Science.gov

Sample records for based stockpile stewardship

  1. 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.

  2. 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.

  3. 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.

  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. 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.

  6. 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.

  7. 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.

  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. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. Nuclear Theory for Astrophysics, Stockpile Stewardship, and Homeland Security

    NASA Astrophysics Data System (ADS)

    Hayes, Anna

    2004-10-01

    A large number of problems key to astrophysics, stockpile stewardship, and homeland defense rely on knowledge of nuclear physics in regimes inaccessible to experiment. In stellar and nuclear explosions unstable nuclei and nuclear isomers are produced in copious quantities and are used to diagnose the explosion. Similarly, analysis of the unstable nuclei from the debris will be key to attribution in the event of a terrorist domestic nuclear attack. In the case of nuclear non-proliferation a number of new schemes are being considered by the IAEA to address the ever greater needs, including neutrino monitoring of the plutonium content of reactors. For all of these problems detailed nuclear theory is required. In this talk I discuss the theoretical physics needs for the type of problems of overlapping interest to astrophysics and national security.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. Development of Designer Diamond Anvils for High Pressure-High-Temperature Experiments in Support of the Stockpile Stewardship Program

    SciTech Connect

    Yogesh K. Vohra

    2005-05-12

    The focus of this program at the University of Alabama at Birmingham (UAB) is to develop the next generation of designer diamond anvils that can perform simultaneous joule heating and temperature profile measurements in a diamond anvil cell. A series of tungsten-rhenium thermocouples will be fabricated onto to the anvil and encapsulated by a chemical vapor deposited diamond layer to allow for a complete temperature profile measurement across the anvil. The tip of the diamond anvil will be engineered to reduce the thermal conductivity so that the tungsten-heating coils can be deposited on top of this layer. Several different approaches will be investigated to engineer the tip of the diamond anvil for reduction in thermal conductivity (a) isotopic mixture of 12C and 13C in the diamond layer, (b) doping of diamond with impurities (nitrogen and/or boron), and (c) growing diamond in a higher concentration of methane in hydrogen plasma. Under this academic alliance with Lawrence Livermore National Laboratory (LLNL), PI and his graduate students will use the lithographic and diamond polishing facility at LLNL. This proposed next generation of designer diamond anvils will allow multi-tasking capability with the ability to measure electrical, magnetic, structural and thermal data on actinide materials with unparallel sensitivity in support of the stockpile stewardship program.

  6. Stewardship

    ERIC Educational Resources Information Center

    Canada, Benjamin O.

    2005-01-01

    In this article, the author found himself particularly drawn to a book he received in the mail--"Stewardship: Choosing Service Over Self-Interest" by Peter Block. Although the dictionary definition of steward is "one who manages another's property, finances or other affairs," from his vantage point as the first African-American superintendent in…

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. The Future of Fernald: Community-Based Stewardship Planning

    SciTech Connect

    Bidwell, D.; Sarno, D. J.

    2003-02-27

    For more than a decade, the U.S. Department of Energy (DOE) has managed an environmental remediation project at its former uranium processing facility near Fernald, Ohio. To address public concerns about what will happen at the site once remediation is completed, the Site- Specific Advisory Board for the site, the Fernald Citizens Advisory Board (FCAB), designed and implemented the Future of Fernald. process to involve the public in planning for the site's future. The FCAB recently coordinated a feasibility study of post-remediation public access to site information. Information is a key component of Community-Based Stewardship, a system in which the public plays an integral role in long-term stewardship of a site. This study found that has just begun to address community needs for information during long-term stewardship. Through a public workshop, conducted as part of the study, the public was able to identify the kinds of information that are needed and how that information should be presented.

  12. 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.

  13. Antimicrobial Stewardship: The Need to Cover All Bases.

    PubMed

    Friedman, N Deborah

    2013-01-01

    Increasing antimicrobial resistance has necessitated an approach to guide the use of antibiotics. The necessity to guide antimicrobial use via stewardship has never been more urgent. The decline in anti-infective innovation and the failure of currently available antimicrobials to treat some serious infections forces clinicians to change those behaviors that drive antimicrobial resistance. The majority of antimicrobial stewardship (AMS) programs function in acute-care hospitals, however, hospitals are only one setting where antibiotics are prescribed. Antimicrobial use is also high in residential aged care facilities and in the community. Prescribing in aged care is influenced by the fact that elderly residents have lowered immunity, are susceptible to infection and are frequently colonized with multi-resistant organisms. While in the community, prescribers are faced with public misconceptions about the effectiveness of antibiotics for many upper respiratory tract illnesses. AMS programs in all of these locations must be sustainable over a long period of time in order to be effective. A future with effective antimicrobials to treat bacterial infection will depend on AMS covering all of these bases. This review discusses AMS in acute care hospitals, aged care and the community and emphasizes that AMS is critical to patient safety and relies on government, clinician and community engagement.

  14. 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…

  15. 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.

  16. 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.

  17. [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.

  18. 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.

  19. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling. (a... prescribed by the Consumer Product Safety Commission. (b) Prohibited acts. Stockpiling of power lawn mowers... prohibited. (c) Base period. The base period for power lawn mowers is, at the option of each manufacturer...

  20. 16 CFR 1205.7 - Prohibited stockpiling.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... SAFETY STANDARD FOR WALK-BEHIND POWER LAWN MOWERS The Standard § 1205.7 Prohibited stockpiling. (a... prescribed by the Consumer Product Safety Commission. (b) Prohibited acts. Stockpiling of power lawn mowers... prohibited. (c) Base period. The base period for power lawn mowers is, at the option of each manufacturer...

  1. 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.

  2. 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.

  3. Community-Based Monitoring Frameworks: Increasing the Effectiveness of Environmental Stewardship

    NASA Astrophysics Data System (ADS)

    Conrad, Catherine T.; Daoust, Tyson

    2008-03-01

    This article presents an adaptable community-based monitoring (CBM) framework. The investigators used a well-tested conceptual CBM framework developed by the Canadian Community Monitoring Network (CCMN) as a basis from which to work. With the use of feedback from various types of CBM groups in the Province of Nova Scotia, Canada, obtained through surveys and interviews, the CCMN framework was modified into a document that attempts to address current disparities and inefficiencies within most CBM systems. The need for such a framework was underscored by the lack of stewardship groups’ use of standardized monitoring protocols and inability to effectively provide information to decision makers. From the information collected through the survey, it was concluded that the proposed framework must be a functional, multiparty form of CBM that addresses the key concerns of a standardized monitoring and communication program and must be able to be fed into the environmental-management system.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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…

  15. 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…

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. 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

  1. 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)

  2. 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.

  3. 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.

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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...

  14. 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...

  15. 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...

  16. 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... stockpiling a product subject to a consumer product safety standard between its date of issuance and...

  17. 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...

  18. 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...

  19. 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.

  20. Ecosystem stewardship: good idea, but how?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 ...

  1. Promoting knowledge integration of scientific principles and environmental stewardship: Assessing an issue-based approach to teaching evolution and marine conservation

    NASA Astrophysics Data System (ADS)

    Zimmerman, Timothy David

    2005-11-01

    Students and citizens need to apply science to important issues every day. Yet the design of science curricula that foster integration of science and everyday decisions is not well understood. For example, can curricula be designed that help learners apply scientific reasons for choosing only environmentally sustainable seafood for dinner? Learners must develop integrated understandings of scientific principles, prior experiences, and current decisions in order to comprehend how everyday decisions impact environmental resources. In order to investigate how such integrated understandings can be promoted within school science classes, research was conducted with an inquiry-oriented curriculum that utilizes technology and a visit to an informal learning environment (aquarium) to promote the integration of scientific principles (adaptation) with environmental stewardship. This research used a knowledge integration approach to teaching and learning that provided a framework for promoting the application of science to environmental issues. Marine biology, often forsaken in classrooms for terrestrial biology, served as the scientific context for the curriculum. The curriculum design incorporated a three-phase pedagogical strategy and new technology tools to help students integrate knowledge and experiences across the classroom and aquarium learning environments. The research design and assessment protocols included comparisons among and within student populations using two versions of the curriculum: an issue-based version and a principle-based version. These inquiry curricula were tested with sophomore biology students attending a marine-focused academy within a coastal California high school. Pretest-posttest outcomes were compared between and within the curricular treatments. Additionally, comparisons were made between the inquiry groups and seniors in an Advanced Placement biology course who attend the same high school. Results indicate that the inquiry curricula

  2. 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.

  3. 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.

  4. 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

  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. 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.'

  7. 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

  8. 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. PMID:20837557

  9. 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.

  10. 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…

  11. 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.

  12. 75 FR 12231 - NACEPT Subcommittee on Promoting Environmental Stewardship

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-15

    ... AGENCY NACEPT Subcommittee on Promoting Environmental Stewardship AGENCY: Environmental Protection Agency... Stewardship. The purpose of the Subcommittee on Promoting Environmental Stewardship (SPES) of the National... Protection Agency on how to promote environmental stewardship practices that encompass all...

  13. Reliability Impact of Stockpile Aging: Stress Voiding

    SciTech Connect

    ROBINSON,DAVID G.

    1999-10-01

    The objective of this research is to statistically characterize the aging of integrated circuit interconnects. This report supersedes the stress void aging characterization presented in SAND99-0975, ''Reliability Degradation Due to Stockpile Aging,'' by the same author. The physics of the stress voiding, before and after wafer processing have been recently characterized by F. G. Yost in SAND99-0601, ''Stress Voiding during Wafer Processing''. The current effort extends this research to account for uncertainties in grain size, storage temperature, void spacing and initial residual stress and their impact on interconnect failure after wafer processing. The sensitivity of the life estimates to these uncertainties is also investigated. Various methods for characterizing the probability of failure of a conductor line were investigated including: Latin hypercube sampling (LHS), quasi-Monte Carlo sampling (qMC), as well as various analytical methods such as the advanced mean value (Ah/IV) method. The comparison was aided by the use of the Cassandra uncertainty analysis library. It was found that the only viable uncertainty analysis methods were those based on either LHS or quasi-Monte Carlo sampling. Analytical methods such as AMV could not be applied due to the nature of the stress voiding problem. The qMC method was chosen since it provided smaller estimation error for a given number of samples. The preliminary results indicate that the reliability of integrated circuits due to stress voiding is very sensitive to the underlying uncertainties associated with grain size and void spacing. In particular, accurate characterization of IC reliability depends heavily on not only the frost and second moments of the uncertainty distribution, but more specifically the unique form of the underlying distribution.

  14. 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

  15. 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.

  16. Teaching Stewardship of Water Environments.

    ERIC Educational Resources Information Center

    Hairston, Rosalina V.

    1997-01-01

    Describes two model water education programs. The River Ecology Program teaches students basic ecological concepts related to rivers, explores the impact of human activities on rivers, and helps students develop an attitude of stewardship for rivers. The Wetlands Watch Program has students conduct studies related to local wetlands and respond…

  17. 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.

  18. 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.

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

    PubMed

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

    2015-04-01

    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.

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

    PubMed

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

    2016-03-01

    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. PMID:26721704

  1. Stockpiling Supplies for the Next Influenza Pandemic

    PubMed Central

    Magalian, Paul D.; Hollingsworth, Mary Kay; Baracco, Gio

    2009-01-01

    Faced with increasing concerns about the likelihood of an influenza pandemic, healthcare systems have been challenged to determine what specific medical supplies that should be procured and stockpiled as a component of preparedness. Despite publication of numerous pandemic planning recommendations, little or no specific guidance about the types of items and quantities of supplies needed has been available. The primary purpose of this report is to detail the approach of 1 healthcare system in building a cache of supplies to be used for patient care during the next influenza pandemic. These concepts may help guide the actions of other healthcare systems. PMID:21970033

  2. 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.

  3. An institutional review of antimicrobial stewardship interventions.

    PubMed

    Cao, Henry; Phe, Kady; Laine, Gregory A; Russo, Hannah R; Putney, Kimberly S; Tam, Vincent H

    2016-09-01

    In order to combat increasing rates of bacterial resistance, many institutions have implemented antimicrobial stewardship programmes (ASPs) to improve antibiotic use. To ascertain the potential impact of our stewardship programme at Baylor St Luke's Medical Center (Houston, TX), antimicrobial-related interventions were analysed over a 4-year period. ASP recommendations related to antimicrobial therapy from 2009 to 2012 were retrieved from the hospital electronic database and were retrospectively reviewed. The number of interventions for each time period was adjusted to the hospital census data. The interventions were randomly assessed and categorised for clinical significance based on established institutional guidelines. In total, 14654 non-duplicate antimicrobial therapy interventions were retrieved, of which 11874 (81.0%) were audited for accuracy. Approximately 13 interventions were made per 1000 patient-days, but there were no significant patterns observed regarding the number of interventions performed from month to month (range 8-21). The most frequent types of interventions were related to inappropriate dosing (39.0%), antimicrobial selection (20.5%) and drug allergy (13.0%). Serious adverse drug events (ADEs) were potentially avoided in 20.7% of all interventions. Cumulative potential cost avoidance was more than US$6.5 million. In our institution, proper drug and dose selection were the major components of the ASP. Without focusing solely on reduction of drug acquisition costs, implementation of an ASP could still be cost effective by improving the quality of patient care and avoiding ADEs with serious consequences. PMID:27530844

  4. Hospital antimicrobial stewardship in the nonuniversity setting.

    PubMed

    Trivedi, Kavita K; Kuper, Kristi

    2014-06-01

    Inappropriate antimicrobial use and antimicrobial resistance persist across the healthcare continuum. Antimicrobial stewardship guidelines assist healthcare institutions in establishing antimicrobial stewardship programs but rely on infectious diseases expertise and leadership, which are not available in all settings. Despite this, many institutions have found ways to use available resources to perform stewardship activities, with improvements in antimicrobial use and reductions in resistance and cost. This article highlights success stories in nonuniversity hospital settings and proposes antimicrobial stewardship strategies that may be more feasible in settings with limited infectious diseases expertise, information technology, or financial resources.

  5. 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...

  6. 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...

  7. 30 CFR 823.12 - Soil removal and stockpiling.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 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, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 3 2011-07-01 2011-07-01 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, 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 75 FR 20991 - NACEPT Subcommittee on Promoting Environmental Stewardship

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-22

    ... AGENCY NACEPT Subcommittee on Promoting Environmental Stewardship AGENCY: Environmental Protection Agency..., EPA gives notice of a meeting of the NACEPT Subcommittee on Promoting Environmental Stewardship. The purpose of the Subcommittee on Promoting Environmental Stewardship (SPES) of the National Advisory...

  16. 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

  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. An Elective Course on Antimicrobial Stewardship

    PubMed Central

    Sherman, Elizabeth M.; Unger, Nathan R.

    2015-01-01

    Objective. To implement an antimicrobial stewardship (AS) elective course for second-year and third-year pharmacy students and to assess its impact on students’ perceptions regarding the application of AS principles. Design. A 2-credit elective course focusing on principles of AS incorporated prelecture didactic recordings with primary literature and guideline-based reading assignments, in-class active-learning group work and student-led presentations, and student-generated examination items. Assessment. Perceptions were assessed by precourse and postcourse survey items. Graded course assessments included completion of preclass assignments (readings, prerecorded lecture and writing assessment items), in-class active participation and group presentations, a midpoint examination, and a final examination. Conclusion. An AS-themed elective course in a doctor of pharmacy curriculum incorporating preclass, self-directed learning and in-class group-based active-learning strategies positively impacted students’ perceived understanding of AS strategies. PMID:26889069

  19. Evacuation modeling near a chemical stockpile site

    SciTech Connect

    Newsom, D.E.; Madore, M.A.; Jaske, R.T.

    1992-01-01

    Dynamic evacuation modeling was used as an aid in emergency response planning by Tooele County, Utah, location of the United States' largest stockpile of unitary chemical weapons. The use of traffic modeling was affected both by the characteristics of the hazard and the unique topography of the area. To address these constraints Argonne National Laboratory, the Federal Emergency Management Agency, and Tooele County created a set of evacuation modeling scenarios to be stored in the county's emergency management information system. For use in planning, the scenarios enable the county to map out effective traffic management strategies. For us in exercises or emergency response the scenarios enable the county to quickly access data to make and implement evacuation decisions.

  20. Evacuation modeling near a chemical stockpile site

    SciTech Connect

    Newsom, D.E.; Madore, M.A.; Jaske, R.T.

    1992-06-01

    Dynamic evacuation modeling was used as an aid in emergency response planning by Tooele County, Utah, location of the United States` largest stockpile of unitary chemical weapons. The use of traffic modeling was affected both by the characteristics of the hazard and the unique topography of the area. To address these constraints Argonne National Laboratory, the Federal Emergency Management Agency, and Tooele County created a set of evacuation modeling scenarios to be stored in the county`s emergency management information system. For use in planning, the scenarios enable the county to map out effective traffic management strategies. For us in exercises or emergency response the scenarios enable the county to quickly access data to make and implement evacuation decisions.

  1. Stockpile Transition Enabling Program (STEP): Process and project requirements

    SciTech Connect

    Ma, Kwok Kee

    1993-06-01

    The Stockpile Transition Enabling Program (STEP) is aimed at identifying weapon components suitable for use in more than one weapon and for qualifying components so identified for multiple use. Work includes identifying the means to maintain the manufacturing capability for these items. This document provides the participants in STEP a common, consistent understanding of the process and requirements. The STEP objectives are presented and the activities are outlined. The STEP project selections are based on the customer needs, product applicability, and maturity of the technology used. A formal project selection process is described and the selection criteria are defined. The concept of {open_quotes}production readiness{close_quotes} is introduced, along with a summary of the project requirements and deliverables to demonstrate production readiness.

  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. 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…

  4. Stewardship in Community Education: The Merlyn Effect.

    ERIC Educational Resources Information Center

    Hyatt, Norman F.; Burnside, Joan L.

    Stewardship is the name given to a theory and model for educational leadership and administration developed by the Department of Educational Administration at Brigham Young University in Provo, Utah. In the stewardship theory, the job of the personnel administrator is to make it safe for others to find their own best ways of doing things to…

  5. 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.

  6. Antibiotic stewardship in the intensive care unit.

    PubMed

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

    2014-01-01

    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. 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... STATE AND PRIVATE FORESTRY ASSISTANCE Stewardship Incentive Program § 230.6 Landowner forest stewardship...) of this subpart, eligible landowners shall have an approved landowner forest stewardship plan....

  8. Antimicrobial Stewardship for the Infection Control Practitioner.

    PubMed

    Nagel, Jerod L; Kaye, Keith S; LaPlante, Kerry L; Pogue, Jason M

    2016-09-01

    Antibiotic misuse is a serious patient safety concern and a national public health priority. Years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and Clostridium difficile This crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. This review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewardship strategies, the role of the infection control practitioner in stewardship, barriers to its implementation and maintenance, approaches to measure the impact of a program, and the steps needed to initiate a program.

  9. Antimicrobial Stewardship for the Infection Control Practitioner.

    PubMed

    Nagel, Jerod L; Kaye, Keith S; LaPlante, Kerry L; Pogue, Jason M

    2016-09-01

    Antibiotic misuse is a serious patient safety concern and a national public health priority. Years of indiscriminant antibiotic use has promoted selection for antibiotic resistant bacteria and Clostridium difficile This crisis has led to clinicians being faced with managing untreatable infections, often in the most vulnerable patient populations. This review summarizes the goals of antimicrobial stewardship programs, the essential members needed to initiate a program, various antimicrobial stewardship strategies, the role of the infection control practitioner in stewardship, barriers to its implementation and maintenance, approaches to measure the impact of a program, and the steps needed to initiate a program. PMID:27515147

  10. Antimicrobial stewardship interventions: thinking inside and outside the box.

    PubMed

    Hamilton, Keith W; Fishman, Neil O

    2014-06-01

    At present, less than half of all acute health care facilities have antimicrobial stewardship programs. By targeting areas that are vulnerable to inappropriate antimicrobial use and by using novel strategies to increase the reach of stewardship interventions, providers can make antimicrobial stewardship a universal practice in all health care settings. This review discusses how stewardship can make large impacts in areas where it has traditionally been absent in facilities both with and without formal antimicrobial stewardship programs.

  11. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    PubMed

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

    2016-01-01

    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. PMID:27621341

  12. 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.

  13. 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. PMID:23930660

  14. 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

  15. 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.

  16. 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

  17. The stewardship model: current viability for genetic biobank practice development.

    PubMed

    Williams, Pamela Holtzclaw; Schepp, Karen; McGrath, Barbara; Mitchell, Pamela

    2010-01-01

    The "stewardship model" of ethics relationships is a conceptual framework initially proposed by Jeffers in Advances in Nursing Science, 24(2), 2001. It conceptualized ethical responsibilities in the practice of systematic collection and storage of biospecimens in biobanks for future healthcare genetic research. Since the article's publication 8 years ago, genetic biobanks have grown in number around the world and discernible biobank relational conceptualizations were published. Nursing leadership adopted competency standards for all genetic nursing practices. The involvement of nurses has increased and is projected for further significant increase as biobank practices emerge from research into clinical care settings. This assessment of current viability of this previously established stewardship model offers fresh insights to existing and future nursing research and practice. The purpose of this article was to analyze the original stewardship model's components, the relational parties, and characteristics; by contrasting those with proposed conceptualizations and existing biobank practices developed subsequent to its publication. The model's current viability and theoretical development status are assessed for its ability to support a future nursing evidence base for best practices. Proposals for the model's expansion are suggested.

  18. 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

  19. Remote Antimicrobial Stewardship in Community Hospitals.

    PubMed

    Wood, Zachary H; Nicolsen, Nicole C; Allen, Nichole; Cook, Paul P

    2015-11-13

    Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to streamline, discontinue, or switch antimicrobial agents. Totals of charts reviewed, recommendations made, recommendations accepted, and categories of intervention were recorded. Linear regression was utilized to measure changes in antimicrobial use over time. For the four larger hospitals, recommendations for changes were made in an average of 45 charts per month per hospital and physician acceptance of the pharmacists' recommendations varied between 83% and 88%. There was no significant decrease in total antimicrobial use, but much of the use was outside of the stewardship program's review. Quinolone use decreased by more than 50% in two of the four larger hospitals. Remote antimicrobial stewardship utilizing an EMR is feasible in community hospitals and is generally received favorably by physicians. As more community hospitals adopt EMRs, there is an opportunity to expand antimicrobial stewardship beyond the academic medical center.

  20. 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.

  1. 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.

  2. 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.

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

    PubMed

    Lokuge, Buddhima; Drahos, Peter; Neville, Warwick

    2006-01-01

    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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 77 FR 18879 - Meeting of the Regional Resource Stewardship Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-28

    ... Meeting of the Regional Resource Stewardship Council AGENCY: Tennessee Valley Authority (TVA). ACTION: Notice of meeting. SUMMARY: The TVA Regional Resource Stewardship Council (RRSC) will hold a meeting on... advise TVA on its natural resource stewardship activities. Notice of this meeting is given under...

  15. 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 NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES...

  16. 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 NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES...

  17. 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 NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES...

  18. 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 NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES...

  19. 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 NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES...

  20. Leachate From Biosolid Stockpiles: Nutrients and Metal Mobility.

    NASA Astrophysics Data System (ADS)

    Peckenham, J. M.; Nadeau, J. A.; Amirbahman, A.; Brutsaert, W.; Wilson, J.

    2004-05-01

    Field stacking of biosolids prior to utilization is a standard agricultural practice. The Maine Department of Environmental Protection is concerned about how this stacking affects groundwater quality, in particular, nitrate-N leached from stockpiles. Maine regulations have had much stricter siting standards for field stacking since 2002. In 2002 we initiated an experiment to characterize the nitrogen chemistry of leachate. Mass loading of nitrogen leaving stockpiles was determined experimentally by placing biosolids on plastic-lined cells to collect liquid flowing through and over the pile. These piles contained approximately 60 cubic meters of biosolids. Biosolid stockpile geometry affects the amount of leachate generated. In a parallel experiment, the composition of leachate moving through till-derived soil has been gauged using pan lysimeters and shallow wells under field conditions. Initial results indicate that ammonia is the dominant nitrogen species released (2,200 to 4,800 mg/L). Nitrate concentrations were found to be less than 1 mg/L in the leachate. Dissolved organic carbon loading was also high (5,800 to 10,000 mg/L). Several heavy metals and phosphorous were detected in association with the leachate in the surrounding lysimeters and boreholes. Additional data from sites reclaimed using biosolids substantiate the transport of nitrogen and metals to groundwater, even without the concentrating effect of stockpiles. These data suggest that soils may not significantly attenuate metal transport under ambient conditions.

  1. 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.

  2. 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... WORK AREAS OF UNDERGROUND COAL MINES Surface Installations § 77.211 Draw-off tunnels; stockpiling and reclaiming operations; general. (a) Tunnels located below stockpiles, surge piles, and coal storage...

  3. 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... WORK AREAS OF UNDERGROUND COAL MINES Surface Installations § 77.211 Draw-off tunnels; stockpiling and reclaiming operations; general. (a) Tunnels located below stockpiles, surge piles, and coal storage...

  4. 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... WORK AREAS OF UNDERGROUND COAL MINES Surface Installations § 77.211 Draw-off tunnels; stockpiling and reclaiming operations; general. (a) Tunnels located below stockpiles, surge piles, and coal storage...

  5. 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... WORK AREAS OF UNDERGROUND COAL MINES Surface Installations § 77.211 Draw-off tunnels; stockpiling and reclaiming operations; general. (a) Tunnels located below stockpiles, surge piles, and coal storage...

  6. 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... WORK AREAS OF UNDERGROUND COAL MINES Surface Installations § 77.211 Draw-off tunnels; stockpiling and reclaiming operations; general. (a) Tunnels located below stockpiles, surge piles, and coal storage...

  7. 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…

  8. 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.

  9. 75 FR 34924 - Conservation Stewardship Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-21

    ... a final rule that appeared in the Federal Register of June 3, 2010 (75 FR 31653). The document 2010... . SUPPLEMENTARY INFORMATION: In FR Doc. 2010-12699 appearing on page 31653 in the Federal Register of Thursday... Commodity Credit Corporation 7 CFR Part 1470 RIN 0578-AA43 Conservation Stewardship Program...

  10. 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.

  11. 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. PMID:15254997

  12. Chemical-Stockpile Disposal Program. Chemical weapons movement history compilation. Historical report 1946-1986

    SciTech Connect

    Brankowitz, W.R.

    1987-06-12

    This report was produced to study the history of past chemical-weapons-movement operations from 1946 to 1986. The history was then to be used as a source of lessons learned for planning any transportation that might be required to implement the Chemical Stockpile Disposal Program. The report candidly discusses problems encountered on past chemical-weapons-movement operations and suggests areas in which the movement of chemical weapons can be improved based on past experience. The report summarizes all movement operations from 1946 to 1986, while acknowledging that this record is incomplete for some years because not all movement records were preserved.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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. PMID:21069771

  19. The impact of weathering and aging on a LIMB ash stockpile material

    SciTech Connect

    Beeghly, J.H.; Bigham, J.M.; Dick, W.A.; Stehouwer, R.C.; Wolfe, W.B.

    1995-03-01

    A 1,500 ton temporary storage pile of water conditioned LIMB (Lime Injected Multistage Burner) ash by-product from the Ohio Edison Edgewater plant Lorain, OH was constructed in July, 1991 at a coal company near New Philadelphia, Ohio. This stockpile was created for dry FGD by-product material to be held in reserve for a land application uses field demonstration. High volume, beneficial uses of dry FGD by-products, such as for mine reclamation and embankment stabilization, will require temporary stockpiling of the by-product. Purpose for constructing this pile was to study changes with time in the LIMB by-product material when exposed to weathering. This by-product material was studied over a 2 1/2 year period. The water to control fugitive dust was added in the ash conditioner at the power plant while being loaded into dump trucks. Amount of water normally added in the conditioning process is close to the optimum moisture content of 40--50 % (dry weight basis), to construct a compacted road embankment or road base. Four environmental operating permits required for construction of the storage pile were obtained, three from Ohio EPA (air, water and solid waste), and one from the Ohio Division of Reclamation (revised reclamation area permit). There was no significant environmental impacts from storm runoff or leachate water from the LIMB ash stockpile during the initial 18 month period through December, 1992. After 2 1/2 years of storage, the potential value of the LIMB material for use as a road embankment material or soil conditioner has declined significantly. Ettringite formation occurs. Aging allows the expansive reaction to take place before its potential use as compacted structural fill or embankment.

  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. 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. PMID:27550482

  2. The role of public health in antimicrobial stewardship in healthcare.

    PubMed

    Trivedi, Kavita K; Pollack, Loria A

    2014-10-15

    Education, surveillance, and promotion of antimicrobial stewardship align with the goals of public health to prevent disease, promote health, and prolong life. Many US federal and state public health organizations are already engaged in antimicrobial stewardship activities. Healthcare providers are encouraged to work with public health officials on appropriate local antimicrobial stewardship strategies to attain the common goal of reducing antimicrobial resistance and preserving antimicrobials for future generations.

  3. Demonstrating the value of antimicrobial stewardship programs to hospital administrators.

    PubMed

    Nagel, Jerod L; Stevenson, James G; Eiland, Edward H; Kaye, Keith S

    2014-10-15

    The movement away from fee-for-service models to those that emphasize quality of care and patient outcomes affords a unique opportunity for antimicrobial stewardship programs to expand their value for hospital administration. Antimicrobial stewardship participants must collaborate with administrators and key stakeholders to position themselves to improve economic, process, and outcomes measures. This will allow the establishment of antimicrobial stewardship programs as essential components of the present and future healthcare quality journey.

  4. Stewardship: Training the Gifted as Community Mentors. Programming for the Gifted Series.

    ERIC Educational Resources Information Center

    Runions, Ted

    The author describes the Mentor Academy Program (MAP) a skill-based model for training gifted high school students as mentors and thereby becoming leaders in processing information and networkers creating and sharing information. Chapter 1 offers historical and philosophical, gifted education, and high school perspectives to stewardship (the dual…

  5. 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

  6. The Antimicrobial Stewardship Approach to Combating Clostridium Difficile.

    PubMed

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

    2015-06-17

    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.

  7. Stewardship in mental health policy: inspiration, influence, institution?

    PubMed

    Brown, Lawrence D; Isett, Kimberley R; Hogan, Michael

    2010-06-01

    The venerable but amorphous concept of stewardship has lately gained prominence in discussions of public policy and management and is sometimes offered as a "strategy" with a distinctive potential to mobilize effective public leadership in the service of broad social missions. In this article we explore how stewardship may be useful to the theory and practice of mental health policy, and, reciprocally, how examples from mental health policy may elucidate the dynamics of stewardship. After examining its key political ingredients--authority, advocacy, and analysis--we discuss the practical challenges in moving stewardship from moral inspiration to institutional reality.

