Antimicrobial stewardship in long term care facilities: what is effective?
Nicolle, Lindsay E
2014-02-12
Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
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 Closuremore » 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.« less
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. Published by Elsevier Inc.
Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike
2018-01-16
Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosure and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."
DOE Office of Scientific and Technical Information (OSTI.GOV)
Grindstaff, Keith; Hathaway, Boyd; Wilson, Mike
2014-10-29
Workers from Mission Support Alliance, LLC., removed the welds around the steel door of the F Reactor before stepping inside the reactor to complete its periodic inspection. This is the first time the Department of Energy (DOE) has had the reactor open since 2008. The F Reactor is one of nine reactors along the Columbia River at the Department's Hanford Site in southeastern Washington State, where environmental cleanup has been ongoing since 1989. As part of the Tri-Party Agreement, the Department completes surveillance and maintenance activities of cocooned reactors periodically to evaluate the structural integrity of the safe storage enclosuremore » and to ensure confinement of any remaining hazardous materials. "This entry marks a transition of sorts because the Hanford Long-Term Stewardship Program, for the first time, was responsible for conducting the entry and surveillance and maintenance activities," said Keith Grindstaff, Energy Department Long-Term Stewardship Program Manager. "As the River Corridor cleanup work is completed and transitioned to long-term stewardship, our program will manage any on-going requirements."« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Garland, Sid; Brown, Sally; Sims, Lynn
Long-term stewardship is the set of activities necessary to return contaminated land to safe and beneficial use. The activities include physical and legal controls to prevent inappropriate exposure to contamination left in place at a site. It is the longest phase of the Department of Energy's Environmental Management Program and ensures the protection of human health and the environment for varied end uses. At the Department of Energy's Oak Ridge Reservation an automated program has been developed and implemented that tracks the multitude of long-term stewardship activities. The Oak Ridge Reservation is a large site that currently has over 50more » actions requiring long-term stewardship activities. The Oak Ridge Reservation consists primarily of three plant sites, and long-term stewardship will enable these sites to be leased to private entities (East Tennessee Technology Park), modernized for an evolving national security mission (Y-12 National Security Complex), and revitalized to continue multi-disciplinary research (Oak Ridge National Laboratory). The varied site end uses of the individual plant sites coupled with the multitude of controls required by leaving waste in place presents challenges. A single remedial action may include surveillance and maintenance activities, media monitoring, property record notices as well as physical controls such as fences and signs. Thus, the array of long-term stewardship activities is complex and intermingled (over 200 inspections each year at various frequencies are required currently) and requires an effective tracking program, termed the Land Use Manager. The Land Use Manager is a web-based data management application for use by personnel responsible for implementing, maintaining, and verifying engineering and land use controls on the Oak Ridge Reservation. The program is a data entry and tracking tool, as well as a notification tool. The status and performance of engineering and land use controls are checked annually for evaluation in the required Remediation Effectiveness Report, and the automated Land Use Manager collects, maintains, tracks, notifies, monitors, and manages the information necessary to perform this evaluation. Land Use Manager tracks site information including type of contamination, regulatory requirements, locates land use controls; provides information on inspections, certification, and reporting; and provides reports. Most data access features, e.g., view, print, query, and download, are available to all users; however, data input, updating, and editing are restricted to the personnel directly responsible for monitoring and inspection. The Land Use Manager application was developed for the Department of Energy Oak Ridge Office by URS - CH2M Oak Ridge LLC, Restoration Services Incorporated, and MIJARA Corporation to meet the specific needs of long-term stewardship tracking on the Oak Ridge Reservation. The successful implementation of long-term stewardship enables the future government and private activities being planned on the Oak Ridge Reservation to proceed. (authors)« less
Intergenerational equity and long-term stewardship plans.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hocking, E. K.
2002-02-05
For an untold number of contaminated sites throughout the world, stewardship will be inevitable. For many such sites, stewardship will be a reasonable approach because of the uncertainties associated with present and future site conditions and site contaminants, the limited performance of available technologies, the nonavailability of technologies, and the risk and cost associated with complete cleanup. Regardless of whether stewardship is a realistic approach to site situations or simply a convenient default, it could be required at most contaminated sites for multiple generations. Because the stewardship plan is required to protect the release of hazardous contaminants to the environment,more » some use restrictions will be put in place to provide that protection. These use restrictions will limit access to resources for as long as the protection is required. The intergenerational quality of long-term stewardship plans and their inherent limitations on resource use require that they be designed to achieve equity among the affected generations. Intergenerational equity, defined here as the fairness of access to resources across generations, could be achieved through a well-developed stewardship plan that provides future generations with the information they need to make wise decisions about resource use. Developing and implementing such a plan would take into account the failure mechanisms of the plan's components, feature short stewardship time blocks that would allow for periodic reassessments of the site and of the stewardship program's performance, and provide present and future generations with necessary site information.« less
Planning the Transition to Long-Term Stewardship for the River Corridor
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cearlock, C.S.; Lerch, J.A.; Sands, J.P.
2007-07-01
Long-term stewardship refers to all activities necessary to ensure protection of human health and the environment following completion of remediation, disposal, or stabilization of a site or a portion of a site. Efforts to establish the proposed approach and criteria to be met for long-term stewardship in the river corridor of the Hanford Site in Richland, Washington, are currently being established and a draft plan is expected to be completed in mid-2007 to facilitate planning for a smooth and seamless transition to long-term stewardship. Once the initial criteria have been established, supporting information will be gathered as the work proceeds.more » Near the end of cleanup actions under the River Corridor Closure Contract, these criteria will be finalized in a long-term stewardship plan that documents how the criteria have been met. In addition, the final long-term stewardship plan will also contain a proposed Finding of Suitability to Transfer in accordance with Comprehensive Environmental Response, Compensation, and Liability Act of 1980 Section 120(h) [1]. This final long-term stewardship plan will provide the foundation for post-River Corridor Closure Contract and management activities in the river corridor pending actual property transfer from the U.S. Department of Energy. (authors)« less
Barlam, Tamar F.; Cosgrove, Sara E.; Abbo, Lilian M.; MacDougall, Conan; Schuetz, Audrey N.; Septimus, Edward J.; Srinivasan, Arjun; Dellit, Timothy H.; Falck-Ytter, Yngve T.; Fishman, Neil O.; Hamilton, Cindy W.; Jenkins, Timothy C.; Lipsett, Pamela A.; Malani, Preeti N.; May, Larissa S.; Moran, Gregory J.; Neuhauser, Melinda M.; Newland, Jason G.; Ohl, Christopher A.; Samore, Matthew H.; Seo, Susan K.; Trivedi, Kavita K.
2016-01-01
Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. PMID:27080992
The effectiveness of experiential environmental education: O'Neill Sea Odyssey program case study
NASA Astrophysics Data System (ADS)
Hanneman, Lauren E.
Environmental education programs aim to develop participant awareness, sensitivity, and understanding of their affective relationship to the natural environment through conceptual knowledge and personal experiences. Previous findings have suggested that participation in environmental education programs leads to short-term positive increases in environmental knowledge, pro-environmental attitudes, and intentions to act in environmentally responsible behaviors; however, few studies have included long-term, follow-up assessment. This research provided an analysis of the effectiveness of the O'Neill Sea Odyssey (OSO) education program in fostering a long-term awareness of personal responsibility about ocean pollution among student participants. A survey administered to 261 students from the greater San Francisco Bay Area in California was used to explore 7th through 10 th grade students' conceptions about the connection between ocean pollution and stewardship behaviors. The study revealed that 75% of 86 former OSO participants retained a high level of awareness of the connection between non-point source pollution and personal behaviors two to five years after the program, regardless of differences in sex, language, grade level, and community setting. These results indicate that OSO participants retained a long-term conceptual awareness about environmental stewardship behaviors taught during the OSO program.
Wilkinson, Krista; Gravel, Denise; Taylor, Geoffrey; McGeer, Allison; Simor, Andrew; Suh, Kathryn; Moore, Dorothy; Kelly, Sharon; Boyd, David; Mulvey, Michael; Mounchili, Aboubakar; Miller, Mark
2011-04-01
Clostridium difficile is an important pathogen in Canadian health care facilities, and infection prevention and control (IPC) practices are crucial to reducing C difficile infections (CDIs). We performed a cross-sectional study to identify CDI-related IPC practices in Canadian health care facilities. A survey assessing facility characteristics, CDI testing strategies, CDI contact precautions, and antimicrobial stewardship programs was sent to Canadian health care facilities in February 2005. Responses were received from 943 (33%) facilities. Acute care facilities were more likely than long-term care (P < .001) and mixed care facilities (P = .03) to submit liquid stools from all patients for CDI testing. Physician orders were required before testing for CDI in 394 long-term care facilities (66%)-significantly higher than the proportions in acute care (41%; P < .001) and mixed care sites (49%; P < .001). A total of 841 sites (93%) had an infection control manual, 639 (76%) of which contained CDI-specific guidelines. Antimicrobial stewardship programs were reported by 40 (29%) acute care facilities; 19 (54%) of these sites reported full enforcement of the program. Canadian health care facilities have widely varying C difficile IPC practices. Opportunities exist for facilities to take a more active role in IPC policy development and implementation, as well as antimicrobial stewardship. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
Science and society: the role of long-term studies in environmental stewardship
Charles T. Driscoll; Kathleen F. Lambert; F. Stuart Chapin; David J. Nowak; Thomas A. Spies; Frederick J. Swanson; David B. Kittredge; Clarisse M. Hart
2012-01-01
Long-term research should play a crucial role in addressing grand challenges in environmental stewardship. We examine the efforts of five Long Term Ecological Research Network sites to enhance policy, management, and conservation decisions for forest ecosystems. In these case studies, we explore the approaches used to inform policy on atmospheric deposition, public...
Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik
2016-07-27
Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.
Memorandum of Understanding on Long-Term Stewardship at Federal Facilities in the United States
The purpose of this Memorandum of Understanding is to provide a common understanding and basis for discussion and coordination between the Environmental Council of the States and relevant federal agencies regarding Long-Term Stewardship.
Local Government Implementation of Long-Term Stewardship at Two DOE Facilities
DOE Office of Scientific and Technical Information (OSTI.GOV)
John Pendergrass; Roman Czebiniak; Kelly Mott
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 asmore » 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.« less
Jenkins, Timothy C.; Knepper, Bryan C.; Shihadeh, Katherine; Haas, Michelle K.; Sabel, Allison L.; Steele, Andrew W.; Wilson, Michael L.; Price, Connie S.; Burman, William J.; Mehler, Philip S.
2016-01-01
Objective To evaluate the long-term outcomes of an antimicrobial stewardship program (ASP) implemented in a hospital with low baseline antibiotic use Design Quasi-experimental, interrupted-time series study Setting 525-bed public safety-net hospital Intervention Implementation of a formal ASP in July 2008 Methods We conducted a time-series analysis to evaluate the impact of the ASP over a 6.25-year period (July 1, 2008 – September 30, 2014) while controlling for trends during a 3-year preintervention period (July 1, 2005 – June 30, 2008). The primary outcome measures were total antibacterial and antipseudomonal use in days of therapy (DOT) per 1000 patient-days (PD). Secondary outcomes included antimicrobial costs and resistance, hospital-onset C. difficile infection, and other patient-centered measures. Results During the preintervention period, total antibacterial and antipseudomonal use were declining (−9.2 and −5.5 DOT/1000 PD per quarter, respectively). During the stewardship period, both continued to decline, although at lower rates (−3.7 and −2.2 DOT/1000 PD, respectively), resulting in a slope change of 5.5 DOT/1000 PD per quarter for total antibacterial use (P = .10) and 3.3 DOT/100 PD per quarter for antipseudomonal use (P = .01). Antibiotic expenditures declined markedly during the stewardship period (−$295.42/1000PD per quarter, p=.002). There were variable changes in antimicrobial resistance and few apparent changes in C. difficile infection and other patient-centered outcomes. Conclusion In a hospital with low baseline antibiotic use, implementation of an ASP was associated with sustained reductions in total antibacterial and antipseudomonal use and declining antibiotic expenditures; however, this study highlights limitations of commonly used stewardship outcome measures. PMID:25740560
Beganovic, Maya; LaPlante, Kerry L
2018-06-01
Up to 50% of hospital-administered and 70% of nursing home-administered antimicrobials are inappropriately prescribed. There is a great need to focus local, national and global efforts on appropriate antibiotic use. Formal programs dedicated to appropriate antibiotic use have been established in most US hospitals. These antimicrobial stewardship programs (ASP) exist to ensure that the correct drug, dose and duration of an antimicrobial is given, and only when there is a true bacterial infection (as opposed to bacterial colonization or a viral infection). These programs increase patient safety and reduce unintended consequences including Clostridium difficile infections, medication-related adverse effects, and antimicrobial resistance. Most of these programs are co-lead by an interdisciplinary team consisting of an infectious diseases (ID) pharmacist and an ID physician. However, consistent and meaningful metrics to study the impact of ASPs have not been elucidated. With the Joint Commission Standards for Acute Care facilities, and Centers for Medicare and Medicare (CMS) for long-term care facilities making antimicrobial stewardship (AMS) a condition of participation, both facilities will be scrambling to create appropriate quality care indicators to measure program success. One major theme across all healthcare settings is that ASPs must collaborate with facility leadership and key stakeholders at each institution in order to have an impactful benefit on patient quality of care, and safety. It is the purpose of this review to offer several economic, process, and patient-outcome measurements for ASP to optimally communicate with facility leadership. [Full article available at http://rimed.org/rimedicaljournal-2018-06.asp].
Long-Term Monitoring Research Needs: A DOE Perspective
NASA Astrophysics Data System (ADS)
Moore, B.; Davis, C. B.
2002-05-01
The U.S. Department of Energy's Office of Environmental Management is responsible for dealing with the nation's legacy of Cold War radioactive and hazardous waste and contamination. Major efforts are underway to deal with this legacy; these are expected to last up to decades and cost up to billions of dollars at some sites. At all sites, however, active remediation must eventually cease; if hazards then remain, the site must enter into a long-term stewardship mode. In this talk we discuss aspects of long-term monitoring pertinent to DOE sites, focusing on challenges to be faced, specific goals or targets to be met, and research needs to be addressed in order to enable DOE to meet its long-term stewardship obligations. DOE LTM research needs fall into three major categories: doing what we can do now much more efficiently; doing things we cannot do now; and proving the validity of our monitoring programs. Given the enormity of the DOE obligations, it will be highly desirable to develop much more efficient monitoring paradigms. Doing so will demand developing autonomous, remote monitoring networks of in situ sensors capable of replacing (or at least supplementing to a large extent) conventional groundwater and soil gas sampling and analysis programs. The challenges involved range from basic science (e.g., inventing in situ sensors for TCE that do not demand routine maintenance) to engineering (attaining superior reliability in data reporting in remote networks) to ergonomics (developing decent ways of selecting and presenting the "right" information from the monitoring network) to regulatory affairs (presenting convincing evidence that the more efficient systems actually provide superior monitoring). We explore these challenges in some detail, focusing on the "long" in long-term monitoring as it applies to DOE sites. Monitoring system performance validation and, ultimately, regulator and stakeholder acceptance of site closure and long-term stewardship plans depend critically on the validity and uncertainty in models used to predict contaminant fate and transport. This is an area of active research at the present time. We survey joint research initiatives in this area involving DOE along with USGS, U.S. EPA, U.S. NRC, and U.S. DOA and non-Federal collaborators, and explore their potential for furthering DOE long-term monitoring needs and objectives.
A human-centered framework for innovation in conservation incentive programs.
Sorice, Michael G; Donlan, C Josh
2015-12-01
The promise of environmental conservation incentive programs that provide direct payments in exchange for conservation outcomes is that they enhance the value of engaging in stewardship behaviors. An insidious but important concern is that a narrow focus on optimizing payment levels can ultimately suppress program participation and subvert participants' internal motivation to engage in long-term conservation behaviors. Increasing participation and engendering stewardship can be achieved by recognizing that participation is not simply a function of the payment; it is a function of the overall structure and administration of the program. Key to creating innovative and more sustainable programs is fitting them within the existing needs and values of target participants. By focusing on empathy for participants, co-designing program approaches, and learning from the rapid prototyping of program concepts, a human-centered approach to conservation incentive program design enhances the propensity for discovery of novel and innovative solutions to pressing conservation issues.
Ecosystem Matters: Activity and Resource Guide for Environmental Educators.
