hojo, Fuhito; Sato, Daisuke; Matsuo, Junji; Miyake, Masaki; Nakamura, Shinji; Kunichika, Miyuki; Hayashi, Yasuhiro; Yoshida, Mitsutaka; Takahashi, Kaori; Takemura, Hiromu; Kamiya, Shigeru; Yamaguchi, Hiroyuki

    2012-08-01

    When Tetrahymena ciliates are cultured with Legionella pneumophila, the ciliates expel bacteria packaged in free spherical pellets. Why the ciliates expel these pellets remains unclear. Hence, we determined the optimal conditions for pellet expulsion and assessed whether pellet expulsion contributes to the maintenance of growth and the survival of ciliates. When incubated with environmental L. pneumophila, the ciliates expelled the pellets maximally at 2 days after infection. Heat-killed bacteria failed to produce pellets from ciliates, and there was no obvious difference in pellet production among the ciliates or bacterial strains. Morphological studies assessing lipid accumulation showed that pellets contained tightly packed bacteria with rapid lipid accumulation and were composed of the layers of membranes; bacterial culturability in the pellets rapidly decreased, in contrast to what was seen in ciliate-free culture, although the bacteria maintained membrane integrity in the pellets. Furthermore, ciliates newly cultured with pellets were maintained and grew vigorously compared with those without pellets. In contrast, a human L. pneumophila isolate killed ciliates 7 days postinfection in a Dot/Icm-dependent manner, and pellets harboring this strain did not support ciliate growth. Also, pellets harboring the human isolate were resuscitated by coculturing with amoebae, depending on Dot/Icm expression. Thus, while ciliates expel pellet-packaged environmental L. pneumophila for stockpiling food, the pellets packaging the human isolate are harmful to ciliate survival, which may be of clinical significance.

  8. Optimizing a District of Columbia Strategic National Stockpile dispensing center.

    PubMed

    Giovachino, Monica; Calhoun, Thomas; Carey, Neil; Coleman, Briant; Gonzalez, Gabriela; Hardeman, Bernard; McCue, Brian

    2005-01-01

    On October 4, 2003, the District of Columbia Department of Health (DOH) held a Strategic National Stockpile (SNS) exercise designed to test its plan for operating mass dispensing centers during a bioterrorist attack or other emergency. The main goals of the exercise were to maximize the throughput of the dispensing plan and improve dispensing procedures. These goals are important for quantifying the resources (eg, numbers and types of staff) necessary to respond to different types and sizes of events, as well as for minimizing the potential for errors or confusion in dispensing medications. We set up the dispensing center according to the District's SNS plan and recruited volunteers to role-play potentially exposed residents. During the exercise, we collected detailed data on the service times for each step in the dispensing process. We also collected observations from exercise participants and observers. We found that the DOH dispensing center could achieve a throughput of 2.5 persons per minute. Using computer modeling, we recommended changes to the dispensing plan that would enable it to achieve a higher throughput of four to five persons per minute. Other recommendations addressed improvements to dispensing plans and procedures.

  9. Technology to Support Integrated Antimicrobial Stewardship Programs: A User Centered and Stakeholder Driven Development Approach

    PubMed Central

    Beerlage-de Jong, Nienke; van Gemert-Pijnen, Lisette; Wentzel, Jobke; Hendrix, Ron; Siemons, Liseth

    2017-01-01

    The rise of antimicrobial resistance (AMR) is a severe global health problem. Tackling this problem requires the prudent prescribing of antimicrobials. This is promoted through Antimicrobial Stewardship Programs (ASPs). In this position paper we describe i) how a socio-technical multidisciplinary approach (based on the CeHRes Roadmap) can be applied in the development and implementation of Antimicrobial Stewardship technologies and ii) how this approach can be of value to support Antimicrobial Stewardship in practice. The CeHRes Roadmap entails five different phases to explore and test how an eHealth technology can be tailored to the target group and successfully implemented in practice: i) contextual inquiry, ii) value specification, iii) design, iv) operationalization, v) evaluation. In this position paper we describe the lessons learned from research and practice to guide future developments of technology based ASP interventions. Since AMR is a huge wicked problem on a global level, it requires innovative methods and models to empower general public and professionals to be proactive rather than reactive in a digitalized world. We highlight how to combat the dangerous rise of antimicrobial resistance in the future. PMID:28458796

  10. Healthcare system cost evaluation of antiviral stockpiling for pandemic influenza preparedness.

    PubMed

    Li, Yang; Hsu, Edbert B; Links, Jonathan M

    2010-06-01

    Healthcare workers need to be protected during a severe influenza outbreak; therefore, we evaluated 4 different antiviral strategies: (1) using antiviral medication for outbreak prophylaxis of all hospital employees; (2) using antiviral medication for postexposure prophylaxis (PEP) or treatment of all hospital employees; (3) using a combination of antiviral medication for outbreak prophylaxis of high-risk clinical staff and postexposure prophylaxis or treatment for all other staff; and (4) using antiviral medication for postexposure prophylaxis or treatment of high-risk clinical staff only. Three different purchasing options were applied to each of the 4 antiviral strategies: (1) just-in-time purchase during a severe influenza outbreak, (2) prepandemic stockpiling, or (3) stockpiling through contracts with pharmaceutical manufacturers to reserve a predetermined antiviral supply. Although outbreak prophylaxis of all hospital employees would offer the maximum protection, the large costs associated with such a purchase make this option unrealistic and impractical. In addition, even though postexposure prophylaxis or treatment of only high-risk clinical staff would incur the least expense, the assumed level of protection if these options were offered only to high-risk clinical staff may not be sufficient to maintain routine hospital operations, since needed non-high-risk staff would not be protected. Considering the potential benefits and drawbacks of stockpiling antiviral medication from a cost perspective, it does not appear feasible for hospitals to stockpile antiviral medication in large quantities prior to a severe influenza outbreak. This article focuses on the financial viability of stockpiling antiviral medication, but the potential impact of other factors on the decision to stockpile was also considered and will be explored in future analyses. While legal hurdles related to prescribing, storing, and dispensing antiviral medication can be addressed

  11. Land Stewardship in the 21st Century: The Contributions of Watershed Management; 2000 March 13-16; Tucson, AZ

    Treesearch

    Peter F. Ffolliott; Malchus B. Baker; Carleton B. Edminster; Madelyn C. Dillon; Karen L. Mora

    2000-01-01

    The purpose of this conference was to increase awareness through exploration and evaluation of global, national, and regional perspectives about the potential contributions that watershed management can make to the conservation, sustainable development, and use of natural resources in ecosystem-based land stewardship in the 21st century. The conference consisted of 2...

  12. Stewardship of very large digital data archives

    NASA Technical Reports Server (NTRS)

    Savage, Patric

    1992-01-01

    This paper addresses the problems foreseen by the author in stewarding the very large digital data archives that will accumulate during the mission of the Earth Orbiting Satellite (EOS). It focuses on the function of 'shepherding' archived digital data into an endless future. Stewardship entails a great deal more than storing and protecting the archive. It also includes all aspects of providing meaningful service to the community of users (scientists) who will want to access the data. The complete steward will be required to do the following: (1) provide against loss due to physical phenomena; (2) assure that data is not 'lost' due to storage technology obsolescence; (3) maintain data in a current formatting methodology with the additional requirement of being able to reconstitute the data to its original, as-received format; (4) secure against loss or pollution of data due to accidental, misguided, or willful software intrusion; (5) prevent unauthorized electronic access to the data, including unauthorized placement of data into the archive; (6) index the data in a metadatabase so that all anticipatable queries can be served without searching through the data itself; (7) provide responsive access to the metadatabase; (8) provide appropriately responsive access to the data; (9) incorporate additions and changes to the archive (and to the metadatabase) in a timely way; and (10) deliver only copies of data to clients - retain physical custody of the 'official' data. Items 1 through 4 are discussed in this paper.

  13. Nutrigenomics and the stewardship of scientific promises.

    PubMed

    Penders, Bart; Goven, Joanna

    2010-09-01

    Here we analyze the rise and establishment of nutrigenomics versus nutrition science from a political perspective. We argue that the exceptionalist status of nutrigenomics has been brought about by a carefully orchestrated economy of expectation, enabling the nutrigenomics community to develop its own research agenda that differs significantly from that of nutrition science. Nutrigenomics promotes research specifically directed towards the heterogeneity of dietary guidelines, while nutrition science pursues a public health goal dominated by homogeneous health messages. Through the development of genomic technology and the protective niche created by large global funding initiatives, this heterogeneity-research agenda has been able to develop itself. Those pursuing and supporting it have, through nutrigenomics' economy of expectation, influenced public opinion, and regulatory and political structures dealing with food and health. With many big global nutrigenomics initiatives slowly approaching their end, this article hints at some of the possible political consequences of its economy of expectation and suggests that a "stewardship" of promises and expectations is in order

  14. Implementation of Rapid Molecular Infectious Disease Diagnostics: the Role of Diagnostic and Antimicrobial Stewardship.

    PubMed

    Messacar, Kevin; Parker, Sarah K; Todd, James K; Dominguez, Samuel R

    2017-03-01

    New rapid molecular diagnostic technologies for infectious diseases enable expedited accurate microbiological diagnoses. However, diagnostic stewardship and antimicrobial stewardship are necessary to ensure that these technologies conserve, rather than consume, additional health care resources and optimally affect patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and to direct testing toward appropriate patients. Antimicrobial stewardship is needed to ensure prompt appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside. This minireview outlines the roles of diagnostic stewardship and antimicrobial stewardship in the implementation of rapid molecular infectious disease diagnostics.

  15. Compatibility and Outgassing Studies for Directed Stockpile Work (FY05)

    SciTech Connect

    Alviso, C; Harvey, C; Vance, A

    2005-11-23

    Compatibility and outgassing studies of non-nuclear materials were carried out in support of the W80 Life Extension Program. These studies included small-scale laboratory experiments as well as participation in Sandia's Materials Aging and Compatibility test (MAC-1). Analysis of the outgassing signature of removable epoxy foam (REF) revealed unusually high levels of volatile organic compounds in the material. REF was replaced with the polyurethane PMDI. Laboratory compatibility tests of high priority materials were performed and revealed incompatibilities between Viton A (LX-07 binder) and syntactic polysulfide as well as Viton A and REF. With the removal of REF from the system, the incompatibility with Viton A is not an issue. In the case of the viton/polysulfide, both of these materials have a history of reliability in the stockpile, and the observed results, while scientifically interesting, appear to be a laboratory anomaly. Participation in the MAC-1 test led to a detailed study of Viton A degradation. At elevated temperatures up to 70 C, the Viton A samples darkened and exhibited increased crosslinking. Laboratory experiments were pursued to correlate the observed changes to exposure to specific compounds that were present in the MAC-1 canister atmospheres. Exposure to siloxanes resulted in changes similar to those seen in the MAC-1 samples. Knowledge gained from the MAC-1 test will be applied to the upcoming MAC-2 test planned for FY06. Finally, the suitability of isotopically labeled nitrogen fill gas ({sup 15}N{sub 2}) was addressed. This gas will behave as standard nitrogen with no compatibility concerns expected.

  16. Antimicrobial stewardship in daily practice: Managing an important resource.

    PubMed

    Le Saux, Nicole

    2014-09-01

    Antimicrobial stewardship is a recent concept that embodies the practical, judicious use of antimicrobials to decrease adverse outcomes from antimicrobials while optimizing the treatment of bacterial infections to reduce the emergence of resistant pathogens. The objectives of the present statement are to illustrate the principles of antimicrobial stewardship and to offer practical examples of how to make antimicrobial stewardship part of everyday hospital and outpatient practice. Vital components of antimicrobial stewardship include appropriate testing to diagnose whether infections are viral or bacterial, and using clinical follow-up rather than antibiotics in cases in which the child is not very ill and uncertainty exists. Other specific, important actions include questioning whether positive urine cultures are contaminated when there is no evidence of pyuria or inflammatory changes, and obtaining a chest radiograph to support a diagnosis of bacterial pneumonia. Optimizing the choice and dosage of antimicrobials also reduces the probability of clinical failures and subsequent courses of antimicrobials. A list of common clinical scenarios to promote stewardship is included.

  17. Antimicrobial stewardship in daily practice: Managing an important resource.

    PubMed

    Le Saux, Nicole

    2014-05-01

    Antimicrobial stewardship is a recent concept that embodies the practical, judicious use of antimicrobials to decrease adverse outcomes from antimicrobials while optimizing the treatment of bacterial infections to reduce the emergence of resistant pathogens. The objectives of the present statement are to illustrate the principles of antimicrobial stewardship and to offer practical examples of how to make antimicrobial stewardship part of everyday hospital and outpatient practice. Vital components of antimicrobial stewardship include appropriate testing to diagnose whether infections are viral or bacterial, and using clinical follow-up rather than antibiotics in cases in which the child is not very ill and uncertainty exists. Other specific, important actions include questioning whether positive urine cultures are contaminated when there is no evidence of pyuria or inflammatory changes, and obtaining a chest radiograph to support a diagnosis of bacterial pneumonia. Optimizing the choice and dosage of antimicrobials also reduces the probability of clinical failures and subsequent courses of antimicrobials. A list of common clinical scenarios to promote stew-ardship is included.

  18. Long-Term Stewardship Program Science and Technology Requirements

    SciTech Connect

    Joan McDonald

    2002-09-01

    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  19. Ensuring preparedness for potential poliomyelitis outbreaks: Recommendations for the US poliovirus vaccine stockpile from the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Practices (ACIP).

    PubMed

    Alexander, Lorraine; Birkhead, Guthrie; Guerra, Fernando; Helms, Charles; Hinman, Alan; Katz, Samuel; LeBaron, Charles W; Modlin, John; Murphy, Trudy V

    2004-12-01

    Paralytic poliomyelitis was once endemic in the United States; however, because of high vaccination levels, the last case of wild disease occurred in 1979. Although worldwide polio eradication may be achieved in the near future, the presence of undervaccinated children in urban areas and among groups who refuse vaccination creates an outbreak risk, should importation of wild virus occur. In 1999, the Advisory Committee on Immunization Practices (ACIP) recommended that inactivated poliovirus vaccine (IPV) be used for routine immunization of the US population and that oral poliovirus vaccine (OPV) be reserved for "mass vaccination campaigns to control outbreaks of paralytic polio." Subsequently, the sole US manufacturer of OPV withdrew from the market. In 2003, a joint National Vaccine Advisory Committee (NVAC)/ACIP working group was charged with reporting to its parent bodies concerning the need for a poliovirus vaccine stockpile. Based on that working group's report, the NVAC and ACIP have concluded that stockpiles of both IPV and OPV should be maintained. In the event of an outbreak in which OPV continues not to be available, IPV should be used for control, and a stockpile of 8 million doses seems to be sufficient. Should IPV be manufactured only in combination with other vaccines, appropriate procurement actions should be taken to ensure that uncombined IPV continues to be stockpiled. Under circumstances of diminished population immunity, OPV may offer outbreak control advantages. The NVAC and ACIP recommend that the United States collaborate with international agencies to provide guaranteed and rapid access to at least 8 million doses of trivalent OPV or 8 million doses of each of the 3 types of monovalent OPV. The regulatory and practical obstacles to implementation of this recommendation will require assertive facilitation at high levels of the federal government and careful planning at the state and local levels.

  20. Report to Congress on stockpile reliability, weapon remanufacture, and the role of nuclear testing

    SciTech Connect

    Miller, G.H.; Brown, P.S.; Alonso, C.T.

    1987-10-01

    This report analyzes two issues: (1) ''whether past warhead reliability problems demonstrate that nuclear explosive testing is needed to identify or to correct stockpile reliability,'' or (2) ''whether a program of stockpile inspection, nonnuclear testing, and remanufacture would be sufficient to deal with stockpile reliability problems.'' Chapter 1 examines the reasons for nuclear testing. Although the thrust of the request from Congressman Aspin et al., has to do with the need for nuclear testing as it relates to stockpile reliability and remanufacture, there are other very important reasons for nuclear testing. Since there has been increasing interest in the US Congress for more restrictive nuclear test limits, we have addressed the overall need for nuclear testing and the potential impact of further nuclear test limitations. Chapter 1 also summarizes the major conclusions of a recent study conducted by the Scientific and Academic Advisory Committee (SAAC) for the President of the University of California; the SAAC report is entitled, ''Nuclear Weapon Tests: The Role of the University of California-Department of Energy Laboratories.'' Chapter 2 presents a brief history of stockpile problems that involved post-deployment nuclear testing for their resolution. Chapter 3 addresses the problems involved in remanufacturing nuclear weapons, and Chapter 4 discusses measures that should be taken to prepare for possible future restrictive test limits.

  1. Using Direct Sub-Level Entity Access to Improve Nuclear Stockpile Simulation Modeling

    SciTech Connect

    Parker, Robert Y.

    1999-08-01

    Direct sub-level entity access is a seldom-used technique in discrete-event simulation modeling that addresses the accessibility of sub-level entity information. The technique has significant advantages over more common, alternative modeling methods--especially where hierarchical entity structures are modeled. As such, direct sub-level entity access is often preferable in modeling nuclear stockpile, life-extension issues, an area to which it has not been previously applied. Current nuclear stockpile, life-extension models were demonstrated to benefit greatly from the advantages of direct sub-level entity access. In specific cases, the application of the technique resulted in models that were up to 10 times faster than functionally equivalent models where alternative techniques were applied. Furthermore, specific implementations of direct sub-level entity access were observed to be more flexible, efficient, functional, and scalable than corresponding implementations using common modeling techniques. Common modeling techniques (''unbatch/batch'' and ''attribute-copying'') proved inefficient and cumbersome in handling many nuclear stockpile modeling complexities, including multiple weapon sites, true defect analysis, and large numbers of weapon and subsystem types. While significant effort was required to enable direct sub-level entity access in the nuclear stockpile simulation models, the enhancements were worth the effort--resulting in more efficient, more capable, and more informative models that effectively addressed the complexities of the nuclear stockpile.

  2. University Research Program in Robotics - "Technologies for Micro-Electrical-Mechanical Systems in directed Stockpile Work (DSW) Radiation and Campaigns", Final Technical Annual Report, Project Period 9/1/06 - 8/31/07

    SciTech Connect

    James S. Tulenko; Carl D. Crane

    2007-12-13

    The University Research Program in Robotics (URPR) is an integrated group of universities performing fundamental research that addresses broad-based robotics and automation needs of the NNSA Directed Stockpile Work (DSW) and Campaigns. The URPR mission is to provide improved capabilities in robotics science and engineering to meet the future needs of all weapon systems and other associated NNSA/DOE activities.

  3. [Antibiotic stewardship: Measures for optimization of antibacterial therapy].

    PubMed

    de With, K

    2015-11-01

    Because the development of resistance is steadily increasing, especially among Gram-negative pathogens and new developments in antibiotics are lacking, a rational antibiotic therapy is necessary now more than ever. A continuing uncritical and non-guideline-conform use of antibiotics leads to selection of multidrug-resistant pathogens, which can colonize patients and as instigators of infections make treatment more difficult. A prerequisite for targeted antibiotic therapy is a critical testing of the suspected infection diagnosis based on a guideline-conform microbiological preanalytical procedure. To promote a guideline-conform antibiotic therapy in hospitals with respect to choice of substance, dosage and duration, in December 2013 so-called antibiotic stewardship (ABS) measures were summarized in a so-called S3-guideline from the Association of the Scientific Medical Societies in Germany (AWMF) under the auspices of the German Society for Infectious Diseases (DGI). With a strategy of targeted antibiotic therapy and infection prevention it is possible to achieve optimum treatment results and to minimize the development of resistance.