  8. Antimicrobial stewardship in the intensive care unit: advances and obstacles.

    PubMed

    Lawrence, Kevin L; Kollef, Marin H

    2009-03-15

    Antimicrobial stewardship involves a multifaceted approach that strives to combat the emergence of resistance, improve clinical outcomes, and control costs by improving antimicrobial use. Therefore, stewardship is of great importance and relevance in the intensive care unit. Clinical decision support systems, biomarker-derived treatment algorithms, and improved knowledge regarding the different components of antimicrobial therapy represent some of the advances that have been made in stewardship. Yet, significant obstacles have prevented the full achievement of stewardship's goals, and approaches to confronting these obstacles should be appreciated. Clinicians should realize that antimicrobials are important therapeutic agents and strive to use them wisely.

  9. The Evolving Role of Antimicrobial Stewardship in Management of Multidrug Resistant Infections.

    PubMed

    Goff, Debra A; File, Thomas M

    2016-06-01

    This article summarizes the current literature describing how antimicrobial stewardship interventions impact antimicrobial resistance. Discussion includes why we need stewardship, how to collaborate with team members, and the evidence of stewardship's impact on resistance.

  10. 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:...

  11. 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

  12. 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.

  13. The Italian Hub of Population Biobanks as a potential tool for improving public health stewardship.

    PubMed

    Bravo, Elena; Napolitano, Mariarosaria; Santoro, Filippo; Belardelli, Filippo; Federic, Antonio

    2013-06-01

    In Italy, a country that is experiencing the decentralization of health services from central to regional level of government, the Minister of Health is proposing stewardship as a model of governance for the public health system. Stewardship favors efficiency in the policy decision-making process, based on reciprocal trust, and tends to be more ethical. The embryonic proposal to test stewardship in the field of population-based research was advanced during the launching conference Challenges and Opportunities of the Italian Hub of Population Biobanks (HIBP) held in 2012 in Rome. Resources collected by population biobanks (i.e., blood and its derivatives, and/or DNA isolated from any type of biological samples and relative associated data) have, in fact, a recognized scientific value for the investigation of links between genetics, health and life style, and epidemiological outcomes through population biobank-based studies, and are essential to planning effective and qualified interventions for public health. The current economic crisis requires a strong push to rationalize investment in health policies. In particular, population biobank-based studies require financial commitment, often of long duration, for the realization of their goals. Thus, innovative solutions to allow fast integration of scientific knowledge into political health strategy are required. During the conference in Rome, it was proposed to test the stewardship model by its application to the inter-relationship between population biobank-based studies and disease prevention. Stewardship minimizes barriers to innovation and uses information more effectively to better develop new strategies for prevention and/or treatment. In the months following the conference, the proposal was defined more clearly, and the HIBP network became a potential tool for testing and implementing this model in the Italian Public Health prevention system.

  14. [Antimicrobial stewardship in primary care setting].

    PubMed

    Mombelli, Matteo; Plüss-Suard, Catherine; Niquille, Anne; Zanetti, Giorgio; Boillat-Blanco, Noémie

    2016-04-13

    Antibiotic overuse in primary care setting is a major contributor to the development of resistant bacteria. Antibiotic consumption is low in Switzerland compared to neighbour countries, but improvement is possible and has to be pursued. Antibiotic stewardship helps physician to better recognize patients who need antibiotic (guidelines implementation, electronic decision support and laboratory testing) and educate patients about the uselessness of antibiotics in a given situation (delayed prescription and shared decision making). Clinical studies demonstrated the efficacy of these interventions in reducing antibiotic consumption, mainly in acute respiratory infections, without affecting patients' clinical outcome.

  15. 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

  16. 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. PMID:26912934

  17. 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.

  18. 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...

  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. In January 2006, ARS,…

  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 behaviors and…

  1. Becoming Rooted in the Stewardship Way of Life.

    ERIC Educational Resources Information Center

    Voboril, Bob

    2003-01-01

    Criticizes how Catholic schools have been forced to survive by adopting a purchase mentality. The solution is to embrace the stewardship way of life. Points out that stewardship takes a while to take effect, but once it does it will create a counter cultural attitude toward one's income and assets. (MZ)

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. Outpatient parenteral antimicrobial therapy and antimicrobial stewardship: challenges and checklists.

    PubMed

    Gilchrist, M; Seaton, R A

    2015-04-01

    Outpatient parenteral antimicrobial therapy (OPAT) has become, for many countries, an established form of healthcare delivery. At the same time, there have been calls to ensure the prudent use of the existing antimicrobial armamentarium. For OPAT, this presents a dilemma. On one hand, stewardship principles look for the most effective agent with minimal collateral effects. In OPAT, whilst the aims of the service are similar, convenience of dosing to optimize early hospital discharge or admission avoidance may take precedence over an agent's spectrum of activity. This brief article aims to highlight the importance and explore the challenges of antimicrobial stewardship in the context of OPAT. Within the UK, the safe and effective use of antimicrobials is modelled around the IDSA/Society for Healthcare Epidemiology of America stewardship practice guidelines with local customization where appropriate. Current UK stewardship practice principles were compared with published good practice recommendations for OPAT to identify how OPAT could support the broader antimicrobial stewardship agenda. It is essential that antimicrobial stewardship teams should understand the challenges faced in the non-inpatient setting and the potential benefits/lower risks associated with avoided admission or shortened hospital stay in this population. Within its limitations, OPAT should practise stewardship principles, including optimization of intravenous to oral switch and the reporting of outcomes, healthcare-associated infections and re-admission rates. OPAT should report to the antimicrobial stewardship team. Ideally the OPAT team should be formally represented within the stewardship framework. A checklist has been proposed to aid OPAT services in ensuring they meet their stewardship agenda.

  8. 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.

  9. Characteristics of Antimicrobial Stewardship Programs at Veterans Affairs Hospitals: Results of a Nationwide Survey.

    PubMed

    Chou, Ann F; Graber, Christopher J; Jones, Makoto; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew; Kelly, Allison; Glassman, Peter A

    2016-06-01

    BACKGROUND Antimicrobial stewardship programs (ASPs) are variably implemented. OBJECTIVE To characterize variations of antimicrobial stewardship structure and practices across all inpatient Veterans Affairs facilities in 2012 and correlate key characteristics with antimicrobial usage. DESIGN A web-based survey regarding stewardship activities was administered to each facility's designated contact. Bivariate associations between facility characteristics and inpatient antimicrobial use during 2012 were determined. SETTING Total of 130 Veterans Affairs facilities with inpatient services. RESULTS Of 130 responding facilities, 29 (22%) had a formal policy establishing an ASP, and 12 (9%) had an approved ASP business plan. Antimicrobial stewardship teams were present in 49 facilities (38%); 34 teams included a clinical pharmacist with formal infectious diseases (ID) training. Stewardship activities varied across facilities, including development of yearly antibiograms (122 [94%]), formulary restrictions (120 [92%]), stop orders for antimicrobial duration (98 [75%]), and written clinical pathways for specific conditions (96 [74%]). Decreased antimicrobial usage was associated with having at least 1 full-time ID physician (P=.03), an ID fellowship program (P=.003), and a clinical pharmacist with formal ID training (P=.006) as well as frequency of systematic patient-level reviews of antimicrobial use (P=.01) and having a policy to address antimicrobial use in the context of Clostridium difficile infection (P=.01). Stop orders for antimicrobial duration were associated with increased use (P=.03). CONCLUSIONS ASP-related activities varied considerably. Decreased antibiotic use appeared related to ID presence and certain select practices. Further statistical assessments may help optimize antimicrobial practices. Infect Control Hosp Epidemiol 2016;37:647-654.

  10. 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

    ... Bureau of Industry and Security National Defense Stockpile Market Impact Committee Request for Public Comments on the Potential Market Impact of Proposed Stockpile Disposals for Fiscal Year 2012 AGENCY: Bureau... of State, Bureau of Economic and Business Affairs, Office of International Energy and...

  11. 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.

  12. 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.

  13. Making a Case for Pediatric Antimicrobial Stewardship Programs.

    PubMed

    Magsarili, Heather K; Girotto, Jennifer E; Bennett, Nicholas J; Nicolau, David P

    2015-11-01

    Although antimicrobials are commonly used in children, it is important to remember that they can have a profound impact on this unique patient population. Inadvertent consequences of antiinfective use in children include antimicrobial resistance, infection caused by Clostridium difficile, increased risk of obesity, and adverse drug events. In addition, compared with adults, children have different dosing requirements, antimicrobial formulation needs, pharmacokinetics, and antimicrobial susceptibility profiles. Therefore, pediatric-specific antimicrobial stewardship efforts are needed to promote appropriate use of antimicrobials in children. The primary purposes of this review article are to provide a rationale behind pediatric-focused antimicrobial stewardship and to describe currently available evidence regarding the initiatives of pediatric antimicrobial stewardship programs (ASPs). A literature search of the Medline database was performed (from inception through March 2015). The studies included in this review focus on antimicrobial stewardship interventions in inpatient pediatric settings. Ten inpatient studies involving pediatric-focused antimicrobial stewardship interventions were identified from the published literature. Four studies used the core strategy of prospective audit with feedback; two used prior approval. The remaining four used supplemental antimicrobial stewardship strategies (guidelines, clinical pathways, and computerized decision support tools). In general, the interventions resulted in decreased antimicrobial use, reduced antimicrobial costs, and fewer prescribing errors. Children have unique medical needs related to antimicrobials and deserve focused ASP efforts. The literature regarding pediatric antimicrobial stewardship interventions is limited, but published interventions may serve as paradigms for developing pediatric ASPs as demonstrated by the general success of these interventions.

  14. Antibiotic stewardship programmes--what's missing?

    PubMed

    Charani, Esmita; Cooke, Jonathan; Holmes, Alison

    2010-11-01

    Inappropriate antibiotic use and antibiotic resistance are now major global issues. Antimicrobial stewardship programmes are increasingly being used to optimize antibiotic prescribing in acute care. The central tenet of these programmes tends to be policy and guidelines aimed at prescribers. However, rules and guidelines alone may not be sufficient to bring about effective and sustainable optimization of practice. Best practice needs to be positively reinforced by an environment that facilitates and supports optimal prescribing choices, i.e. a 'choice architecture' that makes prudent antibiotic prescribing the path of least resistance. To make prudent antibiotic management an integral part of the behaviour of all healthcare professionals and to bring about quality improvement it is necessary to adopt a whole-system approach. To do this it is necessary first to understand the factors that influence antibiotic management and prescribing.

  15. Should Remaining Stockpiles of Smallpox Virus (Variola) Be Destroyed?

    PubMed Central

    2011-01-01

    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. PMID:21470459

  16. 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.

  17. 7 CFR 1469.7 - Benchmark condition inventory and conservation stewardship plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... stewardship plan. 1469.7 Section 1469.7 Agriculture Regulations of the Department of Agriculture (Continued... SECURITY PROGRAM General Provisions § 1469.7 Benchmark condition inventory and conservation stewardship... contract. (b) Conservation stewardship plan. (1) The conservation stewardship plan and associated case...

  18. Best Practices for Curriculum, Teaching, and Evaluation Components of Aquatic Stewardship Education.

    ERIC Educational Resources Information Center

    Siemer, William F.

    This paper reviews the literature to outline principles and best practices for aquatic stewardship education. Stewardship education develops an internalized stewardship ethic and the skills needed for decision making and environmentally responsible actions. Successful stewardship education programs are designed to influence beliefs, values,…

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

    PubMed

    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

    2016-05-15

    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.

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

    PubMed

    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

    2016-05-15

    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.

  1. 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. PMID:20430122

  2. Executive compensation committee plays key role in board's stewardship.

    PubMed

    Galvin, J M

    1991-04-22

    Board members charged with a facility's stewardship should include executives among the key assets involved, and the way to assure executive compensation committee, says Jos. Michael Galvin. PMID:10110127

  3. 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.

  4. Engaging Pharmacy Students, Residents, and Fellows in Antimicrobial Stewardship.

    PubMed

    Chahine, Elias B; El-Lababidi, Rania M; Sourial, Mariette

    2015-12-01

    Antimicrobial stewardship programs are mainly established by infectious diseases physicians and infectious diseases-trained clinical pharmacists with the goal of optimizing patients' outcomes while halting antimicrobial resistance, decreasing adverse events, and controlling health care cost. The role of the infectious diseases-trained clinical pharmacist in antimicrobial stewardship is well established; however, there are not enough formally trained pharmacists to assume the challenging responsibilities of the steward coordinator. The purpose of this article was to review the available literature and resources and propose a model to engage introductory pharmacy practice experience students, advanced pharmacy practice experience students, postgraduate year (PGY) 1 pharmacy residents, PGY2 infectious diseases pharmacy residents, and PGY2 or PGY3 infectious diseases pharmacy fellows in antimicrobial stewardship. Further studies are needed to assess and document the impact of pharmacy students and postgraduate trainees on antimicrobial stewardship programs.

  5. 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

  6. Saint Joseph's University Institute for Environmental Stewardship

    SciTech Connect

    McCann, Michael; Springer, Clint

    2014-06-18

    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

  7. Saint Joseph's University Institute for Environmental Stewardship

    SciTech Connect

    McCann, Michael P.; Springer, Clint J.

    2014-06-05

    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

  8. 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.

  9. Risk associated with the demilitarization of the United States chemical weapons stockpile

    SciTech Connect

    Flanagan, G.F.; Fraize, W.; Kartachak, T.

    1989-01-01

    In accordance with Public Law 99-145 (Title 14, Part B, Section 1412) a programmatic Environmental Impact Statement was prepared to assess the environmental impact of destruction of the continental US (CONUS) stockpile of unitary lethal chemical agent and munitions. The CONUS supply of chemical munitions and agents accounted for 94.4% by weight of the entire US stockpile. The CONUS stockpile is currently stored at the eight sites. The hazards associated with the disposal process included those associated with (1) plant operation, (2) transportation, (3) handling, and (4) external events (pervasive among the other 3 hazard areas). 8 refs., 9 figs., 2 tabs.

  10. 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.

  11. Optimizing research methods used for the evaluation of antimicrobial stewardship programs.

    PubMed

    McGregor, Jessina C; Furuno, Jon P

    2014-10-15

    Antimicrobial stewardship programs (ASPs) are an increasingly common intervention for optimizing antimicrobial therapy in healthcare settings. These programs aim to improve patient care and limit the emergence and spread of multidrug-resistant organisms by supporting prudent antimicrobial use. However, pressure from the current reimbursement climate necessitates that ASPs operate as cost-cutting programs rather than focus on patient outcomes. This has forced the research that is evaluating ASP interventions to concentrate heavily on economic outcomes. As the science of antimicrobial stewardship advances, it is essential that well-conducted evaluations, focused on patient and microbial outcomes, serve as the evidence base that directs optimal ASP intervention design and implementation. In this review, we provide guidance and recommendations for the design of studies to evaluate the impact of ASP interventions on patient and microbial outcomes.

  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. 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.

  14. Risk communications and the Chemical Stockpile Emergency Preparedness Program

    SciTech Connect

    Vogt, B.M.

    1995-12-31

    One of the greater challenges the Army faces is effectively dealing with the concerns of the public, local officials and the news media on the disposal of aging chemical agents. This paper describes the method developed for the Chemical Stockpile Emergency Preparedness Program (CSEPP). The purpose was to provide a fairly comprehensive document on risk communication research and recommended practices as they related to the CSEPP. Using the communications perspective suggested by Covello and colleagues, the existing practices of communicating risk information about chemical weapons and the associated efforts in emergency planning, storage and eventual disposal are described. Risk communication problems specific to the CSEPP are then examined and described via scenarios. A framework is developed that distinguishes between the major components of risk communication, flow and intent. Within this framework, the research and recommendations are summarized as to direction of flow -- dialogue, or two-way interaction, versus monologue, or one-way communication -- and that of intent -- exchange versus persuasion. The findings and recommendations are synthesized and related to risk events for the CSEPP as posited in the scenarios.

  15. 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.

  16. Infections, bacterial resistance, and antimicrobial stewardship: the emerging role of hospitalists.

    PubMed

    Rosenberg, David J

    2012-01-01

    The care of patients with serious infections both within and outside healthcare settings is increasingly complicated by the high prevalence of resistant or multidrug-resistant (MDR) pathogens. Moreover, infections caused by MDR versus susceptible bacteria or other pathogens are associated with significantly higher mortality, length of hospital stay, and healthcare costs. Antimicrobial misuse or overuse is the primary driver for development of antimicrobial resistance, suggesting that better use of antimicrobials will translate into improved patient outcomes, more efficient use of hospital resources, and lowered healthcare costs. Antimicrobial stewardship refers to the various practices and procedures utilized to optimize antimicrobial use. The primary goal of antimicrobial stewardship is to improve patient outcomes and lower antimicrobial resistance and other unintended consequences of antimicrobial therapy. Secondary goals are to reduce length of hospital stays and healthcare-related costs. Hospitalists are increasingly involved in the care of hospitalized patients throughout the United States. Expertise in managing conditions requiring hospitalization, and experience in quality improvement across a wide range of clinical conditions, make hospitalists well positioned to participate in the development and implementation of hospital-based antimicrobial stewardship programs designed to improve patient outcomes, reduce antimicrobial resistance, and provide more efficient and lower-cost hospital care.

  17. Infections, bacterial resistance, and antimicrobial stewardship: the emerging role of hospitalists.

    PubMed

    Rosenberg, David J

    2012-01-01

    The care of patients with serious infections both within and outside healthcare settings is increasingly complicated by the high prevalence of resistant or multidrug-resistant (MDR) pathogens. Moreover, infections caused by MDR versus susceptible bacteria or other pathogens are associated with significantly higher mortality, length of hospital stay, and healthcare costs. Antimicrobial misuse or overuse is the primary driver for development of antimicrobial resistance, suggesting that better use of antimicrobials will translate into improved patient outcomes, more efficient use of hospital resources, and lowered healthcare costs. Antimicrobial stewardship refers to the various practices and procedures utilized to optimize antimicrobial use. The primary goal of antimicrobial stewardship is to improve patient outcomes and lower antimicrobial resistance and other unintended consequences of antimicrobial therapy. Secondary goals are to reduce length of hospital stays and healthcare-related costs. Hospitalists are increasingly involved in the care of hospitalized patients throughout the United States. Expertise in managing conditions requiring hospitalization, and experience in quality improvement across a wide range of clinical conditions, make hospitalists well positioned to participate in the development and implementation of hospital-based antimicrobial stewardship programs designed to improve patient outcomes, reduce antimicrobial resistance, and provide more efficient and lower-cost hospital care. Journal of Hospital Medicine 2012;7:S34-S43. © 2012 Society of Hospital Medicine.

  18. 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. PMID:24855430

  19. 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. PMID:25371683

  20. 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.

  1. 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.

  2. Implementation of a Hemostatic and Antithrombotic Stewardship program.

    PubMed

    Reardon, David P; Atay, Julie K; Ashley, Stanley W; Churchill, William W; Berliner, Nancy; Connors, Jean M

    2015-10-01

    Hemostatic and antithrombotic (HAT) agents are high risk, high cost products. They require close monitoring and dose titration to adequately treat or prevent thrombosis while avoiding bleeding events. Incorporating the principles of inpatient anticoagulation management service into a stewardship program not only improves outcomes and decreases cost, but also improves transitions of care, exposes gaps in therapy management, and leads to the development of institution specific protocols and guidelines. We implemented a HAT Stewardship to provide real time clinical surveillance and management of these agents in an effort to optimize appropriate use, decrease serious adverse events, and minimize costs. The stewardship is staffed daily by an interdisciplinary team comprised of a pharmacist, hematology attending, and medical director. The stewardship focuses on (1) management of heparin-induced thrombocytopenia (HIT), (2) management of patients with Hemophilia A/B with inhibitors and acquired Factor VIII deficiency due to inhibitors, (3) oversight of anticoagulation in patients on extracorporeal membrane oxygenation and (4) assistance with anticoagulation management for patients with mechanical cardiac assist devices. Through implementation of this service, we have been able to demonstrate improved patient care and a positive economic impact exceeding the cost of this program by almost sixfold. Other centers should consider instituting a HAT Stewardship to maximize patient outcomes and minimize adverse events.

  3. 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.

  4. 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.

  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. PMID:24987714

  6. An integrated stewardship model: antimicrobial, infection prevention and diagnostic (AID).

    PubMed

    Dik, Jan-Willem H; Poelman, Randy; Friedrich, Alexander W; Panday, Prashant Nannan; Lo-Ten-Foe, Jerome R; van Assen, Sander; van Gemert-Pijnen, Julia E W C; Niesters, Hubert G M; Hendrix, Ron; Sinha, Bhanu

    2016-01-01

    Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship model comprising three intertwined programs: antimicrobial, infection prevention and diagnostic stewardship, involving all stakeholders. The focus is a so-called 'theragnostics' approach. This leads to a personalized infection management plan, improving patient care and minimizing resistance development. Furthermore, it is important that healthcare regions nationally and internationally work together, ensuring that the patient (and microorganism) transfers will not cause problems in a neighboring institution. This antimicrobial, infection prevention and diagnostic stewardship model can serve as a blue print to implement innovative, integrative infection management.

  7. Antimicrobial stewardship of β-lactams in intensive care units.

    PubMed

    Cotta, Menino Osbert; Roberts, Jason A; Tabah, Alexis; Lipman, Jeffrey; Vogelaers, Dirk; Blot, Stijn

    2014-05-01

    Stewardship of all antimicrobials, including β-lactam antibiotics, has gained in prominence over the last decade. Appropriate use of these agents has become vitally important; especially in the treatment and management of the critically ill. Opportunities therefore exist to develop innovations to optimise the use of antimicrobials in places like the intensive care unit. The next few years represent an important window in which routine antimicrobial stewardship principles such as surveillance of local ecology, minimising overlap of spectrum of activity and prompt de-escalation upon review of cultures can be integrated with new technologies including improved diagnostic techniques, individualised dosing strategies and computerised decision support. It is important though, that these measures to improve stewardship in the intensive care unit continue to be critically evaluated in the literature.

  8. 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.

  9. 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.

  10. 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.

  11. Antimicrobial stewardship program prompts increased and earlier infectious diseases consultation.

    PubMed

    Morrill, Haley J; Gaitanis, Melissa M; LaPlante, Kerry L

    2014-01-01

    A recent analysis demonstrated that infectious diseases (ID) specialty intervention was associated with decreased mortality and hospital readmission. These benefits were greatest if involvement occurred within two days of hospital admission. Antimicrobial stewardship programs should augment the services of an ID specialist team and promote formal consultation. Implementation of an antimicrobial stewardship program at the Providence Veterans Affairs Medical Center was associated with an increased number of consults (increase of 72.2%) and decreased time to consult (3.5 days sooner), which might also dramatically improve patient outcomes, including mortality and readmission rates. PMID:24742249

  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. 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.

  14. 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. PMID:26678275

  15. Antimicrobial stewardship in small animal veterinary practice: from theory to practice.

    PubMed

    Guardabassi, Luca; Prescott, John F

    2015-03-01

    Despite the increasing recognition of the critical role for antimicrobial stewardship in preventing the spread of multidrug-resistant bacteria, examples of effective antimicrobial stewardship programs are rare in small animal veterinary practice. This article highlights the basic requirements for establishing stewardship programs at the clinic level. The authors provide suggestions and approaches to overcome constraints and to move from theoretic concepts toward implementation of effective antimicrobial stewardship programs in small animal clinics.

  16. 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...

  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...

  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...

  19. 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…

  20. 75 FR 48742 - Renewal of the Regional Resource Stewardship Council Charter

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-11

    ... Renewal of the Regional Resource Stewardship Council Charter AGENCY: Tennessee Valley Authority (TVA....C. Appendix), the TVA Board of Directors has renewed the Regional Resource Stewardship Council... will provide advice to TVA on issues affecting natural resource stewardship activities. Numerous...

  1. 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.

  2. Importance of antimicrobial stewardship to the English National Health Service

    PubMed Central

    Dixon, Jill; Duncan, Christopher JA

    2014-01-01

    Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS) to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS), a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future priorities include establishing novel approaches to antimicrobial management (eg, duration of therapy, combination regimens) to protect against resistance and working with the pharmaceutical

  3. Importance of antimicrobial stewardship to the English National Health Service.

    PubMed

    Dixon, Jill; Duncan, Christopher Ja

    2014-01-01

    Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS) to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS), a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future priorities include establishing novel approaches to antimicrobial management (eg, duration of therapy, combination regimens) to protect against resistance and working with the pharmaceutical

  4. 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.

  5. Stewardship and Accountability: Valued Elements in Maximising Human Potential.

    ERIC Educational Resources Information Center

    Todd, Sally M.

    1998-01-01

    Explains the application of five principles of stewardship to the education of gifted children: (1) teachers/parents teach correct principles; (2) students set their own goals in harmony with these principles; (3) teachers serve students as a source of help; (4) students ask for and receive help when needed; and (5) students give an accounting of…

  6. 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.

  7. Developing the first national antimicrobial prescribing and stewardship competences.

    PubMed

    Ashiru-Oredope, D; Cookson, B; Fry, C

    2014-11-01

    Antimicrobial resistance is a national and worldwide threat to the future of healthcare. Educating both healthcare staff and the public in the prudent use of antimicrobials is an essential part of antimicrobial stewardship programmes that aim to contain and control resistance and preserve the usefulness of currently available antibiotics. Using current available evidence, regulatory documents and national antimicrobial stewardship guidance for primary and secondary care, five dimensions for antimicrobial prescribing and stewardship competences have been developed in England, through an independent multiprofessional group led by the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) of the Department of Health (England). They are designed to complement the generic competency framework for all prescribers from the UK National Prescribing Centre (now part of National Institute for Health and Care Excellence) and are relevant to all independent prescribers, including doctors, dentists and non-medical practitioners. The antimicrobial prescribing and stewardship competences published jointly by ARHAI and PHE in 2013 are believed to be the first of their kind. Implementation of these competences will be an important contribution to the delivery of the UK government's 5 year Antimicrobial Resistance Strategy.

  8. 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.

  9. 78 FR 20166 - Meeting of the Regional Resource Stewardship Council

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-03

    ... materials should be limited to one printed page. Written comments are also invited and may be mailed to the Regional Resource Stewardship Council, Tennessee Valley Authority, 400 West Summit Hill Drive, WT-11 B... Guntersville State Park Lodge, 1155 Lodge Drive, Guntersville, Alabama 35976-9126 and will be open to...

  10. 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…

  11. 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…

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Perceptual indicators of environmental health, future land use, and stewardship.

    PubMed

    Burger, Joanna; Myers, O; Boring, C S; Dixon, C; Jeitner, J C; Leonard, J; Lord, C; McMahon, M; Ramos, R; Shukla, S; Gochfeld, Michael

    2003-12-01

    There are important linkages between the health of humans and the environment, restoration of degraded lands, and long-term stewardship of public lands, yet most environmental indicators deal only with assessing the physical and biological aspects of ecosystems. In this article, we examine the ratings of perceptions of several environmental problems for their utility as indicators of environmental quality, and examine perceptions of future land use by people interviewed in Santa Fe, New Mexico, near the Department of Energy's (DOE) Los Alamos National Laboratory (LANL). Overall, people with lower incomes rated environmental problems as more severe than others, were more willing to spend federal funds to solve them, and were consistent in their ratings of severity of environmental problems and their willingness to spend federal funds. Cleaning up LANL and other Department of Energy sites, received the highest rating for expenditure of federal funds. The highest rated future uses for DOE sites were for recreation and for National Environmental Research Parks. People with less education generally gave higher ratings to most future land uses for DOE than did those with more education. However, those with higher education gave higher ratings to nuclear reprocessing, and nuclear material storage. Where there were differences, the people interviewed at Santa Fe rated all environmental problems (except pesticides) as more severe than did those previously interviewed in Albuquerque (located farther from the LANL site), and they were more willing to spend federal funds on these problems. Ratings for all future land uses did not differ between the Santa Fe and Albuquerque respondents. These perception-based indicators show general agreement among people living close and farther away from LANL with respect to cleaning up LANL and the future land uses for the site. These indicators should be considered by regulators, site personnel, and policy makers in future management and

  18. From nuclides to nerve gas: The development of the Chemical Stockpile Emergency Preparedness Exercise Program

    SciTech Connect

    Gant, K.S.; Adler, M.V.

    1991-12-01

    The Army and the Federal Emergency Management Agency established the Chemical Stockpile Emergency Preparedness Program (CSEPP), to improve emergency preparedness around each location storing the nation`s aging stockpile of unitary chemical weapons. The CSEPP requires that a series of exercises be conducted at each location on a regular schedule. The CSEPP exercise program drew upon the existing Army and civilian exercises. Merging the exercise traditions of both the communities and installations into a joint exercise program acceptable to both sides and the particular nature of the hazard required a number of adjustments in the usual approaches. 14 refs., 1 fig.

  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.

  20. 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. PMID:27098167

  1. 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

  2. Saint Joseph's University Institute for Environmental Stewardship

    SciTech Connect

    McCann, Michael P; Springer, Clint

    2013-10-15

    at Saint Joseph's University. The roof system includes four test plots, each with a different drainage system, instrumentation to monitor storm water retention, roof deck temperature, heat flux into and out of the building, rain fall, wind speed and direction, relative humidity and heat emission from the roof system. The vegetative roof was planted with 26 species of plants, distributed throughout the roof area, to assess species/variety growth and coverage characteristics, both in terms of the different drain layer systems, and in terms of the different exposures along the north to south axis of the building. Analysis of the drain layer performance, in terms of storm water retention, shows that the aggregate (stone) drainage layer system performed the best, with the moisture management mat system second, and the geotextile drain layer and reservoir sheet layer systems coming in last. Plant growth performance analysis is ongoing, but significant differences have been observed in the third growing season ('13) along the north to south axis, with most species doing better towards the northern end of the roof (in terms of percent ground coverage and plant spread and reproduction). Interestingly, plant growth in all four of the test plots was reduced relative to the lower areas of the roof (the lower area was ca. 2 inches lower than the test plots, due to the space needed for sensors under the plots. The lower roof area uses an aggregate drain layer comparable to that in the third test plot), even when accounting for the north to south differences. The reasons for these differences are not clear and studies are underway to examine the impact of wind scour, drainage rates, temperature, and other factors. Task C: Education and community outreach efforts by the IES involving conferences at SJU, presentations by faculty and students off campus, and educational signage. The Institute for Environmental Stewardship hosted three storm water management workshops on the SJU campus

  3. Syringe Stockpiling by Persons Who Inject Drugs: An Evaluation of Current Measures for Needle and Syringe Program Coverage.