ERIC Educational Resources Information Center
Adams, Mary; And Others
An ecological approach involved making conscious decisions which result in actions that responsibly contribute to the long-term stewardship of natural resources. This activity and resource guide was designed for use by both educators and resource managers to supplement existing courses and programs concerning ecological matters. These…
LONG-TERM STEWARDSHIP AT DOE HANFORD SITE - 12575
DOE Office of Scientific and Technical Information (OSTI.GOV)
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 - currentlymore » 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 the contractors and DOE-RL. Information Management (IM) is a key part of the LTS program. The IM Program identifies, locates, stores, protects and makes accessible Hanford LTS records and data to support the transfer of property ultimately to LM. As such, DOE-RL manages the Hanford LTS Program in a manner consistent with LM's goals, policies, and procedures.« less
An Online Course Improves Nurses’ Awareness of their Role as Antimicrobial Stewards in Nursing Homes
Wilson, Brigid M.; Shick, Sue; Carter, Rebecca R.; Heath, Barbara; Higgins, Patricia A.; Sychla, Basia; Olds, Danielle M; Jump, Robin L. P.
2017-01-01
Background To support the role of nurses as active proponents of antimicrobial stewardship in long-term care facilities, we developed an educational intervention consisting of a free online course comprised of 6 interactive modules. Here, we report the effect of the course on the knowledge, beliefs and attitudes towards antimicrobial stewardship of nurses working in long-term care facilities. Measurements We used a paired pre- and post-course survey instrument to assess nurses’ knowledge regarding the care of long-term care facility residents with infections as well as attitudes and beliefs regarding antimicrobial stewardship. Results 103 respondents, RNs or LPNs, completed the pre and post-surveys. Their mean knowledge scores improved, from 75% (pre-course) to 86% (post-course, P < 0.001). Following the course, nurses’ agreement that their role influences whether or not residents receive antimicrobials increased significantly (P < 0.001). Discussion The online course improves nurses’ knowledge regarding the care of long-term care facility residents with infections and improves their confidence to engage in antimicrobial stewardship activities. Conclusion Empowering nurses to be antimicrobial stewards may help reduce unnecessary antibiotic use among institutionalized older adults. PMID:28189411
DOE Office of Scientific and Technical Information (OSTI.GOV)
Silvas, A. J.
The purpose of this Post-Closure Strategy is to provide a consistent methodology for continual evaluation of post-closure requirements for use-restricted areas on the Nevada National Security Site (NNSS), Nevada Test and Training Range (NTTR), and Tonopah Test Range (TTR) to consolidate, modify, or streamline the program. In addition, this document stipulates the creation of a single consolidated Post-Closure Plan that will detail the current post-closure requirements for all active use restrictions (URs) and outlines its implementation and subsequent revision. This strategy will ensure effective management and control of the post-closure sites. There are currently over 200 URs located on themore » NNSS, NTTR, and TTR. Post-closure requirements were initially established in the Closure Report for each site. In some cases, changes to the post-closure requirements have been implemented through addenda, errata sheets, records of technical change, or letters. Post-closure requirements have been collected from these multiple sources and consolidated into several formats, such as summaries and databases. This structure increases the possibility of inconsistencies and uncertainty. As more URs are established and the post-closure program is expanded, the need for a comprehensive approach for managing the program will increase. Not only should the current requirements be obtainable from a single source that supersedes all previous requirements, but the strategy for modifying the requirements should be standardized. This will enable more effective management of the program into the future. This strategy document and the subsequent comprehensive plan are to be implemented under the assumption that the NNSS and outlying sites will be under the purview of the U.S. Department of Energy, National Nuclear Security Administration for the foreseeable future. This strategy was also developed assuming that regulatory control of the sites remains static. The comprehensive plan is not intended to be a permanent long-term stewardship plan. However, it is intended to clarify requirements and identify components to effectively manage the sites until regulatory requirements are met or management of the site changes. The Environmental Management Program is required to manage these sites until the NNSS Environmental Restoration program is completed, currently planned for 2030. Prior to completion of the Environmental Restoration program, additional planning will be conducted to ensure that long-term stewardship of the sites is maintained. A comprehensive post-closure plan can be transitioned effectively into any future site-wide long-term stewardship program that may be developed. Therefore, the post-closure plan will include current aspects of the post-closure program that are also important aspects of long-term stewardship, including the following: • Management of physical and engineering controls such as fences, signs, and soil covers • Management of institutional and administrative controls such as use restrictions and real estate systems • Management of monitoring and maintenance programs • Management of information related to the sites such as geographic information system data and related documentation The strategy will also allow for periodic review and modification of any aspect of the program to ensure continued effectiveness.« less
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 following definition: a climate data record (CDR) is a time series of measurements of sufficient length, consistency, and continuity to determine climate variability and change.
Frenette, Charles; Sperlea, David; Tesolin, Joey; Patterson, Connie; Thirion, Daniel J G
2016-09-01
Surgical site infections (SSIs) complicate surgery, resulting in higher morbidity and mortality. Infection control bundles and antibiotic stewardship can be effective at reducing SSIs. The influence of long-term serial interventions is unclear. The goal of this retrospective quasiexperimental study was to assess the influence of a 5-year serial infection control and antibiotic stewardship intervention on SSIs. The multidisciplinary program actively implemented pre-, intra-, and postoperative strategies over a 5-year period from 2009-2014 for all patients undergoing coronary artery bypass graft (CABG), valve replacement, or both at a tertiary care public institution. Outcomes are compared with a 2-year preinterventions period (2007-2009) and 1-year postinterventions period (2014-2015). A total of 6,518 procedures were included. After interventions, the overall combined infection rate for CABG, CABG and valve, and valve procedures decreased by 66.3%, from 11.9%-4.0% (odds ratio, 0.34; 95% confidence interval, 0.23-0.49; P < .001). A significant decrease of >50% (P < .001) relative rate was observed in overall, sternum, leg, CABG, and combined CABG and valve infection rates when comparing pre- and postinterventions groups. The antibiotic stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 46.8%, from 39.8%-86.6% (95% confidence interval, 41.0-52.4; P < .001). Long-term, serial comprehensive infection control and antibiotic stewardship interventions decrease overall SSIs in patients undergoing CABG and valve replacement procedures. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Jenkins, Timothy C; Knepper, Bryan C; Shihadeh, Katherine; Haas, Michelle K; Sabel, Allison L; Steele, Andrew W; Wilson, Michael L; Price, Connie S; Burman, William J; Mehler, Philip S
2015-06-01
To evaluate the long-term outcomes of an antimicrobial stewardship program (ASP) implemented in a hospital with low baseline antibiotic use. Quasi-experimental, interrupted time-series study. Public safety net hospital with 525 beds. Implementation of a formal ASP in July 2008. We conducted a time-series analysis to evaluate the impact of the ASP over a 6.25-year period (July 1, 2008-September 30, 2014) while controlling for trends during a 3-year preintervention period (July 1, 2005-June 30, 2008). The primary outcome measures were total antibacterial and antipseudomonal use in days of therapy (DOT) per 1,000 patient-days (PD). Secondary outcomes included antimicrobial costs and resistance, hospital-onset Clostridium difficile infection, and other patient-centered measures. During the preintervention period, total antibacterial and antipseudomonal use were declining (-9.2 and -5.5 DOT/1,000 PD per quarter, respectively). During the stewardship period, both continued to decline, although at lower rates (-3.7 and -2.2 DOT/1,000 PD, respectively), resulting in a slope change of 5.5 DOT/1,000 PD per quarter for total antibacterial use (P=.10) and 3.3 DOT/1,000 PD per quarter for antipseudomonal use (P=.01). Antibiotic expenditures declined markedly during the stewardship period (-$295.42/1,000 PD per quarter, P=.002). There were variable changes in antimicrobial resistance and few apparent changes in C. difficile infection and other patient-centered outcomes. In a hospital with low baseline antibiotic use, implementation of an ASP was associated with sustained reductions in total antibacterial and antipseudomonal use and declining antibiotic expenditures. Common ASP outcome measures have limitations.
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; - Developing guiding Principles on how the Agency undertakes Science, Data Management and Cataloguing; - Developing a Data Classification Schema that aligns scientific requirements and business workflows with data architecture; - Creating the Scientific Data Stewardship Steering Committee, comprising champions from across the Agency to guide development and support implementation of Data Stewardship in GA; - Forming Scientific Data Communities of Practice of leading scientific experts to identify tandards and practices across their domain, and integrate data stewardship practices into scientific workflows; - Establishing the Data Governance and Services Section to provide ongoing capacity for the development, communication, coordination and governance of data stewardship policies, strategies, standards and practices. GA is now moving towards Data Stewardship as an operational capability and culture within the Agency. The challenges we face into the future include: - Maintaining continuous and enthusiastic engagement from the Agency executive; - Implementing long term cultural change at all levels within the organisation; - Formal recognition that data stewardship is a continuous operational BAU activity; - Incorporation of data custodianship and management activities in work programs and budgets; and - Cultivation and support of the data stewardship champions.
Stewardship of the Evolving Scholarly Record: From the Invisible Hand to Conscious Coordination
ERIC Educational Resources Information Center
Lavoie, Brian; Malpas, Constance
2015-01-01
The long-term future of the scholarly record in its fullest expression cannot be effectively secured with stewardship strategies designed for print materials. The features of the evolving scholarly record suggest that traditional stewardship strategies, built on an "invisible hand" approach that relies on the uncoordinated,…
Antibiotic Use and Need for Antimicrobial Stewardship in Long-Term Care.
Wu, Lisa Dong-Ying; Walker, Sandra A N; Elligsen, Marion; Palmay, Lesley; Simor, Andrew; Daneman, Nick
2015-01-01
Antimicrobial stewardship may be important in long-term care facilities because of unnecessary or inappropriate antibiotic use observed in these residents, coupled with their increased vulnerability to health care-associated infections. To assess antibiotic use in a long-term care facility in order to identify potential antimicrobial stewardship needs. A retrospective descriptive study was conducted at the Veterans Centre, a long-term care facility at Sunnybrook Health Sciences Centre, Toronto, Ontario. All residents taking one or more antibiotics (n = 326) were included as participants. Antibiotic-use data for patients residing in the facility between April 1, 2011, and March 31, 2012, were collected and analyzed. Totals of 358 patient encounters, 835 antibiotic prescriptions, and 193 positive culture results were documented during the study period. For 36% (302/835) of antibiotic prescriptions, the duration was more than 7 days. Cephalosporins (30%; 251/835) and fluoroquinolones (28%; 235/835) were the most frequently prescribed antibiotic classes. Urine was the most common source of samples for culture (60%; 116/193). Characteristics of antimicrobial use at this long-term care facility that might benefit from further evaluation included potentially excessive use of fluoroquinolones and cephalosporins and potentially excessive duration of antibiotic use for individual patients.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kreie, Ken; Findlay, Rick
The U.S. Department of Energy (DOE) Office of Legacy Management (LM) prepared this Long-Term Surveillance and Maintenance Plan (LTSMP) for the Gnome-Coach, New Mexico, Site (the Gnome site). The Gnome site is approximately 25 miles east of Carlsbad in Eddy County, New Mexico (Figure 1). The site was the location of a 3-kiloton-yield underground nuclear test and radioisotope groundwater tracer test. The tests resulted in residual contamination and post-detonation features that require long-term oversight. Long-term responsibility for the site was transferred from the DOE National Nuclear Security Administration Nevada Site Office to LM on October 1, 2006. Responsibilities include surveillance,more » monitoring, and maintenance of institutional controls (ICs) as part of the long-term stewardship of the site. Long-term stewardship is designed to ensure protection of human health and the environment.« less
Scientific Data Stewardship in the 21'st Century
NASA Astrophysics Data System (ADS)
Mabie, J. J.; Redmon, R.; Bullett, T.; Kihn, E. A.; Conkright, R.; Manley, J.; Horan, K.
2008-12-01
The Ionosonde Program at the National Geophysical Data Center (NGDC) serves as a case study for how to approach data stewardship in the 21'st century. As the number and sophistication of scientific instruments increase, along with the volumes and complexity of data that need to be preserved for future generations, the old approach of simply storing data in a library, physical or electronic, is no longer sufficient to ensure the long term preservation of our important environmental data. To ensure the data can be accessed, understood, and used by future generations, the data stewards must be familiar with the observation process before the data reach the archive and the scientific applications to which the data may be called to serve. This familiarity is best obtained by active participation. In the NGDC Ionosonde Program team, we strive to have activity and expertise in ionosonde field operations and scientific data analysis in addition to our core mission of preservation and distribution of data and metadata. We believe this approach produces superior data quality, proper documentation and evaluation tools for data customers as part of the archive process. We are presenting the Ionosonde Program as an example of modern scientific data stewardship.
Feasibility and applicability of antimicrobial stewardship in immunocompromised patients.
Robilotti, Elizabeth; Holubar, Marisa; Seo, Susan K; Deresinski, Stan
2017-08-01
Antimicrobial stewardship is the primary intervention in the battle against antimicrobial resistance, but clinicians do not always apply many key antimicrobial stewardship principles to patients with significant immune defects due to lack of data and fear of bad outcomes. We review evidence regarding the application of stewardship principles to immunocompromised patients, with a focus on solid organ and hematopoietic stem cell transplant recipients. Antimicrobial stewardship programs (ASPs), targeting immunocompromised patient populations such as oncology and transplant, are gaining traction. Emerging literature suggests that several stewardship interventions can be adapted to immunocompromised hosts and improve antimicrobial utilization, but data supporting improved outcomes is very limited. The application of antimicrobial stewardship principles to immunocompromised patients is feasible, necessary, and urgent. As antimicrobial stewardship programs gain momentum across a diverse range of healthcare settings more immunocompromised patients will fall under their purview. It is imperative that centers applying antimicrobial stewardship principles share their experience and establish collaborative research efforts to advance our knowledge base in applying antimicrobial stewardship initiatives to immunocompromised host populations, both in terms of programmatic success and patient outcomes.
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.
Ruiz-Ramos, Jesus; Frasquet, Juan; Romá, Eva; Poveda-Andres, Jose Luis; Salavert-Leti, Miguel; Castellanos, Alvaro; Ramirez, Paula
2017-06-01
To evaluate the cost-effectiveness of antimicrobial stewardship (AS) program implementation focused on critical care units based on assumptions for the Spanish setting. A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed. Model variables and costs, along with their distributions, were obtained from the literature. The study was performed from the Spanish National Health System (NHS) perspective, including only direct costs. The Incremental Cost-Effectiveness Ratio (ICER) was analysed regarding the ability of the program to reduce multi-drug resistant bacteria. Uncertainty in ICERs was evaluated with probabilistic sensitivity analyses. In the short-term, implementing an AS reduces the consumption of antimicrobials with a net benefit of €71,738. In the long-term, the maintenance of the program involves an additional cost to the system of €107,569. Cost per avoided resistance was €7,342, and cost-per-life-years gained (LYG) was €9,788. Results from the probabilistic sensitivity analysis showed that there was a more than 90% likelihood that an AS would be cost-effective at a level of €8,000 per LYG. Wide variability of economic results obtained from the implementation of this type of AS program and short information on their impact on patient evolution and any resistance avoided. Implementing an AS focusing on critical care patients is a long-term cost-effective tool. Implementation costs are amortized by reducing antimicrobial consumption to prevent infection by multidrug-resistant pathogens.
Strategies and challenges of antimicrobial stewardship in long-term care facilities.
Dyar, O J; Pagani, L; Pulcini, C
2015-01-01
As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Antibiotic Stewardship: New Frontier, Familiar Journey.
Martin, Caren McHenry
2017-05-01
Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to improve patient outcomes and decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facility personnel implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff in understanding how to use the facility's antibiogram, find appropriate resources, and provide facility personnel with feedback on their antimicrobial stewardship efforts.
DiTomaso, Joseph M; Van Steenwyk, Robert A; Nowierski, Robert M; Vollmer, Jennifer L; Lane, Eric; Chilton, Earl; Burch, Patrick L; Cowan, Phil E; Zimmerman, Kenneth; Dionigi, Christopher P
2017-01-01
Invasive species are one of the greatest economic and ecological threats to agriculture and natural areas in the US and the world. Among the available management tools, biological control provides one of the most economical and long-term effective strategies for managing widespread and damaging invasive species populations of nearly all taxa. However, integrating biological control programs in a more complete integrated pest management approach that utilizes increased information and communication, post-release monitoring, adaptive management practices, long-term stewardship strategies, and new and innovative ecological and genetic technologies can greatly improve the effectiveness of biological control. In addition, expanding partnerships among relevant national, regional, and local agencies, as well as academic scientists and land managers, offers far greater opportunities for long-term success in the suppression of established invasive species. In this paper we direct our recommendations to federal agencies that oversee, fund, conduct research, and develop classical biological control programs for invasive species. By incorporating these recommendations into adaptive management strategies, private and public land managers will have far greater opportunities for long-term success in suppression of established invasive species. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.