  4. Defense Nuclear Material Stewardship Integrated Inventory Information Management System (IIIMS).

    SciTech Connect

    Aas, Christopher A.; Lenhart, James E.; Bray, Olin H.; Witcher, Christina Jenkin

    2004-11-01

    Sandia National Laboratories was tasked with developing the Defense Nuclear Material Stewardship Integrated Inventory Information Management System (IIIMS) with the sponsorship of NA-125.3 and the concurrence of DOE/NNSA field and area offices. The purpose of IIIMS was to modernize nuclear materials management information systems at the enterprise level. Projects over the course of several years attempted to spearhead this modernization. The scope of IIIMS was broken into broad enterprise-oriented materials management and materials forecasting. The IIIMS prototype was developed to allow multiple participating user groups to explore nuclear material requirements and needs in detail. The purpose of material forecasting was to determine nuclear material availability over a 10 to 15 year period in light of the dynamic nature of nuclear materials management. Formal DOE Directives (requirements) were needed to direct IIIMS efforts but were never issued and the project has been halted. When restarted, duplicating or re-engineering the activities from 1999 to 2003 is unnecessary, and in fact future initiatives can build on previous work. IIIMS requirements should be structured to provide high confidence that discrepancies are detected, and classified information is not divulged. Enterprise-wide materials management systems maintained by the military can be used as overall models to base IIIMS implementation concepts upon.

  5. Core attributes of stewardship; foundation of sound health system.

    PubMed

    Kapoor, Neelesh; Kumar, Dewesh; Thakur, Nivedita

    2014-06-01

    Stewardship is not a new concept for public policy, but has not been used to its optimum by the health policy-makers. Although it is being practiced in most successful models of health system, but the onus to this function is still due till date. Lately, few experts in World Health Organization (WHO) have realized its importance and have been raising the issue at different platforms to pursue the most important function of the health system i.e. stewardship. The core attributes of stewardship need to be understood in totality for better understanding of the concept. These core attributes, required for hassle free functioning of a health system, include responsible manager, political will, normative dimension, balanced interventionist and proponents of good governance.

  6. Current State of Antimicrobial Stewardship in Children's Hospital Emergency Departments.

    PubMed

    Mistry, Rakesh D; Newland, Jason G; Gerber, Jeffrey S; Hersh, Adam L; May, Larissa; Perman, Sarah M; Kuppermann, Nathan; Dayan, Peter S

    2017-04-01

    BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution. Items assessed included beliefs regarding ED antibiotic prescribing, ED prescribing resources, ASP methods used in the ED such as clinical decision support and clinical care guidelines, ED participation in ASP activities, and preferred methods for ED-based ASP implementation. RESULTS A total of 36 ASP leaders (97.3%) and 32 ED directors (86.5%) responded; the overall response rate was 91.9%. Most ASP leaders (97.8%) and ED directors (93.7%) agreed that creation of ED-based ASPs was necessary. ED resources for antibiotic prescribing were obtained via the Internet or electronic health records (EHRs) for 29 hospitals (81.3%). The main ASP activities for the ED included production of antibiograms (77.8%) and creation of clinical care guidelines for pneumonia (83.3%). The ED was represented on 3 hospital ASP committees (8.3%). No hospital ASPs actively monitored outpatient ED prescribing. Most ASP leaders (77.8%) and ED directors (81.3%) preferred implementation of ED-based ASPs using clinical decision support integrated into the EHR. CONCLUSIONS Although ED involvement in ASPs is limited, both ASP and ED leaders believe that ED-based ASPs are necessary. Many children's hospitals have the capability to implement ED-based ASPs via the preferred method: EHR clinical decision support. Infect Control Hosp Epidemiol 2017;38:469-475.

  7. Guidance for the knowledge and skills required for antimicrobial stewardship leaders.

    PubMed

    Cosgrove, Sara E; Hermsen, Elizabeth D; Rybak, Michael J; File, Thomas M; Parker, Sarah K; Barlam, Tamar F

    2014-12-01

    Antimicrobial stewardship programs are increasingly recognized as critical in optimizing the use of antimicrobials. Consequently, more physicians, pharmacists, and other healthcare providers are developing and implementing such programs in a variety of healthcare settings. The purpose of this guidance document is to outline the knowledge and skills that are needed to lead an antimicrobial stewardship program. It was developed by antimicrobial stewardship experts from organizations that are engaged in advancing the field of antimicrobial stewardship.

  8. Global antimicrobial resistance: from surveillance to stewardship. Part 2: stewardship initiatives.

    PubMed

    Cantón, Rafael; Bryan, Jenny

    2012-12-01

    22nd European Congress of Clinical Microbiology and Infectious Diseases London, UK, 31 March-3 April 2012 Twelve months after the WHO launched its World Health Day 2011 campaign to combat antimicrobial resistance, antibiotic stewardship initiatives were a major focus at the annual meeting of the European Society of Clinical Microbiology and Infectious Diseases, in London, UK. In the second part of their report from the Congress, the authors review the impact of some of these initiatives in achieving their goals of reducing overall antibiotic usage, ensuring timely, appropriate prescribing and avoiding sub-optimal dosing and unnecessarily prolonged treatment. The authors also report new data on antibiotic prescribing in primary care and latest research in the development of novel antibiotics for the future.

  9. Ecosystem stewardship: sustainability strategies for a rapidly changing planet.

    PubMed

    Chapin, F Stuart; Carpenter, Stephen R; Kofinas, Gary P; Folke, Carl; Abel, Nick; Clark, William C; Olsson, Per; Smith, D Mark Stafford; Walker, Brian; Young, Oran R; Berkes, Fikret; Biggs, Reinette; Grove, J Morgan; Naylor, Rosamond L; Pinkerton, Evelyn; Steffen, Will; Swanson, Frederick J

    2010-04-01

    Ecosystem stewardship is an action-oriented framework intended to foster the social-ecological sustainability of a rapidly changing planet. Recent developments identify three strategies that make optimal use of current understanding in an environment of inevitable uncertainty and abrupt change: reducing the magnitude of, and exposure and sensitivity to, known stresses; focusing on proactive policies that shape change; and avoiding or escaping unsustainable social-ecological traps. As we discuss here, all social-ecological systems are vulnerable to recent and projected changes but have sources of adaptive capacity and resilience that can sustain ecosystem services and human well-being through active ecosystem stewardship.

  10. Review of rapid diagnostic tests used by antimicrobial stewardship programs.

    PubMed

    Bauer, Karri A; Perez, Katherine K; Forrest, Graeme N; Goff, Debra A

    2014-10-15

    Rapid microbiologic tests provide opportunities for antimicrobial stewardship programs to improve antimicrobial use and clinical and economic outcomes. Standard techniques for identification of organisms require at least 48-72 hours for final results, compared with rapid diagnostic tests that provide final organism identification within hours of growth. Importantly, rapid microbiologic tests are considered "game changers" and represent a significant advancement in the management of infectious diseases. This review focuses on currently available rapid diagnostic tests and, importantly, the impact of rapid testing in combination with antimicrobial stewardship on patient outcomes.

  11. Transformation of antimicrobial stewardship programs through technology and informatics.

    PubMed

    Kullar, Ravina; Goff, Debra A

    2014-06-01

    The successful integration of technology in antimicrobial stewardship programs has made it possible for clinicians to function more efficiently. With government endorsement of electronic health records (EHRs), EHRs and clinical decision support systems (CDSSs) are being used as decision support tools to aid clinicians in efforts to improve antibiotic use. Likewise, medical applications (apps) have provided educational tools easily accessible to clinicians through their mobile devices. In this article, the impact that informatics and technology have had on promoting antibiotic stewardship is described, focusing on EHRs and CDSSs, apps, electronic resources, and social media.

  12. Improving Wellbeing and Environmental Stewardship Through Volunteering in Nature.

    PubMed

    Molsher, Robyn; Townsend, Mardie

    2016-03-01

    Environmental volunteering (EV) can provide a unique way to optimise the wellbeing of participants while fostering environmental stewardship. However, the potential of EV to create human health benefits remains an under-researched area. This study provides evidence for improved wellbeing and mood state for 32 participants from diverse backgrounds undertaking EV activities. Most participants also reported improved environmental stewardship with a greatly improved understanding of the environment and the need to conserve it. Other benefits included: 31% of those seeking work obtained it; and 50% joined a volunteer group at program completion. EV provides a unique mechanism to enhance the wellbeing of the participants, while conserving the environment.

  13. Stockpiles and food availability in feeding facilities after the Great East Japan Earthquake.

    PubMed

    Nozue, Miho; Ishikawa-Takata, Kazuko; Sarukura, Nobuko; Sako, Kazuko; Tsuboyama-Kasaoka, Nobuyo

    2014-01-01

    Food stockpiles and methods of ensuring food availability after the Great East Japan Earthquake of March 11, 2011 have been studied. Questionnaires were sent to 1911 registered dietitians and general dietitians who were members of the Japan Dietetic Association in August 2012. Four hundred thirty-five dietitians (22.8%) completed the questionnaire about work involved in feeding facilities, types and administration of meals, and food stockpiles. Methods of ensuring food availability, preparation, and accommodating food for special dietary uses were recorded for the three-day period immediately following the earthquake, and the period from 4 days to one month after the earthquake. Three days after the earthquake, differences in administration of meals at feeding facilities providing three meals daily, food stockpiles, organization, contactable facilities, and how to contact them for food items were assessed. Sixty-nine percent of all feeding facilities in this study had stockpiles of food before the Great East Japan Earthquake. Administration of meals in feeding facilities and the possibility of contact with cooperative feeding facilities were found to correlate positively with ensuring the availability of food groups. Food scores were higher in facilities providing three meals daily by direct administration of meals and with accessible public administrators, cooperative facilities and suppliers, and facilities that were contactable by landline telephone, mobile phone, fax or email. The necessity for natural disaster-readiness through continuous stockpiling food at feeding facilities is confirmed. Each prospective feeding facility must be required to plan its stockpiles, their turnover and replaceability to maximise food security in the face of disaster.

  14. Annual Scientific Progress Report: National Nuclear Security Administration Stockpile Stewardship: Academic Alliance Research Grant #DE-FG52-06NA26205

    SciTech Connect

    Maple, M. Brian; Zocco, Diego A.

    2008-07-24

    The focus of this grant, entitled 'Experimental investigations of magnetic, superconducting, and other phase transitions in novel f-electron materials at ultra-high pressures using designer diamond anvils', is to explore the novel properties of f-electron compounds under pressure, with a particular emphasis on the physics of superconductivity, magnetism, and their interactions. This report is a synopsis of the research that was undertaken from 6/2007-6/2008.

  15. Annual Scientific Progress Report: National Nuclear Security Administration Stewardship Stockpile: Academic Alliance Research Grant #DE-FG52-06NA26205

    SciTech Connect

    Maple, M. Brian; Jeffries, Jason R.

    2007-07-26

    The focus of this grant, entitled ''Experimental investigations of magnetic, superconducting, and other phase transitions in novel f-electron materials at ultra-high pressures using designer diamond anvils'', is to explore the novel properties of f-electron compounds under pressure, with a particular emphasis on the physics of superconductivity, magnetism, and their interactions. This report is a synopsis of the research that was undertaken from 6/2006-6/2007.

  16. Serendipity and Stewardship: Teaching with the Spirit in a Secular Classroom

    ERIC Educational Resources Information Center

    Hall, Bradford J.

    2009-01-01

    Can one appropriately teach with the spirit in a secular classroom? This chapter addresses the question by exploring how the concepts of serendipity and stewardship encourage a form of spirituality that is inclusive and appropriate for the university setting. Serendipity and stewardship work hand in hand. Stewardship resists the temptation of…

  17. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation plan, forest stewardship plan, or equivalent plan that complies with CCC guidelines and is approved by the...

  18. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation plan, forest stewardship plan, or equivalent plan that complies with CCC guidelines and is approved by the...

  19. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Conservation plan, forest stewardship plan, or... plan, forest stewardship plan, or equivalent plan. (a) The producer must implement a conservation plan, forest stewardship plan, or equivalent plan that complies with CCC guidelines and is approved by the...

  20. 77 FR 38267 - Information Collection; Role of Communities in Stewardship Contracting Projects

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ...; ] DEPARTMENT OF AGRICULTURE Forest Service Information Collection; Role of Communities in Stewardship..., Role of Communities in Stewardship Contracting Projects. DATES: Comments must be received in writing on.... SUPPLEMENTARY INFORMATION: Title: Role of Communities in Stewardship Contracting Projects. OMB Number: 0596-0201...

  1. The Role of Antimicrobial Stewardship in the Clinical Microbiology Laboratory: Stepping Up to the Plate

    PubMed Central

    Hurst, John M.; Steed, Lisa L.

    2016-01-01

    We report the development of a collaborative relationship between antimicrobial stewardship and clinical microbiology that incorporates stewardship practices into daily laboratory rounds. Antimicrobial stewardship involvement on rounds was a welcomed and effective initiative with substantial rates of intervention. New opportunities to positively impact use of antimicrobials and laboratory resources were realized. PMID:27975076

  2. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What is the IRR Program stewardship plan? 170.700 Section... ROADS PROGRAM Program Oversight and Accountability § 170.700 What is the IRR Program stewardship plan? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and...

  3. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false What is the IRR Program stewardship plan? 170.700 Section... ROADS PROGRAM Program Oversight and Accountability § 170.700 What is the IRR Program stewardship plan? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and...

  4. Organizing urban ecosystem services through environmental stewardship governance in New York City

    Treesearch

    James J. Connolly; Erika S. Svendsen; Dana R. Fisher; Lindsay K. Campbell

    2013-01-01

    How do stewardship groups contribute to the management of urban ecosystem services? In this paper, we integrate the research on environmental stewardship with the social-ecological systems literature to explain how stewardship groups serve as bridge organizations between public agencies and civic organizations, working across scales and sectors to build the flexible...

  5. Nitrogen rate and application timing affect the yield and risk associated with stockpiling tall fescue for winter grazing

    USDA-ARS?s Scientific Manuscript database

    Stockpiled tall fescue can provide economical winter feed for grazing livestock in the mid-Atlantic of the United States. The objective of this study was to evaluate the effect of N rate and application timing on the yield of stockpiled tall fescue. Four N rates ranging from 0 to 120 lb N/acre wer...

  6. The Impact of Antibiotic Stewardship Programs in Combating Quinolone Resistance: A Systematic Review and Recommendations for More Efficient Interventions.

    PubMed

    Pitiriga, Vasiliki; Vrioni, Georgia; Saroglou, George; Tsakris, Athanasios

    2017-04-01

    Quinolones are among the most commonly prescribed antibiotics worldwide. A clear relationship has been demonstrated between excessive quinolone use and the steady increase in the incidence of quinolone-resistant bacterial pathogens, both in hospital and community sites. In addition, exposure to quinolones has been associated with colonization and infection with healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus and Clostridium difficile in hospitalized patients. Therefore, the management of quinolone prescribing in hospitals through antibiotic stewardship programs is considered crucial. Although suggestions have been made by previous studies on the positive impact of stewardship programs concerning the emergence and spread of multidrug-resistant bacteria at hospital level, the association of quinolone-targeted interventions with reduction of quinolone resistance is vague. The purpose of this article was to evaluate the impact of stewardship interventions on quinolone resistance rates and healthcare-associated infections, through a literature review using systematic methods to identify and select the appropriate studies. Recommendations for improvements in quinolone-targeted stewardship programs are also proposed. Efforts in battling quinolone resistance should combine various interventions such as restriction formulary policies, prospective audits with feedback to prescribers, infection prevention and control measures, prompt detection of low-level resistance, educational programs, and guidelines for optimal quinolone usage. However, the effectiveness of such strategies should be assessed by properly designed and conducted clinical trials. Finally, novel approaches in diagnostic stewardship for rapidly detecting bacterial resistance, including PCR-based techniques, mass spectrometry, microarrays, and whole-genome sequencing as well as the prompt investigation on the clonality of quinolone-resistant strains, will strengthen our

  7. Big projects could threaten weapons labs` research base

    SciTech Connect

    Lawler, A.

    1996-05-24

    Every few seconds, a mushroom cloud explodes on Paul Cunningham`s Computer screen. The unsettling image is a screen saver in the office of the chief of nuclear materials and stockpile management at Los Alamos National Laboratory - and a wry reminder of the radical changes underway at the three US weapons labs. Now that the US has renounced underground nuclear testing, simulations are becoming the weapons designers chief tool for ensuring that the nuclear arsenal is reliable. The new approach to testing, stockpile stewardship, has triggered a fierce debate within the defense community. At issue is how to keep a balance between financing such new and costly stewardship projects as the $1.1 billion National Ignition Facility, which will simulate the conditions of nuclear detonation, and maintaining a critical mass of experienced weapons designers. This artical describes the debate and funding and political problems which go with it.

  8. ESIP's Emerging Provenance and Context Content Standard Use Cases: Developing Examples and Models for Data Stewardship

    NASA Astrophysics Data System (ADS)

    Ramdeen, S.; Hills, D. J.

    2013-12-01

    Earth science data collections range from individual researchers' private collections to large-scale data warehouses, from computer-generated data to field or lab based observations. These collections require stewardship. Fundamentally, stewardship ensures long term preservation and the provision of access to the user community. In particular, stewardship includes capturing appropriate metadata and documentation--and thus the context of the data's creation and any changes they underwent over time --to enable data reuse. But scientists and science data managers must translate these ideas into practice. How does one balance the needs of current and (projected) future stakeholders? In 2011, the Data Stewardship Committee (DSC) of the Federation of Earth Science Information Partners (ESIP) began developing the Provenance and Context Content Standard (PCCS). As an emerging standard, PCCS provides a framework for 'what' must be captured or preserved as opposed to describing only 'how' it should be done. Originally based on the experiences of NASA and NOAA researchers within ESIP, the standard currently provides data managers with content items aligned to eight key categories. While the categories and content items are based on data life cycles of remote sensing missions, they can be generalized to cover a broader set of activities, for example, preservation of physical objects. These categories will include the information needed to ensure the long-term understandability and usability of earth science data products. In addition to the PCCS, the DSC is developing a series of use cases based on the perspectives of the data archiver, data user, and the data consumer that will connect theory and practice. These cases will act as specifications for developing PCCS-based systems. They will also provide for examination of the categories and content items covered in the PCCS to determine if any additions are needed to cover the various use cases, and also provide rationale and

  9. Bringing the "power" to Cerner's PowerChart for antimicrobial stewardship.

    PubMed

    Pogue, Jason M; Potoski, Brian A; Postelnick, Michael; Mynatt, Ryan P; Trupiano, David P; Eschenauer, Gregory A; Kaye, Keith S

    2014-08-01

    The electronic medical record (EMR) has huge potential for facilitating antimicrobial stewardship efforts by directing providers to preferred antimicrobials. Cerner PowerChart currently holds the number 2 position in the EMR market. Although PowerChart has limited "out of the box" functionalities to optimize stewardship efforts, there are many potential utilities that can be developed to assist in stewardship practice. However, to harness the stewardship potential of the EMR system, significant hospital information technology resources are needed. Herein we describe the experiences of 3 large healthcare systems utilizing Cerner to facilitate prior authorization of antimicrobials, prospective audit and feedback of antimicrobials, and supplemental stewardship strategies.

  10. Mixed methods analysis of urban environmental stewardship networks

    Treesearch

    James J.T. Connolly; Erika S. Svendsen; Dana R. Fisher; Lindsay K. Campbell

    2015-01-01

    While mixed methods approaches to research have been accepted practice within the social sciences for several decades (Tashakkori and Teddlie 2003), the rising demand for cross-disciplinary analyses of socio-environmental processes has necessitated a renewed examination of this approach within environmental studies. Urban environmental stewardship is one area where it...