    PubMed

    McCormack, Angus R; Aitken, Campbell K; Burns, Lucinda A; Cogger, Shelley; Dietze, Paul M

    2016-05-01

    Needle and syringe program (NSP) coverage is commonly used to assess NSP effectiveness. However, existing measures don't capture whether persons who inject drugs (PWIDs) stockpile syringes, an important and novel aspect of NSP coverage. In this study, we determine the extent of stockpiling in a sample of Australian PWIDs and assess whether including stockpiling enhances NSP coverage measures. As part of the Illicit Drug Reporting System study, PWIDs reported syringes procured and given away, total injections in the last month, and syringes currently stockpiled in 2014. We calculated NSP coverage with and without stockpiling to determine proportional change in adequate NSP coverage. We conducted receiver operating characteristic curve analysis to determine whether inclusion of stockpiled syringes in the measure improved sensitivity in discriminating cases and noncases of risky behaviors. Three-quarters of the sample reported syringe stockpiling, and stockpiling was positively associated with nonindigenous background, stable accommodation, no prison history, longer injecting careers, and more frequent injecting. Compared with previous measures, our measure was significantly better at discriminating cases of risky behaviors. Our results could inform NSP policy to loosen restricted-exchange practice, allowing PWIDs greater flexibility in syringe procurement practices, promoting greater NSP coverage, and reducing PWIDs' engagement in risky behaviors.

  4. 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

  5. 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.

  6. Influenza antiviral susceptibility monitoring activities in relation to national antiviral stockpiles in Europe during the winter 2006/2007 season.

    PubMed

    Meijer, A; Lackenby, A; Hay, A; Zambon, M

    2007-04-01

    Due to the influenza pandemic threat, many countries are stockpiling antivirals in the hope of limiting the impact of a future pandemic virus. Since resistance to antiviral drugs would probably significantly alter the effectiveness of antivirals, surveillance programmes to monitor the emergence of resistance are of considerable importance. During the 2006/2007 influenza season, an inventory was conducted by the European Surveillance Network for Vigilance against Viral Resistance (VIRGIL) in collaboration with the European Influenza Surveillance Scheme (EISS) to evaluate antiviral susceptibility testing by the National Influenza Reference Laboratories (NIRL) in relation to the national antiviral stockpile in 30 European countries that are members of EISS. All countries except Ukraine had a stockpile of the neuraminidase inhibitor (NAI) oseltamivir. Additionally, four countries had a stockpile of the NAI zanamivir and three of the M2 ion channel inhibitor rimantadine. Of 29 countries with a NAI stockpile, six countries' NIRLs could determine virus susceptibility by 50% inhibitory concentration (IC50) and in 13 countries it could be done by sequencing. Only in one of the three countries with a rimantadine stockpile could the NIRL determine virus susceptibility, by sequencing only. However, including the 18 countries that had plans to introduce or extend antiviral susceptibility testing, the NIRLs of 21 of the 29 countries with a stockpile would be capable of susceptibility testing appropriate to the stockpiled drug by the end of the 2007/2008 influenza season. Although most European countries in this study have stockpiles of influenza antivirals, susceptibility surveillance capability by the NIRLs appropriate to the stockpiled antivirals is limited. PMID:17991386

  7. 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

  8. 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

    ... research and development projects. Public comments are an important element of the Committee's market impact review process. DATES: To be considered, written comments must be received by December 13, 2013... Stockpile Manager to fund material research and development projects to develop new materials for...

  9. 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.

  10. 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.

  11. 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.

  12. Developing Best Practices for Scientific Data Stewardship? (SDS)

    NASA Astrophysics Data System (ADS)

    Kihn, E.; Redmon, R.

    2008-12-01

    Science Data Stewardship (SDS) is the art of 'maintaining the science integrity and long term utility of scientific records' and ' the actions which maximize the return on investment for archived scientific data'. This paper will present a series of best practices developed under the Electronic Geophysical Year (eGY) for SDS. These practices include areas such as: Storage and Preservation, Ease of Use, Interoperability, Quality Information and Metadata, Data Availability, User Presentation, Attribution and Accountability, and Electronic Data Preservation These practice are of use for anyone concerned with the long term stewardship and preservation of electronic records. This set of practices is currently being extended by the CODATA working group on the eGY. http://www.sciencedatastewardship.org

  13. 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.

  14. 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. PMID:19665090

  15. 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. PMID:25331093

  16. 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.

  17. 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.

  18. Engaging hospitalists in antimicrobial stewardship: Lessons from a multihospital collaborative.

    PubMed

    Mack, Megan R; Rohde, Jeffrey M; Jacobsen, Diane; Barron, James R; Ko, Christin; Goonewardene, Michael; Rosenberg, David J; Srinivasan, Arjun; Flanders, Scott A

    2016-08-01

    Inappropriate antimicrobial use in hospitalized patients contributes to antimicrobial-resistant infections and complications. We sought to evaluate the impact, barriers, and facilitators of antimicrobial stewardship best practices in a diverse group of hospital medicine programs. This multihospital initiative included 1 community nonteaching hospital, 2 community teaching hospitals, and 2 academic medical centers participating in a collaborative with the Centers for Disease Control and Prevention and the Institute for Healthcare Improvement. We conducted multimodal physician education on best practices for antimicrobial use including: (1) enhanced antimicrobial documentation, (2) improved quality and accessibility of local clinical guidelines, and (3) a 72-hour antimicrobial "timeout." Implementation barriers included variability in physician practice styles, lack of awareness of stewardship importance, and overly broad interventions. Facilitators included engaging hospitalists, collecting real time data and providing performance feedback, and appropriately limiting the scope of interventions. In 2 hospitals, complete antimicrobial documentation in sampled medical records improved significantly (4% to 51% and 8% to 65%, P < 0.001 for each comparison). A total of 726 antimicrobial timeouts occurred at 4 hospitals, and 30% resulted in optimization or discontinuation of antimicrobials. With careful attention to key barriers and facilitators, hospitalists can successfully implement effective antimicrobial stewardship practices. Journal of Hospital Medicine 2016;11:576-580. © 2016 Society of Hospital Medicine. PMID:27130473

  19. 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.

  20. 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

  1. Estimating landholders' probability of participating in a stewardship program, and the implications for spatial conservation priorities.

    PubMed

    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.

  2. 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.

  3. 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.

  4. Risk associated with the demilitarization of the United States chemical weapons stockpile

    SciTech Connect

    Flanagan, G.F.

    1988-01-01

    A programmatic Environmental Impact Statement was prepared to assess the environmental impact of destruction of the continental US stockpile of unitary lethal chemical agent and munitions. This report contains topics on: Program Disposal Alternative, Accident/Risk Analysis, Risk Measures, Uncertainties in Estimates of Impacts and Risks, Implementation of the Selection Methodology, and Examining the Identified Alternative for Each Site Inventory. 8 refs., 9 figs. (JL)

  5. 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.

  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. Exceptions or alternatives to labeling requirements for products held by the Strategic National Stockpile. Final rule.

    PubMed

    2012-02-01

    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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. Reentry, recovery, and restoration following a chemical weapons stockpile disposal program accident: Offpost planning and preparedness aspects

    SciTech Connect

    Lewis, L.; Herzenberg, C.; Tanzman, E.; Lerner, K.; Haffenden, R.; Meleski, S. ); Adams, J. )

    1991-01-01

    There is a need for pre-disaster recovery planning. The Department of Defense has recognized that need by strongly emphasizing recovery planning and coordination in its CSEP program. CSEPP is the Chemical Stockpile Emergency Preparedness Program. It was developed to improve emergency preparedness associated with the disposal of US stockpiles of unitary chemical weapons. This disposal was mandated by Congress in 1985 and is scheduled for completion in April 1997.

  13. 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

  14. Dissipation of Three Veterinary Antimicrobials in Beef Cattle Feedlot Manure Stockpiled over Winter.

    PubMed

    Sura, Srinivas; Degenhardt, Dani; Cessna, Allan J; Larney, Francis J; Olson, Andrew F; McAllister, Tim A

    2014-05-01

    Dissipation of veterinary antimicrobials is known to occur during aerated windrow composting of beef cattle manure. However, it is unclear if a similar dissipation occurs during stockpiling. Chlortetracycline, tylosin, and sulfamethazine are three of the most commonly used veterinary antimicrobials in beef cattle production in western Canada. Their dissipation in stockpiled manure was investigated over 140 d during winter in Alberta, Canada. Beef cattle housed in pens were administered 44 mg of chlortetracycline kg feed (dry weight), 44 mg of chlortetracycline + 44 mg sulfamethazine kg feed, 11 mg of tylosin kg feed, or feed without antimicrobials (control). Manure samples were extracted using pressurized liquid extraction, and the extracts were analyzed for chlortetracycline, sulfamethazine, and tylosin by LC-MS-MS. Dissipation of all three antimicrobials in the manure was explained by exponential decay kinetics. Times for 50% dissipation (DT) were 1.8 ± 0.1 d for chlortetracycline alone or 6.0 ± 0.8 d when mixed with sulfamethazine, 20.8 ± 3.8 d for sulfamethazine, and 4.7 ± 1.2 d for tylosin. After 77 d, <1% of initial chlortetracycline and <2% of sulfamethazine remained. Tylosin residues were more variable, decreasing to approximately 12% of initial levels after 28 d, with 20% present after 77 d and 13% after 140 d. Temperatures within stockpiles reached maximum values within 6 d of establishment and varied with location (bottom, 62.5°C; middle, 63.8°C; and top, 42.9°C). Antimicrobials in the manure did not inhibit microbial activity, as indicated by temperature and mass losses of carbon (C) and nitrogen (N). The C/N ratio in the manure decreased over the stockpiling period, indicating decomposition of manure to a more stable state. Dissipation of excreted residues with DT values 1.8 to 20.8 d showed that stockpiling can be as effective as windrow composting in mitigating the transfer of these three veterinary antimicrobials into the environment during

  15. Dissipation of Three Veterinary Antimicrobials in Beef Cattle Feedlot Manure Stockpiled over Winter.

    PubMed

    Sura, Srinivas; Degenhardt, Dani; Cessna, Allan J; Larney, Francis J; Olson, Andrew F; McAllister, Tim A

    2014-05-01

    Dissipation of veterinary antimicrobials is known to occur during aerated windrow composting of beef cattle manure. However, it is unclear if a similar dissipation occurs during stockpiling. Chlortetracycline, tylosin, and sulfamethazine are three of the most commonly used veterinary antimicrobials in beef cattle production in western Canada. Their dissipation in stockpiled manure was investigated over 140 d during winter in Alberta, Canada. Beef cattle housed in pens were administered 44 mg of chlortetracycline kg feed (dry weight), 44 mg of chlortetracycline + 44 mg sulfamethazine kg feed, 11 mg of tylosin kg feed, or feed without antimicrobials (control). Manure samples were extracted using pressurized liquid extraction, and the extracts were analyzed for chlortetracycline, sulfamethazine, and tylosin by LC-MS-MS. Dissipation of all three antimicrobials in the manure was explained by exponential decay kinetics. Times for 50% dissipation (DT) were 1.8 ± 0.1 d for chlortetracycline alone or 6.0 ± 0.8 d when mixed with sulfamethazine, 20.8 ± 3.8 d for sulfamethazine, and 4.7 ± 1.2 d for tylosin. After 77 d, <1% of initial chlortetracycline and <2% of sulfamethazine remained. Tylosin residues were more variable, decreasing to approximately 12% of initial levels after 28 d, with 20% present after 77 d and 13% after 140 d. Temperatures within stockpiles reached maximum values within 6 d of establishment and varied with location (bottom, 62.5°C; middle, 63.8°C; and top, 42.9°C). Antimicrobials in the manure did not inhibit microbial activity, as indicated by temperature and mass losses of carbon (C) and nitrogen (N). The C/N ratio in the manure decreased over the stockpiling period, indicating decomposition of manure to a more stable state. Dissipation of excreted residues with DT values 1.8 to 20.8 d showed that stockpiling can be as effective as windrow composting in mitigating the transfer of these three veterinary antimicrobials into the environment during

  16. 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.

  17. 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

  18. Antimicrobial use and stewardship programs among dialysis centers.

    PubMed

    D'Agata, Erika M C

    2013-01-01

    Antimicrobial exposure contributes to the emergence and spread of multidrug-resistant organisms. As rates of colonization and infection with these organisms are among the highest in the population of chronic hemodialysis patients and antimicrobial exposure among this patient population is extensive, it is imperative to prescribe antimicrobials judiciously. Thirty to forty percent of chronic hemodialysis patients receive at least one dose of antimicrobials in outpatient centers over a one-year period. Up to 30% of these antimicrobials are prescribed inappropriately, as per national guidelines. The predominant reasons include (i) failure to de-escalate to a more narrow-spectrum antimicrobial, (ii) criteria for infection, especially skin and soft tissue infections, are not met, and (iii) indications and duration for surgical prophylaxis for minor vascular-access-related procedures do not follow recommended guidelines. Vancomycin, third- or fourth-generation cephalosporins and cefazolin are the most common antimicrobials or antimicrobial classes prescribed inappropriately. Antimicrobial stewardship programs reduce both inappropriate antimicrobial exposure and associated costs. Effective strategies include (i) education, (ii) guidelines and clinical pathways, (iii) antimicrobial order forms, (iv) de-escalation therapy, and (v) prospective audit and feedback. Dialysis centers need to identify a team of individuals that will lead the antimicrobial stewardship program. Administrative and financial support for this team is essential. After implementation of the program, regular monitoring for compliance with strategies, and identifying factors that are preventing compliance are necessary. The efficacy of the program should also be evaluated at regular intervals through process and outcome measures. PMID:23600755

  19. 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. PMID:25681977

  20. 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. PMID:24956589

  1. 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.

  2. 78 FR 12352 - Notice of Intent To Prepare an Environmental Impact Statement for the Wilderness Stewardship Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... Stewardship Plan, Olympic National Park, Clallam, Grays Harbor, Jefferson and Mason County, WA AGENCY... Wilderness Stewardship Plan (WSP) and Environmental Impact Statement (EIS) will be developed to provide... stewardship objectives and conducting wilderness eligibility studies for areas identified in the GMP Record...

  3. 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.

  4. 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.

  5. 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. PMID:26172107

  6. 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.

  7. Antimicrobial stewardship policy: time to revisit the strategy?

    PubMed

    Roger, P-M; Courjon, J; Léotard, S; Déchamp, C; Négrin, N; Vassallo, M

    2015-11-01

    Recent data indicate that both the overall numbers of antibiotic prescription and the frequency of multidrug-resistant bacteria are increasing significantly. These threatening features are observed, despite national antimicrobial stewardship (AMS) policies aimed at decreasing antibiotic use. AMS should also focus on the initial steps leading to antibiotic prescription. Physicians and their patients should benefit from the structured clinical pathways, the latter being adapted to regional epidemiological data and resources. Continuous evaluation of these predefined clinical paths through a computerized medical dashboard will allow a critical review and finally the optimization of medical practices. These innovative behavioural approaches for clinicians will supply precise information on the relationship among the diagnosis, therapeutics and outcome. This changing environment will carry out the adapted therapeutic procedures, and appropriate antibiotic use will inherently improve. PMID:26387088

  8. 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

  9. Review of Agri-Environment Indexes and Stewardship Payments

    NASA Astrophysics Data System (ADS)

    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.

  10. 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.

  11. Chemical-Stockpile Disposal Program. Monitoring concept plan. Final report, November 1986-September 1987

    SciTech Connect

    Kuryk, B.A.; Roux, R.G.; Brankowitz, W.R.; Flamm, K.J.; Owens, P.M.

    1987-09-10

    Monitoring concepts for all aspects of the Chemical Stockpile Disposal Program are presented. The chemical-agent monitoring standards and equipment are described, and their application to storage, handling, transport, and disposal of chemical agents and munitions is discussed. The report describes the monitoring and control of the disposal-process conditions (e.g., temperature, pressure, etc.) as a means of ensuring safe plant operations. Industrial-pollutant monitoring is also covered. Organizational monitoring and control concepts are described for all aspects of the program.

  12. 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.

  13. 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. PMID:22605544

  14. STEWARDSHIP: A Conceptual Imperative For Managerial Effectiveness In The Nigerian Health System

    PubMed Central

    2007-01-01

    Unacceptable health status indicators such as high infant and maternal mortality rates and low life expectancy have continued unabated inspite of government efforts to change it. This paper espouses the concept of stewardship as a selfless, ethical, cost effective and outcome oriented approach to governance. It is believed that through stewardship approach governments would improve the health status of their populations considerably. The paper implores not only government and health care managers but the Nigerian society also to imbibe the concept of stewardship to make the development of a result-oriented health system easy. PMID:25161436

  15. 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.

  16. A Evaluation of Models of Particulate Suspension for a Thorium Ore Stockpile

    NASA Astrophysics Data System (ADS)

    Smith, W. John, II

    Fifteen mathematical models of particle saltation, suspension, and resuspension were reviewed and categorized. Appropriate models were applied to the estimation of particulate releases from a hypothetical thorium ore storage pile. An assumed location (near Lemhi Pass, Montana) was used to permit the development of site specific information on ore characteristics and environmental influences. The available models were characterized in terms of suitability for representing aspects of the ore pile, such as rough surface features, wide particle size range, and site specific climate. Five models were selected for detailed study. A computer code for each of these is given. Site specific data for the assumed ore stockpile location were prepared. These data were manipulated to provide the input values required for each of the five models. Representative values and ranges for model variables are tabulated. The response of each model to input data for selected variables was determined. Each model was evaluated in terms of the physical realism of its responses and its overall ability to represent the features of an ore stockpile. The two models providing the best representation were a modified version of the dust suspension subroutine TAILPS from the computer code MILDOS, and the dust suspension formulation from the code REDIST. Their responses are physically reasonable, although different from each other for two parameters: ore moisture and surface roughness. With the input values judged most representative of an ore pile near Lemhi Pass, the estimate of the release of suspended particulates is on the order of 1 g/m('2)-yr.

  17. 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.

  18. 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

    2014-02-01

    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. PMID:24945555

  19. 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.

  20. 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.

  1. Antimicrobial Stewardship from Policy to Practice: Experiences from UK Antimicrobial Pharmacists.

    PubMed

    Gilchrist, Mark; Wade, Paul; Ashiru-Oredope, Diane; Howard, Philip; Sneddon, Jacqueline; Whitney, Laura; Wickens, Hayley

    2015-09-01

    Antimicrobial stewardship in the UK has evolved dramatically in the last 15 years. Factors driving this include initial central funding for specialist pharmacists and mandatory reductions in healthcare-associated infections (particularly Clostridium difficile infection). More recently, the introduction of national stewardship guidelines, and an increased focus on stewardship as part of the UK five-year antimicrobial resistance strategy, have accelerated and embedded developments. Antimicrobial pharmacists have been instrumental in effecting changes at an organizational and national level. This article describes the evolution of the antimicrobial pharmacist role, its impact, the progress toward the actions listed in the five-year resistance strategy, and novel emerging areas in stewardship in the UK.

  2. 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

    2014-02-01

    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.

  3. 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...

  4. 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.

  5. Antimicrobial Stewardship in Long-Term Care Facilities: A Call to Action.

    PubMed

    Morrill, Haley J; Caffrey, Aisling R; Jump, Robin L P; Dosa, David; LaPlante, Kerry L

    2016-02-01

    Antimicrobial resistance is a global public health crisis and a national security threat to the United States, as stated in an executive order signed by the president in September 2014. This crisis is a result of indiscriminant antimicrobial use, which promotes selection for resistant organisms, increases the risk of adverse drug events, and renders patients vulnerable to drug-resistant infections. Antimicrobial stewardship is a key measure to combat antimicrobial resistance and specifically seeks to do this by improving antimicrobial use. Antimicrobial stewardship compliments infection control practices and it is important to note that these 2 disciplines are distinct and cannot be discussed interchangeably. Antimicrobial stewardship promotes the appropriate diagnosis, drug, dose, and duration of treatment. The appropriate diagnosis falls into the hands of the prescriber and clinical staff. Optimal antimicrobial drug selection, dosing strategy, and duration of treatment, however, often require expertise in antimicrobial therapy, such as an infectious disease-trained physician or pharmacist. Therefore, successful antimicrobial stewardship programs must be comprehensive and interdisciplinary. Most antimicrobial stewardship programs focus on hospitals; yet, in long-term care, up to 75% of antimicrobial use is inappropriate or unnecessary. Thus, one of the most pressing areas in need for antimicrobial stewardship is in long-term care facilities. Unfortunately, there is little evidence that describes effective antimicrobial stewardship interventions in this setting. This review discusses the need for and barriers to antimicrobial stewardship in long-term care facilities. Additionally, this review describes prior interventions that have been implemented and tested to improve antimicrobial use in long-term care facilities. PMID:26778488

  6. 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.

  7. Antimicrobial Stewardship in Long-Term Care Facilities: A Call to Action.

    PubMed

    Morrill, Haley J; Caffrey, Aisling R; Jump, Robin L P; Dosa, David; LaPlante, Kerry L

    2016-02-01

    Antimicrobial resistance is a global public health crisis and a national security threat to the United States, as stated in an executive order signed by the president in September 2014. This crisis is a result of indiscriminant antimicrobial use, which promotes selection for resistant organisms, increases the risk of adverse drug events, and renders patients vulnerable to drug-resistant infections. Antimicrobial stewardship is a key measure to combat antimicrobial resistance and specifically seeks to do this by improving antimicrobial use. Antimicrobial stewardship compliments infection control practices and it is important to note that these 2 disciplines are distinct and cannot be discussed interchangeably. Antimicrobial stewardship promotes the appropriate diagnosis, drug, dose, and duration of treatment. The appropriate diagnosis falls into the hands of the prescriber and clinical staff. Optimal antimicrobial drug selection, dosing strategy, and duration of treatment, however, often require expertise in antimicrobial therapy, such as an infectious disease-trained physician or pharmacist. Therefore, successful antimicrobial stewardship programs must be comprehensive and interdisciplinary. Most antimicrobial stewardship programs focus on hospitals; yet, in long-term care, up to 75% of antimicrobial use is inappropriate or unnecessary. Thus, one of the most pressing areas in need for antimicrobial stewardship is in long-term care facilities. Unfortunately, there is little evidence that describes effective antimicrobial stewardship interventions in this setting. This review discusses the need for and barriers to antimicrobial stewardship in long-term care facilities. Additionally, this review describes prior interventions that have been implemented and tested to improve antimicrobial use in long-term care facilities.

  8. LONG-TERM STEWARDSHIP AT DOE HANFORD SITE - 12575

    SciTech Connect

    MOREN RJ; GRINDSTAFF KD

    2012-01-11

    The U.S. Department of Energy's (DOE) Hanford Site is located in southeast Washington and consists of 1,518 square kilometers (586 square miles) of land. Established in 1943 as part of the Manhattan Project, Hanford workers produced plutonium for our nation's nuclear defense program until the mid 1980's. Since then, the site has been in cleanup mode that is being accomplished in phases. As we achieve remedial objectives and complete active cleanup, DOE will manage Hanford land under the Long-Term Stewardship (LTS) Program until completion of cleanup and the site becomes ready for transfer to the post cleanup landlord - currently planned for DOE's Office of Legacy Management (LM). We define Hanford's LTS Program in the ''Hanford Long-Term Stewardship Program Plan,'' (DOE/RL-201 0-35)[1], which describes the scope including the relationship between the cleanup projects and the LTS Program. DOE designed the LTS Program to manage and provide surveillance and maintenance (S&M) of institutional controls and associated monitoring of closed waste sites to ensure the protection of human health and the environment. DOE's Richland Operations Office (DOE-RL) and Hanford cleanup and operations contractors collaboratively developed this program over several years. The program's scope also includes 15 key activities that are identified in the DOE Program Plan (DOE/RL-2010-35). The LTS Program will transition 14 land segments through 2016. The combined land mass is approximately 570 square kilometers (220 square miles), with over 1,300 active and inactive waste sites and 3,363 wells. Land segments vary from buffer zone property with no known contamination to cocooned reactor buildings, demolished support facilities, and remediated cribs and trenches. DOE-RL will transition land management responsibilities from cleanup contractors to the Mission Support Contract (MSC), who will then administer the LTS Program for DOE-RL. This process requires an environment of cooperation between

  9. Collaboration in long-term stewardship at DOE Hanford Site

    SciTech Connect

    Moren, R. J.; Zeisloft, J. H.; Feist, E. T.; Brown, D.; Grindstaff, K. D.

    2013-01-10

    The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km{sup 2} (586 mi{sup 2}) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi{sup 2} on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan, DOE/RL-2010-35 Rev 1. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years, 253.8 km{sup 2} (98 mi{sup 2}) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large

  10. 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. PMID:27094234

  11. 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.

  12. Effects of supplementation on intake, digestion, and performance of beef cattle consuming fertilized, stockpiled bermudagrass forage.

    PubMed

    Wheeler, J S; Lalman, D L; Horn, G W; Redmon, L A; Lents, C A

    2002-03-01

    Experiments were conducted to determine the effects of increasing supplement protein concentration on performance and forage intake of beef cows and forage utilization of steers consuming stockpiled bermudagrass forage. Bermudagrass pastures were fertilized with 56 kg of N/ha in late August. Grazing was initiated during early November and continued through the end of January each year. Treatments for the cow performance trials were: no supplement or daily equivalents of 0.2, 0.4, and 0.6 g of supplemental protein per kilogram of BW. Supplements were formulated to be isocaloric, fed at the equivalent of 0.91 kg/d, and prorated for 4 d/wk feeding. Varying the concentration of soybean hulls and soybean meal in the supplements created incremental increases in protein. During yr 1, supplemented cows lost less weight and condition compared to unsupplemented animals (P < 0.05). During yr 2, supplemented cows gained more weight (P = 0.06) and lost less condition (P < 0.05) compared to unsupplemented cows. Increasing supplement protein concentration had no affect on cumulative cow weight change or cumulative body condition score change. Forage intake tended to increase (P = 0.13, yr 1 and P = 0.07, yr 2) in supplemented cows. Supplement protein concentration did not alter forage intake. In a digestion trial, four crossbred steers were used in a Latin square design to determine the effects of supplement protein concentration on intake and digestibility of hay harvested from stockpiled bermudagrass pasture. Treatments were no supplement; or 0.23, 0.46, and 0.69 g of supplemental protein per kilogram of BW. Forage intake increased (P < 0.05) 16% and OM intake increased (P < 0.01) 30% in supplemented compared to unsupplemented steers. Diet OM digestibility increased (P = 0.08) 14.5% and total digestible OM intake increased (P < 0.05) 49% in supplemented compared to unsupplemented steers. Supplement protein concentration did not alter forage intake, total digestible OM intake

  13. The anthropocene: from global change to planetary stewardship.

    PubMed

    Steffen, Will; Persson, Asa; Deutsch, Lisa; Zalasiewicz, Jan; Williams, Mark; Richardson, Katherine; Crumley, Carole; Crutzen, Paul; Folke, Carl; Gordon, Line; Molina, Mario; Ramanathan, Veerabhadran; Rockström, Johan; Scheffer, Marten; Schellnhuber, Hans Joachim; Svedin, Uno

    2011-11-01

    Over the past century, the total material wealth of humanity has been enhanced. However, in the twenty-first century, we face scarcity in critical resources, the degradation of ecosystem services, and the erosion of the planet's capability to absorb our wastes. Equity issues remain stubbornly difficult to solve. This situation is novel in its speed, its global scale and its threat to the resilience of the Earth System. The advent of the Anthropence, the time interval in which human activities now rival global geophysical processes, suggests that we need to fundamentally alter our relationship with the planet we inhabit. Many approaches could be adopted, ranging from geoengineering solutions that purposefully manipulate parts of the Earth System to becoming active stewards of our own life support system. The Anthropocene is a reminder that the Holocene, during which complex human societies have developed, has been a stable, accommodating environment and is the only state of the Earth System that we know for sure can support contemporary society. The need to achieve effective planetary stewardship is urgent. As we go further into the Anthropocene, we risk driving the Earth System onto a trajectory toward more hostile states from which we cannot easily return.

  14. Extended Producer Responsibility and Product Stewardship for Tobacco Product Waste

    PubMed Central

    Curtis, Clifton; Collins, Susan; Cunningham, Shea; Stigler, Paula; Novotny, Thomas E

    2015-01-01

    This paper reviews several environmental principles, including Extended Producer Responsibility (EPR), Product Stewardship (PS), the Polluter Pays Principle (PPP), and the Precautionary Principle, as they may apply to tobacco product waste (TPW). The review addresses specific criteria that apply in deciding whether a particular toxic product should adhere to these principles; presents three case studies of similar approaches to other toxic and/or environmentally harmful products; and describes 10 possible interventions or policy actions that may help prevent, reduce, and mitigate the effects of TPW. EPR promotes total lifecycle environmental improvements, placing economic, physical, and informational responsibilities onto the tobacco industry, while PS complements EPR, but with responsibility shared by all parties involved in the tobacco product lifecycle. Both principles focus on toxic source reduction, post-consumer take-back, and final disposal of consumer products. These principles when applied to TPW have the potential to substantially decrease the environmental and public health harms of cigarette butts and other TPW throughout the world. TPW is the most commonly littered item picked up during environmental, urban, and coastal cleanups globally. PMID:26457262

  15. Financial evaluations of antibiotic stewardship programs—a systematic review

    PubMed Central

    Dik, Jan-Willem H.; Vemer, Pepijn; Friedrich, Alex W.; Hendrix, Ron; Lo-Ten-Foe, Jerome R.; Sinha, Bhanu; Postma, Maarten J.