Frenette, Charles; Sperlea, David; Leharova, Yveta; Thirion, Daniel J G
2016-12-01
OBJECTIVE The goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs). METHODS This study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas-kidney transplantation were included. Outcomes were compared between a preintervention group (2010-2011) and a postintervention group (2012-2014). RESULTS A total of 1,424 procedures averaged an overall SSI rate of 11.2%. After implementation of the interventions, a decrease of 52.8% in SSI rates from 17.4% to 8.2% was observed (P50% (relative rate; P<.001) was observed in superficial incisional and organ-space infections between pre- and postintervention groups. In addition, a 54.9% decrease from 19.7% to 8.9% (P<.001; OR, 2.2; 95% CI, 1.4-3.5) and a 51.6% decrease from 15.5% to 7.5% (P=.001; OR, 2.2; 95% CI, 1.4-3.5) were observed for SSI rates in hepatobiliary surgery and solid organ transplantation, respectively. The antimicrobial stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 15.2% (absolute rate) from 45.1% to 60.3% (P<.003; 95% CI, 5.4-24.9). CONCLUSIONS A long-term serial infection control and antimicrobial stewardship intervention decreased SSIs among patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas-kidney transplantation. Infect Control Hosp Epidemiol 2016;1468-1474.
Evaluating environmental education, citizen science, and stewardship through naturalist programs.
Merenlender, Adina M; Crall, Alycia W; Drill, Sabrina; Prysby, Michelle; Ballard, Heidi
2016-12-01
Amateur naturalists have played an important role in the study and conservation of nature since the 17th century. Today, naturalist groups make important contributions to bridge the gap between conservation science and practice around the world. We examined data from 2 regional naturalist programs to understand participant motivations, barriers, and perspectives as well as the actions they take to advance science, stewardship, and community engagement. These programs provide certification-based natural history and conservation science training for adults that is followed by volunteer service in citizen science, education, and stewardship. Studies in California and Virginia include quantitative and qualitative evaluation data collected through pre- and postcourse surveys, interviews, and long-term tracking of volunteer hours. Motivations of participants focused on learning about the local environment and plants and animals, connecting with nature, becoming certified, and spending time with people who have similar interests. Over half the participants surveyed were over 50 years old, two-thirds were women, and a majority reported household incomes of over $50,000 (60% in California, 85% in Virginia), and <20% of those surveyed in both states described themselves as nonwhite. Thus, these programs need to improve participation by a wider spectrum of the public. We interviewed younger and underrepresented adults to examine barriers to participation in citizen science. The primary barrier was lack of time due to the need to work and focus on career advancement. Survey data revealed that participants' ecological knowledge, scientific skills, and belief in their ability to address environmental issues increased after training. Documented conservation actions taken by the participants include invasive plant management, habitat restoration, and cleanups of natural areas and streams. Long-term data from Virginia on volunteer hours dedicated to environmental citizen science show an increase from 14% in 2007 to 32% in 2014. In general, participants in the naturalist programs we examined increased their content knowledge about ecosystems, had greater confidence in conserving them, and continued to engage as citizen scientists after completing the program. © 2016 Society for Conservation Biology.
New York - New Jersey Highlands Regional Study: 2002 Update
Northeastern Area State and Private Forestry
2003-01-01
Stewardship Goals For The New York - New Jersey Highlands This 2002 Update of the 1992 New York - New Jersey Highlands Regional Study embodies the following goals for the long-term stewardship of the Highlands: 1. Manage future growth that is compatible with the region's ecological constraints; 2. Maintain an adequate surface and ground water supply that...
ER Consolidated Qtrly Rpt_April thru June 2015_October 2015
DOE Office of Scientific and Technical Information (OSTI.GOV)
Cochran, John
2015-10-01
This Sandia National Laboratories, New Mexico Environmental Restoration Operations (ER) Consolidated Quarterly Report (ER Quarterly Report) fulfills all quarterly reporting requirements set forth in the Resource Conservation and Recovery Act Facility Operating Permit, and the Compliance Order on Consent. The 13 sites in the Corrective Action process are listed in Table I-1. Because the status of any Long-Term Stewardship (LTS) activity is detailed in other reports, Section I.3.0 (titled Long-Term Stewardship Work Completed) will not be presented in future ER Quarterly Reports. Section I.3.0 of this ER Quarterly Report identifies the other reports that detail LTS activities.
Government stewardship of the for-profit private health sector in Afghanistan
Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C.; Sears, Kathleen; Sharma, Suneeta
2017-01-01
Abstract Background: Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. Aim: We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. Methods: We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. Results: The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. Conclusions: The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a more efficient and effective for-profit private sector. These successful early efforts offer high-leverage potential to rapidly scale up going forward. PMID:27683341
Government stewardship of the for-profit private health sector in Afghanistan.
Cross, Harry E; Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C; Sears, Kathleen; Sharma, Suneeta
2017-04-01
Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a more efficient and effective for-profit private sector. These successful early efforts offer high-leverage potential to rapidly scale up going forward. © VC The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
USDA-ARS?s Scientific Manuscript database
Sustainable intensification is an emerging model for agriculture designed to reconcile accelerating global demand for agricultural products with long-term environmental stewardship. Defined here as increasing agricultural production while maintaining or improving environmental quality, sustainable i...
The Role of NOAA's National Data Centers in the Earth and Space Science Infrastructure
NASA Astrophysics Data System (ADS)
Fox, C. G.
2008-12-01
NOAA's National Data Centers (NNDC) provide access to long-term archives of environmental data from NOAA and other sources. The NNDCs face significant challenges in the volume and complexity of modern data sets. Data volume challenges are being addressed using more capable data archive systems such as the Comprehensive Large Array-Data Stewardship System (CLASS). Challenges in assuring data quality and stewardship are in many ways more challenging. In the past, scientists at the Data Centers could provide reasonable stewardship of data sets in their area of expertise. As staff levels have decreased and data complexity has increased, Data Centers depend on their data providers and user communities to provide high-quality metadata, feedback on data problems and improvements. This relationship requires strong partnerships between the NNDCs and academic, commercial, and international partners, as well as advanced data management and access tools that conform to established international standards when available. The NNDCs are looking to geospatial databases, interactive mapping, web services, and other Application Program Interface approaches to help preserve NNDC data and information and to make it easily available to the scientific community.
Windows into the forest: extending long-term small-watershed research
Sally Duncan
2004-01-01
Interactions among forests, forestry, and water remain a critical aspect of Forest Service land stewardship. Small, experimental watershed studies managed by Forest Service Research and Development have a long history of advancing science and management and have resulted in a rich collection of long-term data. Early work addressed effects of forestry practices in...
The Future of the U.S. Nuclear Weapons Program
NASA Astrophysics Data System (ADS)
Brooks, Linton F.
2007-03-01
This paper will examine our plans for the future of the U.S. nuclear weapons program including efforts to ``transform'' the stockpile and supporting infrastructure. We proceed from the premise that the United States will need a safe, secure, and reliable nuclear deterrent for the foreseeable future. Moreover, the Stockpile Stewardship Program is working. Today's stockpile---comprised of legacy warheads left over from the Cold War---is safe and reliable. That said, we see increased risk, absent nuclear testing, in assuring the long-term safety and reliability of our current stockpile. Nor is today's nuclear weapons complex sufficiently ``responsive'' to fixing technical problems in the stockpile, or to potential adverse geopolitical change. Our task is to work to ensure that the U.S. nuclear weapons enterprise, including the stockpile and supporting infrastructure, meets long-term national security needs. Our approach is to develop and field replacement warheads for the legacy stockpile---so-called Reliable Replacement Warheads (RRW)---as a means to transform both the nuclear stockpile and supporting infrastructure.
Project FLOSSIE: Marine Data Stewardship at the Waterline
NASA Astrophysics Data System (ADS)
Bouchard, R. H.; Jensen, R. E.; Riley, R. E.
2016-02-01
There are more than 10 million wave records from platforms of the National Data Buoy Center (NDBC) that are archived by National Oceanic and Atmospheric Administration (NOAA). A considerable number of these were measured from the 61 NOMAD (Navy Oceanographic Meteorological Automatic Device) hulls that NDBC has used to make wave measurements since October 1979. Many of these measurements were made before the era of modern marine data stewardship. These long records lend themselves to investigations of climate trends and variability either directly by the measurements themselves, or indirectly by validating long-term numerical wave models or remote sensing applications. However studies (e.g., Gemmrich et al. 2011) indicate that discontinuities and increased variability of the measurements can arise from changing wave systems and platforms. The value of these records is undermined by the lack of understanding or documentation of technology changes - a critical component of data stewardship. To support its mission of long-term understanding of coastal waves and wave models, the U.S. Army Corps of Engineers, Coastal Hydraulics Laboratory (CHL) sponsored the FLOSSIE Project to gage the effects of technology changes on the long-term wave measurements from NOMAD hulls. On behalf of CHL, NDBC engineering and operations integrated old, new, and leading edge technologies on one NOMAD hull. The hull was successfully deployed in July 2015 at the Wave Evaluation and Testing area off of Monterey Bay, CA. The area hosts an NDBC 3-m hull with cross-generational-technologies and a reference standard in a Datawell Waverider buoy. Thus cross-generational and cross-platform inter-comparisons can be performed simultaneously to an accepted standard. The analysis goes beyond the bulk wave parameters. The analysis will examine the energy and directional distributions over the frequency range of wind-generated waves. The project is named in honor of the pioneering World War II Naval meteorologist, Commander Florence (Flossie) Van Straten (1913 - 1992), USNR, who coined the acronym for NOMAD. This paper will discuss the goals of the project, present preliminary data results and application to the long-term measurements, and outline the plans incorporating Best Practices of Marine Data Stewardship for the resulting datasets.
Daughton, Christian G
2003-01-01
Since the 1980s, the occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants, originating primarily from consumer use and actions rather than manufacturer effluents, continues to become more firmly established. The growing, worldwide importance of freshwater resources underscores the need for ensuring that any aggregate or cumulative impacts on (or from) water supplies are minimized. Despite a paucity of effects data from long-term, simultaneous exposure at low doses to multiple xenobiotics (particularly non-target-organism exposure to PPCPs), a wide range of proactive actions could be implemented for reducing or minimizing the introduction of PPCPs to the environment. Most of these actions fall under what could be envisioned as a holistic stewardship program--overseen by the health care industry and consumers alike. Significantly, such a stewardship program would benefit not just the environment--additional, collateral benefits could automatically accrue, including the lessening of medication expense for the consumer and improving patient health and consumer safety. In this article (the second of two parts describing the "green pharmacy") I focus on those actions and activities tied more closely to the end user (e.g., the patient) and issues associated with drug disposal/recycling that could prove useful in minimizing the environmental disposition of PPCPs. I also outline some recommendations and suggestions for further research and pose some considerations regarding the future. In this mini-monograph I attempt to capture cohesively for the first time the wide spectrum of actions available for minimizing the release of PPCPs to the environment. A major objective is to generate an active dialog or debate across the many disciplines that must become actively involved to design and implement a successful approach to life-cycle stewardship of PPCPs. PMID:12727607
US DOE Perspectives on Advisory Board Effectiveness - 13539
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adler, David
2013-07-01
Federal missions on the Oak Ridge Reservation began with the Manhattan Project, and continues today with major facilities supporting the Nation's Science and National Security missions. While most of the land area on the Oak Ridge Reservation is free of environmental impacts from these activities, significant legacy contamination is associated with specific facilities and past waste management areas. In 1989, the Oak Ridge Reservation (ORR) was placed on National Priorities List, and DOE established its Office of Environmental Management that same year. Three years later, in 1992, the Federal Facility Agreement for the reservation was signed. Three years afterward, themore » Oak Ridge Site Specific Advisory Board was established to augment ongoing public involvement activities related to Oak Ridge Reservation cleanup activities. One of the early and most impactful decisions the board made was to organize the End Use Working Group. This broad-based group of board members, DOE representatives, and members of the public was formed in 1997 to study future uses for contaminated areas of the reservation. The group was instrumental in building consensus in the Oak Ridge community regarding the long-term end state of reservation lands. The group's recommendations were a fundamental input into Record's of Decision subsequently developed to establish cleanup requirements across the ORR, and they continue to influence decisions being made today. In developing its recommendations on end states, the End Use Working Group came to the realization that long-term stewardship of contaminated areas of the reservation would be necessary, in some cases in perpetuity. It was from this concept that the Oak Ridge SSAB's 15-year involvement in stewardship would begin. A stewardship committee formed by the End Use Working Group wrote Volume 1 of the Stakeholder Report on Stewardship. This document-and its companion Volume 2, which was written a year later-form a crucial foundation for stewardship planning in Oak Ridge and have been referenced around the DOE complex as other sites consider stewardship planning. From these two broad-based initiatives, the board's focus has evolved to increasingly hone in on more specific, project-based recommendations and initiatives. The Oak Ridge Reservation Site Specific Advisory Board has been a highly effective forum for soliciting community input on Oak Ridge Reservation cleanup. Experience in Oak Ridge indicates that the utility of Board recommendations is far higher when the Board is asked to focus on broad programmatic issues, and less useful when the Board attempts to provide advice and recommendations on matters related to technical or project management issues. In Oak Ridge the Board has helped shape the program on many levels including definition of end-state cleanup objectives, budget development, program sequencing, waste management, and decisions concerning preservation of history related to missions implemented on the Oak Ridge Reservation. (authors)« less
77 FR 22772 - Environmental Management Site-Specific Advisory Board
Federal Register 2010, 2011, 2012, 2013, 2014
2012-04-17
... and environmental restoration; waste management and disposition; stabilization and disposition of non-stockpile nuclear materials; excess facilities; future land use and long-term stewardship; risk assessment...
75 FR 2859 - Environmental Management Site-Specific Advisory Board, Hanford
Federal Register 2010, 2011, 2012, 2013, 2014
2010-01-19
.... ADDRESSES: Red Lion Hotel, 1101 North Columbia Center Boulevard, Kennewick, WA 99336. FOR FURTHER... Committee; Public Involvement Committee; and Budgets and Contracts Committee Long-term Stewardship...
DOE Office of Scientific and Technical Information (OSTI.GOV)
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 speciesmore » and Pu associated with extracellular carrier phases and the creation of environments favorable for Pu transport retardation.« less
Development of the INEEL Site Wide Vadose Zone Roadmap
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yonk, Alan Keith
2001-09-01
The INEEL Vadose Zone Roadmap was developed to identify inadquacies in current knowledge, to assist in contaminant management capabilities relative to the INEEL vadose zone, and to ensure that ongoing and planned Science and Technology developments will meet the risk management challenges facing the INEEL in coming years. The primary objective of the Roadmap is to determine the S&T needs that will facilitate monitoring, characterization, prediction, and assessment activities necessary to support INEEL risk management decisions and to ensure that long-term stewardship of contaminated sites at the INEEL is achieved. The mission of the Roadmap is to insure that themore » long-term S&T strategy is aligned with site programs, that it takes advantage of progress made to date, and that it can assist in meeting the milestones and budgets of operations.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Moren, Richard J.; Grindstaff, Keith D.
Hanford's Long-Term Stewardship (LTS) Program has evolved from a small, informal process, with minimal support, to a robust program that provides comprehensive transitions from cleanup contractors to long-term stewardship for post-cleanup requirements specified in the associated cleanup decision documents. The LTS Program has the responsibility for almost 100,000 acres of land, along with over 200 waste sites and will soon have six cocooned reactors. Close to 2,600 documents have been identified and tagged for storage in the LTS document library. The program has successfully completed six consecutive transitions over the last two years in support of the U.S. DOE Richlandmore » Operations Office's (DOE-RL) near-term cleanup objectives of significantly reducing the footprint of active cleanup operations for the River Corridor. The program has evolved from one that was initially responsible for defining and measuring Institutional Controls for the Hanford Site, to a comprehensive, post remediation surveillance and maintenance program that begins early in the transition process. In 2013, the first reactor area -- the cocooned 105-F Reactor and its surrounding 1,100 acres, called the F Area was transitioned. In another first, the program is expected to transition the five remaining cocooned reactors into the program through using a Transition and Turnover Package (TTP). As Hanford's LTS Program moves into the next few years, it will continue to build on a collaborative approach. The program has built strong relationships between contractors, regulators, tribes and stakeholders and with the U.S. Department of Energy's Office of Legacy Management (LM). The LTS Program has been working with LM since its inception. The transition process utilized LM's Site Transition Framework as one of the initial requirement documents and the Hanford Program continues to collaborate with LM today. One example of this collaboration is the development of the LTS Program's records management system in which, LM has been instrumental. The development of a rigorous data collection and records management systems has been influenced and built off of LMs success, which also ensures compatibility between what Hanford's LTS Program develops and LM. In another example, we are exploring a pilot project to ship records from the Hanford Site directly to LM for long-term storage. This pilot would gain program efficiencies so that records would be handled only once. Rather than storage on-site, then shipment to an interim Federal Records Center in Seattle, records would be shipped directly to LM. The Hanford LTS Program is working to best align programmatic processes, find efficiencies, and to benchmark site transition requirements. Involving the Hanford LTS Program early in the transition process with an integrated contractor and DOE team is helping to ensure that there is time to work through details on the completed remediation of transitioning areas. It also will allow for record documentation and storage for the future, and is an opportunity for the program to mature through the experiences that will be gained by implementing LTS Program activities over time.« less
Evaluation of pharmacy generalists performing antimicrobial stewardship services.