  11. ICMR programme on Antibiotic Stewardship, Prevention of Infection & Control (ASPIC).

    PubMed

    Chandy, Sujith J; Michael, Joy Sarojini; Veeraraghavan, Balaji; Abraham, O C; Bachhav, Sagar S; Kshirsagar, Nilima A

    2014-02-01

    Antimicrobial resistance and hospital infections have increased alarmingly in India. Antibiotic stewardship and hospital infection control are two broad strategies which have been employed globally to contain the problems of resistance and infections. For this to succeed, it is important to bring on board the various stakeholders in hospitals, especially the clinical pharmacologists. The discipline of clinical pharmacology needs to be involved in themes such as antimicrobial resistance and hospital infection which truly impact patient care. Clinical pharmacologists need to collaborate with faculty in other disciplines such as microbiology to achieve good outcomes for optimal patient care in the hospital setting. The ASPIC programme was initiated by the Indian Council of Medical Research (ICMR) in response to the above need and was designed to bring together faculty from clinical pharmacology, microbiology and other disciplines to collaborate on initiating and improving antibiotic stewardship and concurrently curbing hospital infections through feasible infection control practices. This programme involves the participation of 20 centres per year throughout the country which come together for a training workshop. Topics pertaining to the above areas are discussed in addition to planning a project which helps to improve antibiotic stewardship and infection control practices in the various centres. It is hoped that this programme would empower hospitals and institutions throughout the country to improve antibiotic stewardship and infection control and ultimately contain antimicrobial resistance.

  12. Antibiotic stewardship: a call for action by the urologic community.

    PubMed

    Wagenlehner, Florian M E; Bartoletti, Ricardo; Cek, Mete; Grabe, Magnus; Kahlmeter, Gunnar; Pickard, Robert; Bjerklund-Johansen, Truls E

    2013-09-01

    Increasing antibiotic resistance and lack of new antibiotics in the near future calls for a variety of coordinated strategies called "Antibiotic stewardship", to improve antibiotic use with the goal of enhancing patient health outcomes and reducing emergence of resistance to antibiotics.

  13. Ecosystem stewardship: sustainability strategies for a rapidly changing planet

    Treesearch

    F. Stuart Chapin; Stephen R. Carpenter; Gary P. Kofinas; Carl Folke; Nick Abel; William C. Clark; Per Olsson; D. Mark Stafford Smith; Brian Walker; Oran R. Young; Fikret Berkes; Reinette Biggs; J. Morgan Grove; Rosamond L. Naylor; Evelyn Pinkerton; Will Steffen; Frederick J. Swanson

    2010-01-01

    Ecosystem stewardship is an action-oriented framework intended to foster the social-ecological sustainability of a rapidly changing planet. Recent developments identify three strategies that make optimal use of current understanding in an environment of inevitable uncertainty and abrupt change: reducing the magnitude of, and exposure and sensitivity to, known stresses...

  14. 2010/2015 PFOA Stewardship Program - 2014 Annual Progress Reports

    EPA Pesticide Factsheets

    In 2006, EPA and the eight major companies in the industry launched the 2010/15 PFOA Stewardship Program, in which companies committed to reduce global facility emissions and product content of PFOA and related chemicals by 95 percent by 2010, and to work

  15. Environmental protection and stewardship of subglacial aquatic environments

    NASA Astrophysics Data System (ADS)

    Doran, Peter T.; Vincent, Warwick F.

    Environmental stewardship is a guiding principle of the Antarctic Treaty System. Efforts began in the 1990s to generate specific guidelines for stewardship of many terrestrial environments, including surface lakes and rivers. The relatively recent documentation of widespread subglacial aquatic environments, and planning for acquiring samples from them, has generated a need for stewardship guidelines for these environments. In response to a request from the U.S. National Science Foundation, the National Research Council of the National Academies of Sciences (NAS) created the Committee on the Principles of Environmental and Scientific Stewardship for the Exploration and Study of Subglacial Environments. The committee made 13 recommendations and a decision tree as a framework and flow chart for environmental management decisions. The committee report was also largely the basis of a Code of Conduct (CoC) for the exploration of subglacial environments formulated by a Scientific Committee on Antarctic Research Action Group. Both the NAS report and CoC have been used as guidance, to varying degrees, by subglacial research currently in progress.

  16. Defining Best Practices in Boating, Fishing, and Stewardship Education.

    ERIC Educational Resources Information Center

    Fedler, Anthony J., Ed.

    The Recreational Boating and Fishing Foundation (RBFF) aims to increase participation in recreational boating and fishing and thereby increase public awareness, appreciation, and stewardship of aquatic natural resources. This document contains a summary and 11 commissioned papers from an RBFF workshop to create guidelines for best educational…

  17. Watershed management contributions to land stewardship: A literature review

    Treesearch

    Malchus B. Baker; Peter F. Folliott; Carleton B. Edminster; Karen L. Mora; Madelyn C. Dillon

    2000-01-01

    An international conference to increase people's awareness of the contributions that watershed management can make to future land stewardship was held in Tucson, Arizona, March 13-16, 2000. This bibliography is a compilation of the synthesis and poster papers presented at the conference along with the literature cited in these papers on watershed research projects...

  18. Social and institutional influences on wilderness fire stewardship

    Treesearch

    Katie Knotek

    2005-01-01

    One of the priority research areas at the Aldo Leopold Wilderness Research Institute addresses the “need for improved information to guide the stewardship of fire as a natural process in wilderness while protecting social and ecological values inside and outside wilderness.” This research topic area was developed with the knowledge that wildland fire, as a natural...

  19. Stewardship: A Biblical Model for the Formation of Christian Scholars

    ERIC Educational Resources Information Center

    Smith, Julien C. H.; Scales, T. Laine

    2013-01-01

    This article explores theological dimensions of the academic vocation, taking its cue from the research undertaken by the Carnegie Initiative on the Doctorate, which envisions the scholar as a steward of an academic discipline. We contend, however, that the Christian scholar's sense of stewardship extends beyond one's academic…

  20. Assessment of Undergraduate Students' Environmental Stewardship Reasoning and Knowledge

    ERIC Educational Resources Information Center

    Hartman, Christie-Joy Brodrick; DeMars, Christine E.; Griscom, Heather Peckham; Butner, Harold Martin

    2017-01-01

    Purpose: The purpose of this paper is to present a public university's design and implementation of an assessment approach that measures the change in undergraduate students' environmental stewardship reasoning and knowledge abilities over time. Design/methodology/approach: In support of a university's strategic emphasis on environmental…

  1. Antibiotic consumption and antibiotic stewardship in Swedish hospitals.

    PubMed

    Hanberger, Håkan; Skoog, Gunilla; Ternhag, Anders; Giske, Christian G

    2014-05-01

    The aim of this paper was to describe and analyze the effect of antibiotic policy changes on antibiotic consumption in Swedish hospitals and to review antibiotic stewardship in Swedish hospitals. The main findings were: 1) Antibiotic consumption has significantly increased in Swedish hospitals over the last decade. The consumption of cephalosporins has decreased, whereas that of most other drugs including piperacillin-tazobactam, carbapenems, and penicillinase-sensitive and -resistant penicillins has increased and replaced cephalosporins. 2) Invasive infections caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae have increased, but the proportion of pathogens resistant to third-generation cephalosporins causing invasive infections is still very low in a European and international perspective. Furthermore, the following gaps in knowledge were identified: 1) lack of national, regional, and local data on the incidence of antibiotic resistance among bacteria causing hospital-acquired infections e.g. bloodstream infections and hospital-acquired pneumonia-data on which standard treatment guidelines should be based; 2) lack of data on the incidence of Clostridium difficile infections and the effect of change of antibiotic policies on the incidence of C. difficile infections and infections caused by antibiotic-resistant pathogens; and 3) lack of prospective surveillance programs regarding appropriate antibiotic treatment, including selection of optimal antimicrobial drug regimens, dosage, duration of therapy, and adverse ecological effects such as increases in C. difficile infections and emergence of antibiotic-resistant pathogens. Evidence-based actions to improve antibiotic use and to slow down the problem of antibiotic resistance need to be strengthened. The effect of such actions should be analyzed, and standard treatment guidelines should be continuously updated at national, regional, and local levels.

  2. Antibiotic consumption and antibiotic stewardship in Swedish hospitals

    PubMed Central

    Skoog, Gunilla; Ternhag, Anders; Giske, Christian G.

    2014-01-01

    Background The aim of this paper was to describe and analyze the effect of antibiotic policy changes on antibiotic consumption in Swedish hospitals and to review antibiotic stewardship in Swedish hospitals. Results The main findings were: 1) Antibiotic consumption has significantly increased in Swedish hospitals over the last decade. The consumption of cephalosporins has decreased, whereas that of most other drugs including piperacillin-tazobactam, carbapenems, and penicillinase-sensitive and -resistant penicillins has increased and replaced cephalosporins. 2) Invasive infections caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae have increased, but the proportion of pathogens resistant to third-generation cephalosporins causing invasive infections is still very low in a European and international perspective. Furthermore, the following gaps in knowledge were identified: 1) lack of national, regional, and local data on the incidence of antibiotic resistance among bacteria causing hospital-acquired infections e.g. bloodstream infections and hospital-acquired pneumonia—data on which standard treatment guidelines should be based; 2) lack of data on the incidence of Clostridium difficile infections and the effect of change of antibiotic policies on the incidence of C. difficile infections and infections caused by antibiotic-resistant pathogens; and 3) lack of prospective surveillance programs regarding appropriate antibiotic treatment, including selection of optimal antimicrobial drug regimens, dosage, duration of therapy, and adverse ecological effects such as increases in C. difficile infections and emergence of antibiotic-resistant pathogens. Conclusions Evidence-based actions to improve antibiotic use and to slow down the problem of antibiotic resistance need to be strengthened. The effect of such actions should be analyzed, and standard treatment guidelines should be continuously updated at national, regional, and local levels. PMID:24724823

  3. Sharing Responsibility for Data Stewardship Between Scientists and Curators

    NASA Astrophysics Data System (ADS)

    Hedstrom, M. L.

    2012-12-01

    Data stewardship is becoming increasingly important to support accurate conclusions from new forms of data, integration of and computation across heterogeneous data types, interactions between models and data, replication of results, data governance and long-term archiving. In addition to increasing recognition of the importance of data management, data science, and data curation by US and international scientific agencies, the National Academies of Science Board on Research Data and Information is sponsoring a study on Data Curation Education and Workforce Issues. Effective data stewardship requires a distributed effort among scientists who produce data, IT staff and/or vendors who provide data storage and computational facilities and services, and curators who enhance data quality, manage data governance, provide access to third parties, and assume responsibility for long-term archiving of data. The expertise necessary for scientific data management includes a mix of knowledge of the scientific domain; an understanding of domain data requirements, standards, ontologies and analytical methods; facility with leading edge information technology; and knowledge of data governance, standards, and best practices for long-term preservation and access that rarely are found in a single individual. Rather than developing data science and data curation as new and distinct occupations, this paper examines the set of tasks required for data stewardship. The paper proposes an alternative model that embeds data stewardship in scientific workflows and coordinates hand-offs between instruments, repositories, analytical processing, publishers, distributors, and archives. This model forms the basis for defining knowledge and skill requirements for specific actors in the processes required for data stewardship and the corresponding educational and training needs.

  4. Performance by Fall-Calving Cows Grazing Tall Fescue Pastures With Different Proportions Stockpiled

    USDA-ARS?s Scientific Manuscript database

    Tall fescue [Lolium arundinaceum (Schreb.) S.J. Darbyshire.] is often stockpiled to reduce winter feed costs for cattle. Over two consecutive years, a total of 158 Gelbvieh × Angus fall-calving cows (1318 plus/minus 13.2 lb) were allocated randomly to one of eight 24-acre tall fescue pastures on 18 ...

  5. Performance by Fall-Calving Cows Grazing Tall Fescue Pastures with Different Proportions Stockpiled

    USDA-ARS?s Scientific Manuscript database

    Tall fescue [Lolium arundinaceum (Schreb.) Darbysh.] is often stockpiled to reduce winter feed costs for cattle. Over two consecutive years, a total of 158 Gelbvieh × Angus fall-calving cows (599 ± 6.0 kg) were allocated randomly to one of eight 10-ha tall fescue pastures (subdivided into six 1.6-h...

  6. Site-specific emergency response concept plans for the Chemical Stockpile Disposal Program

    SciTech Connect

    Carnes, S.A.

    1989-12-01

    Site-specific emergency response concept plans were developed to help initiate enhanced emergency preparedness for continued storage of the stockpile and the Chemical Stockpile Disposal Program (CSDP) at the eight army installations storing the unitary chemical stockpile -- Aberdeen Proving Ground, Anniston Army Depot, Lexington-Blue Grass Army Depot, Newport Army Ammunition Plant, Pine Bluff Arsenal, Pueblo Depot Activity, Tooele Army Depot, and Umatilla Depot Activity. This document summarizes the emergency response plans for all the sites and highlights similarities and differences among them. Section 2 summarizes site-specific differences in stockpile hazard and risk by showing differences in planning-basis accident categories and distributions of topographical features, meteorological conditions, and populations at risk. Section 3 presents a summary of the methodology used to identify the emergency planning zones for each site and the actual recommended boundaries of those zones for the eight sites. Section 4 identifies feasible and recommended protective actions for the sites and explains reasons for differences in them. Finally, Section 5 notes the dependence of protective action effectiveness on the development and implementation of command and control and warning systems that can be implemented in a timely manner, it also identifies the differences in recommended lead times (i.e., from the onset of an accidental release) needed at the sites for effective implementation of protective actions. 17 refs., 11 figs. , 12 tabs.

  7. Stockpile of personal protective equipment in hospital settings: preparedness for influenza pandemics.

    PubMed

    Hashikura, Mayuko; Kizu, Junko

    2009-11-01

    Personal protective equipment (PPE) is known to be a crucial means of preventing influenza pandemics; however, the amount of PPE that should be stored in hospital settings has been unclear. The purpose of this paper is to propose a PPE calculation system to help hospitals to decide their PPE stockpile. We searched influenza guidelines from a number of countries and research papers on protective devices and infectious diseases. The PPE calculation system included factors such as the influenza pandemic period, risk classification by health care workers (HCW) type, and the type and number of PPE for a HCW per day. We concluded that 4 sets of PPE (N95 respirators, double gloves, gowns, and goggles) per day should be prepared for HCWs in a high-risk group. Similarly, 2 sets of appropriate PPE, depending on the risk level, are required for medium- and low-risk groups. In addition, 2 surgical masks are required for every worker and inpatient and 1 for each outpatient. The PPE stockpile should be prepared to cover at least an 8-week pandemic. Purchasing a PPE stockpile requires a sizable budget. The PPE calculation system in this paper will hopefully support hospitals in deciding their PPE stockpile.

  8. A&M. Special shielding materials. Stockpile of magnetite, used for making ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    A&M. Special shielding materials. Stockpile of magnetite, used for making high-density concrete, and loading conveyor near TAN-607 construction site. Date: September 25, 1953. INEEL negative no. 8710 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  9. 30 CFR 77.211 - Draw-off tunnels; stockpiling and reclaiming operations; general.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Draw-off tunnels; stockpiling and reclaiming operations; general. 77.211 Section 77.211 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES...

  10. 30 CFR 77.211 - Draw-off tunnels; stockpiling and reclaiming operations; general.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Draw-off tunnels; stockpiling and reclaiming operations; general. 77.211 Section 77.211 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES...

  11. 30 CFR 77.211 - Draw-off tunnels; stockpiling and reclaiming operations; general.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Draw-off tunnels; stockpiling and reclaiming operations; general. 77.211 Section 77.211 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES...

  12. 30 CFR 77.211 - Draw-off tunnels; stockpiling and reclaiming operations; general.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Draw-off tunnels; stockpiling and reclaiming operations; general. 77.211 Section 77.211 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES...

  13. 30 CFR 77.211 - Draw-off tunnels; stockpiling and reclaiming operations; general.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Draw-off tunnels; stockpiling and reclaiming operations; general. 77.211 Section 77.211 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES...

  14. Impact of formulary restriction with prior authorization by an antimicrobial stewardship program

    PubMed Central

    Reed, Erica E.; Stevenson, Kurt B.; West, Jessica E.; Bauer, Karri A.; Goff, Debra A.

    2013-01-01

    In an era of increasing antimicrobial resistance and few antimicrobials in the developmental pipeline, many institutions have developed antimicrobial stewardship programs (ASPs) to help implement evidence-based (EB) strategies for ensuring appropriate utilization of these agents. EB strategies for accomplishing this include formulary restriction with prior authorization. Potential limitations to this particular strategy include delays in therapy, prescriber pushback, and unintended increases in use of un-restricted antimicrobials; however, our ASP found that implementing prior authorization for select antimicrobials along with making a significant effort to educate clinicians on criteria for use ensured more appropriate prescribing of these agents, hopefully helping to preserve their utility for years to come. PMID:23154323

  15. Impact of Stewardship on Inhaled Nitric Oxide Utilization in a Neonatal ICU.

    PubMed

    Elmekkawi, Amir; More, Kiran; Shea, Jennifer; Sperling, Christina; Da Silva, Zelia; Finelli, Michael; Rolnitsky, Asaph; Jankov, Robert P

    2016-10-01

    Inhaled nitric oxide (iNO) remains the "gold standard" therapy for hypoxemic respiratory failure in newborns. Despite good quality evidence to guide iNO use in this population, we observed considerable practice variation, particularly in timing and rate of weaning. To promote evidence-based practice, we launched an iNO stewardship program in April 2013. Our objective was to determine whether iNO stewardship led to changes in iNO utilization and weaning. We conducted a quality improvement project in an outborn quaternary NICU, targeting improved iNO guideline compliance. We compared patterns of iNO utilization between 2 cohorts: prestewardship (April 2011-March 2013; retrospective data collection) and poststewardship (April 2013-March 2015; prospective data collection). Eighty-seven neonates received 88 courses of iNO in the 2 years prestewardship, and 64 neonates received 64 courses of iNO in the 2 years poststewardship. There were no significant differences (P > .05) in patient demographics, in the proportion of patients receiving iNO "off-label," in proportion initiated at the referring hospital, or in outcomes (death or extracorporeal membrane oxygenation). There were significant (P < .05) reductions in median total hours on iNO per patient (47 vs 20; P < .001), in iNO hours per patient from maximum dose to initial wean (28 vs 9; P < .01), and in hours from initial wean to discontinuation (14 vs 8; P < .05). The introduction of iNO stewardship was associated with improved adherence to evidence-based guidelines and an overall reduction in total and per-patient iNO use. Copyright © 2016 by the American Academy of Pediatrics.

  16. Development of the Alaska Heritage Stewardship Program for protection of cultural resources at increased risk due to the Exxon Valdez oil spill. Restoration study number 104a. Exxon Valdez oil spill state/federal natural resource damage assessment final report

    SciTech Connect

    Corbett, D.G.; Reger, D.

    1994-08-01

    The authors developed a stewardship program, based on functioning models in Arizona and Texas, to train interested local groups and individuals to protect cultural resources. The program was adapted to Alaska`s remoteness, sparse populations, and climate by giving Stewards greater flexibility to deal with local conditions. The State Office of History and Archaeology and U.S. Fish and Wildlife Service are attempting to implement Stewardship in areas expressing interest.

  17. Medical management of the acute radiation syndrome: recommendations of the Strategic National Stockpile Radiation Working Group.