    2015-01-01

    Introduction: There is an increasing awareness to counteract problems due to incorrect antimicrobial use. Interventions that are implemented are often part of an Antimicrobial Stewardship Program (ASPs). Studies publishing results from these interventions are increasing, including reports on the economical effects of ASPs. This review will look at the economical sections of these studies and the methods that were used. Methods: A systematic review was performed of articles found in the PubMed and EMBASE databases published from 2000 until November 2014. Included studies found were scored for various aspects and the quality of the papers was assessed following an appropriate check list (CHEC criteria list). Results: 1233 studies were found, of which 149 were read completely. Ninety-nine were included in the final review. Of these studies, 57 only mentioned the costs associated with the antimicrobial medication. Others also included operational costs (n = 23), costs for hospital stay (n = 18), and/or other costs (n = 19). Nine studies were further assessed for their quality. These studies scored between 2 and 14 out of a potential total score of 19. Conclusions: This review gives an extensive overview of the current financial evaluation of ASPs and the quality of these economical studies. We show that there is still major potential to improve financial evaluations of ASPs. Studies do not use similar nor consistent methods or outcome measures, making it impossible draw sound conclusions and compare different studies. Finally, we make some recommendations for the future. PMID:25932024

  16. Transformative leadership: an ethical stewardship model for healthcare.

    PubMed

    Caldwell, Cam; Voelker, Carolyn; Dixon, Rolf D; LeJeune, Adena

    2008-01-01

    The need for effective leadership is a compelling priority for those who would choose to govern in public, private, and nonprofit organizations, and applies as much to the healthcare profession as it does to other sectors of the economy (Moody, Horton-Deutsch, & Pesut, 2007). Transformative Leadership, an approach to leadership and governance that incorporates the best characteristics of six other highly respected leadership models, is an integrative theory of ethical stewardship that can help healthcare professionals to more effectively achieve organizational efficiencies, build stakeholder commitment and trust, and create valuable synergies to transform and enrich today's healthcare systems (cf. Caldwell, LeJeune, & Dixon, 2007). The purpose of this article is to introduce the concept of Transformative Leadership and to explain how this model applies within a healthcare context. We define Transformative Leadership and identify its relationship to Transformational, Charismatic, Level 5, Principle-Centered, Servant, and Covenantal Leadership--providing examples of each of these elements of Transformative Leadership within a healthcare leadership context. We conclude by identifying contributions of this article to the healthcare leadership literature.

  17. Antimicrobial Stewardship for a Geriatric Behavioral Health Population

    PubMed Central

    Ellis, Kristen; Rubal-Peace, Georgina; Chang, Victoria; Liang, Eva; Wong, Nicolas; Campbell, Stephanie

    2016-01-01

    Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. PMID:27025523

  18. Antimicrobial stewardship: a matter of process or outcome?

    PubMed

    Khadem, Tina M; Dodds Ashley, Elizabeth; Wrobel, Mark J; Brown, Jack

    2012-08-01

    The risk of antimicrobial resistance and superinfection is increasing alongside rates of hospital-acquired infection. Imprudent antibiotic use combined with few novel antimicrobials can speed resistance. Antimicrobial stewardship programs (ASPs) advocate for judicious use of available antimicrobials to preserve their usefulness. Decreased antibiotic expenditures was the backbone of early justification for ASPs, but the function of these programs has evolved into measuring the quality and appropriateness of antimicrobial use. Proper evaluation of an ASP helps to inform which methods work best for a particular institution and can help to define best practices at a more global level. Study design and duration limitations, however, can make it difficult to measure the impact of these programs. Process measures have been validated and can evaluate quality of care; however, they do not adequately describe the clinical impact of these programs at the patient level. Outcome measures also have limitations; they are not a direct measure of quality of care. Therefore, both process and outcome measures need to be defined and assessed when evaluating an ASP to confirm that goals of the intervention are attained and clinical objectives are met. Most available well-designed studies judging the effectiveness of ASPs use process measures alone. Adding improvements in clinical outcomes to process measures would theoretically attract the attention of a broader audience and provide additional support to expand current ASPs and develop novel ASPs.

  19. Antimicrobial Stewardship for a Geriatric Behavioral Health Population.

    PubMed

    Ellis, Kristen; Rubal-Peace, Georgina; Chang, Victoria; Liang, Eva; Wong, Nicolas; Campbell, Stephanie

    2016-01-01

    Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit.

  20. Antimicrobial stewardship – can we afford to do without it?

    PubMed Central

    Aryee, Anna; Price, Nicholas

    2015-01-01

    Antimicrobial resistance (AMR) is a rapidly developing and alarming global threat which has been highlighted by national governments and public health bodies including the World Health Organization. The spectre of a ‘post-antibiotic era’ is a real possibility unless curtailing the development and spread of these organisms is given high priority. Numerous studies have shown that AMR is associated with worse outcomes for patients and higher healthcare costs. While clinical data from low and middle income countries is lacking, there is increasing evidence that the problem in these areas is as great, or even greater, than in high income nations. Of the many drivers behind the development of AMR, the most significant is selection pressure caused by antibiotic use. Antimicrobial stewardship programmes are a set of interventions that aim to ensure the judicious use of antimicrobials by preventing their unnecessary use, and by providing targeted and limited therapy in situations where they are warranted. The ultimate goal of these programmes is to provide effective antimicrobial therapy whilst safeguarding their effectiveness for future generations. Whilst they do require an initial investment, they have been shown to be an effective way of controlling antimicrobial use, and have been associated with improved patient outcomes and reduced healthcare costs. PMID:24803175

  1. 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.

  2. 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

  3. Evaluation of models of particulate suspension for a thorium ore stockpile

    SciTech Connect

    Smith, W.J.

    1983-01-01

    Fifteen mathematical models of particle saltation, suspension, and resuspension were reviewed and categorized. Appropriate models were applied to the estimation of particulate releases from a hypothetical thorium ore storage pile. An assumed location (near Lemhi Pass, Montana) was used to permit the development of site specific information on ore characteristics and environmental influences. The available models were characterized in terms of suitability for representing aspects of the ore pile, such as rough surface features, wide particle size range, and site specific climate. Five models were selected for detailed study. A computer code for each of these is given. Site specific data for the assumed ore stockpile location were prepared. These data were manipulated to provide the input values required for each of the five models. Representative values and ranges for model variables are tabulated. The response of each model to input data for selected variables was determined. Each model was evaluated in terms of the physical realism of its response of each model to input data for selected variables was determined. Each model was evaluated in terms of the physical realism of its responses and its overall ability to represent the features of an ore stockpile. The two models providing the best representation were a modified version of the dust suspension subroutine TAILPS from the computer code MILDOS, and the dust suspension formulation from the computer code REDIST. Their responses are physically reasonable, although different from each other for two parameters: ore moisture and surface roughness. With the input values judged most representative of an ore pile near Lemhi Pass, the estimate of the release of suspended particulates is on the order of 1 g/m/sup 2/-yr.

  4. Stewardship and future land use at a Department of Energy site: does self-interest determine ratings?

    PubMed

    Burger, J

    2001-07-01

    Based on studies at several Department of Energy sites and Superfund sites, as well as elsewhere, it is clear that people prefer that contaminated lands be restored to usable land. Knowing the future uses for such land can inform environmental cleanup and restoration decision making, often determining the level of cleanup, costs, future management, and stewardship. This article examines the relationship between general environmental attitudes, future land use preferences, and recreational activities for people living around the Department of Energy's Savannah River Site in South Carolina. There were few differences in the rating for general environmental problems as a function of recreational activities. Although future land use ratings were generally correlated with the number of days people engaged in particular activities (hunting, fishing, hiking, camping), people who hunted and fished rated nearly every recreational activity higher than did people who only camped or hiked, or than those who engaged in no outdoor activities. Thus, campers and hikers did not rate camping and hiking higher as future land uses than did other groups. These data suggest that there is widespread support for recreational activities as future uses for the Savannah River Site, regardless of whether people participate in them or not, and that current cleanup and stewardship decisions should consider these views.

  5. Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia

    PubMed Central

    Khan, Muhammad Umair; Hassali, Mohamed Azmi Ahmad; Ahmad, Akram; Elkalmi, Ramadan Mohamed; Zaidi, Syed Tabish Razi; Dhingra, Sameer

    2016-01-01

    Background Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics. The objective of this study was to assess the perception and self-reported practices of community pharmacists towards antimicrobial stewardship. Methods A cross-sectional study was conducted among community pharmacists between March–April, 2015, using a self-administered, pre-tested questionnaire in the State of Selangor, Malaysia. A simple random sampling approach was used to select pharmacy sites. Descriptive and inferential statistical methods were used to analyse the data. Results A total of 188 pharmacists responded to the survey, giving a response rate of 83.5%. The majority of participants (n = 182, 96.8%) believed that antimicrobial stewardship program helps healthcare professionals to improve the quality of patient care. However, more than half of pharmacists were neutral in their opinion about the incorporation of antimicrobial stewardship programs in community pharmacies (n = 102, 54.2%). Though collaboration was often done by pharmacists with other health professionals over the use of antibiotics (n = 104, 55.3%), a significant proportion of participants (n = 102, 54.2%) rarely/occasionally participate in antimicrobial awareness campaigns. Pharmacists having postgraduate qualification were more likely to held positive perceptions of, and were engaged in, antimicrobial stewardship than their non-postgraduate counterpart (p<0.05). Similarly, more experienced pharmacists (> 10 years) held positive perceptions towards antimicrobial stewardship (p<0.05). Conclusion The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized

  6. How to assist clinicians in improving antimicrobial prescribing: tools and interventions provided by stewardship programs.

    PubMed

    López-Medrano, Francisco; Moreno-Ramos, Francisco; de Cueto, Marina; Mora-Rillo, Marta; Salavert, Miguel

    2013-09-01

    In the last decade, there has been an exponential increase in the microorganisms resistant to antimicrobials and a significant increase in the cost of these types of drugs. This phenomenon has increased interest in the development of interventions for counseling on and control of the use of antimicrobials, referred to as stewardship programs. In this article we review, from various points of view, the tools that have been developed with this purpose. First, we highlight the value of locally adapted guidelines and clinical pathways as an essential part of the operational process. Then we emphasize the importance of the relationship between microbiologists and clinicians for the accurate transmission of the information provided by blood cultures to make the most appropriate choice of antimicrobial for the patient's treatment. We also review the computerized tools that have facilitated the correct use of antimicrobials according to the controls established by the departments of pharmacy. Based on the previous tools, some programs based on "bedside recommendations" provided by multidisciplinary teams have been developed for optimizing the rational use of antimicrobials (PROA programs). Finally, we comment on the peculiarities of the programs targeting antifungals that have been developed in recent years.

  7. Using a Dynamic Model to Consider Optimal Antiviral Stockpile Size in the Face of Pandemic Influenza Uncertainty

    PubMed Central

    Greer, Amy L.; Schanzer, Dena

    2013-01-01

    Background The Canadian National Antiviral Stockpile (NAS) contains treatment for 17.5% of Canadians. This assumes no concurrent intervention strategies and no wastage due to non-influenza respiratory infections. A dynamic model can provide a mechanism to consider complex scenarios to support decisions regarding the optimal NAS size under uncertainty. Methods We developed a dynamic model for pandemic influenza in Canada that is structured by age and risk to calculate the demand for antivirals to treat persons with pandemic influenza under a wide-range of scenarios that incorporated transmission dynamics, disease severity, and intervention strategies. The anticipated per capita number of acute respiratory infections due to viruses other than influenza was estimated for the full pandemic period from surveys based on criteria to identify potential respiratory infections. Results Our results demonstrate that up to two thirds of the population could develop respiratory symptoms as a result of infection with a pandemic strain. In the case of perfect antiviral allocation, up to 39.8% of the population could request antiviral treatment. As transmission dynamics, severity and timing of the emergence of a novel influenza strain are unknown, the sensitivity analysis produced considerable variation in potential demand (median: 11%, IQR: 2–21%). If the next pandemic strain emerges in late spring or summer and a vaccine is available before the anticipated fall wave, the median prediction was reduced to 6% and IQR to 0.7–14%. Under the strategy of offering empirical treatment to all patients with influenza like symptoms who present for care, demand could increase to between 65 and 144%. Conclusions The demand for antivirals during a pandemic is uncertain. Unless an accurate, timely and cost-effective test is available to identify influenza cases, demand for antivirals from persons infected with other respiratory viruses will be substantial and have a significant impact on the

  8. Utility and safety of procalcitonin in an antimicrobial stewardship program (ASP) in patients with malignancies.

    PubMed

    Liew, Y X; Lee, W; Cai, Y Y; Teo, J; Tang, S S-L; Ong, R W-Q; Lim, C L-L; Lingegowda, P B; Kwa, A L-H; Chlebicki, M P

    2012-11-01

    As data on procalcitonin utility in antibiotics discontinuation [under an antimicrobial stewardship program (ASP)] in patients with malignancies are lacking, we aimed to evaluate the utility of procalcitonin in an ASP in patients with malignancies. We conducted a retrospective review of the ASP database of all patients with malignancies in whom at least one procalcitonin level was taken and our ASP had recommended changes in carbapenem regimen, from January to December 2011. We compared clinical outcomes between two groups of patients: patients whose physicians accepted and those whose physicians rejected ASP interventions. There were 749 carbapenem cases reviewed. Ninety-nine were suggested to either de-escalate, discontinue antibiotics, or narrow the spectrum of empiric treatment, based on procalcitonin trends. While there was no statistical difference in the mortality within 30 days post-ASP intervention (accepted: 8/65 patients vs. rejected: 9/34 patients; p = 0.076), the median duration of carbapenem therapy was significantly shorter (5 vs. 7 days; p = 0.002). Procalcitonin use safely facilitates decisions on antibiotics discontinuation and de-escalation in patients with malignancies in the ASP.

  9. Strategic Program Planning Lessons Learned In Developing The Long-Term Stewardship Science and Technology Roadmap

    SciTech Connect

    Dixon, B.W.; Hanson, D.J.; Matthern, G.E.

    2003-04-24

    Technology roadmapping is a strategic planning method used by companies to identify and plan the development of technologies necessary for new products. The U.S. Department of Energy's Office of Environmental Management has used this same method to refine requirements and identify knowledge and tools needed for completion of defined missions. This paper describes the process of applying roadmapping to clarify mission requirements and identify enhancing technologies for the Long-Term Stewardship (LTS) of polluted sites after site cleanup has been completed. The nature of some contamination problems is such that full cleanup is not achievable with current technologies and some residual hazards remain. LTS maintains engineered contaminant barriers and land use restriction controls, and monitors residual contaminants until they no longer pose a risk to the public or the environment. Roadmapping was used to clarify the breadth of the LTS mission, to identify capability enhancements needed to improve mission effectiveness and efficiency, and to chart out the research and development efforts to provide those enhancements. This paper is a case study of the application of roadmapping for program planning and technical risk management. Differences between the planned and actual application of the roadmapping process are presented along with lessons learned. Both the process used and lessons learned should be of interest for anyone contemplating a similar technology based planning effort.

  10. On the value of environmental stewardship and sustainability in health administration education.

    PubMed

    Verderber, Stephen; Fauerbach, Julia; Walter, Brandon

    2008-01-01

    Global warming, the depletion of the world'snatural resources, and excessive consumer consumption in developed countries are determinants reshaping the way we live our everyday lives. These factors are rapidly giving rise to new ecological paradigms of environmental stewardship and in healthcare environments that express sustainable theories and practices. This has given rise to a systematic system for promoting and assessing the energy performance and efficiency of healthcare facilities known as Leadership in Energy Efficient Environmental Design (LEED), and a parallel certification program, the Green Guide for Heath Care. These developments are examined in direct relation to the functions of managerial ethics. A series of ten sustainability-based ethical dilemmas are presented. Each is examined in relation to the need to inculcate in future healthcare administrators a critical understanding and appreciation of the need to reposition contemporary healthcare organizations at the center--as leading civic participants and role models in relation to the emerging movement towards carbon neutrality in the healthcare industry. PMID:19655628

  11. On the value of environmental stewardship and sustainability in health administration education.

    PubMed

    Verderber, Stephen; Fauerbach, Julia; Walter, Brandon

    2008-01-01

    Global warming, the depletion of the world'snatural resources, and excessive consumer consumption in developed countries are determinants reshaping the way we live our everyday lives. These factors are rapidly giving rise to new ecological paradigms of environmental stewardship and in healthcare environments that express sustainable theories and practices. This has given rise to a systematic system for promoting and assessing the energy performance and efficiency of healthcare facilities known as Leadership in Energy Efficient Environmental Design (LEED), and a parallel certification program, the Green Guide for Heath Care. These developments are examined in direct relation to the functions of managerial ethics. A series of ten sustainability-based ethical dilemmas are presented. Each is examined in relation to the need to inculcate in future healthcare administrators a critical understanding and appreciation of the need to reposition contemporary healthcare organizations at the center--as leading civic participants and role models in relation to the emerging movement towards carbon neutrality in the healthcare industry.

  12. Lessons from White Lake - Connecting Students to their Community through Environmental Stewardship

    NASA Astrophysics Data System (ADS)

    Tate, Susan

    2014-05-01

    White Lake and its surrounding community have been negatively affected by shoreline degradation and wildlife habitat loss caused primarily by historical logging practices, and reduced water quality from industrial pollution and storm water runoff. This led to the lake being identified as a Great Lakes Area of Concern by the United States Environmental Protection Agency three decades ago. Local community partners have worked diligently in recent years to reverse habitat loss, and repair damaged ecosystems. The "H2O White Lake" (Healthy Habitats On White Lake) project has involved over seven hundred middle school students in grades six through eight over the course of the last five years. Students begin by researching the environmental history of the watershed and then they monitor six tributaries of the lake for nutrient pollution and habitat degradation. Students use the field experience as a community inventory to identify stewardship needs, for which they then identify solutions that take into account land usage and community behaviors. Class projects have focused on stream bank restoration, storm water management, eradication of invasive species, shoreline clean-up, and community outreach and education. This year, the project culminated in the first ever White Lake Environmental Film Festival, for which students had the opportunity to create their own short documentary. This multiple year place based education project allows students to apply their classroom studies of surface water and groundwater dynamics to an authentic, real-world situation, conduct themselves as scientists, and feel valuable through connections with community partners.

  13. Use of Computer Decision Support in an Antimicrobial Stewardship Program (ASP)

    PubMed Central

    Olson, J.A.; Stenehjem, E.; Buckel, W.R.; Thorell, E.A.; Howe, S.; Wu, X.; Jones, P.S.; Lloyd, J.F.

    2015-01-01

    Summary Objective Document information needs, gaps within the current electronic applications and reports, and workflow interruptions requiring manual information searches that decreased the ability of our antimicrobial stewardship program (ASP) at Intermountain Healthcare (IH) to prospectively audit and provide feedback to clinicians to improve antimicrobial use. Methods A framework was used to provide access to patient information contained in the electronic medical record, the enterprise-wide data warehouse, the data-driven alert file and the enterprise-wide encounter file to generate alerts and reports via pagers, emails and through the Centers for Diseases and Control’s National Healthcare Surveillance Network. Results Four new applications were developed and used by ASPs at Intermountain Medical Center (IMC) and Primary Children’s Hospital (PCH) based on the design and input from the pharmacists and infectious diseases physicians and the new Center for Diseases Control and Prevention/National Healthcare Safety Network (NHSN) antibiotic utilization specifications. Data from IMC and PCH now show a general decrease in the use of drugs initially targeted by the ASP at both facilities. Conclusions To be effective, ASPs need an enormous amount of “timely” information. Members of the ASP at IH report these new applications help them improve antibiotic use by allowing efficient, timely review and effective prioritization of patients receiving antimicrobials in order to optimize patient care. PMID:25848418

  14. Optimizing Antibiotic Stewardship in Nursing Homes: A Narrative Review and Recommendations for Improvement.

    PubMed

    Crnich, Christopher J; Jump, Robin; Trautner, Barbara; Sloane, Philip D; Mody, Lona

    2015-09-01

    The emerging crisis in antibiotic resistance and concern that we now sit on the precipice of a post-antibiotic era have given rise to advocacy at the highest levels for widespread adoption of programmes that promote judicious use of antibiotics. These antibiotic stewardship programmes, which seek to optimize antibiotic choice when clinically indicated and discourage antibiotic use when clinically unnecessary, are being implemented in an increasing number of acute care facilities, but their adoption has been slower in nursing homes. The antibiotic prescribing process in nursing homes is fundamentally different from that observed in hospital and clinic settings, with formidable challenges to implementation of effective antibiotic stewardship. Nevertheless, an emerging body of research points towards ways to improve antibiotic prescribing practices in nursing homes. This review summarizes the findings of this research and presents ways in which antibiotic stewardship can be implemented and optimized in the nursing home setting. PMID:26316294

  15. Roles of Data Stewardship: The people who put the theory into practice. (Invited)

    NASA Astrophysics Data System (ADS)

    Parsons, M. A.

    2013-12-01

    To understand something very complex like the Earth system it is helpful to have a model that sketches the major components of the system and their interactions. This helps us to understand the relative importance of those components and their behavior. The same is true, when considering a complex social enterprise such as data stewardship. It is helpful to have a model or a metaphor that allows us to conceive of the entire enterprise, the key players, and their interactions. In the spirit that 'all models are wrong, but some are useful,' this presentation explores several models of data stewardship and how different conceptions of the enterprise define different roles for the participants--be they researchers or data practitioners. The goal is to illustrate how consideration of multiple theories or models of data stewardship can help us better define the actual practice necessary to ensure well-preserved and useful data.

  16. The Potential of Osteopathic Manipulative Treatment in Antimicrobial Stewardship: A Narrative Review.

    PubMed

    Noll, Donald R

    2016-09-01

    The contemporary management of infectious diseases is built around antimicrobial therapy. However, the development of antimicrobial resistance threatens to create a post-antibiotic era. Antimicrobial stewardship attempts to reduce the development of antimicrobial resistance by improving their appropriate use. Osteopathic manipulative treatment as an adjunctive treatment has the potential for enhancing antimicrobial stewardship by enhancing the human immune system, shortening the duration of antimicrobial therapy, reducing complications, and improving treatment outcomes. The present article reviews the evidence published in the literature since this unique treatment approach was first developed more than 100 years ago. The evidence suggests that adjunctive osteopathic manipulative treatment has great potential for enhancing antimicrobial stewardship and should be further investigated.

  17. Building an Antimicrobial Stewardship Program: Cooperative Roles for Pharmacists, Infectious Diseases Specialists, and Clinical Microbiologists.

    PubMed

    Kim, Jihye; Craft, David W; Katzman, Michael

    2015-01-01

    Efforts to optimize the use of antimicrobial agents, referred to as antimicrobial stewardship programs (ASPs), are increasingly becoming part of the clinical enterprise at big and small hospitals. Such programs aim to achieve the synergistic goals of improving patient outcomes, limiting the unintended consequences of drug resistance and superinfections, and reducing health care expenditures. This article will review the need for antimicrobial stewardship and the key components of setting up a program; then, it will describe the ASP at one medical center to underscore how attention to acceptance by the clinical staff is crucial to changing the culture of antimicrobial use. Although the details may differ for each institution, the foundation of a successful stewardship program is support from hospital leadership and the cooperative interaction among the pharmacy, infectious diseases specialists, and clinical microbiologists.

  18. The Potential of Osteopathic Manipulative Treatment in Antimicrobial Stewardship: A Narrative Review.

    PubMed

    Noll, Donald R

    2016-09-01

    The contemporary management of infectious diseases is built around antimicrobial therapy. However, the development of antimicrobial resistance threatens to create a post-antibiotic era. Antimicrobial stewardship attempts to reduce the development of antimicrobial resistance by improving their appropriate use. Osteopathic manipulative treatment as an adjunctive treatment has the potential for enhancing antimicrobial stewardship by enhancing the human immune system, shortening the duration of antimicrobial therapy, reducing complications, and improving treatment outcomes. The present article reviews the evidence published in the literature since this unique treatment approach was first developed more than 100 years ago. The evidence suggests that adjunctive osteopathic manipulative treatment has great potential for enhancing antimicrobial stewardship and should be further investigated. PMID:27571297

  19. Building an Antimicrobial Stewardship Program: Cooperative Roles for Pharmacists, Infectious Diseases Specialists, and Clinical Microbiologists.

    PubMed

    Kim, Jihye; Craft, David W; Katzman, Michael

    2015-01-01

    Efforts to optimize the use of antimicrobial agents, referred to as antimicrobial stewardship programs (ASPs), are increasingly becoming part of the clinical enterprise at big and small hospitals. Such programs aim to achieve the synergistic goals of improving patient outcomes, limiting the unintended consequences of drug resistance and superinfections, and reducing health care expenditures. This article will review the need for antimicrobial stewardship and the key components of setting up a program; then, it will describe the ASP at one medical center to underscore how attention to acceptance by the clinical staff is crucial to changing the culture of antimicrobial use. Although the details may differ for each institution, the foundation of a successful stewardship program is support from hospital leadership and the cooperative interaction among the pharmacy, infectious diseases specialists, and clinical microbiologists. PMID:26283698

  20. [The absence of stewardship in the Chilean health authority after the 2004 health reform].

    PubMed

    Herrera, Tania; Sánchez, Sergio

    2014-11-26

    Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role.

  1. Nature's Trust: A Paradigm for Natural Resources Stewardship

    NASA Astrophysics Data System (ADS)

    Wood, M. C.; Whitelaw, E.; Doppelt, B.; Burchell, A.

    2007-12-01

    Climate change uncertainty puts a premium on all remaining natural resources. Farmland, air, water, wetlands, wildlife, soils, mineral resources and forests must be protected to ensure that Americans - present citizens and future generations - have the fundamental survival resources they need in a future that holds many unknowns. Moreover, in light of the need to manage resources given climate and particle forcing, government must mitigate dangerous carbon loading of the atmosphere. Confronting climate change and protecting natural resources requires a clear sense of government obligation that is inherent to sovereignty, not a matter of political choice. Our government representatives can and must reframe government's discretion into a trustee obligation to protect Nature and ensure natural resource stewardship. Drawing upon enduring legal principles and court decisions, government can be characterized as a trustee of the natural resources essential to human survival. A trust is a fundamental type of ownership whereby one manages property for the benefit of another. Viewed as a trust, the environment consists of a portfolio of quantified natural assets that government manages. As beneficiaries, citizens hold a common property interest in defined, bounded assets that make up Nature's Trust. Such trust principles form the bedrock of statutory law. Trustees have a fiduciary obligation to protect trust assets and may not allow destruction of property they manage. This session will provide a policy frame for current scientific efforts to address climate change and natural resources loss. Under the Nature's Trust frame, U.S. government leaders and agencies at every level inherit a strict fiduciary obligation to protect our collective natural resources, including our water and the atmosphere, as assets in the trust. Their fiduciary standard of care consists of a proportionate responsibility, which ties directly to "Nature's Mandate" as defined by current climate

  2. Nature connection, outdoor play, and environmental stewardship in residential environmental education

    NASA Astrophysics Data System (ADS)

    Andrejewski, Robert G.

    A lack of exposure to the natural world has led to a generation of children disconnected from nature. This phenomenon has profound negative implications for the physical and psychological well being of today's youth. Residential environmental education provides one avenue to connect children to nature. One purpose of this study was to investigate the role of Outdoor School, a residential environmental education program, on ecological knowledge, children's connection to nature, school belonging, outdoor play attitude, environmental stewardship attitude, outdoor play behavior, and environmental stewardship behavior, as reported by participants. A quasi-experimental research design was utilized in the study. A total of 228 fifth grade students (156 treatment, 72 control) from central Pennsylvania participated. The results of the program evaluation indicated that Outdoor School was successful in achieving significant, positive gains in the areas of ecological knowledge, connection to nature, outdoor play behavior, and environmental stewardship behavior. No change was found from pretest to post-test in outdoor play attitudes, environmental stewardship attitudes, and school belonging. Additionally, the study addressed gaps in the literature regarding the relationship between connection to nature, environmental stewardship, and outdoor play using two different approaches. An adaptation of the Theory of Planned Behavior (TPB) was used to predict outdoor play behavior in children. In this model, favorable attitudes, subjective norms, and perceived behavioral control lead to intentions to perform a given behavior. Intention to perform the behavior is the best predictor for behavior performance. For this study, participants' feeling of connection to nature was added as an affective independent variable. This model explained 45% of the variance in outdoor play. The hypothesis that a connection to nature would be a significant predictor of both attitudes toward outdoor play was

  3. Ceftriaxone-induced hemolysis in a child with Lyme arthritis: a case for antimicrobial stewardship.

    PubMed

    Boggs, Sarah R; Cunnion, Kenji M; Raafat, Reem H

    2011-11-01

    Guidelines for the treatment of Lyme arthritis were published by the Infectious Diseases Society of America in 2006 and recommended oral doxycycline for initial therapy. We report here the case of a young girl treated with intravenous ceftriaxone who subsequently developed drug-induced autoimmune hemolytic anemia and renal failure. Her severe sequelae highlight the importance of antimicrobial stewardship. We review here the goals of antimicrobial stewardship and several strategies for achieving them. In addition, we briefly discuss the rare adverse drug event experienced by our patient.

  4. The farmer as a landscape steward: Comparing local understandings of landscape stewardship, landscape values, and land management actions.

    PubMed

    Raymond, Christopher M; Bieling, Claudia; Fagerholm, Nora; Martin-Lopez, Berta; Plieninger, Tobias

    2016-03-01

    We develop a landscape stewardship classification which distinguishes between farmers' understanding of landscape stewardship, their landscape values, and land management actions. Forty semi-structured interviews were conducted with small-holder (<5 acres), medium-holders (5-100 acres), and large-holders (>100 acres) in South-West Devon, UK. Thematic analysis revealed four types of stewardship understandings: (1) an environmental frame which emphasized the farmers' role in conserving or restoring wildlife; (2) a primary production frame which emphasized the farmers' role in taking care of primary production assets; (3) a holistic frame focusing on farmers' role as a conservationist, primary producer, and manager of a range of landscape values, and; (4) an instrumental frame focusing on the financial benefits associated with compliance with agri-environmental schemes. We compare the landscape values and land management actions that emerged across stewardship types, and discuss the global implications of the landscape stewardship classification for the engagement of farmers in landscape management.