Carreno, Joseph J; Kenney, Rachel M; Bloome, Mary; McDonnell, Jane; Rodriguez, Jennifer; Weinmann, Allison; Kilgore, Paul E; Davis, Susan L
2015-08-01
Improvements in medication use achieved by pharmacy generalists using a care bundle approach to antimicrobial stewardship are reported. A six-month prospective, repeated-treatment, quasi-experimental study involving three month-long intervention periods and three month-long control periods was conducted in the setting of an existing antimicrobial stewardship program at a large hospital. The intervention involved prospective audit and feedback conducted by pharmacy generalists who were trained in an antimicrobial stewardship care bundle approach. During control months, a pharmacy generalist who was not trained in antimicrobial stewardship rounded with the multidisciplinary team and provided standard-of-care pharmacy services. The primary endpoint was compliance with a care bundle of four antimicrobial stewardship metrics: documentation of indication for therapy in the medical record, selection of empirical therapy according to institutional guidelines, documented performance of indicated culture testing, and deescalation of therapy when indicated. Two-hundred eighty-six patients were enrolled in the study: 124 in the intervention group and 162 in the control group. The cumulative rate of full compliance with all care bundle components during the six-month study was significantly greater during intervention months than during control months (68.5% versus 45.7%, p < 0.001). After adjusting for infection type, antimicrobial stewardship provided by an intervention-group pharmacist was associated with improved care bundle compliance (adjusted odds ratio, 2.70; p < 0.001). No significant differences in patient outcomes during intervention and control months were detected. Pharmacy generalists trained to comply with a systematic care bundle approach enhanced the quality of antimicrobial management. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
The next generation of data capturing - digital ink for the data stewards of the future
NASA Astrophysics Data System (ADS)
Czerniak, A.; Fleischer, D.; Schirnick, C.
2012-12-01
Data stewardship of the future requires the continuation from an expert driven discipline into a general scientific routine. One solution how this expansion can be done is the use of data management infrastructures already in the student education. Unsurprisingly, well-known drawbacks in terms of data stewardship from the scientific use complicate this expansion into the educational programs. The advantage of educational programs usually based on the application of standard methods is depleted by the general data capturing process at the point of publication or end of project lifetime. Considering student courses as short projects there are no publications and the end of the course exams keep students just like scientists away from data stewardship tasks. The Kiel Data Management Infrastructure brings the data capturing right in the data creation process. With this approach student education courses can be just another use case of data capturing. Smoothing the data capturing process and making use of available technologies drove the Kiel Data Management Infrastructure into a prototype testing of the use of 'digital ink' and the later on possible handwriting recognition. Making the data digitalization as easy as possible without abandoning the standards of paper-based protocols is the use case 'Smart Pens'. This technology fills the gap between the very long-lasting paper protocols and the effort depending digitalization of field and sampling data but it's also robust enough to work with battery powered devices. The combination of the Kiel Data Management Infrastructure with the 'digital ink' technology enables the data capturing from student education to high-end scientific lab work. Valuing educational data equally to scientific lab data is a strong signal to the researchers of the future while their work is recognized all the way from their undergraduate stage to their post-doc position. Students memorize that their data work is not neglected at any time and so they realize that their is no excuse of keeping any data away from the data management infrastructure. The technology of 'digital ink' is a milestone for the data stewardship discipline and fits perfectly into the a lot of gaps between the data creation and the data infrastructure and as long as we do not establish the life long data capturing support for the scientific career we can not complain about reluctant data submissions.
Jump, Robin L. P.; Heath, Barbara; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E.; Olds, Danielle; Higgins, Patricia A.
2014-01-01
We conducted an anonymous survey of providers who care for older adults from 10 Veterans Affairs long-term care facilities to assess their knowledge, beliefs and confidence towards treating infections and antimicrobial stewardship. The average score on 5 questions assessing knowledge was 3.6/5.0 (95% CI 3.3 - 3.9), which supports a need for education regarding the care of older adults with infections. PMID:25728158
Impact of Antimicrobial Stewardship on Physician Practice in a Geriatric Facility
Kassett, Nina; Sham, Rosalind; Aleong, Rosanne; Yang, Daisy; Kirzner, Michael; Craft, Aidlee
2016-01-01
Background There is a paucity of literature describing the implementation of antimicrobial stewardship programs (ASPs) in long-term care (LTC) facilities. The current study evaluated the impact of an ASP that was implemented across a geriatric facility, which included an inpatient specialty hospital and an LTC facility. The program included prospective audits with feedback, multidisciplinary education, information technology interventions, and guideline development. Objective To investigate the impact of the ASP on physicians’ prescribing practices in this geriatric facility. Methods Utilization data for antibiotics commonly used to treat urinary tract infections were retrieved for the period September 1, 2011, to August 31, 2013. The study examined whether there were significant changes in overall antibiotic use, ciprofloxacin use, and physician prescribing behaviour after program implementation in September 2012. Results There was no significant change in the total number of antibiotic prescriptions for urinary tract infections in the hospital or the LTC facility after ASP implementation. Significant reductions were seen in the average days of therapy initially prescribed and the actual days of therapy after ASP implementation in the LTC facility but not the hospital. Across both facilities, significant reductions were seen in the number of ciprofloxacin prescriptions. Conclusions The current study showed that an ASP can affect physicians’ antibiotic prescribing behaviour and antibiotic usage in an LTC environment. PMID:28123192
Ma, Andrew; Clegg, Daniel; Fugit, Randolph V.; Pepe, Anthony; Goetz, Matthew Bidwell; Graber, Christopher J.
2015-01-01
Background: Stewardship of antimicrobial agents is an essential function of hospital pharmacies. The ideal pharmacist staffing model for antimicrobial stewardship programs is not known. Objective: To inform staffing decisions for antimicrobial stewardship teams, we aimed to compare an antimicrobial stewardship program with a dedicated Infectious Diseases (ID) pharmacist (Dedicated ID Pharmacist Hospital) to a program relying on ward pharmacists for stewardship activities (Geographic Model Hospital). Methods: We reviewed a randomly selected sample of 290 cases of inpatient parenteral antibiotic use. The electronic medical record was reviewed for compliance with indicators of appropriate antimicrobial stewardship. Results: At the hospital staffed by a dedicated ID pharmacist, 96.8% of patients received initial antimicrobial therapy that adhered to local treatment guidelines compared to 87% of patients at the hospital that assigned antimicrobial stewardship duties to ward pharmacists (P < .002). Therapy was modified within 24 hours of availability of laboratory data in 86.7% of cases at the Dedicated ID Pharmacist Hospital versus 72.6% of cases at the Geographic Model Hospital (P < .03). When a patient’s illness was determined not to be caused by a bacterial infection, antibiotics were discontinued in 78.0% of cases at the Dedicated ID Pharmacist Hospital and in 33.3% of cases at the Geographic Model Hospital (P < .0002). Conclusion: An antimicrobial stewardship program with a dedicated ID pharmacist was associated with greater adherence to recommended antimicrobial therapy practices when compared to a stewardship program that relied on ward pharmacists. PMID:26405339
Report #2005-P-00007, February 17, 2005. We asked stakeholders to define stewardship, list motivators and obstacles to participating in stewardship programs, and outline key roles for EPA to play to foster participating in environmental stewardship.
Sustainability Research Under EPA/NRMRL
Sustainability means different things to different people, but most can agree that maintaining and supporting critical ecosystems over the long term is important for environmental and human health. Achieving sustainability involves a broad view of environmental stewardship. When ...
Daughton, Christian G
2003-01-01
Since the 1980s, the occurrence of pharmaceuticals and personal care products (PPCPs) as trace environmental pollutants, originating primarily from consumer use and actions rather than manufacturer effluents, continues to become more firmly established. Although PPCPs typically have been identified in surface and ground waters, some are also undoubtedly associated with solid phases such as suspended particulates, sediments, and sewage sludges, despite their relatively high affinity for water. Often amenable to degradation, their continual introduction to waste-receiving waters results from their widespread, continuous, combined use by individuals and domestic animals, giving PPCPs a "pseudo-persistence" in the environment. Little is known about the environmental or human health hazards that might be posed by chronic, subtherapeutic levels of these bioactive substances or their transformation products. The continually growing, worldwide importance of freshwater resources, however, underscores the need for ensuring that any aggregate or cumulative impacts on (or from) water supplies are minimized. Despite the paucity of effects data from long-term, simultaneous exposure at low doses to multiple xenobiotics (particularly non-target-organism exposure to PPCPs), a wide range of proactive actions could be implemented to reduce or minimize the introduction of PPCPs to the environment. Most of these actions fall under what could be envisioned as a holistic stewardship program--overseen by the health care industry and consumers alike. Significantly, such a stewardship program would benefit not just the environment; additional, collateral benefits could automatically accrue, including reducing consumers' medication expenses and improving patient health and consumer safety. In this article, the first of a two-part mini-monograph describing the "green pharmacy," I focus initially on the background behind the imperative for an ecologically oriented stewardship program for PPCPs. I then present a broad spectrum of possible source control/reduction actions, controlled largely by the health care industry, that could minimize the disposition of PPCPs to the environment. This two-part mini-monograph attempts to capture cohesively for the first time the wide spectrum of actions available for minimizing the release of PPCPs to the environment. A major objective is to generate an active dialog or debate across the many disciplines that must become actively involved to design and implement a successful approach to life-cycle stewardship of PPCPs. PMID:12727606
NASA Astrophysics Data System (ADS)
Schloss, J. A.
2012-12-01
The New Hampshire Lakes Lay Monitoring Program was originally designed by faculty at the University of New Hampshire in 1979 to provide the capacity to better monitor for long-term lake water quality changes and trends. As participants became educated, empowered and engaged the program soon evolved to also become a participatory research enterprise. This resulted in not only providing useful information for informed local stewardship and protection at the local level but also for state and region-wide decision-making, state and federal assessments/reporting and advancing our understanding of lake and watershed science. Our successes and failures have been more dependent on understanding the particular human dimensions that influence our volunteers and less to do with the typical project management, quality assurance, and communication concerns we typically deal with in professional based research efforts. Our participants are extremely diverse in terms of their life experiences, interests and motivations so the key to long-term commitment and high quality participation is understanding the difference between a citizen monitor and your archetypical research technician or student. This presentation will highlight some important lessons learned on how to involve various types of volunteers from school groups to retirees, as well as particular approaches and concerns regarding program management, retention, quality control and communications.
K-4 Keepers Collection: A Service Learning Teacher Professional Development Program
NASA Astrophysics Data System (ADS)
Schwerin, T. G.; Blaney, L.; Myers, R. J.
2011-12-01
This poster focuses on the K-4 Keepers Collection, a service-learning program developed for the Earth System Science Education Alliance (ESSEA). ESSEA is a NOAA-, NASA- and NSF-supported program of teacher professional development that increases teachers' pedagogical content knowledge of climate-related Earth system science. The ESSEA program -- whether used in formal higher education courses or frequented by individual teachers who look for classroom activities in the environmental sciences -- provides a full suite of activities, lessons and units for teachers' use. The ESSEA network consists of 45 universities and education centers addressing climate and environment issues. K-4 Keepers Collection - ESSEA K-4 module collections focus on five specific themes of content development: spheres, Polar Regions, oceans, climate and service learning. The K-4 Keepers collection provides the opportunity for teachers to explore topics and learning projects promoting stewardship of the Earth's land, water, air and living things. Examination of the impacts of usage and pollution on water, air, land and living things through service-learning projects allows students to become informed stewards. All of the modules include short-term sample projects that either educate or initiate action involving caring for the environment. The K-4 Keepers course requires teachers to develop similar short or long-term projects for implementation in their classrooms. Objectives include: 1. Increase elementary teachers' environmental literacy addressing ocean, coastal, Great Lakes, stewardship, weather and climate science standards and using NOAA and NASA resources. 2. Develop elementary teachers' efficacy in employing service learning projects focused on conserving and preserving Earth's land, air, water and living things. 3. Prepare college faculty to incorporate service learning and environmental literacy into their courses through professional development and modules on the ESSEA website.
A Report to Congress on Long-Term Stewardship. Volume II, Site Summaries
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
2001-01-01
During World War II and the Cold War, the Federal government developed and operated a vast network of industrial facilities for the research, production, and testing of nuclear weapons, as well as for other scientific and engineering research. These processes left a legacy of radioactive and chemical waste, environmental contamination, and hazardous facilities and materials at well over a 100 sites in 30 States and one U.S. Territory. Hundreds of thousand of acres of residually contaminated soils, contaminated groundwater, surface water and sediment contamination, and contaminated buildings are present at many sites across the country. These sites range in sizemore » from less than one acre, containing only a single facility, to large sites spanning over 100,000 acres with huge uranium enrichment plants and plutonium processing canyons. Since 1989, the U.S. Department of Energy’s (DOE) Environmental Management (EM) program has made significant progress in addressing this environmental legacy. Millions of cubic meters of waste have been removed, stabilized, or disposed of, resulting in significant risk and cost reduction. In addition, DOE began disposing of transuranic (i.e., plutonium-contaminated) waste in the nation’s first deep geologic repository – the Waste Isolation Pilot Plant in New Mexico. DOE is now carrying out its long-term stewardship obligations at dozens of sites, including smaller sites where DOE has completed cleanup work for the entire site and many larger sites where DOE has remediated portions of the site.« less
The ICSU World Data System: a Global System of Data Systems, Year 4
NASA Astrophysics Data System (ADS)
Minster, J. H.; Mokrane, M.
2012-12-01
The primary goals of the ICSU World Data System (ICSU-WDS, created in October 2008), are to ensure the long-term stewardship of quality-assessed data for research and education, and the provision of such data and related data services to the international science community and other stakeholders. New technological options opened by today's management, curation and on-line distribution of multi-disciplinary digital data sets make these goals achievable. The WDS is built as an international federated system of long-term data archives and data related services covering a wide spectrum of sciences. Since our last report, an International Program Office (IPO) was inaugurated, and is hosted by NICT in Tokyo, Japan. In the past two years, 160 organizations have formally requested membership, and 44 of these applications have been fully completed among which 38 are from Regular and Network member organizations dealing directly with data curation and data analysis services. Others include Partner and Associate members. ICSU-WDS fosters and enables interdisciplinary data activities, but recognizes that many disciplines (e.g. seismology, oceanography, astronomy, space sciences, biodiversity, health and social sciences) have already developed domain-specific efficient answers to their data challenges. WDS is evolving into a system of data systems wherein integration of interdisciplinary data depends on implementation of interoperability arrangements. Although the focus of WDS is on the long-term stewardship of scientific data—so that the value of data holdings might actually increase with time—WDS members must share some overarching principles to achieve this goal. This is realized through promotion of close collaboration between members but more importantly through a formal accreditation process based on well-defined certification criteria. These include, for example, the development and adoption of standards and quality control practices, analysis and metadata services, and data publication services that can be recognized across domain boundaries. The latter requires a strong relationship with science publishers and libraries, and we will report on initial steps in that direction. Another focus point is to establish a framework and tools to help scientists develop a workable data management plan from the very inception of science projects and programs, particularly in interdisciplinary and international contexts.
"But the Pension Fund Was Just "SITTING" There...": The Politics of Teacher Retirement Plans
ERIC Educational Resources Information Center
Hess, Frederick M.; Squire, Juliet P.
2010-01-01
The tension at the heart of pension politics is the incentive to satisfy today's claimants in the here and now at the expense of long-term concerns. Teacher pensions, in particular, pose two challenges. The first is that political incentives invite irresponsible fiscal stewardship, as public officials make outsized short-term commitments to…
NIF Operations Management Plan, August 2011
DOE Office of Scientific and Technical Information (OSTI.GOV)
Van Wonterghem, Bruno M.