    PubMed

    Waselenko, Jamie K; MacVittie, Thomas J; Blakely, William F; Pesik, Nicki; Wiley, Albert L; Dickerson, William E; Tsu, Horace; Confer, Dennis L; Coleman, C Norman; Seed, Thomas; Lowry, Patrick; Armitage, James O; Dainiak, Nicholas

    2004-06-15

    Physicians, hospitals, and other health care facilities will assume the responsibility for aiding individuals injured by a terrorist act involving radioactive material. Scenarios have been developed for such acts that include a range of exposures resulting in few to many casualties. This consensus document was developed by the Strategic National Stockpile Radiation Working Group to provide a framework for physicians in internal medicine and the medical subspecialties to evaluate and manage large-scale radiation injuries. Individual radiation dose is assessed by determining the time to onset and severity of nausea and vomiting, decline in absolute lymphocyte count over several hours or days after exposure, and appearance of chromosome aberrations (including dicentrics and ring forms) in peripheral blood lymphocytes. Documentation of clinical signs and symptoms (affecting the hematopoietic, gastrointestinal, cerebrovascular, and cutaneous systems) over time is essential for triage of victims, selection of therapy, and assignment of prognosis. Recommendations based on radiation dose and physiologic response are made for treatment of the hematopoietic syndrome. Therapy includes treatment with hematopoietic cytokines; blood transfusion; and, in selected cases, stem-cell transplantation. Additional medical management based on the evolution of clinical signs and symptoms includes the use of antimicrobial agents (quinolones, antiviral therapy, and antifungal agents), antiemetic agents, and analgesic agents. Because of the strong psychological impact of a possible radiation exposure, psychosocial support will be required for those exposed, regardless of the dose, as well as for family and friends. Treatment of pregnant women must account for risk to the fetus. For terrorist or accidental events involving exposure to radioiodines, prophylaxis against malignant disease of the thyroid is also recommended, particularly for children and adolescents.

  18. Data Stewardship throughout the Ocean Research Data Life Cycle

    NASA Astrophysics Data System (ADS)

    Chandler, Cynthia; Groman, Robert; Allison, Molly; Wiebe, Peter; Glover, David

    2013-04-01

    The Biological and Chemical Oceanography Data Management Office (BCO-DMO) works in partnership with ocean science investigators to publish data from research projects funded by the Biological and Chemical Oceanography Sections and the Office of Polar Programs Antarctic Organisms & Ecosystems Program (OPP ANT) at the U.S. National Science Foundation. Since 2006, researchers have been contributing data to the BCO-DMO data system, and it has developed into a rich repository of data from ocean, coastal and Great Lakes research programs. The end goals of the BCO-DMO are to ensure preservation of NSF funded project data and to provide open access to those data; achievement of those goals is attained through successful completion of a series of related phases. BCO-DMO has developed an end-to-end data stewardship process that includes all phases of the data life cycle: (1) providing data management advice to investigators during the proposal writing stage; (2) registering their funded project at BCO-DMO; (3) adding data and supporting documentation to the BCO-DMO data repository; (4) providing geospatial and text-based data access systems that support data discovery, access, display, assessment, integration, and export of data resources; (5) exploring mechanisms for exchange of data with complementary repositories; (6) publication of data sets to provide publishers of the peer-reviewed literature with citable references (Digital Object Identifiers) and to encourage proper citation and attribution of data sets in the future and (7) submission of final data sets for preservation in the appropriate long-term data archive. Strategic development of collaborative partnerships with complementary data management organizations is essential to sustainable coverage of the full data life cycle from research proposal through preservation of the final data products. Development and incorporation of controlled vocabularies, domain-specific ontologies and globally unique, persistent

  19. Performance of beef heifers grazing stockpiled fescue as influenced by supplemental whole cottonseed.

    PubMed

    Poore, M H; Scott, M E; Green, J T

    2006-06-01

    The objectives of this study were to determine the composition of stockpiled fescue from December through February over 2 yr and to determine the performance of heifers grazing stockpiled fescue with or without supplemental whole cottonseed. In early December, 36 heifers (initial BW 277 +/- 0.70 kg, yr 1; 266 +/- 2.2 kg, yr 2; and initial BCS of 5.0 +/- 0.04) were assigned randomly to 6 groups. Each group was assigned randomly to a 2.4-ha tall fescue pasture (98% endophyte infected), which had received 76 kg of N/ha on September 1. Group was the experimental unit for all measures. Forage DM available during grazing (to ground level) averaged 3,913 and 5,370 kg/ha in yr 1 and 2, respectively. The pasture was strip-grazed for 83 d, with daily forage allocation. Three groups were fed whole cottonseed (0.90 kg of DM/heifer; 24.4% CP, DM basis) daily at 0.33% of BW, and a small amount of a corn-based concentrate (0.19 kg of DM/heifer) to assure complete cottonseed consumption. Nutritive value of forage (dry basis) was determined each week by sampling each pasture to the 5-cm target grazing height. Forage disappearance was estimated every 2 wk from pre- and postgraze forage mass. Forage CP was 16.8% in yr 1 and 12.6% in yr 2. In vitro true organic matter digestibility (IVTOMD) was 82.0 and 71.9%, and ADF was 25.9 and 30.7% in yr 1 and 2, respectively. Most indicators of forage quality declined slightly through the winter, although they recovered in late winter in yr 1. The proportion of fescue that was green declined (P < 0.05) from December (79% in yr 1 and 64% in yr 2) to February (62% in yr 1 and 52% in yr 2). Green tissue averaged 20.4 and 15.2% CP, 91 and 87% IVTOMD, and 22.1 and 23.3% ADF in yr 1 and 2, respectively. Brown tissue averaged 10.3 and 8.5% CP, 64 and 62% IVTOMD, and 35.7 and 37.4% ADF in yr 1 and 2, respectively. Shrunk ADG (0.46 vs. 0.56 kg/d in yr 1 and 0.23 vs. 46 kg/d in yr 2) and change in BCS (- 0.03 vs. 0.33 in yr 1 and 0.13 vs. 0.5 in yr 2) was

  20. Data stewardship - a fundamental part of the scientific method (Invited)

    NASA Astrophysics Data System (ADS)

    Foster, C.; Ross, J.; Wyborn, L. A.

    2013-12-01

    This paper emphasises the importance of data stewardship as a fundamental part of the scientific method, and the need to effect cultural change to ensure engagement by earth scientists. It is differentiated from the science of data stewardship per se. Earth System science generates vast quantities of data, and in the past, data analysis has been constrained by compute power, such that sub-sampling of data often provided the only way to reach an outcome. This is analogous to Kahneman's System 1 heuristic, with its simplistic and often erroneous outcomes. The development of HPC has liberated earth sciences such that the complexity and heterogeneity of natural systems can be utilised in modelling at any scale, global, or regional, or local; for example, movement of crustal fluids. Paradoxically, now that compute power is available, it is the stewardship of the data that is presenting the main challenges. There is a wide spectrum of issues: from effectively handling and accessing acquired data volumes [e.g. satellite feeds per day/hour]; through agreed taxonomy to effect machine to machine analyses; to idiosyncratic approaches by individual scientists. Except for the latter, most agree that data stewardship is essential. Indeed it is an essential part of the science workflow. As science struggles to engage and inform on issues of community importance, such as shale gas and fraccing, all parties must have equal access to data used for decision making; without that, there will be no social licence to operate or indeed access to additional science funding (Heidorn, 2008). The stewardship of scientific data is an essential part of the science process; but often it is regarded, wrongly, as entirely in the domain of data custodians or stewards. Geoscience Australia has developed a set of six principles that apply to all science activities within the agency: Relevance to Government Collaborative science Quality science Transparent science Communicated science Sustained

  1. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America

    PubMed Central

    Barlam, Tamar F.; Cosgrove, Sara E.; Abbo, Lilian M.; MacDougall, Conan; Schuetz, Audrey N.; Septimus, Edward J.; Srinivasan, Arjun; Dellit, Timothy H.; Falck-Ytter, Yngve T.; Fishman, Neil O.; Hamilton, Cindy W.; Jenkins, Timothy C.; Lipsett, Pamela A.; Malani, Preeti N.; May, Larissa S.; Moran, Gregory J.; Neuhauser, Melinda M.; Newland, Jason G.; Ohl, Christopher A.; Samore, Matthew H.; Seo, Susan K.; Trivedi, Kavita K.

    2016-01-01

    Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. PMID:27080992

  2. Greenhouse gas emissions from dairy open lot and manure stockpile in northern China: A case study.

    PubMed

    Ding, Luyu; Lu, Qikun; Xie, Lina; Liu, Jie; Cao, Wei; Shi, Zhengxiang; Li, Baoming; Wang, Chaoyuan; Zhang, Guoqiang; Ren, Shixi

    2016-03-01

    The open lots and manure stockpiles of dairy farm are major sources of greenhouse gas (GHG) emissions in typical dairy cow housing and manure management system in China. GHG (CO(2), CH(4) and N(2)O) emissions from the ground level of brick-paved open lots and uncovered manure stockpiles were estimated according to the field measurements of a typical dairy farm in Beijing by closed chambers in four consecutive seasons. Location variation and manure removal strategy impacts were assessed on GHG emissions from the open lots. Estimated CO(2), CH(4) and N(2)O emissions from the ground level of the open lots were 137.5±64.7 kg hd(-1) yr(-1), 0.45±0.21 kg hd(-1) yr(-1) and 0.13±0.08 kg hd(-1) yr(-1), respectively. There were remarkable location variations of GHG emissions from different zones (cubicle zone vs. aisle zone) of the open lot. However, the emissions from the whole open lot were less affected by the locations. After manure removal, lower CH(4) but higher N(2)O emitted from the open lot. Estimated CO(2), CH(4) and N(2)O emissions from stockpile with a stacking height of 55±12 cm were 858.9±375.8 kg hd(-1) yr(-1), 8.5±5.4 kg hd(-1) yr(-1) and 2.3±1.1 kg hd(-1) yr(-1), respectively. In situ storage duration, which estimated by manure volatile solid contents (VS), would affect GHG emissions from stockpiles. Much higher N(2)O was emitted from stockpiles in summer due to longer manure storage. This study deals with greenhouse gas (GHG) emissions from open lots and stockpiles. It's an increasing area of concern in some livestock producing countries. The Intergovernmental Panel on Climate Change (IPCC) methodology is commonly used for estimation of national GHG emission inventories. There is a shortage of on-farm information to evaluate the accuracy of these equations and default emission factors. This work provides valuable information for improving accounting practices within China or for similar manure management practice in other countries.

  3. Stewardship to tackle global phosphorus inefficiency: The case of Europe.

    PubMed

    Withers, Paul J A; van Dijk, Kimo C; Neset, Tina-Simone S; Nesme, Thomas; Oenema, Oene; Rubæk, Gitte H; Schoumans, Oscar F; Smit, Bert; Pellerin, Sylvain

    2015-03-01

    The inefficient use of phosphorus (P) in the food chain is a threat to the global aquatic environment and the health and well-being of citizens, and it is depleting an essential finite natural resource critical for future food security and ecosystem function. We outline a strategic framework of 5R stewardship (Re-align P inputs, Reduce P losses, Recycle P in bioresources, Recover P in wastes, and Redefine P in food systems) to help identify and deliver a range of integrated, cost-effective, and feasible technological innovations to improve P use efficiency in society and reduce Europe's dependence on P imports. Their combined adoption facilitated by interactive policies, co-operation between upstream and downstream stakeholders (researchers, investors, producers, distributors, and consumers), and more harmonized approaches to P accounting would maximize the resource and environmental benefits and help deliver a more competitive, circular, and sustainable European economy. The case of Europe provides a blueprint for global P stewardship.

  4. Penicillin skin testing: potential implications for antimicrobial stewardship.

    PubMed

    Unger, Nathan R; Gauthier, Timothy P; Cheung, Linda W

    2013-08-01

    As the progression of multidrug-resistant organisms and lack of novel antibiotics move us closer toward a potential postantibiotic era, it is paramount to preserve the longevity of current therapeutic agents. Moreover, novel interventions for antimicrobial stewardship programs are integral to combating antimicrobial resistance worldwide. One unique method that may decrease the use of second-line antibiotics (e.g., fluoroquinolones, vancomycin) while facilitating access to a preferred β-lactam regimen in numerous health care settings is a penicillin skin test. Provided that up to 10% of patients have a reported penicillin allergy, of whom ~10% have true IgE-mediated hypersensitivity, significant potential exists to utilize a penicillin skin test to safely identify those who may receive penicillin or a β-lactam antibiotic. In this article, we provide information on the background, associated costs, currently available literature, pharmacists' role, antimicrobial stewardship implications, potential barriers, and misconceptions, as well as future directions associated with the penicillin skin test.

  5. Spatially explicit data: stewardship and ethical challenges in science.

    PubMed

    Hartter, Joel; Ryan, Sadie J; Mackenzie, Catrina A; Parker, John N; Strasser, Carly A

    2013-09-01

    Scholarly communication is at an unprecedented turning point created in part by the increasing saliency of data stewardship and data sharing. Formal data management plans represent a new emphasis in research, enabling access to data at higher volumes and more quickly, and the potential for replication and augmentation of existing research. Data sharing has recently transformed the practice, scope, content, and applicability of research in several disciplines, in particular in relation to spatially specific data. This lends exciting potentiality, but the most effective ways in which to implement such changes, particularly for disciplines involving human subjects and other sensitive information, demand consideration. Data management plans, stewardship, and sharing, impart distinctive technical, sociological, and ethical challenges that remain to be adequately identified and remedied. Here, we consider these and propose potential solutions for their amelioration.

  6. Antibiotic stewardship through the EU project "ABS International".

    PubMed

    Allerberger, Franz; Frank, Annegret; Gareis, Roland

    2008-01-01

    The increasing problem of antimicrobial resistance requires implementation of antibiotic stewardship (ABS) programs. The project "ABS International--implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the European Union" was started in September 2006 in Austria, Belgium, the Czech Republic, Germany, Hungary, Italy, Poland, Slovenia and Slovakia. A training program for national ABS trainers was prepared and standard templates for ABS tools (antibiotic list, guides for antibiotic treatment and surgical prophylaxis, antibiotic-related organization) and valid process measures, as well as quality indicators for antibiotic use were developed. Specific ABS tools are being implemented in up to five healthcare facilities in each country. Although ABS International clearly focuses on healthcare institutions, future antimicrobial stewardship programs must also cover public education and antibiotic prescribing in primary care.

  7. Antimicrobial stewardship: application in the intensive care unit.

    PubMed

    Owens, Robert C

    2009-09-01

    Critical-care units can be barometers for appropriate antimicrobial use. There, life and death hang on empirical antimicrobial therapy for treatment of infectious diseases. With increasing therapeutic empiricism, triple-drug, broad-spectrum regimens are often necessary, but cannot be continued without fear of the double-edged sword: a life-saving intervention or loss of life following Clostridium difficile infection, infection from a resistant organism, nephrotoxicity, cardiac toxicity, and so on. While broadened initial empirical therapy is considered a standard, it must be necessary, dosed according to pharmacokinetic-pharmacodynamic principles, and stopped when no longer needed. Antimicrobial stewardship interventions shepherd these considerations in antimicrobial therapy. With pharmacists and physicians trained in infectious disease and critical care, clear-cut interventions can be focused on beginning or growing a stewardship program, or proposing future studies.

  8. Spatially Explicit Data: Stewardship and Ethical Challenges in Science

    PubMed Central

    Hartter, Joel; Ryan, Sadie J.; MacKenzie, Catrina A.; Parker, John N.; Strasser, Carly A.

    2013-01-01

    Scholarly communication is at an unprecedented turning point created in part by the increasing saliency of data stewardship and data sharing. Formal data management plans represent a new emphasis in research, enabling access to data at higher volumes and more quickly, and the potential for replication and augmentation of existing research. Data sharing has recently transformed the practice, scope, content, and applicability of research in several disciplines, in particular in relation to spatially specific data. This lends exciting potentiality, but the most effective ways in which to implement such changes, particularly for disciplines involving human subjects and other sensitive information, demand consideration. Data management plans, stewardship, and sharing, impart distinctive technical, sociological, and ethical challenges that remain to be adequately identified and remedied. Here, we consider these and propose potential solutions for their amelioration. PMID:24058292

  9. Lessons Learned in Antibiotic Stewardship: Fluoroquinolone Use in Pediatrics.

    PubMed

    Hersh, Adam L; Gerber, Jeffrey S; Hicks, Lauri A; Pavia, Andrew T

    2015-03-01

    The use of fluoroquinolones differs dramatically between adult and pediatric patients. For adults, they are the leading class of antibiotics prescribed in ambulatory care visits whereas in children, they are the least frequently prescribed class. The reasons for this difference in practice likely relate to perceptions of their potential for harm. This highlights the impact of physicians' perception of direct patient harm in antibiotic decision making which has implications for antibiotic stewardship.

  10. Antimicrobial stewardship programs - cost-minimizing or cost-effective?

    PubMed

    You, Joyce

    2015-02-01

    Antimicrobial stewardship programs (ASPs) are aimed to improve patient care and health care outcomes. It is encouraging to find ASP interventions to be cost-saving in many cost-minimization analyses in literature. Nevertheless, the cost-effectiveness of ASP interventions, measured in cost per quality-adjusted life-years, is less well-established. This Editorial aims to explore the barriers in assessing clinical effectiveness of ASPs and provide suggestions to conduct cost-effectiveness analysis of ASPs.

  11. SEAFRAME. Stewardship Capabilities. Volume 2, Issue 2, 2006

    DTIC Science & Technology

    2006-01-01

    Navy photo . Below: USS Ronald Reagan (CVN 76) underway. Official Navy photo . Collage by Gloria Patterson, NSWC Carderock Division...quick and robust computational tool capable of predicting the drag of many types of high-speed ship designs. Photo by Martin Sheehan, NSWC Carderock...step, we initiated a technical health assessment (THA) to fully examine our stewardship goals. This tool allows us to better understand the essential

  12. Pediatrician perceptions of an outpatient antimicrobial stewardship intervention.

    PubMed

    Szymczak, Julia E; Feemster, Kristen A; Zaoutis, Theoklis E; Gerber, Jeffrey S

    2014-10-01

    Inappropriate antibiotic prescribing commonly occurs in pediatric outpatients with acute respiratory tract infections. Antimicrobial stewardship programs are recommended for use in the hospital, but less is known about whether and how they will work in the ambulatory setting. Following a successful cluster-randomized trial to improve prescribing for common acute respiratory tract infections using education plus audit and feedback in a large, pediatric primary care network, we sought to explore the perceptions of the intervention and antibiotic overuse among participating clinicians. We conducted a qualitative study using semistructured interviews with 24 pediatricians from 6 primary care practices who participated in an outpatient antimicrobial stewardship intervention. All interviews were transcribed and analyzed using a modified grounded theory approach. Deep skepticism of the audit and feedback reports emerged. Respondents ignored reports or expressed distrust about them. One respondent admitted to gaming behavior. When asked about antibiotic overuse, respondents recognized it as a problem, but they believed it was driven by the behaviors of nonpediatric physicians. Parent pressure for antibiotics was identified by all respondents as a major barrier to the more judicious use of antibiotics. Respondents reported that they sometimes "caved" to parent pressure for social reasons. To improve the effectiveness and sustainability of outpatient antimicrobial stewardship, it is critical to boost the credibility of audit data, engage primary care pediatricians in recognizing that their behavior contributes to antibiotic overuse, and address parent pressure to prescribe antibiotics.

  13. Planetary stewardship in an urbanizing world: beyond city limits.

    PubMed

    Seitzinger, Sybil P; Svedin, Uno; Crumley, Carole L; Steffen, Will; Abdullah, Saiful Arif; Alfsen, Christine; Broadgate, Wendy J; Biermann, Frank; Bondre, Ninad R; Dearing, John A; Deutsch, Lisa; Dhakal, Shobhakar; Elmqvist, Thomas; Farahbakhshazad, Neda; Gaffney, Owen; Haberl, Helmut; Lavorel, Sandra; Mbow, Cheikh; McMichael, Anthony J; Demorais, Joao M F; Olsson, Per; Pinho, Patricia Fernanda; Seto, Karen C; Sinclair, Paul; Stafford Smith, Mark; Sugar, Lorraine

    2012-12-01

    Cities are rapidly increasing in importance as a major factor shaping the Earth system, and therefore, must take corresponding responsibility. With currently over half the world's population, cities are supported by resources originating from primarily rural regions often located around the world far distant from the urban loci of use. The sustainability of a city can no longer be considered in isolation from the sustainability of human and natural resources it uses from proximal or distant regions, or the combined resource use and impacts of cities globally. The world's multiple and complex environmental and social challenges require interconnected solutions and coordinated governance approaches to planetary stewardship. We suggest that a key component of planetary stewardship is a global system of cities that develop sustainable processes and policies in concert with its non-urban areas. The potential for cities to cooperate as a system and with rural connectivity could increase their capacity to effect change and foster stewardship at the planetary scale and also increase their resource security.