  5. Toxicity of vesicant agents scheduled for destruction by the Chemical Stockpile Disposal Program.

    PubMed

    Watson, A P; Griffin, G D

    1992-11-01

    The vesicant agents of the unitary chemical munitions stockpile include various formulations of sulfur mustard [bis-(2-chloroethyl) sulfide; agents H, HD, and HT] and small quantities of the organic arsenical Lewisite [dichloro(2-chlorovinyl) arsine; agent L]. These agents can be dispersed in liquid, aerosol, or vapor form and are capable of producing severe chemical burns upon direct contact with tissue. Moist tissues such as the eyes, respiratory tract, and axillary areas are particularly affected. Available data summarizing acute dose response in humans and laboratory animals are summarized. Vesicant agents are also capable of generating delayed effects such as chronic bronchitis, carcinogenesis, or keratitis/keratopathy of the eye under appropriate conditions of exposure and dose. These effects may not become manifest until years following exposure. Risk analysis derived from carcinogenesis data indicates that sulfur mustard possesses a carcinogenic potency similar to that of benzo[a]pyrene. Because mustard agents are alkylating compounds, they destroy individual cells by reaction with cellular proteins, enzymes, RNA, and DNA. Once begun, tissue reaction is irreversible. Mustard agents are mutagenic; data for cellular and laboratory animal assays are presented. Reproductive effects have not been demonstrated in the offspring of laboratory rats. Acute Lewisite exposure has been implicated in cases of Bowen's disease, an intraepidermal squamous cell carcinoma. Lewisite is not known to generate reproductive or teratogenic effects.

  6. Toxicity of vesicant agents scheduled for destruction by the Chemical Stockpile Disposal Program.

    PubMed Central

    Watson, A P; Griffin, G D

    1992-01-01

    The vesicant agents of the unitary chemical munitions stockpile include various formulations of sulfur mustard [bis-(2-chloroethyl) sulfide; agents H, HD, and HT] and small quantities of the organic arsenical Lewisite [dichloro(2-chlorovinyl) arsine; agent L]. These agents can be dispersed in liquid, aerosol, or vapor form and are capable of producing severe chemical burns upon direct contact with tissue. Moist tissues such as the eyes, respiratory tract, and axillary areas are particularly affected. Available data summarizing acute dose response in humans and laboratory animals are summarized. Vesicant agents are also capable of generating delayed effects such as chronic bronchitis, carcinogenesis, or keratitis/keratopathy of the eye under appropriate conditions of exposure and dose. These effects may not become manifest until years following exposure. Risk analysis derived from carcinogenesis data indicates that sulfur mustard possesses a carcinogenic potency similar to that of benzo[a]pyrene. Because mustard agents are alkylating compounds, they destroy individual cells by reaction with cellular proteins, enzymes, RNA, and DNA. Once begun, tissue reaction is irreversible. Mustard agents are mutagenic; data for cellular and laboratory animal assays are presented. Reproductive effects have not been demonstrated in the offspring of laboratory rats. Acute Lewisite exposure has been implicated in cases of Bowen's disease, an intraepidermal squamous cell carcinoma. Lewisite is not known to generate reproductive or teratogenic effects. PMID:1486858

  7. Integrated Baseline System (IBS), Version 1.03. User guide: Chemical Stockpile Emergency Preparedness Program

    SciTech Connect

    Bailey, B.M.; Burford, M.J.; Downing, T.R.; Matsumoto, S.W.; Schrank, E.E.; Williams, J.R.; Winters, C.

    1993-01-01

    The Integrated Baseline System (IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planing and analysis. This document is the user guide for the IBS and explains how to operate the IBS system. The fundamental function of the IBS is to provide tools that civilian emergency management personnel can use in developing emergency plans and in supporting emergency management activities to cope with a chemical-releasing event at a military chemical stockpile. Emergency management planners can evaluate concepts and ideas using the IBS system. The results of that experience can then be factored into refining requirements and plans. This document provides information for the general system user, and is the primary reference for the system features of the IBS. It is designed for persons who are familiar with general emergency management concepts, operations, and vocabulary. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other LBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary. IBS is a dynamic system. Its capabilities are in a state of continuing expansion and enhancement.

  8. Integrated Baseline System (IBS), Version 1. 03. [Chemical Stockpile Emergency Preparedness Program

    SciTech Connect

    Bailey, B.M.; Burford, M.J.; Downing, T.R.; Matsumoto, S.W.; Schrank, E.E.; Williams, J.R.; Winters, C.

    1993-01-01

    The Integrated Baseline System (IBS), operated by the Federal Emergency Management Agency (FEMA), is a system of computerized tools for emergency planing and analysis. This document is the user guide for the IBS and explains how to operate the IBS system. The fundamental function of the IBS is to provide tools that civilian emergency management personnel can use in developing emergency plans and in supporting emergency management activities to cope with a chemical-releasing event at a military chemical stockpile. Emergency management planners can evaluate concepts and ideas using the IBS system. The results of that experience can then be factored into refining requirements and plans. This document provides information for the general system user, and is the primary reference for the system features of the IBS. It is designed for persons who are familiar with general emergency management concepts, operations, and vocabulary. Although the IBS manual set covers basic and advanced operations, it is not a complete reference document set. Emergency situation modeling software in the IBS is supported by additional technical documents. Some of the other LBS software is commercial software for which more complete documentation is available. The IBS manuals reference such documentation where necessary. IBS is a dynamic system. Its capabilities are in a state of continuing expansion and enhancement.

  9. Volume Computation of a Stockpile - a Study Case Comparing GPS and Uav Measurements in AN Open Pit Quarry

    NASA Astrophysics Data System (ADS)

    Raeva, P. L.; Filipova, S. L.; Filipov, D. G.

    2016-06-01

    The following paper aims to test and evaluate the accuracy of UAV data for volumetric measurements to the conventional GNSS techniques. For this purpose, an appropriate open pit quarry has been chosen. Two sets of measurements were performed. Firstly, a stockpile was measured by GNSS technologies and later other terrestrial GNSS measurements for modelling the berms of the quarry were taken. Secondly, the area of the whole quarry including the stockpile site was mapped by a UAV flight. Having considered how dynamic our world is, new techniques and methods should be presented in numerous fields. For instance, the management of an open pit quarry requires gaining, processing and storing a large amount of information which is constantly changing with time. Fast and precise acquisition of measurements regarding the process taking place in a quarry is the key to an effective and stable maintenance. In other words, this means getting an objective evaluations of the processes, using up-to-date technologies and reliable accuracy of the results. Often legislations concerning mine engineering state that the volumetric calculations are to present ±3% accuracy of the whole amount. On one hand, extremely precise measurements could be performed by GNSS technologies, however, it could be really time consuming. On the other hand, UAV photogrammetry presents a fast, accurate method for mapping large areas and calculating stockpiles volumes. The study case was performed as a part of a master thesis.

  10. Stockpiling Drugs for an Avian Influenza Outbreak: Examining the Surge in Oseltamivir Prescriptions During Heightened Media Coverage of the Potential for a Worldwide Pandemic

    PubMed Central

    Gasink, Leanne B.; Linkin, Darren R.; Fishman, Neil O.; Bilker, Warren B.; Weiner, Mark G.; Lautenbach, Ebbing

    2010-01-01

    OBJECTIVE During fall 2005, personal stockpiling of oseltamivir for use during an outbreak of H5N1 influenza virus infection was widely reported. The present study aimed to identify indications for oseltamivir prescriptions to determine whether oseltamivir that was not intended for seasonal influenza was inappropriately consumed and to compare persons who were likely to have stockpiled oseltamivir and those who did not with respect to their knowledge, understanding, concerns, and expectations regarding avian influenza. DESIGN Survey to evaluate usage patterns for oseltamivir and assess views about avian influenza. SUBJECTS A total of 109 outpatients who received a prescription for oseltamivir between September 1, 2005, and December 31, 2005, and 825 matched control subjects. RESULTS Of 109 prescriptions, 36 (33.0%) were prescribed for patients with appropriate indications. Sixty-eight (62.4%) of 109 patients identified as having received oseltamivir and 440 (53.3%) of 825 individuals identified as not having received it responded to the questionnaire. Only 2 prescription recipients whose oseltamivir was not intended for immediate consumption reported that they had consumed the oseltamivir. Persons who probably intended to stockpile oseltamivir were older and more often white than those unlikely to stockpile it. They also reported greater worry about avian influenza and more often expected avian influenza to spread to the United States than those unlikely to stockpile, but there were no significant differences in responses to other questionnaire items. CONCLUSIONS A large proportion of the oseltamivir prescriptions written in fall 2005 were probably intended for personal stockpiling. Similarities in participants’ responses to questionnaire items suggest that educational campaigns may not be an effective method to curtail stockpiling of antimicrobial medications during an infectious threat. Promoting appropriate prescribing practices among providers may be a better

  11. The National Map hydrography data stewardship: what is it and why is it important?

    USGS Publications Warehouse

    Arnold, Dave

    2014-01-01

    The National Hydrography Dataset (NHD) and Watershed Boundary Dataset (WBD) were designed and populated by a large consortium of agencies involved in hydrography across the United States. The effort was led by the U.S. Geological Survey (USGS), the U.S. Environmental Protection Agency (EPA), and the Natural Resources Conservation Service (NRCS). The high-resolution NHD dataset, completed in 2007, is based on the USGS 7.5-minute series topographic maps at a scale of 1:24,000. There are now 26 million features in the NHD representing a 7.5 million mile stream network with over 6.5 million waterbodies. The six-level WBD, completed in 2010, is based on 1:24,000 scale data and contains over 23,000 watershed polygons. The NHD’s flow network, attribution, and linear referencing are used to conduct extensive scientific analyses. The NHD is ideal for cartographic applications such as the US Topo topographic map series, and also is available on the Geospatial Platform, which provides shared and trusted geospatial data, services, and applications for use by government agencies, their partners, and the public. The WBD watersheds are used by scientists and managers to identify discrete drainage areas. The ongoing maintenance of the NHD and WBD is essential for improving these datasets to meet the ever increasing demand for currency, additional detail, and more significant attribution. The best source of information about changes in local hydrography are users closest to the data, such as State and local governments, as well as Federal land management agencies, and other users of the data. The need for local knowledge has led to the creation of a collaborative data stewardship process to revise and maintain the NHD.

  12. 77 FR 33239 - Prairie Stewardship Plan/Environmental Impact Statement, San Juan Island National Historical Park

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... National Park Service Prairie Stewardship Plan/Environmental Impact Statement, San Juan Island National Historical Park AGENCY: National Park Service, Interior. ACTION: Notice of Intent to Prepare an Environmental... Park Service (NPS) is initiating the preparation of an Environmental Impact Statement (EIS) for...

  13. A Partnership Model for Training Episodic Environmental Stewardship 4-H Volunteers

    ERIC Educational Resources Information Center

    Young, Jane Chin; Alexander, Janice; Smith, Martin H.

    2013-01-01

    The Marin Environmental Stewardship pilot project demonstrates the potential for a partnership model that brings together external and internal collaborators to recruit and train episodic 4-H volunteers to meet environmental education needs within a community. The clientele served by the volunteers trained through the project was at-risk, urban…

  14. The Critical Role of Stewardship in Fund Raising: The Coaches vs. Cancer Campaign.

    ERIC Educational Resources Information Center

    Worley, Debra A.; Little, Jennifer K.

    2002-01-01

    Examines the critical role of stewardship in the process of fund raising. Uses the Coaches vs. Cancer campaign to illustrate the limitations of the public relations ROPE (research, objectives, planning, and evaluation) model in explaining fund raising success, and supports K.S. Kelly's contention that addition of a fifth step to the model, the…

  15. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 170.700 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION...? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and FHWA in the administration of the IRR Program and the process used for fulfilling those roles...

  16. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 170.700 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION...? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and FHWA in the administration of the IRR Program and the process used for fulfilling those roles...

  17. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 170.700 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION...? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and FHWA in the administration of the IRR Program and the process used for fulfilling those roles...

  18. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 170.700 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION...? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and FHWA in the administration of the IRR Program and the process used for fulfilling those roles...

  19. 25 CFR 170.700 - What is the IRR Program stewardship plan?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 170.700 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAND AND WATER INDIAN RESERVATION...? The IRR Program stewardship plan delineates the respective roles and responsibilities of BIA and FHWA in the administration of the IRR Program and the process used for fulfilling those roles...

  20. Aspen's Global 100: Beyond Grey Pinstripes 2009-2010--Preparing MBAs for Social and Environmental Stewardship

    ERIC Educational Resources Information Center

    Aspen Institute, 2009

    2009-01-01

    Beyond Grey Pinstripes is a research survey and alternative ranking of business schools that spotlights innovative full-time MBA programs leading the way in integrating social and environmental stewardship into their curriculum and scholarly research. These schools are preparing today's students--tomorrow's leaders--for future market realities by…

  1. 4-H and Forestry Afterschool Clubs: A Collaboration to Foster Stewardship Attitudes and Behaviors in Youth

    ERIC Educational Resources Information Center

    Gupta, Angela S.; Grant, Samantha; Strauss, Andrea Lorek

    2012-01-01

    The University of Minnesota Extension's 4-H and Forestry Afterschool program combined the 4-H structure and various forestry curricula to foster positive attitudes towards the environment and stewardship-related behaviors as these may serve as precursors to later choices that benefit the environment. Evaluation of third through fifth grade…

  2. Preservice Teachers' Perspectives of the Emphasis on Stewardship from Their Initial Teacher Preparation

    ERIC Educational Resources Information Center

    Yontz, Brian D.

    2013-01-01

    The stewardship of schools is central to the renewal and preservation of that which is precious in our nation's schools. This study examined perceptions of future teachers as to the degree to which their teacher preparation program emphasized the idea of stewarding schools. In addition this article outlines specific emerging aspects of the…

  3. Watershed Stewardship Education Program--A Multidisciplinary Extension Education Program for Oregon's Watershed Councils.

    ERIC Educational Resources Information Center

    Conway, Flaxen D. L.; Godwin, Derek; Cloughesy, Mike; Nierenberg, Tara

    2003-01-01

    The Watershed Stewardship Education Program (WSEP) is a multidisciplinary Oregon Extension designed to help watershed councils, landowners, and others work effectively together on water management. Components include practical, easy-to-use educational materials, training in effective collaboration, a Master Watershed Stewards program, and advanced…

  4. Development of an anticoagulation stewardship program at a large tertiary care academic institution.

    PubMed

    Padron, Maria; Miyares, Marta A

    2015-02-01

    Pharmacist-directed anticoagulation management services (AMSs) have been shown to significantly lower anticoagulation-related mortality, length of hospital stay, bleeding complications, blood transfusion requirements, and cost of therapy. AMSs are only 1 component of an anticoagulation stewardship program. Frequently, stewardship programs are limited to inpatient populations. Incorporating components that facilitate transition to outpatient status will ideally encompass complete care. The purpose of this program was to expand anticoagulation services and standardize care by implementing a full-service stewardship program including a transition of care service. The first component of the study involved medication surveillance for inpatients on anticoagulation therapy. The second component involved transitioning patients on anticoagulation, primarily with venous thromboembolism (VTE) to outpatient management. Finally, the pharmacist identified areas for optimization. Optimization involved developing or updating protocols to reflect updates in the literature as well as updating institution-specific information resources. Interventions made through medication surveillance and utilization of the VTE transition of care services translated into a total cost savings of approximately US$270 320. A postgraduate, first-year pharmacy resident contributed to improving patient outcomes while reducing utilization of hospital services and obtaining substantial cost savings through participation in anticoagulation stewardship services.

  5. Teacher Candidates' Perceptions of the Emphasis on Stewardship in Their Initial Teacher Licensure Program

    ERIC Educational Resources Information Center

    Yontz, Brian David

    2010-01-01

    The stewardship of schools is central to the renewal and preservation of that which is precious in our nation's schools. This study examined perceptions of future teachers as to the degree to which their teacher preparation program emphasized the idea of stewarding schools. With a theoretical foundation that initial teacher preparation provides…

  6. Antimicrobial stewardship and the role of pharmacokinetics-pharmacodynamics in the modern antibiotic era.

    PubMed

    Owens, Robert C; Ambrose, Paul G

    2007-03-01

    Antimicrobial stewardship, a term coined by Dale Gerding, is defined as the optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment or prevention of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance development. Methods to promote and ensure good antimicrobial stewardship have been implemented and studied, and have typically provided tangible benefits in terms of a reduction in overall or targeted antimicrobial usage and resistance emergence. Although most of the programmatic antimicrobial stewardship efforts have been conducted in acute care inpatient settings, some strategies usually involving education have been evaluated in the outpatient venue. In this review, we shall discuss issues related to why antimicrobial stewardship is of particular importance in the modern antibiotic era. In addition, general pharmacokinetic-pharmacodynamic (PK-PD) concepts will be reviewed and specific PK-PD analyses that support the optimal selection, dosing, and duration of therapy for beta-lactam antimicrobials will be provided.

  7. 7 CFR 1469.7 - Benchmark condition inventory and conservation stewardship plan.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Benchmark condition inventory and conservation... SECURITY PROGRAM General Provisions § 1469.7 Benchmark condition inventory and conservation stewardship plan. (a) The benchmark condition inventory and associated case file information must include: (1)...

  8. 7 CFR 1469.7 - Benchmark condition inventory and conservation stewardship plan.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Benchmark condition inventory and conservation... SECURITY PROGRAM General Provisions § 1469.7 Benchmark condition inventory and conservation stewardship plan. (a) The benchmark condition inventory and associated case file information must include: (1)...

  9. 7 CFR 1469.7 - Benchmark condition inventory and conservation stewardship plan.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Benchmark condition inventory and conservation... SECURITY PROGRAM General Provisions § 1469.7 Benchmark condition inventory and conservation stewardship plan. (a) The benchmark condition inventory and associated case file information must include: (1)...

  10. Recommendations for Best Professional Practices in Fishing, Boating and Stewardship Education.

    ERIC Educational Resources Information Center

    Fedler, Anthony J.; Matthews, Bruce E.

    2001-01-01

    To implement its mission of increasing participation in fishing and boating and the stewardship of related resources, the Recreational Boating and Fishing Foundation solicited input from 11 experts in related fields. They identified 10 principles for education programs and recommended best practices in four educational areas: program planning,…

  11. Stewardship as a Means to Create Organizational Reform: A View into Minnesota 4-H Youth Development

    ERIC Educational Resources Information Center

    Skuza, Jennifer A.; Freeman, Dorothy M.; Bremseth, Tamara J.; Doering, Shirley A.; Quinlan, Robert B.; Morreim, Patricia A.; Deidrick, James C.

    2010-01-01

    Minnesota 4-H Youth Development (MN 4-H) used stewardship as a means to create organizational reform to address the public use of the 4-H name and emblem in terms of risk management, real estate and equipment, and finances. A task force implemented a participatory process with colleagues and stakeholders to build and implement the reform effort.…

  12. Evolution of data stewardship over two decades at a NASA data center

    NASA Astrophysics Data System (ADS)

    Armstrong, E. M.; Moroni, D. F.; Hausman, J.; Tsontos, V. M.

    2013-12-01

    physical domain was still critical, especially relevant to assessments of data quality, additional skills in computer science, statistics and system engineering also became necessary. Furthermore, the level of effort to implement data curation has not expanded linearly either. Management of ongoing data operations demands increased productivity on a continual basis and larger volumes of data, with constraints on funding, must be managed with proportionately less human resources. The role of data curation has also changed within the perspective of satellite missions. In many early missions, data management and curation was an afterthought (since there were no explicit data management plans written into the proposals), while current NASA mission proposals must have explicit data management plans to identify resources and funds for archiving, distribution and implementing overall data stewardship. In conclusion, the role of the data scientist/engineer at the PO.DAAC has shifted from supporting singular missions and primarily representing a point of contact for the science community to complete end-to-end stewardship through the implementation of a robust set of dataset lifecycle policies from ingest, to archiving, including data quality assessment for a broad swath of parameter based datasets that can number in the hundreds.

  13. Building the strategic national stockpile through the NIAID Radiation Nuclear Countermeasures Program.

    PubMed

    Rios, Carmen I; Cassatt, David R; Dicarlo, Andrea L; Macchiarini, Francesca; Ramakrishnan, Narayani; Norman, Mai-Kim; Maidment, Bert W

    2014-02-01

    The possibility of a public health radiological or nuclear emergency in the United States remains a concern. Media attention focused on lost radioactive sources and international nuclear threats, as well as the potential for accidents in nuclear power facilities (e.g., Windscale, Three Mile Island, Chernobyl, and Fukushima) highlight the need to address this critical national security issue. To date, no drugs have been licensed to mitigate/treat the acute and long-term radiation injuries that would result in the event of large-scale, radiation, or nuclear public health emergency. However, recent evaluation of several candidate radiation medical countermeasures (MCMs) has provided initial proof-of-concept of efficacy. The goal of the Radiation Nuclear Countermeasures Program (RNCP) of the National Institute of Allergy and Infectious Diseases (National Institutes of Health) is to help ensure the government stockpiling of safe and efficacious MCMs to treat radiation injuries, including, but not limited to, hematopoietic, gastrointestinal, pulmonary, cutaneous, renal, cardiovascular, and central nervous systems. In addition to supporting research in these areas, the RNCP continues to fund research and development of decorporation agents targeting internal radionuclide contamination, and biodosimetry platforms (e.g., biomarkers and devices) to assess the levels of an individual's radiation exposure, capabilities that would be critical in a mass casualty scenario. New areas of research within the program include a focus on special populations, especially pediatric and geriatric civilians, as well as combination studies, in which drugs are tested within the context of expected medical care management (e.g., antibiotics and growth factors). Moving forward, challenges facing the RNCP, as well as the entire radiation research field, include further advancement and qualification of animal models, dose conversion from animal models to humans, biomarker identification, and

  14. Reducing mortality from anthrax bioterrorism: strategies for stockpiling and dispensing medical and pharmaceutical supplies.

    PubMed

    Bravata, Dena M; Zaric, Gregory S; Holty, Jon-Erik C; Brandeau, Margaret L; Wilhelm, Emilee R; McDonald, Kathryn M; Owens, Douglas K

    2006-01-01

    A critical question in planning a response to bioterrorism is how antibiotics and medical supplies should be stockpiled and dispensed. The objective of this work was to evaluate the costs and benefits of alternative strategies for maintaining and dispensing local and regional inventories of antibiotics and medical supplies for responses to anthrax bioterrorism. We modeled the regional and local supply chain for antibiotics and medical supplies as well as local dispensing capacity. We found that mortality was highly dependent on the local dispensing capacity, the number of individuals requiring prophylaxis, adherence to prophylactic antibiotics, and delays in attack detection. For an attack exposing 250,000 people and requiring the prophylaxis of 5 million people, expected mortality fell from 243,000 to 145,000 as the dispensing capacity increased from 14,000 to 420,000 individuals per day. At low dispensing capacities (<14,000 individuals per day), nearly all exposed individuals died, regardless of the rate of adherence to prophylaxis, delays in attack detection, or availability of local inventories. No benefit was achieved by doubling local inventories at low dispensing capacities; however, at higher dispensing capacities, the cost-effectiveness of doubling local inventories fell from 100,000 US dollars to 20,000 US dollars/life year gained as the annual probability of an attack increased from 0.0002 to 0.001. We conclude that because of the reportedly rapid availability of regional inventories, the critical determinant of mortality following anthrax bioterrorism is local dispensing capacity. Bioterrorism preparedness efforts directed at improving local dispensing capacity are required before benefits can be reaped from enhancing local inventories. PMID:16999586

  15. Building the strategic national stockpile through the NIAID Radiation Nuclear Countermeasures Program.

    PubMed

    Rios, Carmen I; Cassatt, David R; Dicarlo, Andrea L; Macchiarini, Francesca; Ramakrishnan, Narayani; Norman, Mai-Kim; Maidment, Bert W

    2014-02-01

    The possibility of a public health radiological or nuclear emergency in the United States remains a concern. Media attention focused on lost radioactive sources and international nuclear threats, as well as the potential for accidents in nuclear power facilities (e.g., Windscale, Three Mile Island, Chernobyl, and Fukushima) highlight the need to address this critical national security issue. To date, no drugs have been licensed to mitigate/treat the acute and long-term radiation injuries that would result in the event of large-scale, radiation, or nuclear public health emergency. However, recent evaluation of several candidate radiation medical countermeasures (MCMs) has provided initial proof-of-concept of efficacy. The goal of the Radiation Nuclear Countermeasures Program (RNCP) of the National Institute of Allergy and Infectious Diseases (National Institutes of Health) is to help ensure the government stockpiling of safe and efficacious MCMs to treat radiation injuries, including, but not limited to, hematopoietic, gastrointestinal, pulmonary, cutaneous, renal, cardiovascular, and central nervous systems. In addition to supporting research in these areas, the RNCP continues to fund research and development of decorporation agents targeting internal radionuclide contamination, and biodosimetry platforms (e.g., biomarkers and devices) to assess the levels of an individual's radiation exposure, capabilities that would be critical in a mass casualty scenario. New areas of research within the program include a focus on special populations, especially pediatric and geriatric civilians, as well as combination studies, in which drugs are tested within the context of expected medical care management (e.g., antibiotics and growth factors). Moving forward, challenges facing the RNCP, as well as the entire radiation research field, include further advancement and qualification of animal models, dose conversion from animal models to humans, biomarker identification, and

  16. Antibiotic stewardship programmes in intensive care units: Why, how, and where are they leading us

    PubMed Central

    Zhang, Yu-Zhi; Singh, Suveer

    2015-01-01

    Antibiotic usage and increasing antimicrobial resistance (AMR) mount significant challenges to patient safety and management of the critically ill on intensive care units (ICU). Antibiotic stewardship programmes (ASPs) aim to optimise appropriate antibiotic treatment whilst minimising antibiotic resistance. Different models of ASP in intensive care setting, include “standard” control of antibiotic prescribing such as “de-escalation strategies”through to interventional approaches utilising biomarker-guided antibiotic prescribing. A systematic review of outcomes related studies for ASPs in an ICU setting was conducted. Forty three studies were identified from MEDLINE between 1996 and 2014. Of 34 non-protocolised studies, [1 randomised control trial (RCT), 22 observational and 11 case series], 29 (85%) were positive with respect to one or more outcome: These were the key outcome of reduced antibiotic use, or ICU length of stay, antibiotic resistance, or prescribing cost burden. Limitations of non-standard antibiotic initiation triggers, patient and antibiotic selection bias or baseline demographic variance were identified. All 9 protocolised studies were RCTs, of which 8 were procalcitonin (PCT) guided antibiotic stop/start interventions. Five studies addressed antibiotic escalation, 3 de-escalation and 1 addressed both. Six studies reported positive outcomes for reduced antibiotic use, ICU length of stay or antibiotic resistance. PCT based ASPs are effective as antibiotic-stop (de-escalation) triggers, but not as an escalation trigger alone. PCT has also been effective in reducing antibiotic usage without worsening morbidity or mortality in ventilator associated pulmonary infection. No study has demonstrated survival benefit of ASP. Ongoing challenges to infectious disease management, reported by the World Health Organisation global report 2014, are high AMR to newer antibiotics, and regional knowledge gaps in AMR surveillance. Improved AMR surveillance data

  17. Towards a mutually reinforcing future : opportunities to integrate nuclear weapons stewardship and arms control objectives.

    SciTech Connect

    Sanders, Lani Miyoshi; DeLand, Sharon Marie; Pregenzer, Arian Leigh

    2010-07-01

    2010 NPR and President Obama's 2009 Prague Speech highlighted two key objectives with an inherent underlying tension: (1) Moving towards a world free of nuclear weapons; and (2) Sustaining a safe, secure, and effective nuclear arsenal. Objective 1 depends, inter alia, upon reductions in stockpiles at home and abroad and maintaining stability. Objective 2 depends upon needed investments in modernization and life extension. Objectives being pursued predominantly in parallel by largely separate communities.

  18. Ocean Acidification Scientific Data Stewardship: An approach for end-to-end data management and integration

    NASA Astrophysics Data System (ADS)

    Arzayus, K. M.; Garcia, H. E.; Jiang, L.; Michael, P.

    2012-12-01

    As the designated Federal permanent oceanographic data center in the United States, NOAA's National Oceanographic Data Center (NODC) has been providing scientific stewardship for national and international marine environmental and ecosystem data for over 50 years. NODC is supporting NOAA's Ocean Acidification Program and the science community by providing end-to-end scientific data management of ocean acidification (OA) data, dedicated online data discovery, and user-friendly access to a diverse range of historical and modern OA and other chemical, physical, and biological oceanographic data. This effort is being catalyzed by the NOAA Ocean Acidification Program, but the intended reach is for the broader scientific ocean acidification community. The first three years of the project will be focused on infrastructure building. A complete ocean acidification data content standard is being developed to ensure that a full spectrum of ocean acidification data and metadata can be stored and utilized for optimal data discovery and access in usable data formats. We plan to develop a data access interface capable of allowing users to constrain their search based on real-time and delayed mode measured variables, scientific data quality, their observation types, the temporal coverage, methods, instruments, standards, collecting institutions, and the spatial coverage. In addition, NODC seeks to utilize the existing suite of international standards (including ISO 19115-2 and CF-compliant netCDF) to help our data producers use those standards for their data, and help our data consumers make use of the well-standardized metadata-rich data sets. These tools will be available through our NODC Ocean Acidification Scientific Data Stewardship (OADS) web page at http://www.nodc.noaa.gov/oceanacidification. NODC also has a goal to provide each archived dataset with a unique ID, to ensure a means of providing credit to the data provider. Working with partner institutions, such as the

  19. Evaluation of the impact of meteorological restrictions on the TEAD Chemical Stockpile Disposal Program. Volume 1. Final report

    SciTech Connect

    Flamm, K.J.

    1989-09-08

    This document has been prepared in support of the Tooele Army Depot (TEAD) Site Specific Environmental Impact Statement (SSEIS) for the Chemical Stockpile Disposal Program (CSDP). This study evaluates the impact of TEAD site specific meteorological, geographical and chronological effects on the hazard distances resulting from the Credible Catastrophic Accidents (CCAs) used in the Final Programmatic Environmental Impact Statement (FPEIS). In addition, the study evaluates the impact on the total risk to the public by restricting or partially restricting disposal operations to the portion of the day when stable meteorological conditions do not exist.

  20. Customized Order-Entry Sets Can Prevent Antiretroviral Prescribing Errors: A Novel Opportunity For Antimicrobial Stewardship

    PubMed Central

    Guo, Yi; Chung, Philip; Weiss, Caryn; Veltri, Keith; Minamoto, Grace Y.