Lawrence Livermore National Laboratory’s (LLNL) National Ignition Facility (NIF) is a key component of the National Nuclear Security Administration’s (NNSA) Stockpile Stewardship Program, whose purpose is to maintain the safety, reliability, and effectiveness of our nation’s nuclear stockpile without underground nuclear testing. The NIF is crucial to the Stockpile Stewardship Program because it is the only facility that can create the conditions of extreme temperature and pressure—conditions that exist only in stars or in exploding nuclear weapons—that are relevant to understanding how our modern nuclear weapons operate. As such, the NIF’s primary mission is to attain fusion ignition in themore » laboratory. Fusion ignition not only supports Stockpile Stewardship needs, but also provides the basis for future decisions about fusion’s potential as a long-term energy source. Additionally, NIF provides scientists with access to high-energy-density regimes that can yield new insight and understanding in the areas of astrophysics, hydrodynamics, material properties, plasma physics, and radiative properties. The use of the NIF to support the Stockpile Stewardship Program and the advancement of basic high-energy-density science understanding is planned and managed through program-level execution plans and NIF directorate-level management teams. An example of a plan is the National Ignition Campaign Execution Plan. The NIF Operations Management Plan provides an overview of the NIF Operations organization and describes how the NIF is supported by the LLNL infrastructure and how it is safely and responsibly managed and operated. Detailed information on NIF management of the organization is found in a series of supporting plans, policies, and procedures. A list of related acronyms can be found in Appendix A of this document. The purpose of this document is to provide a roadmap of how the NIF Operations organization functions. It provides a guide to understanding the requirements, document flow down, organizational vision and mission, performance metrics, and interrelationship of the NIF Operations organization with other directorate and laboratory organizations. This document also provides a listing of roles and responsibilities, core processes, procedures, authority matrices, change control boards, and other information necessary for successfully functioning in the NIF Operations organization. This document, the NIF Shot Operations Plan, and the NIF Maintenance Plan together represent the primary documents satisfying our Conduct of Operations compliance requirement.« less
This cost calculator is designed as a guide for municipal or local governments to assist in calculating their expected costs of implementing and conducting long-term stewardship of institutional controls and engineering controls at brownfield properties.
77 FR 11516 - Environmental Management Site-Specific Advisory Board, Paducah
Federal Register 2010, 2011, 2012, 2013, 2014
2012-02-27
... materials; excess facilities; future land use and long-term stewardship; risk assessment and management; and... DEPARTMENT OF ENERGY Environmental Management Site-Specific Advisory Board, Paducah AGENCY... Environmental Management Site-Specific Advisory Board (EM SSAB), Paducah. The Federal Advisory Committee Act...
Enabling Long-Term Earth Science Research: Changing Data Practices (Invited)
NASA Astrophysics Data System (ADS)
Baker, K. S.
2013-12-01
Data stewardship plans are shaped by our shared experiences. As a result, community engagement and collaborative activities are central to the stewardship of data. Since modes and mechanisms of engagement have changed, we benefit from asking anew: ';Who are the communities?' and ';What are the lessons learned?'. Data stewardship with its long-term care perspective, is enriched by reflection on community experience. This presentation draws on data management issues and strategies originating from within long-term research communities as well as on recent studies informed by library and information science. Ethnographic case studies that capture project activities and histories are presented as resources for comparative analysis. Agency requirements and funding opportunities are stimulating collaborative endeavors focused on data re-use and archiving. Research groups including earth scientists, information professionals, and data systems designers are recognizing the possibilities for new ways of thinking about data in the digital arena. Together, these groups are re-conceptualizing and reconfiguring for data management and data curation. A differentiation between managing data for local use and production of data for re-use remotely in locations and fields remote from the data origin is just one example of the concepts emerging to facilitate development of data management. While earth scientists as data generators have the responsibility to plan new workflows and documentation practices, data and information specialists have responsibility to promote best practices as well as to facilitate the development of community resources such as controlled vocabularies and data dictionaries. With data-centric activities and changing data practices, the potential for creating dynamic community information environments in conjunction with development of data facilities exists but remains elusive.
Scientific evidence and research in antimicrobial stewardship.
Almirante, Benito; Garnacho-Montero, José; Pachón, Jerónimo; Pascual, Álvaro; Rodríguez-Baño, Jesús
2013-09-01
Evaluating the impact of antibiotic stewardship programs is challenging. There is evidence that they are effective in terms of reducing the consumption and cost of antibiotics, although establishing their impact on antimicrobial resistance (beyond restrictive policies in outbreaks caused by specific antimicrobial resistant organisms) and clinical outcomes is more difficult. Proper definitions of exposure and outcome variables, the use of advanced and appropriate statistical analyses and well-designed quasi-experimental studies would more accurately support the conclusions. Cluster randomized trials should be used whenever possible and appropriate, although the limitations of this approach should also be acknowledged. These issues are reviewed in this paper. We conclude that there are good research opportunities in the field of antibiotic stewardship. Copyright © 2013 Elsevier España, S.L. All rights reserved.
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,…
Integrating GIS, Archeology, and the Internet.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sera White; Brenda Ringe Pace; Randy Lee
2004-08-01
At the Idaho National Engineering and Environmental Laboratory's (INEEL) Cultural Resource Management Office, a newly developed Data Management Tool (DMT) is improving management and long-term stewardship of cultural resources. The fully integrated system links an archaeological database, a historical database, and a research database to spatial data through a customized user interface using ArcIMS and Active Server Pages. Components of the new DMT are tailored specifically to the INEEL and include automated data entry forms for historic and prehistoric archaeological sites, specialized queries and reports that address both yearly and project-specific documentation requirements, and unique field recording forms. The predictivemore » modeling component increases the DMT’s value for land use planning and long-term stewardship. The DMT enhances the efficiency of archive searches, improving customer service, oversight, and management of the large INEEL cultural resource inventory. In the future, the DMT will facilitate data sharing with regulatory agencies, tribal organizations, and the general public.« less
NASA Astrophysics Data System (ADS)
Fowler, D. K.; Moses, J. F.; Duerr, R. E.; Webster, D.; Korn, D.
2010-12-01
Data Stewardship is becoming a principal part of a data manager’s work at NSIDC. It is vitally important that our organization makes a commitment to both current and long-term goals of data management and the preservation of our scientific data. Data must be available to researchers not only during active missions, but long after missions end. This includes maintaining accurate documentation, data tools, and a knowledgeable user support staff. NSIDC is preparing for long-term support of the ICESat mission data. Though ICESat has seen its last operational day, the data is still being improved and NSIDC is scheduled to archive the final release, Release 33, starting late in 2010. This release will include the final adjustments to the processing algorithms and will produce the best possible products to date. Along with the higher-level data sets, all supporting documentation will be archived at NSIDC. For the long-term archive, it is imperative that there is sufficient information about how products were prepared in order to convince future researchers that the scientific results are reproducible. The processing algorithms along with the Level 0 and ancillary products used to create the higher-level products will be archived and made available to users. This can enable users to examine production history, to derive revised products and to create their own products. Also contained in the long-term archive will be pre-launch, calibration/validation, and test data. These data are an important part of the provenance which must be preserved. For longevity, we’ll need to archive the data and documentation in formats that will be supported in the years to come.
Cookson, B; Mackenzie, D; Kafatos, G; Jans, B; Latour, K; Moro, M L; Ricchizzi, E; Van de Mortel, M; Suetens, C; Fabry, J
2013-09-01
Healthcare-associated infections in long-term care facilities (LTCFs) are of increasing importance. To develop consensus national performance indicators (NPIs) for infection control (ICPI) and antimicrobial stewardship (ASPI) in LTCFs, and assess the performance of 32 European countries against these NPIs. Previously established European standards were the basis for consensus and the same iterative approach with national representatives from the 32 countries. A World Health Organization scoring system recorded how close each country was to implementing each standard. The 42 agreed component indicators were grouped into six NPI categories: 'national programme', 'guidelines', 'expert advice', 'IC structure' (not present in the ASPI), 'surveillance' and 'composite'. 'Guidelines' scored the highest mean total possible score (60%, range 20-100%), followed by 'composite' (53%, range 30-100%), 'expert advice' (48%, range 20-100%), 'surveillance' (47%, range 20-83%), 'national programme' (42%, range 20-100%) and 'IC structure' (39%, range 20-100%). Although several scores were low, some countries were able to implement all NPIs, indicating that this was feasible. Most NPIs were very significantly related, indicating that they were considered to be important by the countries. 'Guidelines' and 'IC structure' were significantly related to European region (P ≤ 0.05). Accreditation/inspection was not evident in seven (22%) countries, nine (28%) countries had accreditation/inspection that included IC assessments, and seven (22%) countries had accreditation/inspection that included IC and antimicrobial stewardship assessments. Multi-variable analysis found that only the NPI and the ICPI 'expert advice' were associated with accreditation/inspection which included IC and antimicrobial stewardship. The identified gaps represent significant potential patient safety issues. The NPIs should serve as a basis for monitoring improvements over the coming years. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
Portsmouth annual environmental report for 2003, Piketon, Ohio
DOE Office of Scientific and Technical Information (OSTI.GOV)
none, none
2004-11-30
The Portsmouth & Gaseous Diffusion Plant (PORTS) is located on a 5.8-square-mile site in a rural area of Pike County, Ohio. U.S. Department of Energy (DOE) activities at PORTS include environmental restoration, waste 'management, and long-term'stewardship of nonleased facilities: Production facilities for the separation of uranium isotopes are leased to the United States Enrichment Corporation (USEC), but most activities associated with the uranium enrichment process ceased in 2001. USEC activities are not covered by this document, with the exception of some environmental compliance information provided in Chap. 2 and radiological and non-radiological environmental monitoring program information discussed in Chaps. 4more » and 5.« less
Comparative Analysis of Sustainable Approaches and Systems for Scientific Data Stewardship
NASA Astrophysics Data System (ADS)
Downs, R. R.; Chen, R. S.
2012-12-01
Sustainable data systems are critical components of the cyberinfrastructure needed to provide long-term stewardship of scientific data, including Earth science data, throughout their entire life cycle. A variety of approaches may help ensure the sustainability of such systems, but these approaches must be able to survive the demands of competing priorities and decreasing budgets. Analyzing and comparing alternative approaches can identify viable aspects of each approach and inform decisions for developing, managing, and supporting the cyberinfrastructure needed to facilitate discovery, access, and analysis of data by future communities of users. A typology of sustainability approaches is proposed, and example use cases are offered for comparing the approaches over time. These examples demonstrate the potential strengths and weaknesses of each approach under various conditions and with regard to different objectives, e.g., open vs. limited access. By applying the results of these analyses to their particular circumstances, systems stakeholders can assess their options for a sustainable systems approach along with other metrics and identify alternative strategies to ensure the sustainability of the scientific data and information for which they are responsible. In addition, comparing sustainability approaches should inform the design of new systems and the improvement of existing systems to meet the needs for long-term stewardship of scientific data, and support education and workforce development efforts needed to ensure that the appropriate scientific and technical skills are available to operate and further develop sustainable cyberinfrastructure.
Robin E. Hoffman; Mark J. Twery; Laura M. Alban; Ralph D. Nyland
1999-01-01
Establishing long-term plans for your forested property is a positive first step toward good forest stewardship. An appropriate management plan considers your needs and desires and helps you achieve them.Conversations with forest landowners have revealed some interesting stories about their likes and dislikes in the forest. Seeing big, healthy trees,...
Nori, Priya; Madaline, Theresa; Munjal, Iona; Bhar, Shubha; Guo, Yi; Seo, Susan K; Porrovecchio, Andrea; Gancher, Elizabeth; Nosanchuk, Joshua; Pirofski, Liise-Anne; Ostrowsky, Belinda
2017-01-01
To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations. Interventions were implemented in 2012-2016 using a quasi-experimental before-and-after study design, and this was assessed using pre- and postintervention surveys or audit of antibiotic prescriptions. Over 180 medical students participated in the AS and IPC seminars. After smartphone app introduction, 69% reported using the app as their preferred source of antibiotic information. Approximately 70% of students felt comfortable prescribing antibiotics for a known infection compared with 40% at baseline ( P = .02), and approximately 83% were able to identify the appropriate personal protective equipment for specific scenarios. Approximately 99% agreed that they have a role in promoting patient safety and preventing healthcare-associated infections as medical students. At 20 months, appropriateness of trainee antibiotic prescriptions increased by 20% ( P < .01). Almost all ID fellows indicated that the AS and IPC seminar was a vital training supplement. Uptake of internist antibiotic recommendations using AS decision support tools was approximately 70%. All 5 interventions addressed learning objectives and knowledge gaps and are applicable across a range of environments. Evaluating long-term impact of our curriculum is the focus of future study.
Antimicrobial Stewardship: How the Microbiology Laboratory Can Right the Ship
Schwartz, David N.; Weinstein, Robert A.
2016-01-01
SUMMARY Antimicrobial stewardship is a bundle of integrated interventions employed to optimize the use of antimicrobials in health care settings. While infectious-disease-trained physicians, with clinical pharmacists, are considered the main leaders of antimicrobial stewardship programs, clinical microbiologists can play a key role in these programs. This review is intended to provide a comprehensive discussion of the different components of antimicrobial stewardship in which microbiology laboratories and clinical microbiologists can make significant contributions, including cumulative antimicrobial susceptibility reports, enhanced culture and susceptibility reports, guidance in the preanalytic phase, rapid diagnostic test availability, provider education, and alert and surveillance systems. In reviewing this material, we emphasize how the rapid, and especially the recent, evolution of clinical microbiology has reinforced the importance of clinical microbiologists' collaboration with antimicrobial stewardship programs. PMID:27974411
Advancing antimicrobial stewardship: Summary of the 2015 CIDSC Report.
Khan, F; Arthur, J; Maidment, L; Blue, D
2016-11-03
Antimicrobial resistance (AMR) is recognized as an important global public health concern that has a cross-cutting impact on human health, animal health, food and agriculture and the environment. The Communicable and Infectious Disease Steering Committee (CIDSC) of the Pan-Canadian Public Health Network (PHN) created a Task Group on Antimicrobial Stewardship to look at this issue from a Canadian perspective. To summarize the key findings of the Task Group Report that identified core components of antimicrobial stewardship programs, best practices, key challenges, gaps and recommendations to advance stewardship across jurisdictions. Search strategies were developed to identify scientific literature, grey literature and relevant websites on antimicrobial stewardship. The information was reviewed and based on this evidence, expert opinion and consensus-building, the Task Group identified core components, best practices, key challenges and gaps and developed recommendations to advance stewardship in Canada. The four components of a promising antimicrobial stewardship initiative were: leadership, interventions, monitoring/evaluation and future research. Best practices include a multi-sectoral/multipronged approach involving a wide range of stakeholders at the national, provincial/territorial, local and health care organizational levels. Key challenges and gaps identified were: the success and sustainability of stewardship undertakings require appropriate and sustained resourcing and expertise; there is limited evidence about how to effectively implement treatment guidance; and there is a challenge in ensuring accessibility, standardization and consistency of use among professionals. : Recommendations to the CIDSC about how to advance stewardship across jurisdictions included the following: institute a national infrastructure; develop best practices to implement stewardship programs; develop education and promote awareness; establish consistent evidence-based guidance, resources, tools and training; mandate the incorporation of stewardship education; develop audit and feedback tools; establish benchmarks and performance targets for stewardship; and conduct timely evaluation of stewardship programs. Findings of this report will inform a more systematic approach to addressing antimicrobial stewardship Canada-wide.
A cost-effectiveness analysis of two different antimicrobial stewardship programs.
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. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.
Pesticide Environmental Stewardship Program Member Handbook
This Pesticide Environmental Stewardship Program (PESP) handbook is a resource with information to help prospective members to learn about PESP, to understand how the program works, and to assist in applying for membership.
How can Multi-Professional Education Support Better Stewardship?
Pereira, Nuno Rocha; Castro-Sanchez, Enrique; Nathwani, Dilip
2017-01-01
Antimicrobial stewardship is widely accepted as an efficient strategy to combat the growing threat of antimicrobial resistance. Education is one of the cornerstones of successful antimicrobial stewardship programs. There is also general agreement that antimicrobial stewardship is a team effort that must involve the whole continuum of healthcare workers. Providing adequate education for all different professionals although challenging is deemed crucial to achieve good results. This paper reviews the different strategies available to educate the multiple healthcare workers, discusses how education can improve antimicrobial stewardship programs and outlines some of the challenges faced and research gaps that need to be addressed in order to improve education in this field. PMID:28458801
Falcione, Bonnie A; Meyer, Susan M
2014-10-15
To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs.
7 CFR 1469.23 - Program payments.
Code of Federal Regulations, 2013 CFR
2013-01-01
... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM Contracts and Payments § 1469.23 Program payments. (a) Stewardship component of CSP payments. (1) The conservation stewardship plan... Agriculture Statistics Service (NASS) land rental data, and Conservation Reserve Program (CRP) rental rates...
Antimicrobial Stewardship: How the Microbiology Laboratory Can Right the Ship.
Morency-Potvin, Philippe; Schwartz, David N; Weinstein, Robert A
2017-01-01
Antimicrobial stewardship is a bundle of integrated interventions employed to optimize the use of antimicrobials in health care settings. While infectious-disease-trained physicians, with clinical pharmacists, are considered the main leaders of antimicrobial stewardship programs, clinical microbiologists can play a key role in these programs. This review is intended to provide a comprehensive discussion of the different components of antimicrobial stewardship in which microbiology laboratories and clinical microbiologists can make significant contributions, including cumulative antimicrobial susceptibility reports, enhanced culture and susceptibility reports, guidance in the preanalytic phase, rapid diagnostic test availability, provider education, and alert and surveillance systems. In reviewing this material, we emphasize how the rapid, and especially the recent, evolution of clinical microbiology has reinforced the importance of clinical microbiologists' collaboration with antimicrobial stewardship programs. Copyright © 2016 American Society for Microbiology.