  14. Antimicrobial stewardship and Clostridium difficile-associated diarrhea.

    PubMed

    Piacenti, Frank J; Leuthner, Kimberly D

    2013-10-01

    Antimicrobial stewardship programs are essential to health care institutions to promote the appropriate use of antibiotics not only to decrease antimicrobial resistance but to prevent the spread and infection of Clostridium difficile. Clostridium difficile-associated diarrhea is increasing rapidly in the United States and is now considered a major public health problem that poses an immediate threat to the health of patients prescribed antibiotics, more so than antimicrobial resistance. Clostridium difficile-associated disease is the result of collateral damage to the normal bacterial flora of the human body, which is an inevitable consequence of any antibiotic use. Antimicrobial stewardship programs such as audit with feedback and antibiotic restriction are designed to help limit Clostridium difficile infections and other hospital-associated organisms by optimizing antimicrobial selection, dosing, de-escalation, and duration of therapy. These programs also incorporate implementation of hospital-wide guidelines, staff education, enforcement of infection-control policies, and the use of electronic medical records when possible to help control antibiotic use. This article reviews the literature on how antimicrobial stewardship programs impact Clostridium difficile rates and discusses experiences in designing, implementing, monitoring, and follow-through of such programs.

  15. Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

    PubMed

    Pfaller, Michael A; Castanheira, Mariana

    2016-01-01

    Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis.

  16. License Stewardship Approach to Commercial Nuclear Power Plant Decommissioning

    SciTech Connect

    Daly, P.T.; Hlopak, W.J.

    2008-07-01

    The paper explores both the conceptual approach to decommissioning commercial nuclear facilities using a license stewardship approach as well as the first commercial application of this approach. The license stewardship approach involves a decommissioning company taking control of a site and the 10 CFR 50 License in order to complete the work utilizing the established trust fund. In conclusion: The license stewardship approach is a novel way to approach the decommissioning of a retired nuclear power plant that offers several key advantages to all parties. For the owner and regulators, it provides assurance that the station will be decommissioned in a safe, timely manner. Ratepayers are assured that the work will be completed for the price they already have paid, with the decommissioning contractor assuming the financial risk of decommissioning. The contractor gains control of the assets and liabilities, the license, and the decommissioning fund. This enables the decommissioning contractor to control their work and eliminates redundant layers of management, while bringing more focus on achieving the desired end state - a restored site. (authors)

  17. The cause and effect of exclusionary zoning within a jurisdiction, and, The stockpile of petroleum needed to contain OPEC's price shocks

    NASA Astrophysics Data System (ADS)

    Vatter, Marc H.

    In Part I, I model a jurisdiction where residents differ by income, and housing confers benefits on neighbors. By majority vote, residents choose minima on consumption of housing that differ by neighborhood, and they separate into neighborhoods by income. In practice, such laws take the form of minimum lot sizes, bans on multi-family units, building codes, and other restrictions. This policy maximizes a benefit-cost welfare criterion. Alternative policies include no minima and a uniform minimum citywide, based on libertarian and utilitarian welfare criteria, respectively. I compare the policies in terms of efficiency, implementability, and distributional consequences, and give numerical examples based on U.S. data. Willingness to pay for the benefit-cost optimum is convex in income. This helps to explain why neighborhood stratification by income has outpaced stratification of income itself in U.S metropolitan areas since 1970. In the examples, gains to a rich household are in the thousands and losses to the poor in the hundreds of dollars annually. In Part II, I estimate the stockpile of petroleum sufficient to contain a price shock perpetrated by the OPEC. I estimate world demand for petroleum such that the long run price elasticity exceeds that in the short run, and supply from non-OPEC producers with a similar kind of lagged response. Given this structure for elasticities, OPEC profits from sudden increases in price. I simulate interaction among consumers, non-OPEC producers, OPEC, and an International Energy Agency (IEA) that punishes OPEC by releasing oil onto the market. I endow the IEA with increasingly large stockpiles until they suffice to limit price shocks to specified levels. Every 5 reduction in the shock raises present-valued world GDP by about 650 billion. The IEA now has 1.4 billion barrels of petroleum, including 700 million in the U.S. Strategic Petroleum Reserve. A 3 billion barrel stockpile would suffice to reduce a 35 price shock to 20, raising

  18. Achievements and challenges for the use of killed oral cholera vaccines in the global stockpile era.

    PubMed

    Desai, Sachin N; Pezzoli, Lorenzo; Alberti, Kathryn P; Martin, Stephen; Costa, Alejandro; Perea, William; Legros, Dominique

    2016-11-04

    Cholera remains an important but neglected public health threat, affecting the health of the poorest populations and imposing substantial costs on public health systems. Cholera can be eliminated where access to clean water, sanitation, and satisfactory hygiene practices are sustained, but major improvements in infrastructure continue to be a distant goal. New developments and trends of cholera disease burden, the creation of an affordable cholera vaccine for use in developing countries, as well as recent evidence of vaccination impact has created an increased demand for oral cholera vaccine (OCV). The global OCV stockpile was established in 2013 and with support from Gavi, has assisted in achieving rapid access to vaccine in emergencies. Recent WHO prequalification of a second affordable OCV supports the stockpile goals of increased availability and distribution to affected populations. It serves as an essential step towards an integrated cholera control and prevention strategy in emergency and endemic settings.

  19. Estimating Landholders’ Probability of Participating in a Stewardship Program, and the Implications for Spatial Conservation Priorities

    PubMed Central

    Adams, Vanessa M.; Pressey, Robert L.; Stoeckl, Natalie

    2014-01-01

    The need to integrate social and economic factors into conservation planning has become a focus of academic discussions and has important practical implications for the implementation of conservation areas, both private and public. We conducted a survey in the Daly Catchment, Northern Territory, to inform the design and implementation of a stewardship payment program. We used a choice model to estimate the likely level of participation in two legal arrangements - conservation covenants and management agreements - based on payment level and proportion of properties required to be managed. We then spatially predicted landholders’ probability of participating at the resolution of individual properties and incorporated these predictions into conservation planning software to examine the potential for the stewardship program to meet conservation objectives. We found that the properties that were least costly, per unit area, to manage were also the least likely to participate. This highlights a tension between planning for a cost-effective program and planning for a program that targets properties with the highest probability of participation. PMID:24892520

  20. Human resources needed to perform antimicrobial stewardship teams' activities in French hospitals.

    PubMed

    Le Coz, P; Carlet, J; Roblot, F; Pulcini, C

    2016-06-01

    In January 2015, the French ministry of Health set up a task force on antibiotic resistance. Members of the task force's "antimicrobial stewardship" group conducted a study to evaluate the human resources needed to implement all the required activities of the multidisciplinary antimicrobial stewardship teams (AST - antibiotic/infectious disease lead supervisors, microbiologists, and pharmacists) in French healthcare facilities. We conducted an online cross-sectional nationwide survey. The questionnaire was designed based on regulatory texts and experts' consensus. The survey took place between March and May 2015. We used the mailing list of the French Infectious Diseases Society (SPILF) to send out questionnaires. A total of 65 healthcare facilities completed the questionnaire. The human resources needed to implement all AST's activities were estimated at 3.6 full-time equivalent (FTE) positions/1000 acute care beds for antibiotic/infectious disease lead supervisors, at 2.5 FTE/1000 beds for pharmacists, and at 0.6 FTE/1000 beds for microbiologists. This almost amounts to a total of 2000 FTE positions for all healthcare facilities (public and private) in France and to an annual cost of 200 million euros. Dedicated and sustainable funding for AST is urgently needed to implement comprehensive and functional AST programs in all healthcare facilities. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Mobile health application to assist doctors in antibiotic prescription - an approach for antibiotic stewardship.

    PubMed

    Tuon, Felipe Francisco; Gasparetto, Juliano; Wollmann, Luciana Cristina; Moraes, Thyago Proença de

    2017-09-20

    Technologies applied to mobile devices can be an important strategy in antibiotic stewardship programs. The aim of this study was to determine the impact of a decision-making application on antibiotic prescription. This was an observational, analytical and longitudinal study on the implementation of an antimicrobial guide for mobile application (app). This study analyzed the period of 12 months before and 12 months after the app implementation at a university hospital based on local epidemiology, avoiding high cost drugs and reducing the potential for drug resistance including carbapenem. Antimicrobials consumption was evaluated in DDD/1000 patients-day and direct expenses converted into USD. The monthly average consumption of aminoglycosides and cefepime had a statistically significant increase (p<0.05), while the consumption of piperacillin/tazobactam and meropenem was significantly decreased (p<0.05). The sensitivity to meropenem as well as to polymyxin increased after the app implementation. A decrease in sensitivity to cefepime was observed after introduction of this antibiotic as a substitute of piperacillin/tazobactam for treating intra-hospital infections. There was a net saving of USD 296,485.90 (p<0.05). An antibiotic protocol in the app can help antibiotic stewardship reducing cost, changing the microbiological profile and antimicrobial consumption. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

  2. Assessing Information Quality: Use Cases for the Data Stewardship Maturity Matrix

    NASA Astrophysics Data System (ADS)

    Hou, C. Y.; Mayernik, M. S.; Peng, G.; Duerr, R.; Rosati, A.

    2015-12-01

    Information Quality (IQ) is an important characteristic of a data repository. Being recognized for providing "good" or "high" quality information enables trust to be built between the data repository and its communities, and therefore, fosters collaborations and potentially improves the utility of its data holdings. However, currently, a common standard or framework does not exist to allow IQ to be assessed consistently across different data repositories. There are several aspects that need to be considered when evaluating IQ. In particular, the data stewardship practices applied to datasets during the curation process can have significant impact on the accessibility, usability, understandability, and integrity of the datasets over time. The Data Stewardship Maturity Matrix (DSMM) provides a framework for the evaluation of a dataset's quality based on nine distinct categories. For each of the categories, the DSMM provides criteria that can be used to apply a 5-level rating to an individual dataset, ranging from Ad Hoc to Optimal. This presentation introduces the overview of the DSMM and the recommended process for using DSMM to evaluate the quality of a dataset. The presentation will also provide the key findings after applying the DSMM to several datasets, including those from the Advanced Cooperative Arctic Data and Information Service, the National Center for Atmospheric Research, and the Long Term Ecological Research's Santa Barbara Coastal site. The presentation concludes by summarizing the crucial lessons learned and the potential benefits when a data repository uses the DSMM to assess and convey the quality of its datasets.

  3. Certainty in Stockpile Computing: Recommending a Verification and Validation Program for Scientific Software

    SciTech Connect

    Lee, J.R.

    1998-11-01

    As computing assumes a more central role in managing the nuclear stockpile, the consequences of an erroneous computer simulation could be severe. Computational failures are common in other endeavors and have caused project failures, significant economic loss, and loss of life. This report examines the causes of software failure and proposes steps to mitigate them. A formal verification and validation program for scientific software is recommended and described.

  4. Exceptions or alternatives to labeling requirements for products held by the Strategic National Stockpile. Final rule.

    PubMed

    2012-02-06

    The Food and Drug Administration (FDA) is adopting as a final rule, without change, the interim final rule that issued regulations permitting FDA Center Directors to grant exceptions or alternatives to certain regulatory labeling requirements applicable to human drugs, biological products, or medical devices that are or will be included in the Strategic National Stockpile (SNS). FDA is taking this action to complete the rulemaking initiated with the interim final rule.

  5. Coal face and stockpile ash analyser for the coal mining industry.

    PubMed

    Borsaru, M; Dixon, R; Rojc, A; Stehle, R; Jecny, Z

    2001-09-01

    A portable nucleonic instrument was developed for the determination of coal ash on the coal face or the surface of coal stockpiles. The instrument employs the backscattered gamma-gamma technique. There are two gamma-ray sources used in this instrument: a 1.1 MBq 133Ba source as the primary source of radiation and a 37 kBq 137Cs for gain stabilization. The instrument is commercially available.

  6. Organic Amendment Effects on Greenhouse Gas Emissions from Long-Term Stockpiled Soils

    NASA Astrophysics Data System (ADS)

    Zvomuya, F.; Laskosky, J.

    2014-12-01

    In oil sands projects in Alberta, Canada, salvaged soils are often placed in large stockpiles where they are stored for the duration of the project, typically 20-30 years. Alberta regulations require that topsoil and subsoil are salvaged in two distinct operations - a process known as two-lifting. Reclamation using long-term stockpiled soils often gives poor results, characterized by lower soil organic carbon and nitrogen concentrations compared with equivalent natural, undisturbed soils. It is thought that the change from an aerobic to an anaerobic environment during soil stockpiling and back again to aerobic during placement are largely responsible for the low carbon and nitrogen due to microbial activity transforming C and N in the soil into CO2, CH4 and N2O and releasing them to the atmosphere. Evidence from recent studies indicates that biochar improves soil physical, chemical and biological properties, and hence could mitigate C and N losses due to greenhouse gas emissions from the soil indirectly. We postulate that documented improvements in soil physical, chemical, and biological properties in soils treated with amendments such as biochar may help mitigate C and N losses due to greenhouse gas emissions from the soil indirectly. This laboratory incubation experiment tested the effects of differential rates (0, 10, 20, and 40 g biochar carbon equivalents kg-1 dry soil) of biochar, peat, and humalite on greenhouse gas emissions from a 25-year old two-lift stockpiled soil. The soils were fertilized according to standard practice, placed in 120-mL plastic containers, and incubated at 25°C for 45 days. Gas samples were taken at 1- to 7-day intervals and analyzed for CO2, CH4, and N2O. Data on treatment differences in emissions will be presented. Results from this experiment will provide an insight into the potential for organic amendments to mitigate greenhouse gas emission during reclamation using degraded soils.

  7. Noninvasive Weight Determination of In-Place Ore Stockpiles at Six Defense Depots

    DTIC Science & Technology

    1998-06-01

    possible to determine the actual bulk density of the material comprising the structure directly from the gravity measurements ( Nettleton 1940...from the microgravity readings. Three methods were used to determine the density of the stockpiled ores. The first method, developed by Nettleton ...acquired using a Topcon GTS-3C total station system with accompanying data collector, theodolite, and laser rangefinder at the New Haven, Warren, and

  8. Comparative Cost of Stockpiling Various Types of Respiratory Protective Devices to Protect the Health Care Workforce During an Influenza Pandemic.

    PubMed

    Baracco, Gio; Eisert, Sheri; Eagan, Aaron; Radonovich, Lewis

    2015-06-01

    Specific guidance on the size and composition of respiratory protective device (RPD) stockpiles for use during a pandemic is lacking. We explore the economic aspects of stockpiling various types and combinations of RPDs by adapting a pandemic model that estimates the impact of a severe pandemic on a defined population, the number of potential interactions between patients and health care personnel, and the potential number of health care personnel needed to fulfill those needs. Our model calculates the number of the different types of RPDs that should be stockpiled and the consequent cost of purchase and storage, prorating this cost over the shelf life of the inventory. Compared with disposable N95 or powered air-purifying respirators, we show that stockpiling reusable elastomeric half-face respirators is the least costly approach. Disposable N95 respirators take up significantly more storage space, which increases relative costs. Reusing or extending the usable period of disposable devices may diminish some of these costs. We conclude that stockpiling a combination of disposable N95 and reusable half-face RPDs is the best approach to preparedness for most health care organizations. We recommend against stockpiling powered air-purifying respirators as they are much more costly than alternative approaches.

  9. Lifetime predictions for alumina ceramics used in nuclear weapons stockpile components

    SciTech Connect

    Glass, S.J.; Monroe, S.L.; Newton, C.

    1997-09-01

    Ceramic materials are used extensively in non-nuclear components in the weapons stockpile including neutron tubes, firing sets, radar, strong link and weak link assemblies, batteries, and current/voltage stacks. Ceramics also perform critical functions in electronics, passively as insulators and actively as resistors and capacitors. Glass and ceramic seals also provide hermetic electrical feedthroughs in connectors for many weapons components. The primary goal of the ceramic material lifetime prediction program is to provide the enhanced surveillance program with the capability to specify the reliability and lifetimes of glass and ceramic-containing components under conditions typical of the stockpile environment. The authors have studied the reliability and subcritical crack growth (SCG) behavior of 94% alumina (Al{sub 2}O{sub 3}), which is likely the most common ceramic in the stockpile. Measurements have been made on aluminas manufactured by four war reserve qualified vendors (Coors, Wesgo, AlSiMag, and Diamonite). These materials are expected to be representative of typical product obtained from vendors who have supplied alumina for weapons components during the past several decades.

  10. U.S. Army chemical demilitarization and remediation activity non-stockpile monitoring approach

    SciTech Connect

    Queen, J.; Miskelly, P.; Chatfield, M.J.

    1995-06-01

    In Section 176 of Public Law (PL) 102-484, the 1993 Defense Authorization Act, Congress directed the U.S. Army to submit a report identifying the locations, types, and quantities of non-stockpile chemical material (NSCM). As part of that report, published in the Survey and Analysis Report for the Non-Stockpile Chemical Material Program, five categories of NSCM were addressed: buried chemical warfare material (CWM); recovered chemical weapons- and miscellaneous CWM. To better define the scope of CWM burial sites, four separate types of sites were discussed-chemical agent identification set (CAIS) burials, small CWM burial sites with no explosives, small CWM burial sites with explosives, and large CWM burial sites (with and without explosives). A total of 215 potential CWM burial sites, distributed throughout 33 states, the U.S. Virgin Islands, and the District of Columbia, were identified. This article describes the rapid response system; CAIS characterization and disposal; monitoring during RRS operations; monitoring standards, and the non-stockpile monitoring program.

  11. The Critical Role of the Staff Nurse in Antimicrobial Stewardship--Unrecognized, but Already There.

    PubMed

    Olans, Richard N; Olans, Rita D; DeMaria, Alfred

    2016-01-01

    An essential participant in antimicrobial stewardship who has been unrecognized and underutilized is the "staff nurse." Although the role of staff nurses has not formally been recognized in guidelines for implementing and operating antimicrobial stewardship programs (ASPs) or defined in the medical literature, they have always performed numerous functions that are integral to successful antimicrobial stewardship. Nurses are antibiotic first responders, central communicators, coordinators of care, as well as 24-hour monitors of patient status, safety, and response to antibiotic therapy. An operational analysis of inpatient admissions evaluates these nursing stewardship activities and analyzes the potential benefits of nurses' formal education about, and inclusion into, ASPs.

  12. 2015 National Agenda for Digital Stewardship

    DTIC Science & Technology

    2014-09-01

    unimpeded.5 Commercial services such as Amazon Glacier , Rosetta, Preservica and community-based platforms such as LOCKSS, DuraCloud, and the Digital...continue unimpeded.10 Commercial services such as Amazon Glacier , Rosetta, Preservica and community-based platforms such as LOCKSS, Duraspace, and the

  13. Stewardship of the environment in emerging nations

    SciTech Connect

    Carlson, T.

    1997-06-01

    This paper discusses the development of an environmentally friendly synthetic oil-based mud (SBM) and its use on numerous exploration and development wells in Nigeria. The cost effectiveness of using the system along with environmental issues are discussed to show how using new technology can benefit both the operator and the host country. After four years of research and development, a fluid was developed that utilized a vegetable-based ester as the continuous phase. The ester based mud (EBM) was introduced into the North Sea in late 1989 and has since gone on to successfully drill hundreds of wells throughout the world. The EBM developed in 1989 has won environmental approval by Environmental Regulators in the most active drilling areas of the world. A truly unique characteristic of EBM is its ability to biodegrade under both aerobic as well as anaerobic conditions.