    2015-01-01

    Background: Patients with human immunodeficiency virus (HIV) infection on antiretroviral (ARV) therapy are at increased risk for medication errors during transitions of care between the outpatient and inpatient settings. This can lead to treatment failure or toxicity. Previous studies have emphasized the prevalence of medication errors in such patients, but few have reported initiatives to prevent errors from occurring. Methods: The study was conducted in a 1,400-bed health care center with a state-designated Acquired Immunodeficiency Syndrome (AIDS) Center in the Bronx, New York. The antimicrobial stewardship team and HIV specialists developed customized order-entry sets (COES) to guide ARV prescribing and retrospectively reviewed their effect on error rates of initial ARV orders for inpatients before reconciliation. Patient records were reviewed in six-month periods before and after intervention. The student’s t-test or Mann–Whitney U test was used to compare continuous variables; chi-square or Fisher’s exact test was used for categorical variables. Results: A total of 723 and 661 admissions were included in the pre-intervention and post-intervention periods, respectively. Overall, error rates decreased by 35% (38.0% to 24.8%, P < 0.01) with COES. Wrong doses and drug interactions decreased by more than 40% (P < 0.005). Error reductions were observed in protease inhibitor (PI)-based (43.6% versus 28.7%, P < 0.01) and non–PI-based (38.0% versus 24.4%, P = 0.02) regimens with COES. A shift in predominant drug-class errors was observed as there was a trend toward increased usage of non-PI regimens post-intervention. Admission in the pre-intervention period (adjusted odds ratio [AOR], 1.79; 95% confidence interval [CI], 1.39–2.31) and use of PI-based regimens (AOR, 2.03; 95% CI, 1.53–2.70) remained significantly associated with ARV prescribing errors after controlling for confounding factors. Conclusion: Detailed COES improved ARV prescribing habits

  1. Role of antibiotic stewardship in extending the age of modern medicine.

    PubMed

    Mendelson, M

    2015-05-01

    Antibiotic resistance is threatening modern medicine. Overuse and misuse of antibiotics is driving resistance to such an extent that we have entered the post-antibiotic era, where some multidrug- and pandrug-resistant bacterial infections are no longer treatable. If the situation is not reversed,10 million people will die annually of drug-resistant infections by 2050. More than just a question of mortality, such infections are causing the closure of wards, cancellation of operations, and interference with other common medical procedures that rely on antibiotics for their success. The response to this crisis requires co-ordinated international action with increased surveillance of bacterial resistance, infection prevention, and antibiotic stewardship, i.e. access to affordable, quality-assured antibiotics prescribed appropriately. This review describes antibiotic stewardship at the individual patient and programmatic level, which must be adopted by every prescriber if we are to preserve modern medicine for future generations. PMID:26242674

  2. Role of antibiotic stewardship in extending the age of modern medicine.

    PubMed

    Mendelson, M

    2015-04-10

    Antibiotic resistance is threatening modern medicine. Overuse and misuse of antibiotics is driving resistance to such an extent that we have entered the post-antibiotic era, where some multidrug- and pandrug-resistant bacterial infections are no longer treatable. If the situation is not reversed,10 million people will die annually of drug-resistant infections by 2050. More than just a question of mortality, such infections are causing the closure of wards, cancellation of operations, and interference with other common medical procedures that rely on antibiotics for their success. The response to this crisis requires co-ordinated international action with increased surveillance of bacterial resistance, infection prevention, and antibiotic stewardship, i.e. access to affordable, quality-assured antibiotics prescribed appropriately. This review describes antibiotic stewardship at the individual patient and programmatic level, which must be adopted by every prescriber if we are to preserve modern medicine for future generations.

  3. Minnesota anglers' fisheries-related value orientations and their stewardship of fish resources

    USGS Publications Warehouse

    Bruskotter, J.T.; Fulton, D.C.

    2008-01-01

    Research on natural resource-related values and value orientations has grown substantially over the past decade. However, existing studies have focused almost exclusively on value orientations related to wildlife and forests. This article reports data from two mail surveys of Minnesota anglers used to develop scales for measuring fisheries-related value orientations. We report results of regression analyses examining the relationship between anglers' value orientations and norms concerning fisheries stewardship and the use of technological aids to angling. Results indicate 10 items reliably measure three value orientations we termed utilitarianism, dominance, and protectionism. Regression analyses suggest anglers' stewardship norms are influenced by all three value orientation types, while support for the use of technological aids was related with protectionism and utilitarianism, but not dominance. Results suggest anglers' fisheries-related value orientations cannot be adequately captured using single domain scales. Implications for the study of natural resources-related value orientations are discussed. Copyright ?? Taylor & Francis Group, LLC.

  4. Antibiotic Stewardship Initiatives as Part of the UK 5-Year Antimicrobial Resistance Strategy

    PubMed Central

    Johnson, Alan P.; Ashiru-Oredope, Diane; Beech, Elizabeth

    2015-01-01

    Antibiotic use is a major driver for the emergence and spread of antibiotic resistance. Antimicrobial stewardship programmes aim to improve antibiotic prescribing with the objectives of optimizing clinical outcomes while at the same time minimizing unintended consequences such as adverse effects and the selection of antibiotic resistance. In 2013, a five-year national strategy for tackling antimicrobial resistance was published in the UK. The overarching goal of the strategy is to slow the development and spread of resistance and to this end it has three strategic aims, namely to improve knowledge and understanding of resistance, to conserve and steward the effectiveness of existing treatments and to stimulate the development of new antibiotics, diagnostics and novel therapies. This article reviews the antimicrobial stewardship activities included in the strategy and describes their implementation and evaluation. PMID:27025636

  5. Energy Market and Economic Impacts of S. 280, the Climate Stewardship and Innovation Act of 2007

    EIA Publications

    2007-01-01

    This report responds to a request from Senators Joseph Lieberman and John McCain for an estimate of the economic impacts of S.280, the Climate Stewardship and Innovation Act of 2007. S. 280 would establish a series of caps on greenhouse gas emissions starting in 2012 followed by increasingly stringent caps beginning in 2020, 2030 and 2050. The report provides estimates of the effects of S. 280 on energy markets and the economy through 2030.

  6. Outcomes and metrics for antimicrobial stewardship: survey of physicians and pharmacists.

    PubMed

    Bumpass, J Brock; McDaneld, Patrick M; DePestel, Daryl D; Lamp, Kenneth C; Chung, Thomas J; McKinnon, Peggy S; Crompton, Monica G; Hermsen, Elizabeth D

    2014-10-15

    We conducted a survey to compare antimicrobial stewardship outcomes considered to be most important with those used in practice as metrics. Respondent opinion of important outcomes compared with those collected as metrics were antimicrobial use (15% vs 73%), antimicrobial cost (10% vs 73%), appropriateness of antimicrobial use (56% vs 51%), infection-related mortality rate (34% vs 7%), and antibiotic-associated length of stay (22% vs 12%). Patient outcomes are important to many practitioners but are rarely used as metrics.

  7. [The role of antimicrobial stewardship programs in the control of bacterial resistance].

    PubMed

    Pasquau, J; Sadyrbaeva, S; De Jesús, S E; Hidalgo-Tenorio, C

    2016-09-01

    In order to improve infection prognosis and reduce the existing microbial resistance problem (a challenge similar to that of climate change), a higher implication of the Administration, an increased level of social awareness and the development of specific corporate networks, including the pharmaceutical industry, is needed. However, we must first consolidate Antimicrobial Stewardship Programmes with experts who seek to improve antibiotic therapy effectivity in severe infections and to reduce global antibiotic exposure. PMID:27608314

  8. Human stewardship or ruining cultural landscapes of the ancient Tula wells, southern Ethiopia.

    PubMed

    Tiki, Waktole; Oba, Gufu; Tvedt, Terje

    2011-01-01

    This article uses the concepts of "human stewardship" and "ruined landscape" as a theoretical framework for analysing the community's perception of landscape change in the ancient tula well system of Borana in southern Ethiopia. The ancient tula well system, the main permanent water source, has been in operation for more than five centuries and it closely links human activity and the environment. The welfare of the tula well system and the performance of the Borana pastoral system are directly related. Borana management of the tula wells uses concepts such as laaf aadaa seeraa and laaf bade to differentiate between ‘land managed by customary laws’ (hereafter human stewardship) and ‘lost’ or ‘ruined’ land (laaf bade). The cultural landscapes of the ancient wells have undergone changes from ecosystems featuring ‘human stewardship’ (before the 1960s), that is, laaf aadaa seeraa to ‘ruined landscapes’ (after the 1960s), that is, laaf bade. Our interest is in understanding how the Borana perceive the impact of land use changes from these two conceptual perspectives. In group discussions, key informant interviews and household surveys across five of the nine well clusters, we found that the society described the changed tula cultural landscape in terms of drivers of well dynamics (i.e. use and disuse), break up of land use zonations, patterns of human settlement (traditional versus peri-urban), expansion of crop cultivation, and changes in environmental quality. Using the two concepts, we analysed linkages between changing patterns of land use that transformed the system from laaf aadaa seeraa, which ensured human stewardship, to laaf bade, which resulted in ruined landscapes. From these we analysed environmental narratives that showed how the society differentiated the past human stewardship that ensured sustainable landscape management from the present ruining of tula well cultural landscapes. PMID:21560273

  9. Human stewardship or ruining cultural landscapes of the ancient Tula wells, southern Ethiopia.

    PubMed

    Tiki, Waktole; Oba, Gufu; Tvedt, Terje

    2011-01-01

    This article uses the concepts of "human stewardship" and "ruined landscape" as a theoretical framework for analysing the community's perception of landscape change in the ancient tula well system of Borana in southern Ethiopia. The ancient tula well system, the main permanent water source, has been in operation for more than five centuries and it closely links human activity and the environment. The welfare of the tula well system and the performance of the Borana pastoral system are directly related. Borana management of the tula wells uses concepts such as laaf aadaa seeraa and laaf bade to differentiate between ‘land managed by customary laws’ (hereafter human stewardship) and ‘lost’ or ‘ruined’ land (laaf bade). The cultural landscapes of the ancient wells have undergone changes from ecosystems featuring ‘human stewardship’ (before the 1960s), that is, laaf aadaa seeraa to ‘ruined landscapes’ (after the 1960s), that is, laaf bade. Our interest is in understanding how the Borana perceive the impact of land use changes from these two conceptual perspectives. In group discussions, key informant interviews and household surveys across five of the nine well clusters, we found that the society described the changed tula cultural landscape in terms of drivers of well dynamics (i.e. use and disuse), break up of land use zonations, patterns of human settlement (traditional versus peri-urban), expansion of crop cultivation, and changes in environmental quality. Using the two concepts, we analysed linkages between changing patterns of land use that transformed the system from laaf aadaa seeraa, which ensured human stewardship, to laaf bade, which resulted in ruined landscapes. From these we analysed environmental narratives that showed how the society differentiated the past human stewardship that ensured sustainable landscape management from the present ruining of tula well cultural landscapes.

  10. Local Government Implementation of Long-Term Stewardship at Two DOE Facilities

    SciTech Connect

    John Pendergrass; Roman Czebiniak; Kelly Mott; Seth Kirshenberg; Audrey Eidelman; Zachary Lamb; Erica Pencak; Wendy Sandoz

    2003-08-13

    The Department of Energy (DOE) is responsible for cleaning up the radioactive and chemical contamination that resulted from the production of nuclear weapons. At more than one hundred sites throughout the country DOE will leave some contamination in place after the cleanup is complete. In order to protect human health and the environment from the remaining contamination DOE, U.S. Environmental Protection Agency (EPA), state environmental regulatory agencies, local governments, citizens and other entities will need to undertake long-term stewardship of such sites. Long-term stewardship includes a wide range of actions needed to protect human health in the environment for as long as the risk from the contamination remains above acceptable levels, such as barriers, caps, and other engineering controls and land use controls, signs, notices, records, and other institutional controls. In this report the Environmental Law Institute (ELI) and the Energy Communities Alliance (ECA) examine how local governments, state environmental agencies, and real property professionals implement long-term stewardship at two DOE facilities, Losa Alamos National Laboratory and Oak Ridge Reservation.

  11. [The absence of stewardship in the Chilean health authority after the 2004 health reform].

    PubMed

    Herrera, Tania; Sánchez, Sergio

    2014-01-01

    Stewardship is the most important political function of a health system. It is a government responsibility carried out by the health authority. Among other dimensions, it is also a meta-function that includes conduction and regulation. The Health Authority and Management Act, which came about from the health reform of 2004, separated the functions of service provision and stewardship with the aim of strengthening the role of the health authority. However, the current structure of the health system contains overlapping functions between the different entities that leads to lack of coordination and inconsistencies, and a greater weight on individual health actions at the expense of collective ones. Consequently, a properly funded national health strategy to improve the health of the population is missing. Additionally, the components of citizen participation and governance are weak. It is necessary, therefore, to revisit the Chilean health structure in order to develop one that truly enables the exercise of the health authority’s stewardship role. PMID:25514550

  12. Mapping Antimicrobial Stewardship in Undergraduate Medical, Dental, Pharmacy, Nursing and Veterinary Education in the United Kingdom

    PubMed Central

    Castro-Sánchez, Enrique; Drumright, Lydia N.; Gharbi, Myriam; Farrell, Susan; Holmes, Alison H.

    2016-01-01

    Objectives To investigate the teaching of antimicrobial stewardship (AS) in undergraduate healthcare educational degree programmes in the United Kingdom (UK). Participants and Methods Cross-sectional survey of undergraduate programmes in human and veterinary medicine, dentistry, pharmacy and nursing in the UK. The main outcome measures included prevalence of AS teaching; stewardship principles taught; estimated hours apportioned; mode of content delivery and teaching strategies; evaluation methodologies; and frequency of multidisciplinary learning. Results 80% (112/140) of programmes responded adequately. The majority of programmes teach AS principles (88/109, 80.7%). ‘Adopting necessary infection prevention and control precautions’ was the most frequently taught principle (83/88, 94.3%), followed by 'timely collection of microbiological samples for microscopy, culture and sensitivity’ (73/88, 82.9%) and ‘minimisation of unnecessary antimicrobial prescribing’ (72/88, 81.8%). The ‘use of intravenous administration only to patients who are severely ill, or unable to tolerate oral treatment’ was reported in ~50% of courses. Only 32/88 (36.3%) programmes included all recommended principles. Discussion Antimicrobial stewardship principles are included in most undergraduate healthcare and veterinary degree programmes in the UK. However, future professionals responsible for using antimicrobials receive disparate education. Education may be boosted by standardisation and strengthening of less frequently discussed principles. PMID:26928009

  13. New thoughts on the "forgotten" aspect of antimicrobial stewardship: adverse event reporting.

    PubMed

    Hoffmann, Charles; Khadem, Tina; Schweighardt, Anne; Brown, Jack

    2015-01-01

    Antimicrobial stewardship is an activity that optimizes patient care through selection of the most appropriate antimicrobial therapy. Antimicrobial stewardship programs strive to enhance patient care and reduce preventable consequences of antimicrobial use. They are also vital in monitoring for the development of adverse events occurring as a result of antimicrobial therapy, although literature reviews of this activity are scarce. Although randomized controlled trials are considered the gold standard to study the efficacy of a medication, these trials are not designed to test safety end points and often are only able to identify the most commonly occurring and acute adverse events. In addition, prior to a drug going to market, it is difficult to detect rare adverse events because the associated costs are economically untenable given the limited pipeline of novel agents. These limitations in some ways may be resolved with the use of postmarketing surveillance and spontaneous reporting systems such as the United States Food and Drug Administration Adverse Event Reporting System. The focus of this commentary is to highlight the importance of adverse event reporting by antimicrobial stewardship programs to spontaneous reporting systems as a means to improve patient care.

  14. The Gateway Paper--stewardship and governance in the health sector in Pakistan.

    PubMed

    Nishtar, Sania

    2006-12-01

    As an opening for a dialogue on health reforms in the country, the Gateway Paper places emphasis on strengthening the stewardship function of mandated State agencies in Pakistan with particular attention to two key areas. Firstly, greater emphasis on a stewardship role for the Ministry and departments of health in the context of inter-sectoral scope of health and secondly, a stronger role for the State agencies as regulators of healthcare within the country. The Gateway Paper envisages that the role of State agencies will become more critical as new models of financing health and delivering services are structured given that these entail regulation of private sector providers, providing oversight for ensuring a system for ongoing education and implementation of frameworks for public-private partnerships. The Gateway Paper refers to stewardship with reference to analysis and overview of health policies within the country, their relationship with evidence, their follow-up into planning and finally their implementation. The Paper also provides an insight into policies from a process-related as well as content and program related perspectives. In doing so a number of questions relating to the evidence and policy disconnect; issues at strategic and operational levels of planning, and governance-related impediments to program implementation have been discussed and a viewpoint articulated on an approach to addressing these challenges.

  15. Effectiveness of voluntary habitat stewardship in conserving grassland: case of operation burrowing owl in Saskatchewan.

    PubMed

    Warnock, Robert G; Skeel, Margaret A

    2004-03-01

    There have been no published performance evaluations of nongovernmental, voluntary habitat stewardship programs. The Operation Burrowing Owl (OBO) stewardship program, initiated in 1987, was evaluated for its effectiveness in conservation of grassland habitat during 1986-1993. The 108 OBO sites from 1987 to 88 and 98 randomly selected non-OBO sites that were grassland in 1986 in the Regina-Weyburn, Saskatchewan study area were classified by size and agricultural soil suitability. By 1993, 41 (38%) of the 108 OBO sites had been withdrawn from the program. The 1986 area of grassland was compared with grassland area calculated from digitized 1993 LANDSAT imagery. A correction for satellite inaccuracies was determined. Grassland retention in 1993 was significantly higher at OBO sites (66%) than at random sites (49%), demonstrating that the OBO voluntary program effectively conserved habitat. Also, grassland retention was significantly lower on sites with better agricultural soils, and for sites <12 ha in size. Site type (OBO or random), size and their interaction, followed by agricultural soil suitability, had the greatest effects on grassland retention. During an era of accelerated grassland loss, OBO strongly and positively (statistically significant) affected conservation of grassland sites most at risk: sites <12 ha in size and with good to excellent agricultural soils. This suggests that grassland conservation efforts focus on vulnerable sites (small size and/or good agricultural soils) to provide nesting habitat for burrowing owls. Our study demonstrates that a voluntary stewardship program can significantly increase conservation of habitat. PMID:15037954

  16. An analysis of Chemical Stockpile Emergency Preparedness Program exercise results. Volume 1: The CSEPP Exercise Results Database

    SciTech Connect

    Hewett, P.L. Jr.; Mitrani, J.E.; Absil-Mills, M.J.G.; Tallarovic, P.; Molsen, J.; Vercellone, J.; Madore, M.A.

    1998-06-01

    The primary focus of the Chemical Stockpile Emergency Preparedness Program (CSEPP) is to enhance the response capabilities of the eight US Army installations that store chemical weapons agent and of the communities immediately surrounding each Army storage installation. Exercises are a major component of the program and are conducted annually at each of the eight installations. Following each exercise, a report summarizing the results of the exercise is produced. To gain a better perspective on the site-specific and program-wide results of these exercises, the Project Manager for Chemical Stockpile Emergency Preparedness requested that Argonne National Laboratory develop a database containing the results of exercises held through June 1996. This document provides a summary of the process used to develop the CSEPP Exercise Results Database. The database provides CSEPP managers in the Department of the Army and the Federal Emergency Management Agency a method for tracking and analyzing exercise results. The report discusses the collection and coding of exercise data and provides tables to guide coding of future exercise results. An electronic copy of the database (CD-ROM) accompanies the report. This report focuses only on methods used to collect exercise data and develop the database; Volume 2 discusses the analysis of the data collected.

  17. Assessment of polycyclic aromatic hydrocarbons (PAHs) contamination in surface soil of coal stockpile sites in South Kalimantan, Indonesia.

    PubMed

    Mizwar, Andy; Priatmadi, Bambang Joko; Abdi, Chairul; Trihadiningrum, Yulinah

    2016-03-01

    Concentrations, spatial distribution, and sources of 16 polycyclic aromatic hydrocarbons (PAHs), listed as priority pollutants by the United States Environmental Protection Agency (USEPA), were investigated in surface soils of three different coal stockpile, agricultural, and residential sites in South Kalimantan Province, Indonesia. Total PAHs concentration ranged from 4.69 to 22.67 mg kg(-1)-dw. PAHs concentrations in soil of coal stockpile sites were higher than those in agricultural and residential soil. A complex of petrogenic origin and pyrolytic sources was found within the study area, as suggested by the isomeric ratios of PAHs. The results of principal component analysis and multiple linear regressions (PCA/MLR) showed that three sources contributed to the PAHs in the study area, including biomass and coal combustion (48.46%), raw coal (35.49%), and vehicular emission (16.05%). The high value of total benzo[a]pyrene equivalent concentration (B[a]Peq) suggests that local residents are exposed to a high carcinogenic potential.

  18. Participatory eHealth development to support nurses in antimicrobial stewardship

    PubMed Central

    2014-01-01

    Background Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put antimicrobial treatment into effect. To optimally support nurses in ASPs, they should have access to information that supports them in their preparation, administration and monitoring tasks. In addition, it should help them to detect possible risks or adverse events associated with antimicrobial therapy. In this formative study, we investigate how nurses’ can be supported in ASPs by means of an eHealth intervention that targets their information needs. Methods We applied a participatory development approach that involves iterative cycles in which health care workers, mostly nurses, participate. Focus groups, observations, prototype evaluations (via a card sort task and a scenario-based information searching task) and interviews are done with stakeholders (nurses, managers, pharmacist, and microbiologist) on two pulmonary wards of a 1000-bed teaching hospital. Results To perform the complex antimicrobial-related tasks well, nurses need to consult various information sources on a myriad of occasions. In addition, the current information infrastructure is unsupportive of ASP-related tasks, mainly because information is not structured to match nurse tasks, is hard to find, out of date, and insufficiently supportive of awareness. Based our findings, we created a concept for a nurse information application. We attuned the application’s functionality, content, and structure to nurse work practice and tasks. Conclusions By applying a participatory development approach, we showed that task support is a basic need for nurses. Participatory development proved useful regarding several aspects. First, it allows for combining bottom-up needs (nurses’) and top-down legislations (medical

  19. Documenting stewardship responsibilities across the annual cycle for birds on U.S. public lands.

    PubMed

    La Sorte, Frank A; Fink, Daniel; Hochachka, Wesley M; Aycrigg, Jocelyn L; Rosenberg, Kenneth V; Rodewald, Amanda D; Bruns, Nicholas E; Farnsworth, Andrew; Sullivan, Brian L; Wood, Chris; Kelling, Steve

    2015-01-01

    In the face of global environmental change, the importance of protected areas in biological management and conservation is expected to grow. Birds have played an important role as biological indicators of the effectiveness of protected areas, but with little consideration given to where species occur outside the breeding season. We estimated weekly probability of occurrence for 308 bird species throughout the year within protected areas in the western contiguous USA using eBird occurrence data for the combined period 2004 to 2011. We classified species based on their annual patterns of occurrence on lands having intermediate conservation mandates (GAP status 2 and 3) administered by the Bureau of Land Management (BLM) and the United States Forest Service (USFS). We identified species having consistent annual association with one agency, and species whose associations across the annual cycle switched between agencies. BLM and USFS GAP status 2 and 3 lands contained low to moderate proportions of species occurrences, with proportions highest for species that occurred year-round or only during the summer. We identified two groups of species whose annual movements resulted in changes in stewardship responsibilities: (1) year-round species that occurred on USFS lands during the breeding season and BLM lands during the nonbreeding season; and (2) summer species that occurred on USFS lands during the breeding season and BLM lands during spring and autumn migration. Species that switched agencies had broad distributions, bred on high-elevation USFS lands, were not more likely to be identified as species of special management concern, and migrated short (year-round species) to long distances (summer species). Our findings suggest cooperative efforts that address the requirements of short-distance migratory species on GAP status 2 lands (n = 20 species) and GAP status 3 lands (n = 24) and long-distance migratory species on GAP status 2 lands (n = 9) would likely benefit

  20. Documenting stewardship responsibilities across the annual cycle for birds on U.S. public lands.

    PubMed

    La Sorte, Frank A; Fink, Daniel; Hochachka, Wesley M; Aycrigg, Jocelyn L; Rosenberg, Kenneth V; Rodewald, Amanda D; Bruns, Nicholas E; Farnsworth, Andrew; Sullivan, Brian L; Wood, Chris; Kelling, Steve

    2015-01-01

    In the face of global environmental change, the importance of protected areas in biological management and conservation is expected to grow. Birds have played an important role as biological indicators of the effectiveness of protected areas, but with little consideration given to where species occur outside the breeding season. We estimated weekly probability of occurrence for 308 bird species throughout the year within protected areas in the western contiguous USA using eBird occurrence data for the combined period 2004 to 2011. We classified species based on their annual patterns of occurrence on lands having intermediate conservation mandates (GAP status 2 and 3) administered by the Bureau of Land Management (BLM) and the United States Forest Service (USFS). We identified species having consistent annual association with one agency, and species whose associations across the annual cycle switched between agencies. BLM and USFS GAP status 2 and 3 lands contained low to moderate proportions of species occurrences, with proportions highest for species that occurred year-round or only during the summer. We identified two groups of species whose annual movements resulted in changes in stewardship responsibilities: (1) year-round species that occurred on USFS lands during the breeding season and BLM lands during the nonbreeding season; and (2) summer species that occurred on USFS lands during the breeding season and BLM lands during spring and autumn migration. Species that switched agencies had broad distributions, bred on high-elevation USFS lands, were not more likely to be identified as species of special management concern, and migrated short (year-round species) to long distances (summer species). Our findings suggest cooperative efforts that address the requirements of short-distance migratory species on GAP status 2 lands (n = 20 species) and GAP status 3 lands (n = 24) and long-distance migratory species on GAP status 2 lands (n = 9) would likely benefit

  1. Stewardship and Critical Leadership: Sufficient for Leadership in Urban Schools?

    ERIC Educational Resources Information Center

    Gooden, Mark A.

    2002-01-01

    Asserts that traditional notions of leadership have been problematic in their applications to people of color and women because such notions were constructed based on research that did not include them. Explores problems associated with omitting traditionally subjugated groups, offering recommendations for those interested in leading in urban…

  2. 15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their... REGULATIONS CHEMICAL WEAPONS CONVENTION REQUIREMENTS Pt. 745, Supp. 2 Supplement No. 2 to Part 745—States... Chemical Weapons and on Their Destruction List of States Parties as of May 21, 2009 Afghanistan...

  3. 15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their... REGULATIONS CHEMICAL WEAPONS CONVENTION REQUIREMENTS Pt. 745, Supp. 2 Supplement No. 2 to Part 745—States... Chemical Weapons and on Their Destruction List of States Parties as of May 21, 2009 Afghanistan...

  4. 15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their... REGULATIONS CHEMICAL WEAPONS CONVENTION REQUIREMENTS Pt. 745, Supp. 2 Supplement No. 2 to Part 745—States... Chemical Weapons and on Their Destruction List of States Parties as of May 21, 2009 Afghanistan...

  5. 15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their... REGULATIONS CHEMICAL WEAPONS CONVENTION REQUIREMENTS Pt. 745, Supp. 2 Supplement No. 2 to Part 745—States... Chemical Weapons and on Their Destruction List of States Parties as of May 21, 2009 Afghanistan...

  6. 15 CFR Supplement No. 2 to Part 745 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the Prohibition of the Development, Production, Stockpiling, and Use of Chemical Weapons and on Their... REGULATIONS CHEMICAL WEAPONS CONVENTION REQUIREMENTS Pt. 745, Supp. 2 Supplement No. 2 to Part 745—States... Chemical Weapons and on Their Destruction List of States Parties as of May 21, 2009 Afghanistan...

  7. SARA Title III and community hazards planning: Lessons for the US Army's Chemical Stockpile Emergency Preparedness Program

    SciTech Connect

    Feldman, D.L.

    1991-01-01

    This paper provides an overview and analysis of the impact of Title 3 of the Superfund Amendments and Reauthorization Act of 1986 (SARA Title 3) on improving community participation and risk communication and facilitating decisions leading to enhanced emergency preparedness for timely response to accidental hazardous chemical releases. The US Army's Chemical Stockpile Disposal Program (CSDP) and attendant Chemical Stockpile Emergency Preparedness Program (CSEPP) are case studies. In addition to reviewing progress in SARA Title 3 implementation in the 10 states directly affected by these programs, interviews were conducted with regional Environmental Protection Agency (EPA) and Federal Emergency Management Agency (FEMA) representatives responsible for overseeing staffing and fiscal decisions that enable this law to take effect. These interviews also permit derivation of a broad federal perspective on Title 3's success (or lack thereof) in heightening public awareness of chemical hazards and improving local political competence in addressing chemical hazards warning, notification, communication, and procurement and equipment acquisition issues. We conclude that SARA Title 3 has significantly transformed the process of chemical and other technological hazards management by forcing greater cooperation between federal agencies (particularly EPA, FEMA, and, in some instances, the Occupational Health and Safety Administration, or OSHA) and states in planning and conducting emergency exercises. The process of emergency planning is becoming increasingly decentralized. However, we also conclude that Local Emergency Planning Committees (LEPCs) and State Emergency Response Commissions (SERCs)--institutions established under Title 3--are faced with several challenges in order to ensure viable risk communication and achievement of enhanced preparedness in local communities nationwide. 36 refs., 3 tabs.

  8. Antimicrobial Stewardship in a Community Hospital: Attacking the More Difficult Problems

    PubMed Central

    Philmon, Carla L.; Johnson, Gregory D.; Ward, William S.; Rivers, LaToya L.; Williamson, Sharon A.; Goodman, Edward L.