2015 Stewardship Science Academic Programs Annual
DOE Office of Scientific and Technical Information (OSTI.GOV)
Stone, Terri; Mischo, Millicent
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 tomore » 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.« less
Michael J. Dockry; Serra J. Hoagland
2017-01-01
Native American forests and tribal forest management practices have sustained indigenous communities, economies, and resources for millennia. These systems provide a wealth of knowledge and successful applications of long-term environmental stewardship and integrated, sustainable forest management. Tribal forestry has received an increasing amount of attention from...
Meyer, Susan M.
2014-01-01
Objective. To design an elective for pharmacy students that facilitates antimicrobial stewardship awareness, knowledge, and skill development by solving clinical cases, using human patient simulation technology. Design. The elective was designed for PharmD students to describe principles and functions of stewardship programs, select, evaluate, refine, or redesign patient-specific plans for infectious diseases in the context of antimicrobial stewardship, and propose criteria and stewardship management strategies for an antimicrobial class at a health care institution. Teaching methods included active learning and lectures. Cases of bacterial endocarditis and cryptococcal meningitis were developed that incorporated human patient simulation technology. Assessment. Forty-five pharmacy students completed an antimicrobial stewardship elective between 2010 and 2013. Outcomes were assessed using student perceptions of and performance on rubric-graded assignments. Conclusion. A PharmD elective using active learning, including novel cases conducted with human patient simulation technology, enabled outcomes consistent with those desired of pharmacists assisting in antimicrobial stewardship programs. PMID:25386016
NASA Astrophysics Data System (ADS)
Casey, K. S.; Hausman, S. A.
2016-02-01
In the last year, the NOAA National Oceanographic Data Center (NODC) and its siblings, the National Climatic Data Center and National Geophysical Data Center, were merged into one organization, the NOAA National Centers for Environmental Information (NCEI). Combining its expertise under one management has helped NCEI accelerate its efforts to embrace and integrate private, public, and hybrid cloud environments into its range of data stewardship services. These services span a range of tiers, from basic, long-term preservation and access, through enhanced access and scientific quality control, to authoritative product development and international-level services. Throughout these tiers of stewardship, partnerships and pilot projects have been launched to identify technological and policy-oriented challenges, to establish solutions to these problems, and to highlight success stories for emulation during operational integration of the cloud into NCEI's data stewardship activities. Some of these pilot activities including data storage, access, and reprocessing in Amazon Web Services, the OneStop data discovery and access framework project, and a set of Cooperative Research and Development Agreements under the Big Data Project with Amazon, Google, IBM, Microsoft, and the Open Cloud Consortium. Progress in these efforts will be highlighted along with a future vision of how NCEI could leverage hybrid cloud deployments and federated systems across NOAA to enable effective data stewardship for its oceanographic, atmospheric, climatic, and geophysical Big Data.
Jacob C. Sheppard; Clare M. Ryan; Dale J. Blahna
2017-01-01
The ecological outcomes of civic environmental stewardship are poorly understood, especially at scales larger than individual sites. In this study we characterized civic environmental stewardship programs in the Green-Duwamish watershed in King County, WA, and evaluated the extent to which stewardship outcomes were monitored. We developed a four-step process based on...
Influence of financial incentive programs in sustaining wildlife values
Thomas J. Straka; Michael A. Kilgore; Michael G. Jacobson; John L. Greene; Steven E. Daniels
2007-01-01
Conservation incentive programs have substantial impacts on the nationâs forests and wildlife habitat. There are eight major conservation incentive programs. The Forest Stewardship Program (FSP) provides forest landowner assistance by focusing on resource management plans embodying multi-resource stewardship principles. The Forest Land Enhancement Program (FLEP) is the...
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…
Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward.
Skelton, Felicia; Suda, Katie; Evans, Charlesnika; Trautner, Barbara
2018-01-11
Context Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.
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…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Spencer, Charles G
2012-12-01
The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the U.S. Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) vision for a commitment to energy effi ciency and sustainability and to achievement of the Guiding Principles. Specifi cally, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan, while promoting overall sustainability and reduction of greenhouse gas emissions. The mission of the Y-12 Energy Management program is to incorporate energy-effi cient technologies site-wide and to position Y-12 tomore » meet NNSA energy requirement needs through 2025 and beyond. The plan addresses greenhouse gases, buildings, fleet management, water use, pollution prevention, waste reduction, sustainable acquisition, electronic stewardship and data centers, site innovation and government-wide support.« less
Antimicrobial Stewardship and Urinary Tract Infections
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
Madaline, Theresa; Munjal, Iona; Bhar, Shubha; Guo, Yi; Seo, Susan K.; Porrovecchio, Andrea; Gancher, Elizabeth; Nosanchuk, Joshua; Pirofski, Liise-anne; Ostrowsky, Belinda
2017-01-01
Abstract Background. To impart principles of antimicrobial stewardship (AS) and infection prevention and control (IPC), we developed a curriculum tailored to the diverse aptitudes of learners at our medical center. Methods. We integrated case-based modules, group learning activities, smartphone applications (apps), decision support tools, and prescription audit and feedback into curricula of the medical school, medicine residency program, infectious diseases (ID) fellowship program, and hospital medicine program operations. Interventions were implemented in 2012–2016 using a quasi-experimental before-and-after study design, and this was assessed using pre- and postintervention surveys or audit of antibiotic prescriptions. Results. Over 180 medical students participated in the AS and IPC seminars. After smartphone app introduction, 69% reported using the app as their preferred source of antibiotic information. Approximately 70% of students felt comfortable prescribing antibiotics for a known infection compared with 40% at baseline (P = .02), and approximately 83% were able to identify the appropriate personal protective equipment for specific scenarios. Approximately 99% agreed that they have a role in promoting patient safety and preventing healthcare-associated infections as medical students. At 20 months, appropriateness of trainee antibiotic prescriptions increased by 20% (P < .01). Almost all ID fellows indicated that the AS and IPC seminar was a vital training supplement. Uptake of internist antibiotic recommendations using AS decision support tools was approximately 70%. Conclusions. All 5 interventions addressed learning objectives and knowledge gaps and are applicable across a range of environments. Evaluating long-term impact of our curriculum is the focus of future study. PMID:28748196
Impact of Environmental Education on the Knowledge and Attitude of Students towards the Environment
ERIC Educational Resources Information Center
Erhabor, Norris I.; Don, Juliet U.
2016-01-01
Environmentally aware and empowered youths are potentially the greatest agent of change for the long term protection and stewardship of the environment. Thus environmental education which promotes such change will enable these youths to have a greater voice on environmental issue if effectively implemented in Nigeria. Hence, this study was…
The Nature Conservancy's Student Stewardship Program, Student Workbook.
ERIC Educational Resources Information Center
Roberts, Mary, Ed.
Five schools in northeastern Ohio were chosen to participate in this environmental education project. Students were assigned a natural area in their community to study in detail. This workbook is designed for recording data collected during the year long project. The topics to be studied are organized according to the month that they will be done,…
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. Copyright © 2016 Elsevier Inc. All rights reserved.
Antimicrobial stewardship programs: interventions and associated outcomes.
Patel, Dimple; Lawson, Wendy; Guglielmo, B Joseph
2008-04-01
Guidelines regarding antimicrobial stewardship programs recommend an infectious diseases-trained physician and an infectious diseases-trained pharmacist as core members. Inclusion of clinical microbiologists, infection-control practitioners, information systems experts and hospital epidemiologists is considered optimal. Recommended stewardship interventions include prospective audit and intervention, formulary restriction, education, guideline development, clinical pathway development, antimicrobial order forms and the de-escalation of therapy. The primary outcome associated with these interventions has been the associated cost savings; however, few published investigations have taken into account the overall cost of the intervention. Over the past 5 years, there has been an increased focus upon interventions intended to decrease bacterial resistance or reduce superinfection, including infections associated with Clostridium difficile colitis. Few programs have been associated with a reduction in antimicrobial drug adverse events. Antimicrobial stewardship programs are becoming increasingly associated with clear benefits and will be integral in the in-patient healthcare setting.
Kelly, Allison A; Jones, Makoto M; Echevarria, Kelly L; Kralovic, Stephen M; Samore, Matthew H; Goetz, Matthew B; Madaras-Kelly, Karl J; Simbartl, Loretta A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A
2017-05-01
OBJECTIVE To detail the activities of the Veterans Health Administration (VHA) Antimicrobial Stewardship Initiative and evaluate outcomes of the program. DESIGN Observational analysis. SETTING The VHA is a large integrated healthcare system serving approximately 6 million individuals annually at more than 140 medical facilities. METHODS Utilization of nationally developed resources, proportional distribution of antibiotics, changes in stewardship practices and patient safety measures were reported. In addition, inpatient antimicrobial use was evaluated before and after implementation of national stewardship activities. RESULTS Nationally developed stewardship resources were well utilized, and many stewardship practices significantly increased, including development of written stewardship policies at 92% of facilities by 2015 (P<.05). While the proportional distribution of antibiotics did not change, inpatient antibiotic use significantly decreased after VHA Antimicrobial Stewardship Initiative activities began (P<.0001). A 12% decrease in antibiotic use was noted overall. The VHA has also noted significantly declining use of antimicrobials prescribed for resistant Gram-negative organisms, including carbapenems, as well as declining hospital readmission and mortality rates. Concurrently, the VHA reported decreasing rates of Clostridium difficile infection. CONCLUSIONS The VHA National Antimicrobial Stewardship Initiative includes continuing education, disease-specific guidelines, and development of example policies in addition to other highly utilized resources. While no specific ideal level of antimicrobial utilization has been established, the VHA has shown that improving antimicrobial usage in a large healthcare system may be achieved through national guidance and resources with local implementation of antimicrobial stewardship programs. Infect Control Hosp Epidemiol 2017;38:513-520.
Stockpile Stewardship's 20th Anniversary
Hecker, Siegfried; Gottemoeller, Rose; Reis, Victor H.; McMillan, Charles; Rohlfing, Joan; Hurricane, Omar; Hagengruber, Roger; Taylor, John
2018-06-22
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.
Antimicrobial Stewardship: The Need to Cover All Bases
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. PMID:27029310
4th Annual DOE-ERSP PI Meeting: Abstracts
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hazen, Terry C.
2009-03-01
This contains abstracts from the 2009 Annual Environmental Remediation Sciences Program (ERSP) Principal Investigators (PI) Meeting. The ERSP seeks to advance fundamental science to understand, predict, and mitigate the impacts of environmental contamination from past nuclear weapons production and provide a scientific basis for the long-term stewardship of nuclear waste disposal. These ambitious goals cannot be achieved by any one project alone. Therefore, ERSP funds a combination of research programs at the DOE national laboratories, individual projects at universities and federal agencies, and large long(er)-term field site research. Integration of these activities to advance the ERSP goals is a constantmore » challenge, but made significantly simpler by bringing together all funded ERSP researchers once a year to discuss the very latest research results. It is at these meetings where new ideas and/or scientific advancements in support of ERSP goals can be discussed and openly debated among all PIs in the program. The ERSP thrives, in part, on the new ideas, concepts, scientific connections, and collaborations generated as a result of these meetings. The annual PI Meeting is very much a working meeting with three major goals: (1) to provide opportunities for scientific interaction among the ERSP scientists, a critical element for the program; (2) to provide the ERSP program staff with an opportunity to evaluate the progress of each program and project; and (3) to showcase the ERSP to interested parties within DOE and within other federal agencies In addition to program managers from within OBER, there will be representatives from other offices within DOE and other federal agencies in attandance at the meeting.« less
McPherson, Christopher; Lee, Brian R.; Terrill, Cindy; Hersh, Adam L.; Gerber, Jeffrey S.; Kronman, Matthew P.; Newland, Jason G.
2018-01-01
In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention’s (CDC) seven core elements of a successful ASP within a large subset of US Children’s Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a dedicated ASP pharmacist or drug expert (88%) were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources. PMID:29370071
McPherson, Christopher; Lee, Brian R; Terrill, Cindy; Hersh, Adam L; Gerber, Jeffrey S; Kronman, Matthew P; Newland, Jason G
2018-01-25
In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention's (CDC) seven core elements of a successful ASP within a large subset of US Children's Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a dedicated ASP pharmacist or drug expert (88%) were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.
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…
What is urban environmental stewardship? Constructing a practitioner-derived framework
M. Romolini; W. Brinkley; K.L. Wolf
2012-01-01
Agencies and organizations deploy various strategies in response to environmental challenges, including the formulation of policy, programs, and regulations. Citizen-based environmental stewardship is increasingly seen as an innovative and important approach to improving and conserving landscape health. A new research focus on the stewardship of urban natural resources...
Branching Out: The North Carolina Forest Stewardship Activity Guide.
ERIC Educational Resources Information Center
Chesson, Gail
Stewardship is the responsibility of individuals to maintain and improve their natural resources and surroundings. The Forest Stewardship Program (FSP) in North Carolina aims at enhancing the management of all forest resources on private lands. This activity guide is designed to help youth appreciate and understand forests and natural…
Stockpile Stewardship: Los Alamos
McMillan, Charlie; Morgan, Nathanial; Goorley, Tom; Merrill, Frank; Funk, Dave; Korzekwa, Deniece; Laintz, Ken
2018-01-16
"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.
PFOA Stewardship Program Baseline Year Summary Report
In 2006, EPA and the eight major companies in the industry launched the 2010/15 PFOA Stewardship Program, in which companies committed to reduce global facility emissions and product content of PFOA and related chemicals by 95 percent by 2010, and to work
Pollack, Loria A; Srinivasan, Arjun
2014-10-15
The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Engaging Pharmacy Students, Residents, and Fellows in Antimicrobial Stewardship.
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. © The Author(s) 2013.
Chung, Gladys W.; Wu, Jia En; Yeo, Chay Leng; Chan, Douglas; Hsu, Li Yang
2013-01-01
Antimicrobial stewardship is an emerging field currently defined by a series of strategies and interventions aimed toward improving appropriate prescription of antibiotics in humans in all healthcare settings. The ultimate goal is the preservation of current and future antibiotics against the threat of antimicrobial resistance, although improving patient safety and reducing healthcare costs are important concurrent aims. Prospective audit and feedback interventions are probably the most widely practiced of all antimicrobial stewardship strategies. Although labor-intensive, they are more easily accepted by physicians compared with formulary restriction and preauthorization strategies and have a higher potential for educational opportunities. Objective evaluation of antimicrobial stewardship is critical for determining the success of such programs. Nonetheless, there is controversy over which outcomes to measure and there is a pressing need for novel study designs that can objectively assess antimicrobial stewardship interventions despite the limitations inherent in the structure of most such programs. PMID:23302793
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.