  14. Idaho National Laboratory Comprehensive Land Use and Environmental Stewardship Report

    SciTech Connect

    No name listed on publication

    2011-08-01

    Land and facility use planning and decisions at the Idaho National Laboratory (INL) Site are guided by a comprehensive site planning process in accordance with Department of Energy Policy 430.1, 'Land and Facility Use Policy,' that integrates mission, economic, ecologic, social, and cultural factors. The INL Ten-Year Site Plan, prepared in accordance with Department of Energy Order 430.1B, 'Real Property Asset Management,' outlines the vision and strategy to transform INL to deliver world-leading capabilities that will enable the Department of Energy to accomplish its mission. Land use planning is the overarching function within real property asset management that integrates the other functions of acquisition, recapitalization, maintenance, disposition, real property utilization, and long-term stewardship into a coordinated effort to ensure current and future mission needs are met. All land and facility use projects planned at the INL Site are considered through a formal planning process that supports the Ten-Year Site Plan. This Comprehensive Land Use and Environmental Stewardship Report describes that process. The land use planning process identifies the current condition of existing land and facility assets and the scope of constraints across INL and in the surrounding region. Current land use conditions are included in the Comprehensive Land Use and Environmental Stewardship Report and facility assets and scope of constraints are discussed in the Ten-Year Site Plan. This report also presents the past, present, and future uses of land at the INL Site that are considered during the planning process, as well as outlining the future of the INL Site for the 10, 30, and 100-year timeframes.

  15. Fresh, stockpiled, and composted beef cattle feedlot manure: nutrient levels and mass balance estimates in Alberta and Manitoba.

    PubMed

    Larney, Francis J; Buckley, Katherine E; Hao, Xiying; McCaughey, W Paul

    2006-01-01

    The fate of manure nutrients in beef cattle (Bos taurus) feedlots is influenced by handling treatment, yet few data are available in western Canada comparing traditional practices (fresh handling, stockpiling) with newer ones (composting). This study examined the influence of handling treatment (fresh, stockpiled, or composted) on nutrient levels and mass balance estimates of feedlot manure at Lethbridge, Alberta, and Brandon, Manitoba. Total carbon (TC) concentration of compost (161 kg Mg(-1)) was lower (P < 0.001) than stockpiled (248 kg Mg(-1)), which was in turn lower (P < 0.001) than fresh manure (314 kg Mg(-1)). Total nitrogen (TN) concentration was not affected by handling treatment while total phosphorus (TP) concentration increased with composting at Lethbridge. The percent inorganic nitrogen (PIN) was lower (P < 0.01) for compost (5.1%) than both fresh (24.7%) and stockpiled (28.9%) manure. Composting led to higher (P < 0.05) dry matter (DM) losses (39.8%) compared to stockpiling (22.5%) and higher (P < 0.05) total mass (water + DM) losses (65.6 vs. 35.2%). Carbon (C) losses were higher (P < 0.01) with composting (66.9% of initial) than with stockpiling (37.5%), as were nitrogen (N) losses (46.3 vs. 22.5%, P < 0.05). Composting allowed transport of two times as much P as fresh manure and 1.4 times as much P as stockpiled manure (P < 0.001) on an "as is" basis. Our study looked at one aspect of manure management (i.e., handling treatment effects on nutrient concentrations and mass balance estimates) and, as such, should be viewed as one component in the larger context of a life cycle assessment.

  16. Antibiotic use in US hospitals: quantification, quality measures and stewardship.

    PubMed

    Reddy, Sujan C; Jacob, Jesse T; Varkey, Jay B; Gaynes, Robert P

    2015-07-01

    A majority of patients hospitalized in the US hospitals receive an antibiotic during their hospitalization. Furthermore, up to half of antibiotics prescribed in hospitals are inappropriate. In the setting of continued emergence of antibiotic-resistant pathogens and a limited pipeline of new antimicrobials, attention to optimizing antibiotic use in healthcare settings is essential. We review the measures of antibiotic consumption in the USA, the evolving metrics for comparing antibiotic use (known as benchmarking), trends in antibiotic use, the structure and outcome measures of Antimicrobial Stewardship Programs and interventions to optimize antimicrobial use.

  17. Sensors for environmental monitoring and long-term environmental stewardship.

    SciTech Connect

    Miller, David Russell; Robinson, Alex Lockwood; Ho, Clifford Kuofei; Davis, Mary Jo

    2004-09-01

    This report surveys the needs associated with environmental monitoring and long-term environmental stewardship. Emerging sensor technologies are reviewed to identify compatible technologies for various environmental monitoring applications. The contaminants that are considered in this report are grouped into the following categories: (1) metals, (2) radioisotopes, (3) volatile organic compounds, and (4) biological contaminants. Regulatory drivers are evaluated for different applications (e.g., drinking water, storm water, pretreatment, and air emissions), and sensor requirements are derived from these regulatory metrics. Sensor capabilities are then summarized according to contaminant type, and the applicability of the different sensors to various environmental monitoring applications is discussed.

  18. Analysis of S.139, the Climate Stewardship Act of 2003

    EIA Publications

    2003-01-01

    On January 9, 2003, Senators John McCain and Joseph I. Lieberman introduced Senate Bill 139 (S.139), the Climate Stewardship Act of 2003, in the U.S. Senate. S.139 would require the Administrator of the U.S. Environmental Protection Agency (EPA) to promulgate regulations to limit greenhouse gas emissions. On January 28, 2003, Senator James M. Inhofe requested that the Energy Information Administration (EIA) perform a comprehensive analysis of S.139. On April 2, 2003, Senators McCain and Lieberman, cosponsors of S.139, made a further request for analyses of their bill. This Service Report responds to both requests.

  19. Donor Relations: The Essential Guide to Stewardship Policies, Procedures, and Protocol. The Newcomer Series.

    ERIC Educational Resources Information Center

    Taylor, Karla, Ed.; Joyce, Shannon, Ed.

    This book discusses various facets of stewardship as it applies specifically to philanthropy and donor relations for institutions of higher education. Stewardship is defined as a way of preserving opportunities for further support, as the legal and public relations protection of institutions, and as a "right" thing to do. Following an…

  20. 76 FR 23335 - Wilderness Stewardship Plan/Environmental Impact Statement, Sequoia and Kings Canyon National...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-26

    ... National Park Service Wilderness Stewardship Plan/Environmental Impact Statement, Sequoia and Kings Canyon... Intent to Prepare Environmental Impact Statement for Wilderness Stewardship Plan, Sequoia and Kings Canyon National Parks. SUMMARY: In accordance with Sec. 102(2)(C) of the National Environmental Policy...

  1. Communicating the value and benefits of silviculture through partnerships and collaborative stewardship

    Treesearch

    Leslie A. C. Weldon

    1997-01-01

    Opening comments to this session share observations on the current management climate within the USDA Forest Service. Partnerships and collaborative stewardship as agency philosophy are discussed. Silviculturists roles, as scientists and managers are compared, and the need for internal and external cooperation stressed as we strive to meet forest stewardship goals....

  2. Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

    PubMed

    Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

    2016-03-01

    We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting.

  3. 76 FR 11243 - Solicitation of Input From Stakeholders To Inform the National Framework for Electronics Stewardship

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-01

    ...The Environmental Protection Agency (EPA), General Services Administration (GSA), and Council on Environmental Quality (CEQ) are requesting written stakeholder input to inform the national framework for electronics stewardship that is being developed by the Interagency Task Force on Electronics Stewardship. On November 15, 2010, President Obama signed a presidential proclamation celebrating......

  4. Donor Relations: The Essential Guide to Stewardship Policies, Procedures, and Protocol. The Newcomer Series.

    ERIC Educational Resources Information Center

    Taylor, Karla, Ed.; Joyce, Shannon, Ed.

    This book discusses various facets of stewardship as it applies specifically to philanthropy and donor relations for institutions of higher education. Stewardship is defined as a way of preserving opportunities for further support, as the legal and public relations protection of institutions, and as a "right" thing to do. Following an…

  5. Stewardship of the Evolving Scholarly Record: From the Invisible Hand to Conscious Coordination

    ERIC Educational Resources Information Center

    Lavoie, Brian; Malpas, Constance

    2015-01-01

    The long-term future of the scholarly record in its fullest expression cannot be effectively secured with stewardship strategies designed for print materials. The features of the evolving scholarly record suggest that traditional stewardship strategies, built on an "invisible hand" approach that relies on the uncoordinated,…

  6. Perceived Change in Leadership Skills as a Result of the Wilderness Education Association Wilderness Stewardship Course.

    ERIC Educational Resources Information Center

    Hobbs, Elisabeth; Spencer, Steve

    A study examined the impact of a Wilderness Education Association Wilderness Stewardship course on students' leadership skills development. Twelve students at Western Kentucky University completed the Leadership Skills Inventory (LSI) before and after a 2-week Wilderness Stewardship course that included ten days of field experience in camping,…

  7. Performance of beef cows and calves fed different sources of rumen-degradable protein when grazing stockpiled limpograss pastures.

    PubMed

    Aguiar, A D; Vendramini, J M B; Arthington, J D; Sollenberger, L E; DiLorenzo, N; Hersom, M J

    2015-04-01

    /100 mol) as well as branched-chain VFA (1.3 ± 2.2 mol/100 mol) concentrations in the rumen. In addition, there was no difference (P = 0.91) in PUN (7.9 ± 0.3 mg/dL) concentration between treatments. Therefore, urea can be as effective as CSM as the main source of RDP in the molasses-based supplement offered to mature lactating beef cows grazing stockpiled limpograss pastures.

  8. NEAR REAL TIME CHARACTERIZATION OF BNL STOCKPILED SOILS, ANOTHER ASTD SUCCESS STORY.

    SciTech Connect

    BOWERMAN,B.S.; ADAMS,J.W.; KALB,P.D.; LOCKWOOD,A.

    2003-02-23

    As of October 2001, approximately 7,000 yd{sup 3} of stockpiled soil, contaminated to varying degrees with radioactive materials and heavy metals, remained at Brookhaven National Laboratory (BNL) after the remediation of the BNL Chemical/Animal/Glass Pits disposal area. During the 1997 removal action, the more hazardous/radioactive materials were segregated, along with, chemical liquids and solids, animal carcasses, intact gas cylinders, and a large quantity of metal and glass debris. Nearly all of these materials have been disposed of. In order to ensure that all debris was removed and to characterize the large quantity of heterogeneous soil, BNL initiated an extended sorting, segregation, and characterization project, co-funded by the BNL Environmental Management Directorate and the DOE EM Office of Science and Technology Accelerated Site Technology Deployment (ASTD) program. Project objectives were to remove any non-conforming items, and to assure that mercury and radioactive contaminant levels were within acceptable limits for disposal as low-level radioactive waste. Sorting and segregation were conducted simultaneously. Large stockpiles, ranging from 150 to 1,200 yd{sup 3}, were subdivided into manageable 20 yd{sup 3} ''subpiles'' after powered vibratory screening. The 1/2 inch screen removed gravel and almost all non-conforming items, which were separated for further characterization. Soil that passed through the screen was also visually inspected before being moved to a subpile. Eight samples plus QA duplicates were collected from each subpile for chemical analysis, and a 1-Liter jar of material for gamma spectroscopy. A field lab equipped for chemical analysis and gamma spectroscopy was set up in a trailer close by the stockpile site. Chemical analysis included X-ray fluorescence (XRF) to screen for high (>260 ppm) total mercury concentrations, and modified Toxicity Characteristic Leaching Procedure (TCLP) tests to verify that the soils were not RCRA

  9. Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money

    PubMed Central

    Oberjé, Edwin J.M.; Tanke, Marit A.C.; Jeurissen, Patrick P.T.

    2017-01-01

    Antimicrobial stewardship is recognized as a key component to stop the current European spread of antimicrobial resistance. It has also become evident that antimicrobial resistance is a problem that cannot be tackled by single institutions or physicians. Prevention of antimicrobial resistance needs rigorous actions at ward level, institution level, national level and at supra-national levels. Countries can learn from each other and possibly transplant best practices across borders to prevent antimicrobial resistance. The aim of this study is to highlight some of the success stories of proven cost-effective interventions, and to describe the actions that have been taken, the outcomes that have been found, and the difficulties that have been met. In some cases we came across substantial scope for real-life cost savings. Although the best approach to effectively hinder the spread of antimicrobial resistance remains unclear and may vary significantly among settings, several EU-wide examples demonstrate that cost-effective antimicrobial stewardship is possible. Such examples can encourage others to implement (the most cost-effective) elements in their system. PMID:28458794

  10. Enhancing Stewardship of Community-Engaged Research Through Governance

    PubMed Central

    Villegas, Malia; Zenone, Heather; White Hat, Emily R.; Wallerstein, Nina; Duran, Bonnie

    2015-01-01

    Objectives. We explored the relationship of community-engaged research final approval type (tribal government, health board, or public health office (TG/HB); agency staff or advisory board; or individual or no community approval) with governance processes, productivity, and perceived outcomes. Methods. We identified 294 federally funded community-engaged research projects in 2009 from the National Institutes of Health’s Research Portfolio Online Reporting Tools, Centers for Disease Control and Prevention’s Prevention Research Centers, and Native American Research Centers for Health databases. Two hundred (68.0%) investigators completed a survey about governance processes and productivity measures; 312 partners (77.2% of 404 invited) and 138 investigators (69.0% of 200 invited) completed a survey about perceived outcomes. Results. Projects with TG/HB approval had increased likelihood of community control of resources (odds ratios [ORs] ≥ 4.80). Projects with other approvals had decreased likelihood of development or revision of institutional review board policies (ORs ≤ 0.37), having written agreements (ORs ≤ 0.17), and agreements about publishing (ORs ≤ 0.28), data use (ORs ≤ 0.17), and publishing approval (ORs ≤ 0.14). Conclusions. Community-engaged research projects with TG/HB approval had strong stewardship of project resources and agreements. Governance as stewardship protects community interests; thus, is an ethical imperative for communities, especially native communities, to adopt. PMID:25880952

  11. Enhancing stewardship of community-engaged research through governance.

    PubMed

    Oetzel, John G; Villegas, Malia; Zenone, Heather; White Hat, Emily R; Wallerstein, Nina; Duran, Bonnie

    2015-06-01

    We explored the relationship of community-engaged research final approval type (tribal government, health board, or public health office (TG/HB); agency staff or advisory board; or individual or no community approval) with governance processes, productivity, and perceived outcomes. We identified 294 federally funded community-engaged research projects in 2009 from the National Institutes of Health's Research Portfolio Online Reporting Tools, Centers for Disease Control and Prevention's Prevention Research Centers, and Native American Research Centers for Health databases. Two hundred (68.0%) investigators completed a survey about governance processes and productivity measures; 312 partners (77.2% of 404 invited) and 138 investigators (69.0% of 200 invited) completed a survey about perceived outcomes. Projects with TG/HB approval had increased likelihood of community control of resources (odds ratios [ORs] ≥ 4.80). Projects with other approvals had decreased likelihood of development or revision of institutional review board policies (ORs ≤ 0.37), having written agreements (ORs ≤ 0.17), and agreements about publishing (ORs ≤ 0.28), data use (ORs ≤ 0.17), and publishing approval (ORs ≤ 0.14). Community-engaged research projects with TG/HB approval had strong stewardship of project resources and agreements. Governance as stewardship protects community interests; thus, is an ethical imperative for communities, especially native communities, to adopt.

  12. Gasoline toxicology: overview of regulatory and product stewardship programs.

    PubMed

    Swick, Derek; Jaques, Andrew; Walker, J C; Estreicher, Herb

    2014-11-01

    Significant efforts have been made to characterize the toxicological properties of gasoline. There have been both mandatory and voluntary toxicology testing programs to generate hazard characterization data for gasoline, the refinery process streams used to blend gasoline, and individual chemical constituents found in gasoline. The Clean Air Act (CAA) (Clean Air Act, 2012: § 7401, et seq.) is the primary tool for the U.S. Environmental Protection Agency (EPA) to regulate gasoline and this supplement presents the results of the Section 211(b) Alternative Tier 2 studies required for CAA Fuel and Fuel Additive registration. Gasoline blending streams have also been evaluated by EPA under the voluntary High Production Volume (HPV) Challenge Program through which the petroleum industry provide data on over 80 refinery streams used in gasoline. Product stewardship efforts by companies and associations such as the American Petroleum Institute (API), Conservation of Clean Air and Water Europe (CONCAWE), and the Petroleum Product Stewardship Council (PPSC) have contributed a significant amount of hazard characterization data on gasoline and related substances. The hazard of gasoline and anticipated exposure to gasoline vapor has been well characterized for risk assessment purposes.

  13. The role of the multidisciplinary team in antifungal stewardship.

    PubMed

    Agrawal, Samir; Barnes, Rosemary; Brüggemann, Roger J; Rautemaa-Richardson, Riina; Warris, Adilia

    2016-11-01

    There are a variety of challenges faced in the management of invasive fungal diseases (IFD), including high case-fatality rates, high cost of antifungal drugs and development of antifungal resistance. The diagnostic challenges and poor outcomes associated with IFD have resulted in excessive empirical use of antifungals in various hospital settings, exposing many patients without IFD to potential drug toxicities as well as causing spiralling antifungal drug costs. Further complexity arises as different patient groups show marked variation in their risk for IFD, fungal epidemiology, sensitivity and specificity of diagnostic tests and the pharmacokinetics and pharmacodynamics of antifungal drugs. To address these issues and to ensure optimal management of IFD, specialist knowledge and experience from a range of backgrounds is required, which extends beyond the remit of most antibiotic stewardship programmes. The first step in the development of any antifungal stewardship (AFS) programme is to build a multidisciplinary team encompassing the necessary expertise in the management of IFD to develop and implement the AFS programme. The specific roles of the key individuals within the AFS team and the importance of collaboration are discussed in this article.

  14. Algal biochar enhances the re-vegetation of stockpiled mine soils with native grass.

    PubMed

    Roberts, David A; Cole, Andrew J; Paul, Nicholas A; de Nys, Rocky

    2015-09-15

    In most countries the mining industry is required to rehabilitate disturbed land with native vegetation. A typical approach is to stockpile soils during mining and then use this soil to recreate landforms after mining. Soil that has been stockpiled for an extended period typically contains little or no organic matter and nutrient, making soil rehabilitation a slow and difficult process. Here, we take freshwater macroalgae (Oedogonium) cultivated in waste water at a coal-fired power station and use it as a feedstock for the production of biochar, then use this biochar to enhance the rehabilitation of two types of stockpiled soil - a ferrosol and a sodosol - from the adjacent coal mine. While the biomass had relatively high concentrations of some metals, due to its cultivation in waste water, the resulting biochar did not leach metals into the pore water of soil-biochar mixtures. The biochar did, however, contribute essential trace elements (particularly K) to soil pore water. The biochar had very strong positive effects on the establishment and growth of a native plant (Kangaroo grass, Themeda australis) in both of the soils. The addition of the algal biochar to both soils at 10 t ha(-1) reduced the time to germination by the grass and increased the growth and production of plant biomass. Somewhat surprisingly, there was no beneficial effect of a higher application rate (25 t ha(-1)) of the biochar in the ferrosol, which highlights the importance of matching biochar application rates to the requirements of different types of soil. Nevertheless, we demonstrate that algal biochar can be produced from biomass cultivated in waste water and used at low application rates to improve the rehabilitation of a variety of soils typical of coal mines. This novel process links biomass production in waste water to end use of the biomass in land rehabilitation, simultaneously addressing two environmental issues associated with coal-mining and processing. Copyright © 2015

  15. Supporting Data Stewardship Throughout the Data Life Cycle in the Solid Earth Sciences

    NASA Astrophysics Data System (ADS)

    Ferrini, V.; Lehnert, K. A.; Carbotte, S. M.; Hsu, L.