    2014-01-01

    Background: Antibiotic stewardship has been proposed as an important way to reduce or prevent antibiotic resistance. In 2001, a community hospital implemented an antimicrobial management program. It was successful in reducing antimicrobial utilization and expenditure. In 2011, with the implementation of a data-mining tool, the program was expanded and its focus transitioned from control of antimicrobial use to guiding judicious antimicrobial prescribing. Objective: To test the hypothesis that adding a data-mining tool to an existing antimicrobial stewardship program will further increase appropriate use of antimicrobials. Design: Interventional study with historical comparison. Methods: Rules and alerts were built into the data-mining tool to aid in identifying inappropriate antibiotic utilization. Decentralized pharmacists acted on alerts for intravenous (IV) to oral conversion, perioperative antibiotic duration, and restricted antimicrobials. An Infectious Diseases (ID) Pharmacist and ID Physician/Hospital Epidemiologist focused on all other identified alert types such as antibiotic de-escalation, bug-drug mismatch, and double coverage. Electronic chart notes and phone calls to physicians were utilized to make recommendations. Results: During 2012, 2,003 antimicrobial interventions were made with a 90% acceptance rate. Targeted broad-spectrum antimicrobial use decreased by 15% in 2012 compared to 2010, which represented cost savings of $1,621,730. There were no statistically significant changes in antimicrobial resistance, and no adverse patient outcomes were noted. Conclusions: The addition of a data-mining tool to an antimicrobial stewardship program can further decrease inappropriate use of antimicrobials, provide a greater reduction in overall antimicrobial use, and provide increased cost savings without negatively affecting patient outcomes. PMID:25477615

  9. Developing Global Leaders for Research, Regulation, and Stewardship of Crop Protection Chemistry in the 21st Century.

    PubMed

    Unsworth, John B; Corsi, Camilla; Van Emon, Jeanette M; Farenhorst, Annemieke; Hamilton, Denis J; Howard, Cody J; Hunter, Robert; Jenkins, Jeffrey J; Kleter, Gijs A; Kookana, Rai S; Lalah, Joseph O; Leggett, Michael; Miglioranza, Karina S B; Miyagawa, Hisashi; Peranginangin, Natalia; Rubin, Baruch; Saha, Bipul; Shakil, Najam A

    2016-01-13

    To provide sufficient food and fiber to the increasing global population, the technologies associated with crop protection are growing ever more sophisticated but, at the same time, societal expectations for the safe use of crop protection chemistry tools are also increasing. The goal of this perspective is to highlight the key issues that face future leaders in crop protection, based on presentations made during a symposium titled "Developing Global Leaders for Research, Regulation and Stewardship of Crop Protection Chemistry in the 21st Century", held in conjunction with the IUPAC 13th International Congress of Pesticide Chemistry in San Francisco, CA, USA, during August 2014. The presentations highlighted the fact that leaders in crop protection must have a good basic scientific training and understand new and evolving technologies, are aware of the needs of both developed and developing countries, and have good communication skills. Concern is expressed over the apparent lack of resources to meet these needs, and ideas are put forward to remedy these deficiencies.

  10. Carbapenem-resistance in gram-negative bacilli and intravenous minocycline: an antimicrobial stewardship approach at the Detroit Medical Center.

    PubMed

    Pogue, Jason M; Neelakanta, Anupama; Mynatt, Ryan P; Sharma, Sarit; Lephart, Paul; Kaye, Keith S

    2014-12-01

    In the era of carbapenem-resistance in Acinobacter baumannii and Enterobacteriaceae, there are limited treatment options for these pathogens. It is essential that clinicians fully assess all available therapeutic alternatives for these multidrug-resistant organisms. We herein describe the approach of the antimicrobial stewardship team at the Detroit Medical Center (DMC) for the evaluation and use of intravenous (IV) minocycline for the treatment of these resistant organisms, given potential advantages of IV minocycline over tigecycline and doxycycline. In vitro analyses at the DMC demonstrated good activity against A. baumannii (78% susceptibility), including 74% of carbapenem-resistant strains, but limited activity against our carbapenem-resistant K.pneumoniae (12% susceptibility.) Based in part on these results, IV minocycline was added to the formulary, primarily for the treatment of carbapenem-resistant A. baumannii. Early experience has been positive: 6/9 (67%) of patients who received IV minocycline had infections due to these organisms cured, including 6/7 (86%) who received doses of 200 mg twice daily.

  11. Developing Global Leaders for Research, Regulation, and Stewardship of Crop Protection Chemistry in the 21st Century.

    PubMed

    Unsworth, John B; Corsi, Camilla; Van Emon, Jeanette M; Farenhorst, Annemieke; Hamilton, Denis J; Howard, Cody J; Hunter, Robert; Jenkins, Jeffrey J; Kleter, Gijs A; Kookana, Rai S; Lalah, Joseph O; Leggett, Michael; Miglioranza, Karina S B; Miyagawa, Hisashi; Peranginangin, Natalia; Rubin, Baruch; Saha, Bipul; Shakil, Najam A

    2016-01-13

    To provide sufficient food and fiber to the increasing global population, the technologies associated with crop protection are growing ever more sophisticated but, at the same time, societal expectations for the safe use of crop protection chemistry tools are also increasing. The goal of this perspective is to highlight the key issues that face future leaders in crop protection, based on presentations made during a symposium titled "Developing Global Leaders for Research, Regulation and Stewardship of Crop Protection Chemistry in the 21st Century", held in conjunction with the IUPAC 13th International Congress of Pesticide Chemistry in San Francisco, CA, USA, during August 2014. The presentations highlighted the fact that leaders in crop protection must have a good basic scientific training and understand new and evolving technologies, are aware of the needs of both developed and developing countries, and have good communication skills. Concern is expressed over the apparent lack of resources to meet these needs, and ideas are put forward to remedy these deficiencies. PMID:25855233

  12. Integrated Weed Control for Land Stewardship at Legacy Management's Rocky Flats Site in Colorado - 13086

    SciTech Connect

    Nelson, Jody K.

    2013-07-01

    Land stewardship is one of nine sustainability programs in the U.S. Department of Energy's Environmental Management System. Land stewardship includes maintaining and improving ecosystem health. At the Rocky Flats Site near Westminster, Colorado, land stewardship is an integral component of the Office of Legacy Management's post-closure monitoring and management at the site. Nearly 263 hectares (650 acres) were disturbed and re-vegetated during site cleanup and closure operations. Proactive management of revegetation areas is critical to the successful reestablishment of native grasslands, wetlands, and riparian communities. The undisturbed native plant communities that occur at the site also require active management to maintain the high-quality wetlands and other habitats that are home to numerous species of birds and other wildlife such as elk and deer, rare plant communities, and the federally listed threatened Preble's meadow jumping mouse. Over the past several decades, an increase of Noxious weeds has impacted much of Colorado's Front Range. As a result, weed control is a key component of the land stewardship program at Rocky Flats. Thirty-three species of state-listed Noxious weeds are known to occur in the Central and Peripheral Operable Units at Rocky Flats, along with another five species that are considered invasive at the site. Early detection and rapid response to control new invasive species is crucial to the program. An integrated weed control/vegetation management approach is key to maintaining healthy, sustainable plant communities that are able to resist Noxious weed invasions. Weed mapping, field surveys, and field-staff training sessions (to learn how to identify new potential problem species) are conducted to help detect and prevent new weed problems. The integrated approach at Rocky Flats includes administrative and cultural techniques (prevention), mechanical controls, biological controls, and chemical controls. Several species of biocontrol

  13. BIOGEOCHEMICAL CYCLING AND ENVIRONMENTAL STABILITY OF PLUTONIUM RELEVANT TO LONG-TERM STEWARDSHIP OF DOE SITES.

    SciTech Connect

    FRANCIS, A.J.; GILLOW, J.P.; DODGE, C.J.

    2006-11-16

    Pu is generally considered to be relatively immobile in the terrestrial environment, with the exception of transport via airborne and erosion mechanisms. More recently the transport of colloidal forms of Pu is being studied as a mobilization pathway from subsurface contaminated soils and sediments. The overall objective of this research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for retardation of Pu transport.

  14. Human biological materials in research: ethical issues and the role of stewardship in minimizing research risks.

    PubMed

    Jeffers, B R

    2001-12-01

    Recent scientific and technologic advances generated from the human genome project have increased the ability of researchers to study human biological materials. This has enhanced the ease with which highly personal information such as genetic makeup can be revealed about individuals, families, and communities. In addition, a change in the societal value of human biological tissue from waste to commercial resource has occurred. A new model of stewardship is developed that can be used as a guide for protecting human research participants who are involved in studies that include collecting and handling human biological samples. Nursing implications to ensure protection of human research participants are discussed.

  15. The Confounding Role of Antimicrobial Stewardship Programs in Understanding the Impact of Technology on Patient Care.

    PubMed

    Doern, Christopher D

    2016-10-01

    Numerous studies have demonstrated the benefit of the combination of antimicrobial stewardship program (ASP) intervention and rapid diagnostic testing (RDT). However, few studies have attempted to study the incremental benefit of ASP and RDT, making it difficult to understand the true benefits of each intervention. This issue is discussed in the context of an article by S. H. McVane and F. S. Nolte (J Clin Microbiol 54:2476-2484, 2016, http://dx.doi.org/doi:10.1128/JCM.00996-16), with suggestions about how the findings of this study can be applied to other areas of clinical microbiology. PMID:27535682

  16. BIOGEOCHEMICAL CYCLING AND ENVIRONMENTAL STABILITY OF PLUTONIUM RELEVANT TO LONG-TERM STEWARDSHIP OF DOE SITES

    SciTech Connect

    Francis, A.J.; Gillow, J.B.; Dodge, C.J.

    2006-06-01

    Pu is generally considered to be relatively immobile in the terrestrial environment, with the exception of transport via airborne and erosion mechanisms. More recently the transport of colloidal forms of Pu is being studied as a mobilization pathway from subsurface contaminated soils and sediments. The overall objective of this research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for retardation of Pu transport.

  17. Sewage pollution: mitigation is key for coral reef stewardship.

    PubMed

    Wear, Stephanie L; Thurber, Rebecca Vega

    2015-10-01

    Coral reefs are in decline worldwide, and land-derived sources of pollution, including sewage, are a major force driving that deterioration. This review presents evidence that sewage discharge occurs in waters surrounding at least 104 of 112 reef geographies. Studies often refer to sewage as a single stressor. However, we show that it is more accurately characterized as a multiple stressor. Many of the individual agents found within sewage, specifically freshwater, inorganic nutrients, pathogens, endocrine disrupters, suspended solids, sediments, and heavy metals, can severely impair coral growth and/or reproduction. These components of sewage may interact with each other to create as-yet poorly understood synergisms (e.g., nutrients facilitate pathogen growth), and escalate impacts of other, non-sewage-based stressors. Surprisingly few published studies have examined impacts of sewage in the field, but those that have suggest negative effects on coral reefs. Because sewage discharge proximal to sensitive coral reefs is widespread across the tropics, it is imperative for coral reef-focused institutions to increase investment in threat-abatement strategies for mitigating sewage pollution. PMID:25959987

  18. Sewage pollution: mitigation is key for coral reef stewardship.

    PubMed

    Wear, Stephanie L; Thurber, Rebecca Vega

    2015-10-01

    Coral reefs are in decline worldwide, and land-derived sources of pollution, including sewage, are a major force driving that deterioration. This review presents evidence that sewage discharge occurs in waters surrounding at least 104 of 112 reef geographies. Studies often refer to sewage as a single stressor. However, we show that it is more accurately characterized as a multiple stressor. Many of the individual agents found within sewage, specifically freshwater, inorganic nutrients, pathogens, endocrine disrupters, suspended solids, sediments, and heavy metals, can severely impair coral growth and/or reproduction. These components of sewage may interact with each other to create as-yet poorly understood synergisms (e.g., nutrients facilitate pathogen growth), and escalate impacts of other, non-sewage-based stressors. Surprisingly few published studies have examined impacts of sewage in the field, but those that have suggest negative effects on coral reefs. Because sewage discharge proximal to sensitive coral reefs is widespread across the tropics, it is imperative for coral reef-focused institutions to increase investment in threat-abatement strategies for mitigating sewage pollution.

  19. Antimicrobial stewardship: Improving antibiotic prescribing practice in a respiratory ward.

    PubMed

    Yeo, Jing Ming

    2016-01-01

    International efforts have mandated guidelines on antibiotic use and prescribing, therefore the focus is now on encouraging positive behavioral changes in antibiotic prescribing practice. Documentation of indication and intended duration of antibiotic use in drug charts is an evidence-based method of reducing inappropriate antibiotic prescribing. It is also a standard detailed in our local antimicrobial guidelines. We collected baseline data on compliance with documentation of indication and duration in drug charts in a respiratory ward which revealed compliance rates of 24% and 39% respectively. We introduced interventions to improve accessibility to the guideline and to increase awareness by distributing antibiotic guardian pocket cards with a three-point checklist and strategically-placed mini-posters. We also aim to increase team motivation by obtaining their feedback in multidisciplinary team meetings and by introducing certificates for their involvement in the quality improvement process. The results of the second cycle post-intervention showed an increase in compliance rates for documentation of indication and duration of 97% and 69% respectively. After a further awareness and discussion session at the multidisciplinary team meeting with the local antimicrobial management team audit nurses, a third cycle showed compliance rates of 94% and 71% for indication and duration respectively. This project has highlighted the importance of improving accessibility and of encouraging interventions that would bring about a change in personal value and subsequently in behavior and individual practice.

  20. A NASA Program Perspective on Data Stewardship (Invited)

    NASA Astrophysics Data System (ADS)

    Maiden, M. E.

    2009-12-01

    At a recent meeting of scientific digital data managers at NASA Headquarters, a colleague posed the question, ‘Can you ensure your data be available for analysis one hundred years from now?’. Another colleague immediately said, ‘The answer to that question is: No.’. In my position of NASA Earth Science Data System Program Executive, I am responsible to assure the availability of NASA Earth Science data in perpetuity for the so-called long-term archive. NASA has a continuing responsibility to the Earth science research community to provide high quality data as long as they are valuable to support active research. This in itself is a long-term responsibility. In addition, past the period of active research, when the science community deems the data to be valuable, but no longer of immediate interest for active research, it is still necessary to preserve the data in a manner that they can be used after many decades (or even centuries) to support analyses, should the need arise. Our discipline-based distributed data center structure has been supporting very well the active archive role for the past 15 years. Regarding preparing for data preparation in perpetuity, my efforts have heretofore been to ensure that the data centers follow best practices for the near term, and to pursue NASA’s Earth Science strategic policy of passing our data to a designated US National Archive via interagency agreements and transfer for long-term archive. NASA bears much responsibility on the technical preparations for the success of long-term “digital curation” within the data life cycle, and on how we partner and work with our archival institutions. As a research organization, NASA can afford to be thorough and forerunning but can sometimes take a path that does not bear fruit. This presentation examines some issues, choices, and experiences over the past two decades of NASA’s Earth Science Data System Program.

  1. Mitigation of human-pathogenic fungi that exhibit resistance to medical agents: can clinical antifungal stewardship help?

    PubMed

    Hull, Claire M; Purdy, Nicola J; Moody, Suzy C

    2014-01-01

    Reducing indiscriminate antimicrobial usage to combat the expansion of multidrug-resistant human-pathogenic bacteria is fundamental to clinical antibiotic stewardship. In contrast to bacteria, fungal resistance traits are not understood to be propagated via mobile genetic elements, and it has been proposed that a global explosion of resistance to medical antifungals is therefore unlikely. Clinical antifungal stewardship has focused instead on reducing the drug toxicity and high costs associated with medical agents. Mitigating the problem of human-pathogenic fungi that exhibit resistance to antimicrobials is an emergent issue. This article addresses the extent to which clinical antifungal stewardship could influence the scale and epidemiology of resistance to medical antifungals both now and in the future. The importance of uncharted selection pressure exerted by agents outside the clinical setting (agricultural pesticides, industrial xenobiotics, biocides, pharmaceutical waste and others) on environmentally ubiquitous spore-forming molds that are lesserstudied but increasingly responsible for drug-refractory infections is considered.

  2. Science-based material modeling activities at Sandia National Laboratories/California : an overview.

    SciTech Connect

    Chen, Er-Ping

    2004-08-01

    The purpose of this presentation is to provide an overview of the science-based materials modeling activities at Sandia National Laboratories, California. The main mission driver for the work is the development of predictive modeling and simulation capabilities leveraging high performance computing software and hardware. Presentation will highlight research accomplishments in several specific topics of current interest. Sandia/California has been engaged in the development of high performance computing based predictive modeling and simulation capabilities in support of the Science-Based Stockpile Stewardship Program of the U. S. Department of Energy. Of particular interest is the development of constitutive models that can efficiently and accurately predict post-failure material response and load-redistribution in systems and components. Fracture and failure are inherently multi-scale and our philosophy is to include required physics in our models at all appropriate scales. We approach the problems from the continuum point of view and intend to provide continuum models that include dominant subscale mechanisms. Moreover, numerical algorithms are needed to allow implementation of physical models in high performance computing codes such that large-scale modeling and simulation can be conducted. Other drivers of our effort include the emerging application of micro- and nano-systems and the increasing interest in biotechnology. In this presentation, our research in fracture and failure modeling, atomic-continuum coupling code development, microstructure-material properties relationships exploration, and general continuum theories advancement will be presented. Where appropriate, examples will be given to demonstrate the utility of the models.

  3. Implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital

    PubMed Central

    2012-01-01

    Background Antimicrobial stewardship has been promoted as a key strategy for coping with the problems of antimicrobial resistance and Clostridium difficile. Despite the current call for stewardship in community hospitals, including smaller community hospitals, practical examples of stewardship programs are scarce in the reported literature. The purpose of the current report is to describe the implementation of an antimicrobial stewardship program on the medical-surgical service of a 100-bed community hospital employing a core strategy of post-prescriptive audit with intervention and feedback. Methods For one hour twice weekly, an infectious diseases physician and a clinical pharmacist audited medical records of inpatients receiving systemic antimicrobial therapy and made non-binding, written recommendations that were subsequently scored for implementation. Defined daily doses (DDDs; World Health Organization Center for Drug Statistics Methodology) and acquisition costs per admission and per patient-day were calculated monthly for all administered antimicrobial agents. Results The antimicrobial stewardship team (AST) made one or more recommendations for 313 of 367 audits during a 16-month intervention period (September 2009 – December 2010). Physicians implemented recommendation(s) from each of 234 (75%) audits, including from 85 of 115 for which discontinuation of all antimicrobial therapy was recommended. In comparison to an 8-month baseline period (January 2009 – August 2009), there was a 22% decrease in defined daily doses per 100 admissions (P = .006) and a 16% reduction per 1000 patient-days (P = .013). There was a 32% reduction in antimicrobial acquisition cost per admission (P = .013) and a 25% acquisition cost reduction per patient-day (P = .022). Conclusions An effective antimicrobial stewardship program was implemented with limited resources on the medical-surgical service of a 100-bed community hospital. PMID:23043720

  4. Increasing Capacity for Stewardship of Oceans and Coasts: Findings of the National Research Council Report

    NASA Astrophysics Data System (ADS)

    Roberts, S. J.; Feeley, M. H.

    2008-05-01

    inappropriate evaluation procedures; and, lack of a coordinated and strategic approach among donors. A New Framework Improving ocean stewardship and ending the fragmentation of current capacity building programs will require a new, broadly adopted framework for capacity building that emphasizes cooperation, sustainability, and knowledge transfer within and among communities. The report identifies four specific features of capacity building that would increase the effectiveness and efficiency of future programs: 1. Regional action plans based on periodic program assessments to guide investments in capacity and set realistic milestones and performance measures. 2. Long-term support to establish self-sustaining programs. Sustained capacity building programs require a diversity of sources and coordinated investments from local, regional, and international donors. 3. Development of leadership and political will. One of the most commonly cited reasons for failure and lack of progress in ocean and coastal governance initiatives is lack of political will. One strategy for strengthening support is to identify, develop, mentor, and reward leaders. 4. Establishment of networks and mechanisms for regional collaboration. Networks bring together those working in the same or similar ecosystems with comparable management or governance challenges to share information, pool resources, and learn from one another. The report also recommends the establishment of regional centers to encourage and support collaboration among neighboring countries.

  5. National Nuclear Security Administration Service Center Environmental Programs Long-Term Environmental Stewardship Baseline Handbook

    SciTech Connect

    Griswold, D. D.; Rohde, K.

    2003-02-26

    As environmental restoration (ER) projects move toward completion, the planning, integration, and documentation of long-term environmental stewardship (LTES) activities is increasingly important for ensuring smooth transition to LTES. The Long-Term Environmental Stewardship Baseline Handbook (Handbook) prepared by the National Nuclear Security Administration (NNSA) Service Center Environmental Programs Department (EPD) outlines approaches for integrating site-specific LTES planning and implementation into site ER baseline documentation. Since LTES will vary greatly from site to site, the Handbook also provides for flexibility in addressing LTES in ER Project life-cycle baselines, while clearly identifying Environmental Management (EM) requirements. It provides suggestions for enacting LTES principles and objectives through operational activities described in site-specific LTES plans and life cycle ER Project baseline scope, cost, and schedule documentation and tools for more thorough planning, better quantification, broader understanding of risk and risk management factors, and more comprehensive documentation. LTES planning applied to baselines in a phased approach will facilitate seamlessly integrating LTES into site operational activities, thereby minimizing the use of resources.

  6. The resistance tsunami, antimicrobial stewardship, and the golden age of microbiology.

    PubMed

    Prescott, John F

    2014-07-16

    Modern medicine is built on antibiotics. Antibiotics are something that we take for granted. We have however spent over 60 years educating bacteria to become resistant, and the global resistance tsunami has caught everyone unawares. Since bacteria have changed, we also have to change, and to change most of the practices of how we use antibiotics. Because the development of new antibiotics is so expensive, a stewardship approach may help to preserve those that we have now while we work to develop new antibiotics and to develop other approaches to controlling and treating infections. We need to adopt the ethic of Good Stewardship Practice (GSP) as an active and dynamic process of continuous improvement in antibiotic use, a process with many steps of different sizes involving everyone involved in antibiotic use. All antibiotic users have an important role to play in GSP. Although the resistance situation is pessimistic, and the future of antibiotics looks uncertain, we are fortunately entering what may be seen as the golden age of microbiology. This encompasses an astonishing array of technologies for rapid pathogen and resistance gene detection, for clone identification by genome sequencing, for identification of novel bacterial genes and for identification of the Achilles' heels of different pathogens. Future antibiotics may have to be far more targeted to the individual pathogen and the site of infection. A global tax on antibiotics might reduce their use while funding the cost of developing new antibiotics and new approaches to control of infectious diseases.

  7. Carbon stewardship: land management decisions and the potential for carbon sequestration in Colorado, USA

    NASA Astrophysics Data System (ADS)

    Failey, Elisabeth L.; Dilling, Lisa

    2010-04-01

    Land use and its role in reducing greenhouse gases is a key element of policy negotiations to address climate change. Calculations of the potential for enhanced terrestrial sequestration have largely focused on the technical characteristics of carbon stocks, such as vegetation type and management regime, and to some degree, on economic incentives. However, the actual potential for carbon sequestration critically depends on who owns the land and additional land management decision drivers. US land ownership patterns are complex, and consequently land use decision making is driven by a variety of economic, social and policy incentives. These patterns and incentives make up the 'carbon stewardship landscape'—that is, the decision making context for carbon sequestration. We examine the carbon stewardship landscape in the US state of Colorado across several public and private ownership categories. Achieving the full potential for land use management to help mitigate carbon emissions requires not only technical feasibility and financial incentives, but also effective implementing mechanisms within a suite of often conflicting and hard to quantify factors such as multiple-use mandates, historical precedents, and non-monetary decision drivers.

  8. Hospital-wide rollout of antimicrobial stewardship: a stepped-wedge randomized trial.

    PubMed

    Palmay, Lesley; Elligsen, Marion; Walker, Sandra A N; Pinto, Ruxandra; Walker, Scott; Einarson, Thomas; Simor, Andrew; Rachlis, Anita; Mubareka, Samira; Daneman, Nick

    2014-09-15

    Our objective was to rigorously evaluate the impact of an antimicrobial stewardship audit-and-feedback intervention, via a stepped-wedge randomized trial. An effective intensive care unit (ICU) audit-and-feedback program was rolled out to 6 non-ICU services in a randomized sequence. The primary outcome was targeted antimicrobial utilization, using a negative binomial regression model to assess the impact of the intervention while accounting for secular and seasonal trends. The intervention was successfully transitioned, with high volumes of orders reviewed, suggestions made, and recommendations accepted. Among patients meeting stewardship review criteria, the intervention was associated with a large reduction in targeted antimicrobial utilization (-21%, P = .004); however, there was no significant change in targeted antibiotic use among all admitted patients (-1.2%, P = .9), and no reductions in overall costs and microbiologic outcomes. An ICU day 3 audit-and-feedback program can be successfully expanded hospital-wide, but broader benefits on non-ICU wards may require interventions earlier in the course of treatment.

  9. Hospital-wide rollout of antimicrobial stewardship: a stepped-wedge randomized trial.

    PubMed

    Palmay, Lesley; Elligsen, Marion; Walker, Sandra A N; Pinto, Ruxandra; Walker, Scott; Einarson, Thomas; Simor, Andrew; Rachlis, Anita; Mubareka, Samira; Daneman, Nick

    2014-09-15

    Our objective was to rigorously evaluate the impact of an antimicrobial stewardship audit-and-feedback intervention, via a stepped-wedge randomized trial. An effective intensive care unit (ICU) audit-and-feedback program was rolled out to 6 non-ICU services in a randomized sequence. The primary outcome was targeted antimicrobial utilization, using a negative binomial regression model to assess the impact of the intervention while accounting for secular and seasonal trends. The intervention was successfully transitioned, with high volumes of orders reviewed, suggestions made, and recommendations accepted. Among patients meeting stewardship review criteria, the intervention was associated with a large reduction in targeted antimicrobial utilization (-21%, P = .004); however, there was no significant change in targeted antibiotic use among all admitted patients (-1.2%, P = .9), and no reductions in overall costs and microbiologic outcomes. An ICU day 3 audit-and-feedback program can be successfully expanded hospital-wide, but broader benefits on non-ICU wards may require interventions earlier in the course of treatment. PMID:24928294

  10. Antibiotic Consumption During a 4-year Period in a Community Hospital with an Antimicrobial Stewardship Program

    PubMed Central

    Garcell, Humberto Guanche; Arias, Ariadna Villanueva; Fernandez, Eliezer Alemán; Guerrero, Yaquelín Batista; Serrano, Ramon N. Alfonso

    2016-01-01

    Objectives We sought to evaluate the trend of antibiotic consumption in patients admitted to a community hospital in Qatar with an antimicrobial stewardship program. Methods This observational study was carried out in a 75-bed facility in Western Qatar over a 4-year period (2012–2015). The monitoring of antimicrobial consumption from inpatient wards was performed from the pharmacy records and presented as defined daily dose (DDD) divided by the patient days and expressed as 100 bed-days (DBD). Results The consumption of antimicrobials in 2012 was 171.3 DBD, and increased to 252.7 DBD in 2013, 229.1 DBD in 2014, and 184.7 DBD in 2015. Cephalosporins use reduced from 98.2 DBD in 2013 to 51.5 DBD in 2015 while the consumption of penicillins increased during the beginning of 2014 with a slight decrease in 2015. Carbapenems consumption during 2014–2015 was lower than previous years, and vice-versa for aminoglycosides. Fluoroquinolones had a sustained increase with 37.1% increased consumption in 2015 compared to the two previous years. There was an increase in the use of intravenous (IV) (108.5%) and oral azithromycin (55.1%) and the use of oral (152.8%) and IV moxifloxacin (22.9%). Conclusions We observed a decrease in antibiotic use in patients admitted to a community hospital with an antimicrobial stewardship program, but the increase in fluoroquinolones consumption is a concern that requires focused strategies. PMID:27602189

  11. From Cleanup to Stewardship. A companion report to Accelerating Cleanup: Paths to Closure and background information to support the scoping process required for the 1998 PEIS Settlement Study

    SciTech Connect

    1999-10-01

    Long-term stewardship is expected to be needed at more than 100 DOE sites after DOE's Environmental Management program completes disposal, stabilization, and restoration operations to address waste and contamination resulting from nuclear research and nuclear weapons production conducted over the past 50 years. From Cleanup to stewardship provides background information on the Department of Energy (DOE) long-term stewardship obligations and activities. This document begins to examine the transition from cleanup to long-term stewardship, and it fulfills the Secretary's commitment to the President in the 1999 Performance Agreement to provide a companion report to the Department's Accelerating Cleanup: Paths to Closure report. It also provides background information to support the scoping process required for a study on long-term stewardship required by a 1998 Settlement Agreement.

  12. Between land and sea: divergent data stewardship practices in deep-sea biosphere research

    NASA Astrophysics Data System (ADS)

    Cummings, R.; Darch, P.

    2013-12-01

    Data in deep-sea biosphere research often live a double life. While the original data generated on IODP expeditions are highly structured, professionally curated, and widely shared, the downstream data practices of deep-sea biosphere laboratories are far more localized and ad hoc. These divergent data practices make it difficult to track the provenance of datasets from the cruise ships to the laboratory or to integrate IODP data with laboratory data. An in-depth study of the divergent data practices in deep-sea biosphere research allows us to: - Better understand the social and technical forces that shape data stewardship throughout the data lifecycle; - Develop policy, infrastructure, and best practices to improve data stewardship in small labs; - Track provenance of datasets from IODP cruises to labs and publications; - Create linkages between laboratory findings, cruise data, and IODP samples. In this paper, we present findings from the first year of a case study of the Center for Dark Energy Biosphere Investigations (C-DEBI), an NSF Science and Technology Center that studies life beneath the seafloor. Our methods include observation in laboratories, interviews, document analysis, and participation in scientific meetings. Our research uncovers the data stewardship norms of geologists, biologists, chemists, and hydrologists conducting multi-disciplinary research. Our research team found that data stewardship on cruises is a clearly defined task performed by an IODP curator, while downstream it is a distributed task that develops in response to local need and to the extent necessary for the immediate research team. IODP data are expensive to collect and challenging to obtain, often costing $50,000/day and requiring researchers to work twelve hours a day onboard the ships. To maximize this research investment, a highly trained IODP data curator controls data stewardship on the cruise and applies best practices such as standardized formats, proper labeling, and

  13. "Nuestra Tierra Dinamica" Global Climate Change STEM Education Fostering Environmental Stewardship

    NASA Astrophysics Data System (ADS)

    La Grave, M.; de Valenzuela, M.; Russell, R.

    2012-12-01

    CLUB ECO LÓGICO is a democratic and participatory program that provides active citizenship in schools and community, placing climate change into context for the Latino Community. The program's objectives focus on: 1. The Environment. Reducing the school and community impact on the environment through environmental footprint through stewardship actions. 2. Empowerment. Engaging participants through project and service learning and make decisions about how to improve their schools, their homes and their community's environment. 3. Community and Research Partnerships. Fostering collaborations with local community, stakeholders, government, universities, research organizations, and businesses that have expertise in environmental research, management, education and climate change. 4. Awareness. Increasing environmental and climate science knowledge of participants through STEM activities and hands-on access to technology. 5. Research and evaluation. Assessing the relevance of program activities through the engagement of the Latino community in planning and the effectiveness and impact of STEM activities through formative and summative evaluation. To address these objectives, the program has several inter related components in an after school setting: SUN EARTH Connections: Elementary (grades K to 2) students learn the basic climate change concepts through inquiry and hands on STEM activities. Bilingual 8 facilitators adapt relevant NASA educational resources for use in inquiry based, hands on activities. Drama and the arts provide unique experiences as well as play a key role in learning, participation and facilitation. GREEN LABS: Elementary students (grades 3 to 5) participate in stations where each Lab is staffed by at least two professionals: a College level fully bilingual Latin American Professional and a stakeholder representing either a research organization or other relevant environmental organization. Our current Green Lab themes include: Air, Soils, Water

  14. Effect of protein supplementation and forage allowance on the growth and reproduction of beef heifers grazing stockpiled tall fescue.