Li, Zhongwang; Cheng, Baoli; Zhang, Kai; Xie, Guohao; Wang, Yan; Hou, Jinchao; Chu, Lihua; Zhao, Jialian; Xu, Zhijun; Lu, Zhongqiu; Sun, Huaqin; Zhang, Jian; Wang, Zhiyi; Wu, Haiya; Fang, Xiangming
2017-09-01
Antimicrobial stewardship programs, particularly pharmacist-driven programs, help reduce the unnecessary use of antimicrobial agents. The objective of this study was to assess the influence of pharmacist-driven antimicrobial stewardship on antimicrobial use, multidrug resistance, and patient outcomes in adult intensive care units in China. We conducted a multicenter prospective cohort study with a sample of 577 patients. A total of 353 patients were included under a pharmacist-driven antimicrobial stewardship program, whereas the remaining 224 patients served as controls. The primary outcome was all-cause hospital mortality. The pharmacist-driven antimicrobial stewardship program had a lower hospital mortality rate compared with the nonpharmacist program (19.3% vs 29.0%; P = .007). Furthermore, logistic regression analysis indicated that the pharmacist-driven program independently predicted hospital mortality (odds ratio, 0.57; 95% confidence interval, 0.36-0.91; P = .017) after adjustment. Meanwhile, this strategy had a lower rate of multidrug resistance (23.8% vs 31.7%; P = .037). Moreover, the strategy optimized antimicrobial use, such as having a shorter duration of empirical antimicrobial therapy (2.7 days; interquartile range [IQR], 1.7-4.6 vs 3.0; IQR, 1.9-6.2; P = .002) and accumulated duration of antimicrobial treatment (4.0; IQR, 2.0-7.0 vs 5.0; IQR, 3.0-9.5; P = .030). Pharmacist-driven antimicrobial stewardship in an intensive care unit decreased patient mortality and the emergence of multidrug resistance, and optimized antimicrobial agent use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Doernberg, Sarah B; Dudas, Victoria; Trivedi, Kavita K
2015-01-01
Asymptomatic bacteriuria in the elderly commonly results in antibiotic administration and, in turn, contributes to antimicrobial resistance, adverse drug events, and increased costs. This is a major problem in the long-term care facility (LTCF) setting, where residents frequently transition to and from the acute-care setting, often transporting drug-resistant organisms across the continuum of care. The goal of this study was to assess the feasibility and efficacy of antimicrobial stewardship programs (ASPs) targeting urinary tract infections (UTIs) at community LTCFs. This was a quasi-experimental study targeting antibiotic prescriptions for UTI using time-series analysis with 6-month retrospective pre-intervention and 6-month intervention period at three community LTCFs. The ASP team (infectious diseases (ID) pharmacist and ID physician) performed weekly prospective audit and feedback of consecutive prescriptions for UTI. Loeb clinical consensus criteria were used to assess appropriateness of antibiotics; recommendations were communicated to the primary treating provider by the ID pharmacist. Resident outcomes were recorded at subsequent visits. Generalized estimating equations using segmented regression were used to evaluate the impact of the ASP intervention on rates of antibiotic prescribing and antibiotic resistance. One-hundred and four antibiotic prescriptions for UTI were evaluated during the intervention, and recommendations were made for change in therapy in 40 (38 %), out of which 10 (25 %) were implemented. Only eight (8 %) residents started on antibiotics for UTI met clinical criteria for antibiotic initiation. An immediate 26 % decrease in antibiotic prescriptions for UTI during the ASP was identified with a 6 % reduction continuing through the intervention period (95 % Confidence Interval ([CI)] for the difference: -8 to -3 %). Similarly, a 25 % immediate decrease in all antibiotic prescriptions was noted after introduction of the ASP with a 5 % reduction continuing throughout the intervention period (95 % CI: -8 to -2 %). No significant effect was noted on resistant organisms or Clostridium difficile. Weekly prospective audit and feedback ASP in three community LTCFs over 6 months resulted in antibiotic utilization decreases but many lost opportunities for intervention.
2010/2015 PFOA Stewardship Program - 2014 Annual Progress Reports
In 2006, EPA and the eight major companies in the industry launched the 2010/15 PFOA Stewardship Program, in which companies committed to reduce global facility emissions and product content of PFOA and related chemicals by 95 percent by 2010, and to work
Brett J. Butler; Marla Markowski-Lindsay; Stephanie Snyder; Paul Catanzaro; David B. Kittredge; Kyle Andrejczyk; Brenton J. Dickinson; Derya Eryilmaz; Jaketon H. Hewes; Paula Randler; Donna Tadle; Michael A. Kilgore
2014-01-01
The USDA Forest Service's Forest Stewardship Program (FSP) is the nation's most prominent private forestry assistance program. We examined the FSP using a multiple analytic approach: analysis of annual FSP accomplishments, survey of state FSP coordinators, analytic comparison of family forest owners receiving and not receiving forestry practice assistance,...
Highlights of the national evaluation of the Forest Stewardship Planning Program
R.J. Moulton; J.D. Esseks
2001-01-01
In 1998 and 1999, a nationwide random sample of 1238 nonindustrial private (NIPF) landowners with approved multiple resource Forest Stewardship Plans were interviewed to determine if this program is meeting its Congressional mandate of promoting sustainable management of forest resources on NIPF ownerships. It was found that two-thirds of program participants had never...
Benson, John M
2014-02-01
The impact on antimicrobial costs of an antimicrobial stewardship program (ASP) that integrated pharmacy students as integral members was evaluated. Demographic and discharge disposition data and antimicrobial acquisition cost data were retrospectively collected for all patients admitted to Promise Hospital of Salt Lake between June 1, 2009, and May 31, 2012. During this study, the primary role of pharmacy students in the ASP was to monitor all infection-related patient problems in the facility and meet daily with the infectious diseases pharmacist and clinical pharmacist to develop recommendations for optimizing antimicrobial use. The primary outcome measure was the mean antimicrobial acquisition cost per patient per day, calculated before ASP implementation (baseline period) and two years after ASP implementation (intervention period). The acquisition costs of antimicrobial agents per patient day were compared before and two years after implementation of the ASP involving pharmacy students. Statistical significance was determined using Student's t test for continuous data and the chi-square test for nominal data. The rate of patient discharge to skilled nursing facilities was significantly higher during the intervention period versus the baseline period (p = 0.016); no other significant comparisons were found. The mean ± S.D. antimicrobial costs per patient day were $75.37 ± $11.85 in the baseline period and $64.13 ± $13.78 in the intervention period (p = 0.022). This difference represents a cost savings of $261,630 during the two-year intervention period. Decreased antimicrobial costs were observed over a two-year period after implementation of an ASP that incorporated pharmacy students as integral members of the program.
Jury, Lucy A; Tomas, Myreen; Kundrapu, Sirisha; Sitzlar, Brett; Donskey, Curtis J
2013-11-01
A Clostridium difficile infection (CDI) stewardship initiative reduced inappropriate prescription of empirical CDI therapy and improved timeliness of treatment and adherence to clinical practice guidelines for management of CDI. The initiative required minimal resources and could easily be incorporated into traditional antimicrobial stewardship programs.
ERIC Educational Resources Information Center
Hou, Chung-Yi
2015-01-01
With the proliferation of digital technologies, scientists are exploring various methods for the integration of data to produce scientific discoveries. To maximize the potential of data for science advancement, proper stewardship must be provided to ensure data integrity and usability both for the short- and the long-term. In order to assist…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Erhart, Steven C.; Spencer, Charles G.
The accomplishments to date and the long-range planning of the Y-12 Energy Management and Sustainability and Stewardship programs support the U.S. Department of Energy (DOE) and the National Nuclear Security Administration (NNSA) vision for a commitment to energy effi ciency and sustainability and to achievement of the Guiding Principles. Specifi cally, the Y-12 vision is to support the Environment, Safety and Health Policy and the DOE Strategic Sustainability Performance Plan (SSPP), while promoting overall sustainability and reduction of greenhouse gas (GHG) emissions. The mission of the Y-12 Energy Management program is to incorporate energy-efficient technologies site-wide and to position Y-12more » to meet NNSA energy requirement needs through 2025 and beyond. This plan addresses: Greenhouse Gas Reduction and Comprehensive Greenhouse Gas Inventory; Buildings, ESPC Initiative Schedule, and Regional and Local Planning; Fleet Management; Water Use Efficiency and Management; Pollution Prevention and Waste Reduction; Sustainable Acquisition; Electronic Stewardship and Data Centers; Renewable Energy; Climate Change; and Budget and Funding.« less
Peron, Emily P.; Hirsch, Amy A.; Jury, Lucy A.; Jump, Robin L.P.; Donskey, Curtis J.
2015-01-01
BACKGROUND/OBJECTIVE Antimicrobials are frequently prescribed in long-term care facilities (LTCFs). In order to develop effective stewardship interventions, there is a need for data on current patterns of unnecessary antimicrobial prescribing among LTCF residents. The objective of this study was to examine the frequency of, reasons for, and adverse effects of unnecessary antimicrobial use in our Veterans Affairs (VA) LTCF. DESIGN Retrospective chart review. SETTING Cleveland VA Medical Center LTCF. PARTICIPANTS Randomly selected patients receiving antimicrobial therapy from October 1, 2008 to March 31, 2009. MEASUREMENTS Days of necessary and unnecessary antimicrobial therapy determined using Infectious Diseases Society of America guidelines, syndromes treated with unnecessary antimicrobials, and the frequency of development of Clostridium difficile infection (CDI), colonization or infection with antimicrobial resistant pathogens, and other adverse effects. RESULTS Of 1351 days of therapy prescribed in 100 regimens, 575 days (42.5%) were deemed unnecessary. Of the 575 unnecessary days of therapy, 334 (58%) were for antimicrobial regimens that were entirely unnecessary (n=42). Asymptomatic bacteriuria was the most common reason for entirely unnecessary regimens (n=21), resulting in 173 days of unnecessary therapy. Regimens that were partially unnecessary resulted in 241 (42%) days of unnecessary therapy, with longer than recommended treatment duration accounting for 226 (94%) unnecessary days of therapy. Within 30 days of completing the antimicrobial regimens, 5 patients developed CDI, 5 had colonization or infection with antimicrobial-resistant pathogens, and 10 experienced other adverse drug events. CONCLUSIONS In our VA LTCF, 43% of all days of antimicrobial therapy were unnecessary. Our findings suggest that antimicrobial stewardship interventions in LTCFs should focus on improving adherence to recommended treatment durations and eliminating inappropriate treatment of asymptomatic bacteriuria. PMID:23405923
GLAS Long-Term Archive: Preservation and Stewardship for a Vital Earth Observing Mission
NASA Astrophysics Data System (ADS)
Fowler, D. K.; Moses, J. F.; Zwally, J.; Schutz, B. E.; Hancock, D.; McAllister, M.; Webster, D.; Bond, C.
2012-12-01
Data Stewardship, preservation, and reproducibility are fast becoming principal parts of a data manager's work. In an era of distributed data and information systems, it is of vital importance that organizations make a commitment to both current and long-term goals of data management and the preservation of scientific data. Satellite missions and instruments go through a lifecycle that involves pre-launch calibration, on-orbit data acquisition and product generation, and final reprocessing. Data products and descriptions flow to the archives for distribution on a regular basis during the active part of the mission. However there is additional information from the product generation and science teams needed to ensure the observations will be useful for long term climate studies. Examples include ancillary input datasets, product generation software, and production history as developed by the team during the course of product generation. These data and information will need to be archived after product data processing is completed. NASA has developed a set of Earth science data and information content requirements for long term preservation that is being used for all the EOS missions as they come to completion. Since the ICESat/GLAS mission was one of the first to end, NASA and NSIDC, in collaboration with the science team, are collecting data, software, and documentation, preparing for long-term support of the ICESat mission. For a long-term archive, it is imperative to preserve sufficient information about how products were prepared in order to ensure future researchers that the scientific results are accurate, understandable, and useable. Our experience suggests data centers know what to preserve in most cases. That is, the processing algorithms along with the Level 0 or Level 1a input and ancillary products used to create the higher-level products will be archived and made available to users. In other cases, such as pre-launch, calibration/validation, and test data, the data centers must seek guidance from the science team. All these data are essential for product provenance, contributing to and helping establish the integrity of the scientific observations for long term climate studies. In this presentation we will describe application of information gathering with guidance from the ICESat/GLAS Science Team, and the flow of additional information from the ICESat Science team and Science Investigator-Led Processing System to the NSIDC Distributed Active Archive Center. This presentation will also cover how we envision user support through the years of the Long-Term Archive.
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,…
Collado, Roberto; Losa, Juan Emilio; Álvaro, Elena Alba; Toro, Piedad; Moreno, Leonor; Pérez, Montserrat
2015-12-01
Monitoring antimicrobial consumption in hospitals is a necessary measure. The indicators commonly employed do not clearly reflect the antibiotic selection pressure. The objective of this study is to evaluate two different methods that analyze antimicrobial consumption based on DDD, per stay and per discharge, before and after the implementation an antimicrobial stewardship program. Comparative pre-post study of antimicrobial consumption with the implementation of an antimicrobial stewardship program using DDD per 100 bed-days and DDD per 100 discharges as indicators. Hospital bed days remained stable and discharges increased slightly along the period of study Antibiotic consumption in DDD per 100 bed-days decreased by 2.5% versus 3.8% when expressed as DDD per 100 discharges. Antifungal consumption decreased by more than 50%. When average hospital stay decreases, reductions in the consumption of antimicrobials with an antimicrobial stewardship program system occur at the expense of reducing the number of patients receiving treatment, while increases occur due to longer durations of treatment.
Development of Antimicrobial Competencies and Training for Staff Hospital Pharmacists
Crader, Marsha F.
2014-01-01
Antimicrobial stewardship is an important component in health care outcomes of all patients. Many institutions are seeking the best methods to incorporate antimicrobial stewardship strategies into their hospitals including pharmacy services. Multiple factors should be considered when beginning or expanding an antimicrobial stewardship program. The purpose of this article is to discuss the development of basic antibiotic competencies and training for staff pharmacists in a community hospital. The article includes an assessment of pharmacists’ knowledge pre education and post education, perception of benefits from an antibiotic education program, and learning needs and preferences. PMID:24421561
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 indicate priorities for preservation. Though the use cases currently focus on two areas, 'creating' a data set and 'using' a data set, the use cases will eventually cover the full data lifecycle. Currently developing a template to be used in future use case creation, the DSC is also preparing and testing more use case scenarios. This presentation will introduce the ESIP use cases based on the PCCS. It will at once expand stakeholder participation and show the application of these materials beyond the ESIP community in which they were developed. More information about the ESIP use case activities can be found on the DSC wiki - http://wiki.esipfed.org/index.php/Preservation_Use_Case_Activity.
ERIC Educational Resources Information Center
Reilly, Kate; Wooster, Betsy
2008-01-01
Riparian ecosystems are an exciting and dynamic subject for study. These areas are valuable lands and important wildlife habitats, and they contribute greatly to the environmental health of an area. Definitions for the term "riparian" vary, but in this curriculum, the land called the "Green Zone" lies between flowing water and upland ecosystems.…
ERIC Educational Resources Information Center
Mink, Meridith Beck
2016-01-01
In September 2015, the Institute of Museum and Library Services (IMLS) awarded the Council on Library and Information Resources (CLIR) a grant to investigate the early impacts of the National Digital Stewardship Residency (NDSR) programs, in order to inform subsequent development of similar programs by others with a vested interest in building…
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…
Evaluating the forest stewardship program through a national survey of participants
J.D. Esseks; R.J. Moulton
2000-01-01
This paper reports findings from a national survey of 1,231 participants in the Forest Stewardship Program (FSP) of USDA's Forest Service. Launched in 1991, the FSP provides technical assistance through state forestry agencies to help landowners develop management plans for their non-industrial forestland. The survey allowed us to address five main evaluative...
Stockpile Stewardship: How We Ensure the Nuclear Deterrent Without Testing
None
2018-01-16
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.
Point-of-Prescription Interventions to Improve Antimicrobial Stewardship
Hamilton, Keith W.; Gerber, Jeffrey S.; Moehring, Rebekah; Anderson, Deverick J.; Calderwood, Michael S.; Han, Jennifer H.; Mehta, Jimish M.; Pollack, Lori A.; Zaoutis, Theoklis; Srinivasan, Arjun; Camins, Bernard C.; Schwartz, David N.; Lautenbach, Ebbing
2015-01-01
Antimicrobial stewardship is pivotal to improving patient outcomes, reducing adverse events, decreasing healthcare costs, and preventing further emergence of antimicrobial resistance. In an era in which antimicrobial resistance is increasing, judicious antimicrobial use is the responsibility of every healthcare provider. Antimicrobial stewardship programs (ASPs) have made headway in improving antimicrobial prescribing using such “top-down” methods as formulary restriction and prospective audit with feedback; however, engagement of prescribers has not been fully explored. Strategies that include frontline prescribers and other unit-based healthcare providers have the potential to expand stewardship, both to augment existing centralized ASPs and to provide alternative approaches to perform stewardship at healthcare facilities with limited resources. This review discusses interventions focusing on antimicrobial prescribing at the point of prescription as well as a pilot project to engage unit-based healthcare providers in antimicrobial stewardship. PMID:25595748
Interoperability Across the Stewardship Spectrum in the DataONE Repository Federation
NASA Astrophysics Data System (ADS)
Jones, M. B.; Vieglais, D.; Wilson, B. E.
2016-12-01
Thousands of earth and environmental science repositories serve many researchers and communities, each with their own community and legal mandates, sustainability models, and historical infrastructure. These repositories span the stewardship spectrum from highly curated collections that employ large numbers of staff members to review and improve data, to small, minimal budget repositories that accept data caveat emptor and where all responsibility for quality lies with the submitter. Each repository fills a niche, providing services that meet the stewardship tradeoffs of one or more communities. We have reviewed these stewardship tradeoffs for several DataONE member repositories ranging from minimally (KNB) to highly curated (Arctic Data Center), as well as general purpose (Dryad) to highly discipline or project specific (NEON). The rationale behind different levels of stewardship reflect resolution of these tradeoffs. Some repositories aim to encourage extensive uptake by keeping processes simple and minimizing the amount of information collected, but this limits the long-term utility of the data and the search, discovery, and integration systems that are possible. Other repositories require extensive metadata input, review, and assessment, allowing for excellent preservation, discovery, and integration but at the cost of significant time for submitters and expense for curatorial staff. DataONE recognizes these different levels of curation, and attempts to embrace them to create a federation that is useful across the stewardship spectrum. DataONE provides a tiered model for repositories with growing utility of DataONE services at higher tiers of curation. The lowest tier supports read-only access to data and requires little more than title and contact metadata. Repositories can gradually phase in support for higher levels of metadata and services as needed. These tiered capabilities are possible through flexible support for multiple metadata standards and services, where repositories can incrementally increase their requirements as they want to satisfy more use cases. Within DataONE, metadata search services support minimal metadata models, but significantly expanded precision and recall become possible when repositories provide more extensively curated metadata.