    2013-12-01

    is based first and foremost on the scientific needs of its user community. As data stewardship becomes a more integral component of the scientific workflow, IEDA investigator support services (e.g. Data Management Plan Tool and Data Compliance Reporting Tool) continue to evolve with the goal of lessening the 'burden' of data management for individual investigators by increasing awareness and facilitating the adoption of data management practices. We will highlight a variety of IEDA system components that support investigators throughout the data life cycle, and will discuss lessons learned and future directions.

  16. Antimicrobial stewardship in outpatient settings: leveraging innovative physician-pharmacist collaborations to reduce antibiotic resistance.

    PubMed

    Klepser, Michael E; Adams, Alex J; Klepser, Donald G

    2015-01-01

    Antibiotic resistance is one of the world's most pressing public health problems. Historically, most drug-resistant bacteria have emerged in hospital settings, yet the vast majority of antimicrobials used in humans in the United States are administered in outpatient settings. Strong collaboration between physicians and pharmacists in the development of antimicrobial stewardship programs in outpatient settings is thus a critical strategy for curtailing antibiotic resistance. Recently, pilot projects have been launched in 3 states that pair physicians and community pharmacists under a Collaborative Practice Agreement (CPA) to treat patients with influenza and group A Streptococcus (GAS) pharyngitis. Under this model, community pharmacists use rapid point-of-care tests to guide clinical decision making and initiate treatment as appropriate under a physician-led, evidence-based protocol. Experience with this research initiative has suggested this model can lead to more judicious use of antibiotics and antivirals, improve public health, and provide safe and convenient care for patients.

  17. Antimicrobial stewardship: a collaborative partnership between infection preventionists and health care epidemiologists.

    PubMed

    Moody, Julia; Cosgrove, Sara E; Olmsted, Russell; Septimus, Edward; Aureden, Kathy; Oriola, Shannon; Patel, Gita Wasan; Trivedi, Kavita K

    2012-03-01

    It is clear that the widespread and injudicious use of antimicrobials has greatly increased the presence of MDROs that threaten the health of all. There is worldwide acknowledgement that this threat is growing, and that prudent use of antimicrobials combined with infection prevention can prevent harm and improve patient safety. Antimicrobial stewardship programs must harness the talents of all members of the health care team to effectively identify the organism, determine its susceptibility, institute any precautions required, and prescribe the narrowest-acting antibiotic that will destroy it. IPs/HEs play a pivotal role in this approach, by assisting with early organism and infected patient identification, by promoting compliance with standard and transmission-based precautions and other infection prevention strategies such as care bundle practices, hand hygiene, and by educating staff, patients, and visitors.

  18. Considering a new domain for antimicrobial stewardship: Topical antibiotics in the open surgical wound.

    PubMed

    Edmiston, Charles E; Leaper, David; Spencer, Maureen; Truitt, Karen; Litz Fauerbach, Loretta; Graham, Denise; Johnson, Helen Boehm

    2017-06-05

    The global push to combat the problem of antimicrobial resistance has led to the development of antimicrobial stewardship programs (ASPs), which were recently mandated by The Joint Commission and the Centers for Medicare and Medicaid Services. However, the use of topical antibiotics in the open surgical wound is often not monitored by these programs nor is it subject to any evidence-based standardization of care. Survey results indicate that the practice of using topical antibiotics intraoperatively, in both irrigation fluids and powders, is widespread. Given the risks inherent in their use and the lack of evidence supporting it, the practice should be monitored as a core part of ASPs, and alternative agents, such as antiseptics, should be considered. Copyright © 2017. Published by Elsevier Inc.

  19. Approaches to Modifying the Behavior of Clinicians Who Are Noncompliant With Antimicrobial Stewardship Program Guidelines.

    PubMed

    Goldstein, Ellie J C; Goff, Debra A; Reeve, William; Naumovski, Snezana; Epson, Erin; Zenilman, Jonathan; Kaye, Keith S; File, Thomas M

    2016-08-15

    Antimicrobial stewardship programs (ASPs) are a key national initiative to promote appropriate use of antibiotics and to reduce the burden of resistance. The dilemma of managing the outlier physician is especially complex. We outline strategies to establish a successful ASP that reviews appropriate efforts to achieve the goal of modifying outlier physicians' behavior. One must try to differentiate deviation from ASP norms from all other issues of outliers. Essential elements include identifying and understanding the local problems, planning, and achieving hospital administration and medical staff support. A successful ASP includes effective communication and acceptance of evidence-based recommendations, so that patient clinical outcomes will be optimized. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  20. Current recommendations and importance of antifungal stewardship for the management of invasive candidiasis.

    PubMed

    Miyazaki, Taiga; Kohno, Shigeru

    2015-01-01

    Invasive candidiasis can have a major effect on patient prognosis and medical economics. Quickly eliminating the focus of the infection and administering appropriate antifungal therapy are important. Clinical guidelines for invasive candidiasis have been issued in the USA, Europe and recently in Japan. The purpose of this review is to summarize the current recommendations on how to diagnose and treat invasive candidiasis based on the evidence gathered to date and by referencing guidelines from various countries. Echinocandin antifungals play a central role in the prevention and treatment of invasive candidiasis although a recent increase in echinocandin-resistant Candida glabrata is seen as problematic. In the future, promoting the appropriate use of antifungal agents by antifungal stewardship teams will be necessary to suppress adverse effects, appearance of resistant strains and unnecessary medical expenses, as well as improve positive clinical outcomes and prognoses.

  1. Remanufacture

    SciTech Connect

    Cornwall, J.; Dimotakis, P.; Dyson, F.; Garwin, R.; Katz, J.; Koonin, S.; LeLevier, R.; Panofsky, W.; Peurifoy, B.; Schwitters, R.; Treiman, S.; Williams, E.

    1999-10-18

    The reconstitution of DOE remanufacturing takes place within the commitment to Science-Based Stockpile Stewardship (SBSS), and in an environment of the CTBT. The purpose of remanufacture is to maintain a safe and reliable stockpile of nuclear devices, together with their non-nuclear components that constitute a nuclear warhead.

  2. Evaluation of the Washington State National Pharmaceutical Stockpile dispensing exercise: Part I--Patient volunteer findings.

    PubMed

    Beaton, Randal D; Oberle, Mark W; Wicklund, Julie; Stevermer, Andrew; Boase, Janice; Owens, David

    2003-01-01

    The Centers for Disease Control and Prevention's National Pharmaceutical Stockpile (NPS) program is designed to ensure the availability of life-saving antibiotics, other medical supplies, and equipment and their prompt delivery to the site of a disaster, including a possible bioterrorist incident, anywhere in the United States. On January 24, 2002, the Washington State Department of Health conducted an exercise, simulating a mass exposure to Bacillis anthracis, to test the NPS dispensing portion of the Washington State plan. This drill included the recruitment, education, and postexposure prophylaxis of over 230 volunteer patients. This article describes and discusses findings from an exit survey completed by these patient volunteers.

  3. A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

    PubMed

    Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

    2016-07-27

    Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.

  4. Dramatic effects of a new antimicrobial stewardship program in a rural community hospital.

    PubMed

    Libertin, Claudia R; Watson, Stephanie H; Tillett, William L; Peterson, Joy H

    2017-09-01

    New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia. An educational grand rounds lecture series was provided before implementation of the ASP to all prescribers. After implementation, algorithms to aid the selection of empirical antibiotics for specific infectious disease syndromes based on local antibiograms were provided to prescribers to improve this selection. Rates of C difficile infections, total targeted antimicrobial costs, and drug utilization rates were calculated for 1 year pre-ASP implementation (2013) and 1 year post-ASP implementation (October 2014-December 2015). The patient safety metric of C difficile infections decreased from 3.35 cases per 1,000 occupied bed days (OBDs) in 2013 to 1.35 cases per 1,000 OBDs in 2015. Total targeted antimicrobial costs decreased 50% from $16.93 per patient day in 2013 to $8.44 per patient day in 2015. Overall antimicrobial use decreased 10% from before the ASP initiative to 1 year after it. Annualized savings were $280,000 in 1 year, based on drug savings only. Judicious use of antimicrobials and resources can improve a patient safety metric and decrease costs dramatically in rural institutions where the average hospital census is <100 patients per day. The savings would allow the institutions to spend better while improving the use of antimicrobials. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights

  5. Shelf-life extension program (SLEP) as a significant contributor to Strategic National Stockpile Maintenance: the Israeli experience with ciprofloxacin.

    PubMed

    Bodas, Moran; Yuval, Landschaft; Zadok, Ron; Hess, Zippora; Haran, Batya; Kaplan, Mimi; Eisenkraft, Arik

    2012-06-01

    In the past decade, the 2001 anthrax incident in the U.S. and the 2003 SARS epidemic have highlighted the biological threat to civilian populations. The risk posed by the natural or manmade spread of biological agents among the population dictates a need for better national preparedness. One key component of this preparation is the establishment of a Strategic National Stockpile (SNS) of pharmaceuticals that would provide appropriate medical countermeasures in case of an outbreak. However, to reduce the expense of such a stockpile and to make it worthwhile, there is also a need for a shelf-life extension program (SLEP) through which pharmaceuticals could be extended beyond manufacturer-ascribed shelf life, as long as they meet regulation standards. In this article, we review the Israeli experience with the national ciprofloxacin stockpile procurement and shelf-life extension program.

  6. Project FLOSSIE: Marine Data Stewardship at the Waterline

    NASA Astrophysics Data System (ADS)

    Bouchard, R. H.; Jensen, R. E.; Riley, R. E.

    2016-02-01

    There are more than 10 million wave records from platforms of the National Data Buoy Center (NDBC) that are archived by National Oceanic and Atmospheric Administration (NOAA). A considerable number of these were measured from the 61 NOMAD (Navy Oceanographic Meteorological Automatic Device) hulls that NDBC has used to make wave measurements since October 1979. Many of these measurements were made before the era of modern marine data stewardship. These long records lend themselves to investigations of climate trends and variability either directly by the measurements themselves, or indirectly by validating long-term numerical wave models or remote sensing applications. However studies (e.g., Gemmrich et al. 2011) indicate that discontinuities and increased variability of the measurements can arise from changing wave systems and platforms. The value of these records is undermined by the lack of understanding or documentation of technology changes - a critical component of data stewardship. To support its mission of long-term understanding of coastal waves and wave models, the U.S. Army Corps of Engineers, Coastal Hydraulics Laboratory (CHL) sponsored the FLOSSIE Project to gage the effects of technology changes on the long-term wave measurements from NOMAD hulls. On behalf of CHL, NDBC engineering and operations integrated old, new, and leading edge technologies on one NOMAD hull. The hull was successfully deployed in July 2015 at the Wave Evaluation and Testing area off of Monterey Bay, CA. The area hosts an NDBC 3-m hull with cross-generational-technologies and a reference standard in a Datawell Waverider buoy. Thus cross-generational and cross-platform inter-comparisons can be performed simultaneously to an accepted standard. The analysis goes beyond the bulk wave parameters. The analysis will examine the energy and directional distributions over the frequency range of wind-generated waves. The project is named in honor of the pioneering World War II Naval

  7. Growth Performance by Fall-Calving Cow-Calf Pairs Grazing Tall Fescue Pastures with Different Proportions Stockpiled Until Late Fall

    USDA-ARS?s Scientific Manuscript database

    Stockpiling tall fescue (Festuca arundinacea Schreb.) is a viable but variable management practice used to reduce winter feed costs for cattle. The objective of this 2-yr study was to determine the impact of stockpiling different proportions of total fescue acreage on growth performance of fall-calv...

  8. Antimicrobial stewardship programme in critical care medicine: A prospective interventional study.

    PubMed

    Ruiz, J; Ramirez, P; Gordon, M; Villarreal, E; Frasquet, J; Poveda-Andres, J L; Salavert-Lletí, M; Catellanos, A

    2017-09-04

    Hospital antimicrobial stewardship programmes have achieved savings and a more rational use of antimicrobial treatments in general wards. The purpose of this report is to evaluate the experience of an antimicrobial stewardship programme in an intensive care unit (ICU). Prospective interventional, before-and-after study. 24-bed medical ICU in a tertiary hospital. Prospective audit and feedback antimicrobial stewardship programme. Antimicrobial consumption, antimicrobial related costs, multi-drug resistant microorganisms (MDRM) prevalence, nosocomial infections incidence, ICU length of stay, and ICU mortality rates were compared before and after one-year intervention. A total of 218 antimicrobial episodes of 182 patients were evaluated in 61 team meetings. Antimicrobial stewardship suggestions were accepted in 91.5% of the cases. Total antimicrobial DDD/100 patient-days consumption was reduced from 380.6 to 295.2 (-22.4%; p=0.037). Antimicrobial stewardship programme was associated with a significant decrease in the prescription of penicillins plus b-lactamase inhibitors, linezolid, cephalosporins, and aminoglycosides. Overall antimicrobial spending was reduced by €119,636. MDRM isolation and nosocomial infections per 100 patient-days did not change after the intervention period. No changes in length of stay or mortality rate were observed. An ICU antimicrobial stewardship programme significantly reduced antimicrobial use without affecting inpatient mortality and length of stay. Our results further support the implementation of an antimicrobial stewardship programme in critical care units. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  9. Antimicrobial stewardship using pharmacy data for the nurse-led school-based clinics in Counties Manukau District Health Board for management of group A streptococcal pharyngitis and skin infection.

    PubMed

    Tupai-Firestone, Ridvan; Tsai, Jia-Yun Catherine; Anderson, Philippa; Broome, Laura; McKee, Tracy; Lennon, Diana R

    2016-05-27

    To evaluate antimicrobial usage in the school-based clinics against operating guidelines. Antimicrobial prescribing data (2014) from 10/18 participating pharmacies serving 14,153/23,588 primary school children of the programme were accessible. Prescriptions from 5/10 pharmacies were available for identifying type, amount, and indication of the medicine. One pharmacy serving a defined population (n=3,513) with single healthcare provider delivering the school programme was selected for detailed evaluation and identifying individuals receiving multiple treatments. Data from 10 pharmacies (n=7,889 prescriptions) showed 91.2% of prescriptions were for group A streptococcal-positive throat swab, 8.8% for skin infections. More detail from 5/10 pharmacies showed only 2% of group A streptococcal pharyngitis treatments (107/4,672) were not first-line (56 cephalexin and 51 rifampin prescriptions). Fusidic acid (159/452, 35.18%) or cephalexin (169/452, 37.39%) were most commonly used for skin infection. Analysis in the defined population showed <4% (151/4,325) of assessed skin conditions received antimicrobials, and only 6 individuals received more than one course of oral antimicrobial over the year. Antimicrobial administration demonstrates high compliance with the protocol. There was very limited use of second-line antimicrobials for recurrent pharyngitis. Most skin infections did not require antimicrobial treatment. Repeated antimicrobials for individuals were rare.

  10. Enzymes for Degradation of Energetic Materials and Demilitarization of Explosives Stockpiles - SERDP Annual (Interim) Report, 12/98

    SciTech Connect

    Shah, M.M.

    1999-01-18

    The current stockpile of energetic materials requiring disposal contains about half a million tons. Through 2001, over 2.1 million tons are expected to pass through the stockpile for disposal. Safe and environmentally acceptable methods for disposing of these materials are needed. This project is developing safe, economical, and environmentally sound processes using biocatalyst (enzymes) to degrade energetic materials and to convert them into economically valuable products. Alternative methods for destroying these materials are hazardous, environmentally unacceptable, and expensive. These methods include burning, detonation, land and sea burial, treatment at high temperature and pressure, and treatment with harsh chemicals. Enzyme treatment operates at room temperature and atmospheric pressure in a water solution.

  11. A model "go-kit" for use at Strategic National Stockpile Points of Dispensing.

    PubMed

    May, Larissa; Cote, Timothy; Hardeman, Bernard; Gonzalez, Gabriela R; Adams, Sherry B; Blair, Roderick K; Pane, Gregg

    2007-01-01

    The Strategic National Stockpile (SNS) is a national repository of pharmaceuticals and other medical supplies forseeably needed during a medical disaster. In the event of SNS deployment, state and local public health authorities must be prepared to receive, distribute, and dispense the materials. We propose a cache of supplies, termed the "POD go-kit," prepared in advance and locally available prior to the establishment of Points of Dispensing (POD) for SNS material. Characteristics of the preassembled go-kit are its multiplicity of use, ease of storage and transportation, minimal redundancy with SNS material, and packaging in a manner consistent with POD function. The POD go-kit is assembled into 4 separate "subkits": administrative supplies, patient routing supplies, dispensing supplies, and POD staff protection supplies. Incorporating existing practices from the SNS Listserv, this article itemizes the contents of the POD go-kit and its subkits and provides a rationale for its packaging. The Division of Strategic National Stockpile (DSNS) has not certified the proposed "POD go-kit" as a standardized POD go-kit.

  12. [Cross-sectional study of family drug stockpile and children medication in China].

    PubMed

    Nie, X L; Jia, L L; Peng, X X; Li, H R; Xing, M; Lin, N; Li, M X; Wang, X L

    2016-07-01

    To investigate the current situation of family medicine stockpile and children medication in China, analyze the existing problems and provide the rationalized suggestions. The questionnaire was designed and convenient sampling survey was performed in 20 children hospitals in China. Descriptive analysis was conducted on the survey results. A total of 13 940 completed questionnaires were returned, 98.33% of the families had medicine stockpile, the top three types of the medicine for children were cold medicine(73.95%), oral paregoric/febrifuge(48.01%)and external used drugs for skin disease(wound)(41.10%). The medicine was bought according to physician's prescription and guide(71.18%). Drug poisoning occurred in children of 238 families(1.71%), overdose use was the first cause(44.96%). 22.33% of the parents didn't read the specification carefully before medicine use. The non-appropriate medication for children were mainly the use of adult medicine(32.70%), untimely medication(30.90%), non-rational or unneeded use of febrifuge(26.35%). In China, the families mainly store common medicine for their children. The parents bought medicine mainly according to physician' s prescription and paid attention to the safety and efficiency of the medicine, but non-appropriate use of medicine was still common. It is necessary to improve the rational use of medicine for children through expert counsel and guidance.

  13. The Employment of Emergency Medical Units of the National Medical Stockpile

    PubMed Central

    Hacon, William S.

    1967-01-01

    Canada has a good National Medical Stockpile valued at 21 million dollars and consisting of packaged emergency medical units ready for use in peacetime or wartime disaster. These units are available for release to provinces for pre-positioning in selected communities provided that certain storage conditions are met and that physicians and other key health workers are prepared to take operational charge of the equipment. The major packaged units are the Emergency Hospital with a capacity of 200 beds, the Advanced Treatment Centre with equipment to give emergency medical care to 500 casualties, the Casualty Collecting Unit with equipment to give first-aid care to 500 casualties, the Emergency Blood Depot, the Emergency Clinic and the Emergency Public Health Laboratory. In addition, training equipment, supplies and units are provided. The value of the stockpile has already been demonstrated in disasters occurring inside and outside Canada. Ten Emergency Hospitals have been shipped to South Vietnam for civilian use. A similar Emergency Hospital was flown to Yellowknife, N.W.T., within 24 hours of the destruction, by fire, of the Stanton Yellowknife Hospital in May 1966. ImagesFig. 1Fig. 2Fig. 3 PMID:6015738

  14. A database system for characterization of munitions items in conventional ammunition demilitarization stockpiles

    SciTech Connect

    Chun, K.C.; Chiu, S.Y.; Ditmars, J.D.; Huber, C.C.; Nortunen, L.; Sabb, R.