    PubMed

    Lyons, S E; Shaeffer, A D; Drewnoski, M E; Poore, M H; Poole, D H

    2016-04-01

    Stockpiled tall fescue can provide adequate winter forage for beef cattle, although unsupplemented replacement heifers may display marginal performance before breeding. The objective of this study was to determine if protein supplementation and/or additional forage improves growth and reproductive performance of replacement heifers grazing stockpiled fescue. Cattle averaging 272 ± 1.59 kg were stratified by BW and then randomly assigned to 1 of 4 plots within a pasture replication. Treatment combinations were assigned in a 2 × 2 factorial arrangement and included 1) a conservative forage allocation ("normal," targeting 85% forage use) and mineral supplement (normal forage allocation with mineral supplement [FM]), 2) normal forage allocation with protein tub (FT), 3) more liberal forage allocation ("extra," targeting 70% forage use) and mineral supplement (extra forage allocation with mineral supplement [EM]), and 4) "extra forage allocation with protein tub (ET). Treatments were administered for 8 wk from early November to early January. Heifers were fed fescue hay for 1 wk before breeding in late January. Heifers were synchronized with the 7-d CO-Synch + controlled internal drug release device protocol and inseminated in late January. Heifers were checked for pregnancy by ultrasonography at 35 and 90 d after AI. Main and interaction effects between the 2 treatments were determined. Total supplement intake was greater for protein tub than mineral supplement (0.36 vs. 0.11 kg·heifer·d, respectively; < 0.0001), and the additional dietary protein in the tub groups resulted in greater serum urea N concentrations ( < 0.0001; 8.15 vs. 10.4 mg/dL for mineral and protein tub, respectively). Forage utilization efficiency was greater for normal than extra forage allocation (74.7 vs. 65.8%, respectively; < 0.0001). Main effects of both treatments on ADG were significant ( < 0.0001; 0.28, 0.43, 0.43, and 0.51 kg·heifer·d for FM, FT, EM, and ET, respectively). There was

  15. Development and Validation of an Instrument for Assessing Climate Change Knowledge and Perceptions: The Climate Stewardship Survey (CSS)

    ERIC Educational Resources Information Center

    Walker, Scott L.; McNeal, Karen S.

    2013-01-01

    The Climate Stewardship Survey (CSS) was developed to measure knowledge and perceptions of global climate change, while also considering information sources that respondents 'trust.' The CSS was drafted using a three-stage approach: development of salient scales, writing individual items, and field testing and analyses. Construct validity and…

  16. Energy Market and Economic Impacts of S. 280, the Climate Stewardship and Innovation Act of 2007, Supplement to

    EIA Publications

    2007-01-01

    This paper responds to a September 18, 2007, letter from Senators Barrasso, Inhofe, and Voinovich, seeking further energy and economic analysis to supplement information presented in the Energy Information Administration's (EIA) recent analysis of S.280, the Climate Stewardship and Innovation Act of 2007.

  17. The Stewardship of Public Trust: Are Professional Communicators up to the Moral Challenge of Public Problem-Solving?

    ERIC Educational Resources Information Center

    Pavlich, Peggy

    With the assumption that the preservation of free speech and democracy is paramount to social, political, and environmental adaptation, the question arises: to whom falls the stewardship of honest and fair public discourse for problem solving? If the average United States citizen is, at best skeptical of the news media, and, at worst, turned off…

  18. Application of the “4R” nutrient stewardship concept to horticultural crops: getting nutrients in the “right” place

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The 4R nutrient stewardship concept was introduced in 2009 by International Plant Nutrition Institute to define the right source, rate, time, and place to apply fertilizers to produce not only the most economical outcome in any given crop but to also to provide desirable social and environmental ben...

  19. Considerations About Antimicrobial Stewardship in Settings with Epidemic Extended-Spectrum β-Lactamase-Producing or Carbapenem-Resistant Enterobacteriaceae.

    PubMed

    Viale, Pierluigi; Giannella, Maddalena; Bartoletti, Michele; Tedeschi, Sara; Lewis, Russell

    2015-09-01

    Infections caused by gram-negative bacteria (GNB) resistant to multiple classes of antibiotics are increasing in many hospitals. Extended-spectrum β-lactamase (ESBL)-producing and carbapenem-resistant Enterobacteriaceae in particular are now endemic in many parts of the world and represent a serious public health threat. In this era, antimicrobial stewardship programs are essential as targeted and responsible use of antibiotics improves patient outcomes and hopefully limits the selective pressure that drives the further emergence of resistance. However, some stewardship strategies aimed at promoting carbapenem-sparing regimens remain controversial and are difficult to implement when resistance rates to non-carbapenem antibiotics are increasing. Coordinated efforts between stewardship programs and infection control are essential for reversing conditions that favor the emergence and dissemination of multidrug-resistant GNB within the hospital and identifying extra-institutional "feeder reservoirs" of resistant strains such as long-term care facilities, where colonization is common despite limited numbers of serious infections. In settings where ESBL resistance is endemic, the cost-effectiveness of expanded infection control efforts and antimicrobial stewardship is still unknown. Once a patient has been colonized, selective oral or digestive decontamination may be considered, but evidence supporting its effectiveness is limited in patients who are already colonized or in centers with high rates of resistance. Moreover, temporary success at decolonization may be associated with a higher risk of relapse with strains that are resistant to the decolonizing antibiotics.

  20. The Daniel K. Inouye College of Pharmacy Scripts: The Development of Antimicrobial Stewardship Programs in Hawai'i.

    PubMed

    Goo, Roy Alan Sh; Chu, Cherie Hl; Yoneda, Melissa K; Ma, Carolyn Sj

    2016-07-01

    In recent years the misuse of antimicrobials has contributed to the growing problem of antimicrobial resistance. Antimicrobial Stewardship Programs (ASP) decrease the misuse of antimicrobials by supporting a rational, systematic approach. ASP strategies vary from broad-ranging policies and other decision support tools to prospective audit review of patients on antimicrobials. Many healthcare facilities, however, have been slow to adopt stewardship attributable to the fact that early ASP models required individuals with specialized training, and a significant amount of time and infrastructural investment from facilities. In response to the increasing need for ASPs in Hawai'i, the Hawai'i Department of Health (HDOH) partnered with the Daniel K. Inouye College of Pharmacy (DKICP) to develop the Hawai'i Antimicrobial Stewardship Collaborative (HASC), a voluntary collaboration whose main objective is to assist hospital institutions in the implementation of a simplified model of the Centers for Disease Control and Prevention's Core Elements of Hospital Antimicrobial Stewardship Programs. The work of HASC places Hawai'i's health care institutions in an advantageous position to be able to comply with impending accreditation standards relating to antibiotics and infections.

  1. Chemical-Stockpile Disposal Program. Risk analysis of the disposal of chemical munitions at regional or national sites. Final report, 3 February 1986-25 August 1987

    SciTech Connect

    Barsell, A.W.; Bellis, E.A.; Bolig, C.A.; Deremer, R.K.; Everline, C.J.

    1987-08-01

    This document was prepared for the U.S. Army to support the Final Programmatic Environmental Impact Statement for the Chemical Stockpile Disposal Program. This report describes the results of a comprehensive probabilistic assessment of the frequency and magnitude of chemical agent release for the storage, handling, on-site transportation, off-site transportation, and chemical-demilitarization plant operations associated with the disposal of the chemical stockpile at two regional disposal sites or at a single national disposal site. Rail transportation from seven sites, air transportation from two sites and water transportation from one site were the off-site transportation modes analyzed. Both internal accident initiators (e.g., human error, equipment malfunction) and external accident initiators (e.g., earthquakes, airplane crashes) were included in the analysis.

  2. Chemical-Stockpile Disposal Program. Risk analysis of the onsite disposal of chemical munitions. Final report, 12 February 1986-25 August 1987

    SciTech Connect

    Barsell, A.W.; Bellis, E.A.; Bolig, C.A.; Deremer, R.K.; Everline, C.J.

    1987-08-01

    This document was prepared for the U.S. Army to support the Final Programmatic Environmental Impact Statement for the Chemical Stockpile Disposal Program. This report describes the results of a comprehensive probabilistic assessment of the frequency and magnitude of chemical-agent release associated with storage, handling, onsite transportation and chemical-demilitarization plant operation at eight U.S. Army installations. Both internal accident initiators (e.g., human error) and external accident initiators (e.g., earthquakes) were analyzed.

  3. Framework for Optimal Global Vaccine Stockpile Design for Vaccine-Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples.

    PubMed

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J

    2016-07-01

    Managing the dynamics of vaccine supply and demand represents a significant challenge with very high stakes. Insufficient vaccine supplies can necessitate rationing, lead to preventable adverse health outcomes, delay the achievements of elimination or eradication goals, and/or pose reputation risks for public health authorities and/or manufacturers. This article explores the dynamics of global vaccine supply and demand to consider the opportunities to develop and maintain optimal global vaccine stockpiles for universal vaccines, characterized by large global demand (for which we use measles vaccines as an example), and nonuniversal (including new and niche) vaccines (for which we use oral cholera vaccine as an example). We contrast our approach with other vaccine stockpile optimization frameworks previously developed for the United States pediatric vaccine stockpile to address disruptions in supply and global emergency response vaccine stockpiles to provide on-demand vaccines for use in outbreaks. For measles vaccine, we explore the complexity that arises due to different formulations and presentations of vaccines, consideration of rubella, and the context of regional elimination goals. We conclude that global health policy leaders and stakeholders should procure and maintain appropriate global vaccine rotating stocks for measles and rubella vaccine now to support current regional elimination goals, and should probably also do so for other vaccines to help prevent and control endemic or epidemic diseases. This work suggests the need to better model global vaccine supplies to improve efficiency in the vaccine supply chain, ensure adequate supplies to support elimination and eradication initiatives, and support progress toward the goals of the Global Vaccine Action Plan. PMID:25109229

  4. Framework for Optimal Global Vaccine Stockpile Design for Vaccine-Preventable Diseases: Application to Measles and Cholera Vaccines as Contrasting Examples.

    PubMed

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J

    2016-07-01

    Managing the dynamics of vaccine supply and demand represents a significant challenge with very high stakes. Insufficient vaccine supplies can necessitate rationing, lead to preventable adverse health outcomes, delay the achievements of elimination or eradication goals, and/or pose reputation risks for public health authorities and/or manufacturers. This article explores the dynamics of global vaccine supply and demand to consider the opportunities to develop and maintain optimal global vaccine stockpiles for universal vaccines, characterized by large global demand (for which we use measles vaccines as an example), and nonuniversal (including new and niche) vaccines (for which we use oral cholera vaccine as an example). We contrast our approach with other vaccine stockpile optimization frameworks previously developed for the United States pediatric vaccine stockpile to address disruptions in supply and global emergency response vaccine stockpiles to provide on-demand vaccines for use in outbreaks. For measles vaccine, we explore the complexity that arises due to different formulations and presentations of vaccines, consideration of rubella, and the context of regional elimination goals. We conclude that global health policy leaders and stakeholders should procure and maintain appropriate global vaccine rotating stocks for measles and rubella vaccine now to support current regional elimination goals, and should probably also do so for other vaccines to help prevent and control endemic or epidemic diseases. This work suggests the need to better model global vaccine supplies to improve efficiency in the vaccine supply chain, ensure adequate supplies to support elimination and eradication initiatives, and support progress toward the goals of the Global Vaccine Action Plan.

  5. Prediction of temperature and thermal inertia effect in the maturation stage and stockpiling of a large composting mass

    SciTech Connect

    Barrena, R.; Canovas, C.; Sanchez, A. . E-mail: asanchez@eupma.uab.es

    2006-07-01

    A macroscopic non-steady state energy balance was developed and solved for a composting pile of source-selected organic fraction of municipal solid waste during the maturation stage (13,500 kg of compost). Simulated temperature profiles correlated well with temperature experimental data (ranging from 50 to 70 deg. C) obtained during the maturation process for more than 50 days at full scale. Thermal inertia effect usually found in composting plants and associated to the stockpiling of large composting masses could be predicted by means of this simplified energy balance, which takes into account terms of convective, conductive and radiation heat dissipation. Heat losses in a large composting mass are not significant due to the similar temperatures found at the surroundings and at the surface of the pile (ranging from 15 to 40 deg. C). In contrast, thermophilic temperature in the core of the pile was maintained during the whole maturation process. Heat generation was estimated with the static respiration index, a parameter that is typically used to monitor the biological activity and stability of composting processes. In this study, the static respiration index is presented as a parameter to estimate the metabolic heat that can be generated according to the biodegradable organic matter content of a compost sample, which can be useful in predicting the temperature of the composting process.

  6. An analysis of Chemical Stockpile Emergency Preparedness Program exercise results. Volume 2: Preliminary evaluation and analysis of CSEPP exercise database

    SciTech Connect

    Wernette, D.; Lerner, K.

    1998-06-01

    This study investigated the quality and usefulness of the information in the Chemical Stockpile Emergency Preparedness Program (CSEPP) exercise database. It incorporates the results of two separate analytical efforts. The first effort investigated the process of assigning standardized codes to issues identified in CSEPP exercise reports. A small group of issues was coded independently by each of several individuals, and the results of the individual codings were compared. Considerable differences were found among the individuals` codings. The second effort consisted of a statistical multivariate analysis, to investigate whether exercise issues are evenly distributed among exercise tabs, sites, and objectives. It was found that certain tabs, sites, and objectives were disproportionately associated with problem areas in exercises. In some cases, these problem areas have persisted over time, but in other cases they have undergone significant shifts over the time span of the investigation. The study concludes that the database can be a useful resource for analyzing problem areas and setting priorities for CSEPP program resources. However, some further analyses should be performed in order to more fully explore the data and increase confidence in the results.

  7. Current State of Antimicrobial Stewardship at Solid Organ and Hematopoietic Cell Transplant Centers in the United States.

    PubMed

    Seo, Susan K; Lo, Kaming; Abbo, Lilian M

    2016-10-01

    OBJECTIVE To assess the extent of antimicrobial stewardship programs (ASPs) at solid organ transplant (SOT) and hematopoietic cell transplant (HCT) centers in the United States. DESIGN An 18-item voluntary survey was developed to gauge current antimicrobial stewardship practices in transplant patients, examine the availability and perceived usefulness of novel diagnostics and azole levels to guide therapy, and identify challenges for implementation of ASPs at these centers. PARTICIPANTS The survey was distributed electronically to infectious disease physicians and pharmacists at adult and pediatric SOT and HCT centers during May 1-22, 2015. Facilities were deidentified. RESULTS After duplicate removal, 71 (56%) of 127 unique transplant centers in 32 states were analyzed. Forty-four sites (62%) performed at least 100 SOT annually, and 40 (56%) performed at least 100 HCT annually. Top 5 stewardship activities encompassing transplant patients were formulary restriction, guideline development, prospective audit and feedback, education, and dose optimization. Respiratory viral panels (66/66 [100%]), azole levels (64/66 [97%]), and serum/bronchoalveolar lavage galactomannan (58/66 [88%]) were perceived as most useful to guide therapy. Apparent challenges to antimicrobial stewardship included undefined duration for certain infections (53/59 [90%]), diagnostic uncertainty (47/59 [80%]), the perception that antibiotic-resistant infections required escalation (42/59 [71%]), prescriber opposition (41/59 [69%]), and costly drugs (37/59 [63%]). CONCLUSIONS ASP activities were performed at many adult and pediatric SOT and HCT centers in the United States. Diagnostic and therapeutic uncertainty in transplant patients is challenging for ASPs. Collaborative research should examine the impact of antimicrobial stewardship practices in SOT and HCT. Infect Control Hosp Epidemiol 2016;1-6.

  8. Long-term stewardship of the environmental legacy at restored sites within the Department of Energy nuclear weapons complex.

    PubMed

    Wells, James R; Spitz, Henry B

    2003-11-01

    It is readily apparent, as the Department of Energy Office of Environmental Management proceeds in remediating its vast network of contaminated nuclear weapons facilities, that final cleanup at many facilities will not be performed to a level allowing unrestricted use of the facility. Instead, these facilities must rely on engineering, administrative, and institutional controls to ensure the level of cleanup performed at the site remains adequately protective of public health and the environment. In order for these controls to remain effective, however, a plan for long-term stewardship of these sites must be developed that is approved by the U.S. Congress. Although this sounds simple enough for the present, serious questions remain regarding how best to implement a program of stewardship to ensure its effectiveness over time, particularly for sites with residual contamination of radionuclides with half-lives on the order of thousands of years. Individual facilities have attempted to answer these questions at the site-specific level. However, the complexities of the issues require federal support and oversight to ensure the programs implemented at each of the facilities are consistent and effective. The Department of Energy recently submitted a report to Congress outlining the extent of long-term stewardship needs at each of its facilities. As a result, the time is ripe for forward thinking Congressional action to address the relevant issues and ensure the remedy of long-term stewardship successfully carries out its intended purpose and remains protective of public health and the environment. The regulatory elements necessary for the stewardship program to succeed can only be implemented through the plenary powers of the U.S. Congress.

  9. Biogeochemical Cycling and Environmental Stability of Pu Relevant to Long-Term Stewardship of DOE Sites

    SciTech Connect

    Santschi, Peter H.

    2006-06-01

    The overall objective of this proposed research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Central to Pu cycling (transport initiation to immobilization) is the role of microorganisms. The hypothesis underlying this proposal is that microbial activity is the causative agent in initiating the mobilization of Pu in near-surface environments: through the transformation of Pu associated with solid phases, production of extracellular polymeric substances (EPS) carrier phases, and the creation of microenvironments. Also, microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.

  10. Reconnecting cities to the biosphere: stewardship of green infrastructure and urban ecosystem services.

    PubMed

    Andersson, Erik; Barthel, Stephan; Borgström, Sara; Colding, Johan; Elmqvist, Thomas; Folke, Carl; Gren, Åsa

    2014-05-01

    Within-city green infrastructure can offer opportunities and new contexts for people to become stewards of ecosystem services. We analyze cities as social-ecological systems, synthesize the literature, and provide examples from more than 15 years of research in the Stockholm urban region, Sweden. The social-ecological approach spans from investigating ecosystem properties to the social frameworks and personal values that drive and shape human interactions with nature. Key findings demonstrate that urban ecosystem services are generated by social-ecological systems and that local stewards are critically important. However, land-use planning and management seldom account for their role in the generation of urban ecosystem services. While the small scale patchwork of land uses in cities stimulates intense interactions across borders much focus is still on individual patches. The results highlight the importance and complexity of stewardship of urban biodiversity and ecosystem services and of the planning and governance of urban green infrastructure. PMID:24740616

  11. Biogeochemical Cycling and Environmental Stability of Pu Relevant to Long-Term Stewardship of DOE Sites

    SciTech Connect

    Honeyman, Bruce D.; Francis, A.J.; Gillow, Jeffrey B.; Dodge, Cleveland J.; Santschi, Peter H.; Chin-Chang Hung; Diaz, Angelique; Tinnacher, Ruth; Roberts, Kimberly; Schwehr, Kathy

    2006-04-05

    The overall objective of this research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Central to Pu cycling (transport initiation and immobilization) is the role of microorganisms. The hypothesis underlying this work is that microbial activity is the causative agent in initiating the mobilization of Pu in near-surface environments: through the transformation of Pu associated with solid phases, production of extracellular polymeric substances (EPS) carrier phases and the creation of microenvironments. Also, microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.

  12. Biogeochemical Cycling and Environmental Stability of Pu Relevant to Long-Term Stewardship of DOE Sites

    SciTech Connect

    Francis, Arokiasamy J.; Santschi, Peter H.; Honeyman, Bruce D.

    2005-06-01

    The overall objective of this proposed research is to understand the biogeochemical cycling of Pu in environments of interest to long-term DOE stewardship issues. Central to Pu cycling (transport initiation to immobilization) is the role of microorganisms. The hypothesis underlying this proposal is that microbial activity is the causative agent in initiating the mobilization of Pu in near-surface environments: through the transformation of Pu associated with solid phases, production of extracellular polymeric substances (EPS) carrier phases, and the creation of microenvironments. Also, microbial processes are central to the immobilization of Pu species, through the metabolism of organically complexed Pu species and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.

  13. Bedside resource stewardship in disasters: a provider's dilemma practicing in an ethical gap.

    PubMed

    Daniel, Michelle

    2012-01-01

    During disasters, clinicians may be forced to play dual roles, as both a provider and an allocator of scarce resources. At present, a clear framework to govern resource stewardship at the bedside is lacking. Clinicians who find themselves practicing in this ethical gap between clinical and public health ethics can experience significant moral distress. One provider describes her experience allocating an oxygen tank in the intensive care unit at a hospital in Port-au-Prince, Haiti, immediately following the 2010 earthquake. Using a clinical vignette and reflective narrative she attempts to identify the factors that influenced her allocation decision, opening up the factors for commentary and debate by an ethicist. A better paradigm for the ethical care of patients during disasters is needed to better guide provider choices in the future.

  14. Reconnecting cities to the biosphere: stewardship of green infrastructure and urban ecosystem services.

    PubMed

    Andersson, Erik; Barthel, Stephan; Borgström, Sara; Colding, Johan; Elmqvist, Thomas; Folke, Carl; Gren, Åsa

    2014-05-01

    Within-city green infrastructure can offer opportunities and new contexts for people to become stewards of ecosystem services. We analyze cities as social-ecological systems, synthesize the literature, and provide examples from more than 15 years of research in the Stockholm urban region, Sweden. The social-ecological approach spans from investigating ecosystem properties to the social frameworks and personal values that drive and shape human interactions with nature. Key findings demonstrate that urban ecosystem services are generated by social-ecological systems and that local stewards are critically important. However, land-use planning and management seldom account for their role in the generation of urban ecosystem services. While the small scale patchwork of land uses in cities stimulates intense interactions across borders much focus is still on individual patches. The results highlight the importance and complexity of stewardship of urban biodiversity and ecosystem services and of the planning and governance of urban green infrastructure.

  15. Clinical Diagnoses and Antimicrobials Predictive of Pediatric Antimicrobial Stewardship Recommendations: A Program Evaluation

    PubMed Central

    Goldman, Jennifer L.; Lee, Brian R.; Hersh, Adam L.; Yu, Diana; Stach, Leslie M.; Myers, Angela L.; Jackson, Mary Anne; Day, James C.; McCulloh, Russell J.; Newland, Jason G.

    2015-01-01

    BACKGROUND The number of pediatric antimicrobial stewardship programs (ASPs) is increasing and program evaluation is a key component to improve efficiency and enhance stewardship strategies. OBJECTIVE To determine the antimicrobials and diagnoses most strongly associated with a recommendation provided by a well-established pediatric ASP. DESIGN AND SETTING Retrospective cohort study from March 3, 2008, to March 2, 2013, of all ASP reviews performed at a free-standing pediatric hospital. METHODS ASP recommendations were classified as follows: stop therapy, modify therapy, optimize therapy, or consult infectious diseases. A multinomial distribution model to determine the probability of each ASP recommendation category was performed on the basis of the specific antimicrobial agent or disease category. A logistic model was used to determine the odds of recommendation disagreement by the prescribing clinician. RESULTS The ASP made 2,317 recommendations: stop therapy (45%), modify therapy (26%), optimize therapy (19%), or consult infectious diseases (10%). Third-generation cephalosporins (0.20) were the antimicrobials with the highest predictive probability of an ASP recommendation whereas linezolid (0.05) had the lowest probability. Community-acquired pneumonia (0.26) was the diagnosis with the highest predictive probability of an ASP recommendation whereas fever/neutropenia (0.04) had the lowest probability. Disagreement with ASP recommendations by the prescribing clinician occurred 22% of the time, most commonly involving community-acquired pneumonia and ear/nose/throat infections. CONCLUSIONS Evaluation of our pediatric ASP identified specific clinical diagnoses and antimicrobials associated with an increased likelihood of an ASP recommendation. Focused interventions targeting these high-yield areas may result in increased program efficiency and efficacy. PMID:25773192

  16. Earth Science Keyword Stewardship: Access and Management through NASA's Global Change Master Directory (GCMD) Keyword Management System (KMS)

    NASA Astrophysics Data System (ADS)

    Stevens, T.; Olsen, L. M.; Ritz, S.; Morahan, M.; Aleman, A.; Cepero, L.; Gokey, C.; Holland, M.; Cordova, R.; Areu, S.; Cherry, T.; Tran-Ho, H.

    2012-12-01

    Discovering Earth science data can be complex if the catalog holding the data lacks structure. Controlled keyword vocabularies within metadata catalogues can improve data discovery. NASA's Global Change Master Directory's (GCMD) Keyword Management System (KMS) is a recently released a RESTful web service for managing and providing access to controlled keywords (science keywords, service keywords, platforms, instruments, providers, locations, projects, data resolution, etc.). The KMS introduces a completely new paradigm for the use and management of the keywords and allows access to these keywords as SKOS Concepts (RDF), OWL, standard XML, and CSV. A universally unique identifier (UUID) is automatically assigned to each keyword, which uniquely identifies each concept and its associated information. A component of the KMS is the keyword manager, an internal tool that allows GCMD science coordinators to manage concepts. This includes adding, modifying, and deleting broader, narrower, or related concepts and associated definitions. The controlled keyword vocabulary represents over 20 years of effort and collaboration with the Earth science community. The maintenance, stability, and ongoing vigilance in maintaining mutually exclusive and parallel keyword lists is important for a "normalized" search and discovery, and provides a unique advantage for the science community. Modifications and additions are made based on community suggestions and internal review. To help maintain keyword integrity, science keyword rules and procedures for modification of keywords were developed. This poster will highlight the use of the KMS as a beneficial service for the stewardship and access of the GCMD keywords. Users will learn how to access the KMS and utilize the keywords. Best practices for managing an extensive keyword hierarchy will also be discussed. Participants will learn the process for making keyword suggestions, which subsequently help in building a controlled keyword

  17. Chemical Stockpile Disposal Program: Review and comment on the Phase 1 environmental report for the Pueblo Depot Activity, Pueblo, Colorado

    SciTech Connect

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

    1994-03-01

    As part of the Chemical Stockpile Disposal Program, an independent review is presented of the US Army Phase I environmental report for the disposal of chemical agents and munitions stored at the Pueblo Depot Activity (PUDA) in Pueblo, Colorado. The Phase I report addresses new and additional concerns not incorporated in the final programmatic environmental impact statement (FPEIS). These concerns are addressed by examining site-specific data for the PUDA. On the basis of our review of the Phase I report, we concluded that on-site meteorological data from December 1988 to June 1992 appear to be of insufficient quality to have been used instead of the off-site Pueblo airport data. No additional meteorological data have been collected since June 1992. The Phase I report briefly mentions problems with the air pollution control system. These problems will likely require the systems to be upgraded at the Johnston Atoll site and at each of the other depots in the continental United States. Without such improvements, the probability of accidents during start-up and shutdown would likely increase. The Army has a lessons-learned program to incorporate improvements into the design of future facilities. The Phase I report does not make any design change commitments. These issues need to be fully evaluated and resolved before any final conclusion concerning the adequacy of the decision in the FPEIS can be made with respect to the PUDA. With the exception of this issue, the inclusion of other 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 the PUDA). We recommend 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.

  18. Canada ordered to implement WTO ruling against "stockpiling" of generic drugs.

    PubMed

    Elliott, R

    2000-01-01

    In the last issue, we reported on a mixed World Trade Organization (WTO) ruling regarding Canada's patent laws, based on a complaint by the member states of the European Communities (joined by the United States). In March 2000, a WTO Panel accepted the provision in Canada's Patent Act that creates an "early working exception" to patent rights--in other words, that allows a third party to use a patented invention during the term of patent protection, as long as the use is for obtaining regulatory approval of an equivalent product to be sold once the patent expires. This was an important victory from the perspective of allowing earlier access to generic versions of patented drugs.

  19. Use of PNA FISH for blood cultures growing Gram-positive cocci in chains without a concomitant antibiotic stewardship intervention does not improve time to appropriate antibiotic therapy.

    PubMed

    Cosgrove, Sara E; Li, David X; Tamma, Pranita D; Avdic, Edina; Hadhazy, Eric; Wakefield, Teresa; Gherna, Michael; Carroll, Karen C

    2016-09-01

    Peptide nucleic acid fluorescence in situ hybridization (PNA FISH) is a rapid diagnostic assay that can identify certain organisms growing in blood cultures 30-90 min from the time of positive Gram-stain. Existing studies have demonstrated a clinical utility with this assay when antibiotic stewardship programs assist clinicians with interpreting the results. However, the benefit of these rapid assays in the absence of concomitant antibiotic stewardship involvement is unclear. In this randomized study of 220 patients with enterococcal or streptococcal bacteremia, we found that PNA FISH, in the absence of concomitant input from an antibiotic stewardship program, had no impact on time to effective or optimal therapy, length of hospital stay, or in-hospital mortality. Our results suggest that in the absence of guidance from an antibiotic stewardship program, the clinical benefits of rapid diagnostic microbiological tools may be reduced. PMID:27412814

  20. Use of PNA FISH for blood cultures growing Gram-positive cocci in chains without a concomitant antibiotic stewardship intervention does not improve time to appropriate antibiotic therapy.

    PubMed

    Cosgrove, Sara E; Li, David X; Tamma, Pranita D; Avdic, Edina; Hadhazy, Eric; Wakefield, Teresa; Gherna, Michael; Carroll, Karen C

    2016-09-01

    Peptide nucleic acid fluorescence in situ hybridization (PNA FISH) is a rapid diagnostic assay that can identify certain organisms growing in blood cultures 30-90 min from the time of positive Gram-stain. Existing studies have demonstrated a clinical utility with this assay when antibiotic stewardship programs assist clinicians with interpreting the results. However, the benefit of these rapid assays in the absence of concomitant antibiotic stewardship involvement is unclear. In this randomized study of 220 patients with enterococcal or streptococcal bacteremia, we found that PNA FISH, in the absence of concomitant input from an antibiotic stewardship program, had no impact on time to effective or optimal therapy, length of hospital stay, or in-hospital mortality. Our results suggest that in the absence of guidance from an antibiotic stewardship program, the clinical benefits of rapid diagnostic microbiological tools may be reduced.