    1994-05-01

    The MIDAS (Munition Items Disposition Action System) database system is an electronic data management system capable of storage and retrieval of information on the detailed structures and material compositions of munitions items designated for demilitarization. The types of such munitions range from bulk propellants and small arms to projectiles and cluster bombs. The database system is also capable of processing data on the quantities of inert, PEP (propellant, explosives and pyrotechnics) and packaging materials associated with munitions, components, or parts, and the quantities of chemical compounds associated with parts made of PEP materials. Development of the MIDAS database system has been undertaken by the US Army to support disposition of unwanted ammunition stockpiles. The inventory of such stockpiles currently includes several thousand items, which total tens of thousands of tons, and is still growing. Providing systematic procedures for disposing of all unwanted conventional munitions is the mission of the MIDAS Demilitarization Program. To carry out this mission, all munitions listed in the Single Manager for Conventional Ammunition inventory must be characterized, and alternatives for resource recovery and recycling and/or disposal of munitions in the demilitarization inventory must be identified.

  15. Review of agri-environment indexes and stewardship payments.

    PubMed

    Hajkowicz, Stefan; Collins, Kerry; Cattaneo, Andrea

    2009-02-01

    Agri-environment programs aim to secure environmental and social stewardship services through payments to farmers. A critical component of many agri-environment programs is an agri-environment index (AEI) used to quantify benefits and target investments. An AEI will typically comprise multiple indicators, which are weighted and combined using a utility function, to measure the benefit of investment options (e.g., projects, farms, regions). This article presents a review of AEIs with 11 case studies from agri-environment programs in the United States, Australia, and the United Kingdom. We identify a generic procedure used to define AEIs and explore the implications of alternative methodological approaches. We conclude that AEIs have become an extremely important policy instrument and make suggestions for their improvement.

  16. How to educate prescribers in antimicrobial stewardship practices

    PubMed Central

    Pulcini, Céline; Gyssens, Inge C.

    2013-01-01

    Widespread antimicrobial use has compromised its value, leading to a crisis of antimicrobial resistance. A major cause of misuse is insufficient knowledge of prescribing of antimicrobials in many categories of professionals. An important principle of antimicrobial stewardship is avoiding selection pressure in the patient, both on pathogen and commensal by avoiding unnecessary use, choosing the least broad-spectrum antibiotic, adequate doses, a good timing and the shortest possible duration. Up to now, most educational efforts have been targeted at professionals (mostly medical doctors) after their training and at the adult public. In the past few years, progress has been made in educating children. It is now crucial that academia and ministries of Health and Education jointly focus on an adapted undergraduate medical/professional curriculum that teaches all necessary principles of microbiology, infectious diseases and clinical pharmacology, with emphasis on the principles of prudent prescribing. PMID:23361336

  17. Health care provider education as a tool to enhance antibiotic stewardship practices.

    PubMed

    Ohl, Christopher A; Luther, Vera P

    2014-06-01

    Antibiotic stewardship education for health care providers provides a foundation of knowledge and an environment that facilitates and supports optimal antibiotic prescribing. There is a need to extend this education to medical students and health care trainees. Education using passive techniques is modestly effective for increasing prescriber knowledge, whereas education using active techniques is more effective for changing prescribing behavior. Such education has been shown to enhance other antibiotic stewardship interventions. In this review, the need and suggested audience for antibiotic stewardship education are highlighted, and effective education techniques are recommended for increasing knowledge of antibiotics and improving their use.

  18. iPhones, iPads, and medical applications for antimicrobial stewardship.

    PubMed

    Goff, Debra A

    2012-07-01

    One of the most important antimicrobial stewardship activities of the infectious diseases pharmacist and physician is to provide education and clinical information about antimicrobials to health care professionals and patients; however, clinician training and continuing education in appropriate antimicrobial use in the United States are highly variable and nonstandardized. The iPhone, iPad, and the availability of more than 12,000 medical applications (referred to as "apps") allow stewardship programs the ability to integrate novel technology with point-of-care education. This article reviews medical apps for antimicrobial stewardship programs to use on the iPhone or iPad.

  19. Aquaculture and environmental stewardship: Milford shellfish biology seminar—1991

    NASA Astrophysics Data System (ADS)

    Blogoslawski, Walter J.

    1992-07-01

    For the past 11 years the annual Shellfish Biology Seminar at Milford CT has provided a unique forum for aquaculture scientists and industry officials to exchange information about estuaries facing increased pollution problems, especially Long Island Sound and the Great South Bay. Because these two areas are so rich in productivity and diversity, fish and shellfish farmers utilize their waters, shellfish beds, and shore land for hatcheries and grow-out facilities. These individuals seek better management of the coastal estuarine environment and its resources, providing a working example of environmental stewardship. In aquaculture, good science is required to understand the complex variables and interaction of estuarine currents, tides, temperature, and cycles of reproduction. Aquaculturists are beginning to understand the need for specific nutrients and how the wastes of one species can be utilized for enhanced production of another species. Over the years, this meeting has formed an amalgam of both the aquaculture industry and research scientists where both groups foster mutual environmental concern. Science is able to focus on the theoretical aspects of pollutant damage. while the aquaculture industry is able to define the problem and need for assistance to eliminate pollutants from their crops—shellfish and finfish. Overfishing is not an issue at these meetings, as the group accepts the damage already done to wild resources and seeks new technologies to grow food sources under controlled and stable market conditions. Therefore, it could be said that the seminar serves as a meeting ground where the theoretical knowledge of scientific study finds practical application in the industry and is fueled by the needs of that industry. This ideal blend of the two groups produces better management of the resource and a safer environment—the goal of stewardship.

  20. Soil microbial characteristics and seed bank dynamics of stock-piled top soils in ther western Rio Grande Plains

    USDA-ARS?s Scientific Manuscript database

    Increased energy extraction has impacted rangelands throughout the western U.S. Ecological restoration can be enhanced with proper management of affected top soils. Little information exists on effects of stockpiling on soil microbial community composition and functionality and seed bank dynamics. T...

  1. 7 CFR 1450.207 - Conservation plan, forest stewardship plan, or equivalent plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... purposes as determined by CCC. (c) If applicable, a tree planting plan must be developed and included in the conservation plan, forest stewardship plan, or equivalent plan. Such tree planting plan may...

  2. EPA, Product Stewardship Institute, and University of California Launch Toolkit to Reduce Marine Debris

    EPA Pesticide Factsheets

    SAN FRANCISCO - Today, the U.S. Environmental Protection Agency, the Product Stewardship Institute, and the University of California announced the launch of a new Marine Debris Campus Toolkit designed to help college campuses and other institutions

  3. Antimicrobial stewardship: a review of prospective audit and feedback systems and an objective evaluation of outcomes.

    PubMed

    Chung, Gladys W; Wu, Jia En; Yeo, Chay Leng; Chan, Douglas; Hsu, Li Yang

    2013-02-15

    Antimicrobial stewardship is an emerging field currently defined by a series of strategies and interventions aimed toward improving appropriate prescription of antibiotics in humans in all healthcare settings. The ultimate goal is the preservation of current and future antibiotics against the threat of antimicrobial resistance, although improving patient safety and reducing healthcare costs are important concurrent aims. Prospective audit and feedback interventions are probably the most widely practiced of all antimicrobial stewardship strategies. Although labor-intensive, they are more easily accepted by physicians compared with formulary restriction and preauthorization strategies and have a higher potential for educational opportunities. Objective evaluation of antimicrobial stewardship is critical for determining the success of such programs. Nonetheless, there is controversy over which outcomes to measure and there is a pressing need for novel study designs that can objectively assess antimicrobial stewardship interventions despite the limitations inherent in the structure of most such programs.

  4. Memorandum of Understanding on Long-Term Stewardship at Federal Facilities in the United States

    EPA Pesticide Factsheets

    The purpose of this Memorandum of Understanding is to provide a common understanding and basis for discussion and coordination between the Environmental Council of the States and relevant federal agencies regarding Long-Term Stewardship.

  5. Strategic Plan for Sustainable Energy Management and Environmental Stewardship for Los Angeles Unified School District

    SciTech Connect

    Walker, A.; Beattie, D.; Thomas, K.; Davis, K.; Sim, M.; Jhaveri, A.

    2007-11-01

    This Strategic Plan for Sustainable Energy Management and Environmental Stewardship states goals, measures progress toward goals and how actions are monitored to achieve continuous improvement for the Los Angeles Unified School District.

  6. Framework for assessing stewardship of the oral health system in Islamic Republic of Iran.

    PubMed

    Tahani, B; Yazdani, S; Khoshnevisan, M H; Dugdale, P; Siddiqi, S; Ahmady, A Ebn

    2014-03-13

    This study designed a framework for assessing the stewardship function of the oral health system in Islamic Republic of Iran. The modified RAND Corporation/University of California Los Angeles (RAND-UCLA) Appropriateness Method was used in a 2-step process that combined literature evidence and the collective judgement of experts. After a comprehensive literature review, policy instruments related to stewardship components were extracted as candidate standards and categorized according to the 6 sub-functions of stewardship (accountability; defining strategic direction; alignment of policy objectives and organizational structure; regulation; intersectoral leadership; and generation of intelligence). Five key informants then rated the appropriateness of the 85 standards on a 5-point Likert scale. The 38 highest ranked standards, including at least 2 standards in each of the 6 sub-functions, formed a set of proposed standards for evaluating the current stewardship of oral health system. Piloting of the instrument will be reported separately.

  7. INL-Site Idaho Completion Project Long Term Stewardship Strategic Plan

    SciTech Connect

    Olaveson, B.

    2007-09-17

    This Strategic Plan provides a brief historical overview of ICP long-term stewardship at the INL Site and the major goals and strategies that will drive the continued implementation of long-term stewardship in the future. The specific activities and processes that will be required to implement these goals should be outlined within an implementation plan and within implementing procedures and work plans.

  8. Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.

    PubMed

    Pollack, Loria A; Srinivasan, Arjun

    2014-10-15

    The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals.

  9. The Proposed Change Strategy to Embed Energy Stewardship into the Army’s Culture

    DTIC Science & Technology

    2012-06-02

    3). Remove or do not promote leaders who fail to support energy stewardship. 4). Consider awarding members an “Additional Skill Identifier ( ASI ...designation as an “energy steward-manager.” Assign continuing education credits and promotion points for earning the Energy Stewardship ASI . 5...Harvard Business School Press. Schein, E. (2010). Organizational culture and leadership, 4th ed. San Francisco , CA: Wiley & Sons

  10. Estimated costs attributable to events of "out-of-temperature" in the stockpiling of hexavalent vaccines occurring in Italy.

    PubMed

    Silvestri, R; Marchetti, F

    2015-01-01

    Antigens contained in vaccines are inherently unstable biologically; such a characteristic is conferred by their three-dimensional structure. Preserving the ability of the vaccines to protect against disease is necessary to ensure the supervision and monitoring of all steps of the cold chain. DTPa-HBV-IPV/Hib vaccine (Infanrix hexaTM, GSK Vaccines, Belgium) is designed to prevent disease due to diphtheria, tetanus, pertussis (DTP), hepatitis B virus (HBV), poliomyelitis and Haemophilus influenzae type b (Hib); it was first licensed for use in Europe in 2000 and is currently licensed in at least 95 countries. Since October 2013, more than 102 million doses of GSK's DTPa-HBV-IPV/Hib vaccine have been distributed globally, with nearly 15 million doses distributed in Italy. DTPa-HBV-IPV/Hib components are stable up to a temperature of 25°C for 72 hours. Lacking of officially approved stability data may generate some concern in case of cold chain accidents. An analysis based on collected data was carried out to estimate potential costs attributable to events of "out-of-temperature" in the stockpiling of hexavalent vaccines occurring in Italy in 2014. The analysis, based on real data, documented that the loss for the National Health Service (NHS) was in the range of 100,000 - 400,000 euros in one year. However, the amount of money that in principle could have been lost would have ranged between nearly half and one million euros/year. A substantial loss of money was avoided thanks to the availability of officially approved stability data for GSK's DTPa-HBV-IPV/Hib vaccine.

  11. An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration.

    PubMed

    MacDougall, Conan; Schwartz, Brian S; Kim, Lisa; Nanamori, Mari; Shekarchian, Sharmin; Chin-Hong, Peter V

    2017-01-01

    Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ(2) and t tests and mixed-effects logistic regression. Analysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%). A curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students.

  12. An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration

    PubMed Central

    Schwartz, Brian S.; Kim, Lisa; Nanamori, Mari; Shekarchian, Sharmin; Chin-Hong, Peter V.

    2017-01-01

    Abstract Background. Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. Methods. We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ2 and t tests and mixed-effects logistic regression. Results. Analysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%). Conclusions. A curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students. PMID:28480231

  13. Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS): A Quality Improvement Collaborative.

    PubMed

    Newland, Jason G; Gerber, Jeffrey S; Kronman, Matthew P; Meredith, Georgann; Lee, Brian R; Thurm, Cary; Hersh, Adam L

    2017-04-04

    Although many children's hospitals have established antimicrobial stewardship programs (ASPs), data-driven benchmarks for optimizing antimicrobial use across centers are lacking. We developed a multicenter quality improvement collaborative focused on sharing data reports and benchmarking antimicrobial use to improve antimicrobial prescribing among hospitalized children. A national antimicrobial stewardship collaborative among children's hospitals, Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS), was established in 2013. Characteristics of the hospitals and their ASPs were obtained through a standardized survey. Antimicrobial-use data reports were developed on the basis of input from the participating hospitals. Collaborative learning opportunities were provided through monthly webinars and annual meetings. Since 2013, 36 US hospitals have participated in the SHARPS collaborative. The median full-time equivalent (pharmacist and physician) dedicated to 30 of these ASPs was 0.75 (interquartile range, 0.45-1.4). To date, the collaborative has developed 26 data reports that include benchmarking reports according to specific antimicrobial agents, indications, and clinical service lines. The collaborative has conducted 27 webinars and 3 in-person meetings to highlight the stewardship work being conducted in the hospitals. The data reports and learning opportunities have resulted in approximately 36 distinct stewardship interventions. A pediatric antimicrobial stewardship collaborative has been successful in promoting the development of and innovation among pediatric ASPs. Additional research is needed to determine the impact of these efforts.

  14. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    PubMed

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

  15. Public health, law, and local control: destruction of the US chemical weapons stockpile.

    PubMed

    Greenberg, Michael R

    2003-08-01

    Destruction of US chemical weapons has begun at one of the 8 sites in the continental United States, was completed on Johnston Island in the Pacific Ocean, and is scheduled to begin in at least 3 other locations during the upcoming year. About 25% of the stockpile and 38% of the munitions had been destroyed as of December 31, 2002. However, the program has become controversial with regard to choice of technology, emergency management, and cost. This controversy is in large part due to efforts by some state and local governments and activist groups to play a more central role in a decision making process that was once fully controlled by the US Army.

  16. The National Pharmaceutical Stockpile Program: an overview and perspective for the Pacific Islands.

    PubMed

    Pesik, Nicki; Gorman, Sue; Williams, Wayne D

    2002-03-01

    The National Pharmaceutical Stockpile (NSP) program was created as a national resource and is an essential response component of the Centers for Disease Control and Prevention's (CDC's) larger Bioterrorism Preparedness and Response Initiative. The role of the NPS program is to maintain a national repository of life-saving pharmaceuticals and medical supplies that can be delivered to communities in the event of a biological or chemical terrorist attack or an event involving mass casualties. The NPS is to be a re-supply and backup mechanism to state and local emergency response. Before a decision is made to deploy NPS assets, CDC will collaborate with local, state, and federal officials to determine the nature and extent of the event. Once the federal decision to deploy NPS assets is made, CDC's NPS program will arrange for delivery of assets to reach the affected area within 12 hours.

  17. Comparison Between Multicopter Uav and Total Station for Estimating Stockpile Volumes

    NASA Astrophysics Data System (ADS)

    Arango, C.; Morales, C. A.

    2015-08-01

    Currently the UAV (Unmanned Aerial Vehicle) have become an alternative for different engineering applications, especially in surveying, one of these applications is the calculation of volumes of stockpiled material, but there are questions about its accuracy and efficiency, the purpose of this article is to compare traditional surveying methods for estimating total volumes through data obtained by total stations and data obtained by a multicopter UAV. In order to answer these questions we obtain data from the same location and the results were compared. After comparing the results it was found that there was a 2,88% difference between the volume calculated with the total station data and the actual volume, and -0,67% difference between the volume calculated with the UAV data and the actual volume, concluding that the estimated volume with UAV data is more accurate.

  18. Quality control of meteorological data for the chemical stockpile emergency preparedness program.

    SciTech Connect

    Liljegren, J.C.; Tschopp, S.; Rogers, K.; Wasmer, F.; Liljegren, L.; Myirski, M.; Decision and Information Sciences; U.S. Army Chemical Materials Agency

    2009-08-01

    The Chemical Stockpile Emergency Preparedness Program Meteorological Support Project ensures the accuracy and reliability of data acquired by meteorological monitoring stations located at seven U.S. Army chemical weapons depots where storage and weapons destruction (demilitarization) activities are ongoing. The data are delivered in real time to U.S. Army plume dispersion models, which are used to plan for and respond to a potential accidental release of a chemical weapons agent. The project provides maintenance, calibration, and audit services for the instrumentation; collection, automated screening, visual inspection, and analysis of the data; and problem reporting and tracking to carefully control the data quality. The resulting high-quality meteorological data enhance emergency response modeling and public safety.

  19. Public Health, Law, and Local Control: Destruction of the US Chemical Weapons Stockpile

    PubMed Central

    Greenberg, Michael R.

    2003-01-01

    Destruction of US chemical weapons has begun at one of the 8 sites in the continental United States, was completed on Johnston Island in the Pacific Ocean, and is scheduled to begin in at least 3 other locations during the upcoming year. About 25% of the stockpile and 38% of the munitions had been destroyed as of December 31, 2002. However, the program has become controversial with regard to choice of technology, emergency management, and cost. This controversy is in large part due to efforts by some state and local governments and activist groups to play a more central role in a decisionmaking process that was once fully controlled by the US Army. PMID:12893599

  20. Regional preparedness for mass acetylcholinesterase inhibitor poisoning through plans for stockpiling and interhospital sharing of pralidoxime.

    PubMed

    Broach, John; Krupa, Robert; Bird, Steven B; Manuell, Mary-Elise

    2014-01-01

    Regional preparedness efforts related to the stockpiling and interhospital sharing of critical antidotal medications is an important topic in the age of terrorism and weapons of mass destruction. Little attention has been paid to how well regional preparedness efforts specifically affect availability of pralidoxime (2-PAM) if it were needed to treat a mass poisoning with acetylcholinesterase inhibitors (organophosphorus pesticides or nerve agents). The authors sought to assess whether hospitals in one region of Massachusetts (Department of Public Health Region 2, Central Massachusetts) have adequate plans for responding to a large number of patients requiring 2-PAM as might occur after the intentional release of nerve agents or organophosphorus chemicals into a civilian population or the food or water supply. The Massachusetts DPH Region 2 contains 10 acute care hospitals including one level 1 Trauma Center that is also the only tertiary care hospital in the region. A 13-question online survey was used to assess three important components of 2-PAM availability: 1) the amount of 2-PAM available, 2) regional medication sharing activities, and 3) attitudes and awareness of resources available in the Strategic National Stockpile (SNS). Seven of 10 hospitals participated in the survey (response rate 70 percent). Of these seven hospitals, only 2 (28.5 percent) had any 2-PAM on hand (4 and 6 g). Despite the existence of a region-wide memorandum of understanding that includes medication sharing, only two hospitals' responses included awareness of this agreement. Two hospitals had considered the problem of inadequate 2-PAM supplies before receiving the survey. Five of 7 (71.4 percent) hospitals would consider accessing the SNS if the need for antidotes were exceeded by their own supply. Recognition of regional planning for sharing of antidotes such as 2-PAM is lacking in the surveyed region and could lead to inability to care for large number of patients affected by an