NASA Astrophysics Data System (ADS)
Hua, H.; Manipon, G.; Starch, M.
2017-12-01
NASA's upcoming missions are expected to be generating data volumes at least an order of magnitude larger than current missions. A significant increase in data processing, data rates, data volumes, and long-term data archive capabilities are needed. Consequently, new challenges are emerging that impact traditional data and software management approaches. At large-scales, next generation science data systems are exploring the move onto cloud computing paradigms to support these increased needs. New implications such as costs, data movement, collocation of data systems & archives, and moving processing closer to the data, may result in changes to the stewardship, preservation, and provenance of science data and software. With more science data systems being on-boarding onto cloud computing facilities, we can expect more Earth science data records to be both generated and kept in the cloud. But at large scales, the cost of processing and storing global data may impact architectural and system designs. Data systems will trade the cost of keeping data in the cloud with the data life-cycle approaches of moving "colder" data back to traditional on-premise facilities. How will this impact data citation and processing software stewardship? What are the impacts of cloud-based on-demand processing and its affect on reproducibility and provenance. Similarly, with more science processing software being moved onto cloud, virtual machines, and container based approaches, more opportunities arise for improved stewardship and preservation. But will the science community trust data reprocessed years or decades later? We will also explore emerging questions of the stewardship of the science data system software that is generating the science data records both during and after the life of mission.
Taimi Lynne Hoag Award for Environmental Stewardship
The Region 5 Tribal Operation Committee established this Award in the name of Taimi Hoag to recognize significant contributions in environmental management and/or environmental stewardship by a tribal government leader, program manager, or staff person.
Global Data Assembly Center (GDAC) Report to the GHRSST Science Team
NASA Technical Reports Server (NTRS)
Armstrong, Edward; Vazquez, Jorge; Bingham, Andy; Gierach, Michelle; Huang, Thomas; Chen, Cynthia; Finch, Chris; Thompson, Charles
2013-01-01
In 2012-2013 the Global Data Assembly Center (GDAC) at NASA's Physical Oceanography Distributed Active Archive Center (PO.DAAC) continued its role as the primary clearinghouse and access node for operational GHRSST data streams, as well as its collaborative role with the NOAA Long Term Stewardship and Reanalysis Facility (LTSRF) for archiving. Our presentation reported on our data management activities and infrastructure improvements since the last science team meeting in 2012.
Markley, J Daniel; Pakyz, Amy; Bernard, Shaina; Lee, Kimberly; Appelbaum, Nital; Bearman, Gonzalo; Stevens, Michael P
2017-03-01
Mobile medical apps are commonly used by health care professionals and could be used by antimicrobial stewardship programs to enhance adherence to local recommendations. We conducted a survey of health care workers to inform the design of an antimicrobial stewardship smartphone app. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
What does it take to get family forest owners to enroll in a forest stewardship-type program?
Michael A. Kilgore; Stephanie A. Snyder; Joseph Schertz; Steven J. Taff
2008-01-01
We estimated the probability of enrollment and factors influencing participation in a forest stewardship-type program, Minnesota's Sustainable Forest Incentives Act, using data from a mail survey of over 1000 randomly-selected Minnesota family forest owners. Of the 15 variables tested, only five were significant predictors of a landowner's interest in...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Barnes, Cris William
After the decision to end nuclear testing and the inception of the Stockpile Stewardship program, the condition of the stockpile was the primary mission driver. During the first two decades of stewardship, the primary program goal could be described as underwriting the Stockpile-to-Target Sequence (STS), the military requirements on the conditions the nuclear warheads needed to survive and still operate.
Fiscal Year 2015 Site Sustainability Plan
DOE Office of Scientific and Technical Information (OSTI.GOV)
Witt, Monica Rene
Los Alamos National Laboratory is taking action to operate as a living laboratory for sustainable solutions in buildings, climate, energy, purchasing, transportation, waste, and water. LANL prepared the fiscal year (FY) 2015 Site Sustainability Plan (SSP) to describe progress towards the goals established in the SSPP. In addition, per the requirements of DOE Order 436.1, Departmental Sustainability, Los Alamos National Laboratory (LANL) uses its International Organization for Standardization (ISO) 14001:2004 certified Environmental Management System (EMS) to establish objectives to improve compliance, reduce environmental impacts, increase operational capacity, and meet long-term sustainability goals. The goals of the 2015 SSP are fullymore » integrated into LANL’s institutional environmental objectives under the EMS and its Long-Term Strategy for Environmental Stewardship & Sustainability (LTSESS).« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nikkel, Daniel J.; Meisner, Robert
The Advanced Simulation and Computing Campaign, herein referred to as the ASC Program, is a core element of the science-based Stockpile Stewardship Program (SSP), which enables assessment, certification, and maintenance of the safety, security, and reliability of the U.S. nuclear stockpile without the need to resume nuclear testing. The use of advanced parallel computing has transitioned from proof-of-principle to become a critical element for assessing and certifying the stockpile. As the initiative phase of the ASC Program came to an end in the mid-2000s, the National Nuclear Security Administration redirected resources to other urgent priorities, and resulting staff reductions inmore » ASC occurred without the benefit of analysis of the impact on modern stockpile stewardship that is dependent on these new simulation capabilities. Consequently, in mid-2008 the ASC Program management commissioned a study to estimate the essential size and balance needed to sustain advanced simulation as a core component of stockpile stewardship. The ASC Program requires a minimum base staff size of 930 (which includes the number of staff necessary to maintain critical technical disciplines as well as to execute required programmatic tasks) to sustain its essential ongoing role in stockpile stewardship.« less
Improving patient care through implementation of an antimicrobial stewardship program.
Palmer, Hannah R; Weston, Jaye; Gentry, Layne; Salazar, Miguel; Putney, Kimberly; Frost, Craig; Tipton, Joyce A; Cottreau, Jessica; Tam, Vincent H; Garey, Kevin W
2011-11-15
The implementation of an antimicrobial stewardship program at a health system is described. In 2008, the Center for Antimicrobial Stewardship and Epidemiology (CASE) was formed at St. Luke's Episcopal Hospital (SLEH) to improve the quality of care for patients as it related to antimicrobial therapy. The charter of CASE contained specific aims for improving patient care, furthering clinical research, and training the next generation of clinical infectious diseases pharmacists. The CASE team consists of at least two infectious diseases pharmacists and one physician (the medical director) who provide direct oversight for antimicrobial utilization within the hospital. The CASE medical director, an infectious diseases physician, is responsible for overseeing the activities of the center. With the oversight of the CASE advisory board, the medical director develops and implements the antimicrobial stewardship and management policies for SLEH. Another key innovative feature of CASE is its extensive involvement in training new infectious diseases pharmacists and conducting research. CASE uses a model in which a clinical scenario or problem is identified, a research project is undertaken to further elucidate the problem, and policy changes are made to improve patient outcomes. The CASE team is supported by a CASE advisory board, a CASE research collaborative including university faculty, and a dedicated training program for pharmacy fellows, residents, and students. Implementation of an antimicrobial stewardship program at a health system helped decrease the inappropriate use of antibiotics, improve patient care and outcomes, further clinical research, and increase training opportunities for future clinical infectious diseases pharmacists.
Initiatives and resources to promote antimicrobial stewardship.
Paño-Pardo, José Ramón; Campos, José; Natera Kindelán, Clara; Ramos, Antonio
2013-09-01
The development of an antimicrobial stewardship program (ASP) requires institutional support. However, obtaining sufficient institutional support is often a complex task that requires convincing the hospital's managers of the benefits of these programs. Additionally, in the design and implementation of an ASP, antimicrobial stewardship (AS) leaders need tools for diverse purposes, such as measuring antimicrobial consumption, education and training and designing protocols. In this review we provide useful information for AS promoters to facilitate the task of designing and implementing an ASP. First, we summarize information about various institutions that promote AS and include evidence that supports the need for and benefits of these programs. Then, several campaigns promoting AS are described. Finally, online resources for professionals dealing with AS are briefly summarized. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Stockpile Stewardship: How We Ensure the Nuclear Deterrent Without Testing
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
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,more » the High Explosive Applications Facility (HEAF), the National Ignition Facility (NIF), and the Site 300 contained firing facility.« less
Antibiotic stewardship through the EU project "ABS International".
Allerberger, Franz; Frank, Annegret; Gareis, Roland
2008-01-01
The increasing problem of antimicrobial resistance requires implementation of antibiotic stewardship (ABS) programs. The project "ABS International--implementing antibiotic strategies for appropriate use of antibiotics in hospitals in member states of the European Union" was started in September 2006 in Austria, Belgium, the Czech Republic, Germany, Hungary, Italy, Poland, Slovenia and Slovakia. A training program for national ABS trainers was prepared and standard templates for ABS tools (antibiotic list, guides for antibiotic treatment and surgical prophylaxis, antibiotic-related organization) and valid process measures, as well as quality indicators for antibiotic use were developed. Specific ABS tools are being implemented in up to five healthcare facilities in each country. Although ABS International clearly focuses on healthcare institutions, future antimicrobial stewardship programs must also cover public education and antibiotic prescribing in primary care.
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.
CDC, TJC Urge Providers To Up Their Game on Antibiotic Stewardship.
Srinivasan, Arjun; Vento, Todd
2017-03-01
With data showing continued increases in the use of antibiotics, even in cases in which such prescribing is unnecessary and ill-advised, both the CDC and TJC are pushing initiatives aimed at improving antibiotic stewardship. The initiatives stress the importance of patient and provider education, the tracking of antibiotic use and resistance, and the need for top-level support. Although smaller hospitals face challenges in meeting the new standards, some health systems are getting around the problem through the use of telemedicine. The CDC is pushing hospitals to implement seven core elements that the agency maintains are critical to an effective antibiotic stewardship program. TJC has established a new standard requiring all hospitals to create antibiotic stewardship programs that are steered by a multidisciplinary team. Intermountain Healthcare in Salt Lake City is helping smaller hospitals in its network meet these new TJC and CDC directives by supplying support and expertise via telemedicine. The telehealth program also enables both emergency and inpatient providers to access infectious disease expertise when patients present with issues of concern.
Patterns of forest land owner participation in the West Virginia forest stewardship program
B. M. Jennings; D. J. Magill; D. W. Magill; J. Warren
2003-01-01
West Virginia is the Nation's third most forested State in terms of percent forest cover with at least 80 percent of its land forested. Despite this wealth of timber, in the late 19th and early 20th century the State was almost completely cut over with 30 billion board feet being harvested between 1870 and 1920. Currently, there are numerous second growth stands...
Baur, David; Gladstone, Beryl Primrose; Burkert, Francesco; Carrara, Elena; Foschi, Federico; Döbele, Stefanie; Tacconelli, Evelina
2017-09-01
Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients. Two authors independently assessed the eligibility of trials and extracted data. Studies involving long-term care facilities were excluded. The main outcomes were incidence ratios (IRs) of target infections and colonisation per 1000 patient-days before and after implementation of antibiotic stewardship. Meta-analyses were done with random-effect models and heterogeneity was calculated with the I 2 method. We included 32 studies in the meta-analysis, comprising 9 056 241 patient-days and 159 estimates of IRs. Antibiotic stewardship programmes reduced the incidence of infections and colonisation with multidrug-resistant Gram-negative bacteria (51% reduction; IR 0·49, 95% CI 0·35-0·68; p<0·0001), extended-spectrum β-lactamase-producing Gram-negative bacteria (48%; 0·52, 0·27-0·98; p=0·0428), and meticillin-resistant Staphylococcus aureus (37%; 0·63, 0·45-0·88; p=0·0065), as well as the incidence of C difficile infections (32%; 0·68, 0·53-0·88; p=0·0029). Antibiotic stewardship programmes were more effective when implemented with infection control measures (IR 0·69, 0·54-0·88; p=0·0030), especially hand-hygiene interventions (0·34, 0·21-0·54; p<0·0001), than when implemented alone. Antibiotic stewardship did not affect the IRs of vancomycin-resistant enterococci and quinolone-resistant and aminoglycoside-resistant Gram-negative bacteria. Significant heterogeneity between studies was detected, which was partly explained by the type of interventions and co-resistance patterns of the target bacteria. Antibiotic stewardship programmes significantly reduce the incidence of infections and colonisation with antibiotic-resistant bacteria and C difficile infections in hospital inpatients. These results provide stakeholders and policy makers with evidence for implementation of antibiotic stewardship interventions to reduce the burden of infections from antibiotic-resistant bacteria. German Center for Infection Research. Copyright © 2017 Elsevier Ltd. All rights reserved.
Khan, Muhammad Umair; Hassali, Mohamed Azmi Ahmad; Ahmad, Akram; Elkalmi, Ramadan Mohamed; Zaidi, Syed Tabish Razi; Dhingra, Sameer
2016-01-01
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. 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. 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). The study highlighted some gaps in the perception and practices of community pharmacist towards antimicrobial stewardship. Development of customized interventions would be critical to bridging these gaps and improve their perception and practices towards antimicrobial stewardship.
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 interventions would be critical to bridging these gaps and improve their perception and practices towards antimicrobial stewardship. PMID:26901404
7 CFR 1470.22 - Conservation stewardship plan.
Code of Federal Regulations, 2010 CFR
2010-01-01
..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts... process as outlined in the National Planning Procedures Handbook to encourage participants to address... the participant's decisions that describes the schedule of conservation activities to be implemented...
Environmental Stewardship: A Conceptual Review and Analytical Framework.
Bennett, Nathan J; Whitty, Tara S; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H
2018-04-01
There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.
Environmental Stewardship: A Conceptual Review and Analytical Framework
NASA Astrophysics Data System (ADS)
Bennett, Nathan J.; Whitty, Tara S.; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H.
2018-04-01
There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jacobs, R
The Physics and Advanced Technologies (PAT) Directorate was created in July 2000 by Bruce Tarter, Director of Lawrence Livermore National Laboratory (LLNL). The Director called for the new organization to execute and support programs that apply cutting-edge physics and advanced technology to develop integrated solutions to problems in national security, fusion energy, information science, health care, and other national grand challenges. When I was appointed a year later as the PAT Directorate's first Associate Director, I initiated a strategic planning project to develop a vision, mission, and long-term goals for the Directorate. We adopted the goal of becoming a leadermore » in frontier physics and technology for twenty-first-century national security missions: Stockpile Stewardship, homeland security, energy independence, and the exploration of space. Our mission is to: (1) Help ensure the scientific excellence and vitality of the major LLNL programs through its leadership role in performing basic and applied multidisciplinary research and development with programmatic impact, and by recruiting and retaining science and technology leaders; (2) Create future opportunities and directions for LLNL and its major programs by growing new program areas and cutting-edge capabilities that are synergistic with, and supportive of, its national security mission; (3) Provide a direct conduit to the academic and high-tech industrial sectors for LLNL and its national security programs, through which the Laboratory gains access to frontier science and technology, and can impact the science and technology communities; (4) Leverage unique Laboratory capabilities, to advance the state universe. This inaugural PAT Annual Report begins a series that will chronicle our progress towards fulfilling this mission. I believe the report demonstrates that the PAT Directorate has a strong base of capabilities and accomplishments on which to build in meeting its goals. Some of the highlights include: (1) Leadership of the Laboratory's Physical Data Research Program that provides fundamental physics information for the Stockpile Stewardship Program. (2) Development of the handheld Microbead Immunoassay Dipstick System that will allow relatively untrained first-responders to run sophisticated onsite diagnostics for pathogens, including those associated with biowarfare agents, by using a simple, one-step measurement. (3) Major advances in target design for inertial fusion energy research using both laser and ion-beam drivers. (4) Development of the Advanced Technology Kill Vehicle concept for use as a high-performance interceptor in a broad range of missile defense programs. Over the course of the past decade, the Laboratory has seen its major program evolve from weapons research, development, and testing, to Stockpile Stewardship. Today, the country's national security priorities are changing rapidly: nuclear security is becoming a broader set of missions, and the Laboratory is being asked to contribute to a range of new mission areas from countering bioterrorism to ensuring information security. As we embark on the twenty-first century, the new PAT Directorate is poised to help lead the Laboratory's response to the country's changing national security needs.« less
Shelley, Barry G
2011-02-01
Researchers, policy makers, and practitioners have used various terms to describe instruments that reward the stewardship of ecosystem services that benefit "external" actors. Payments for environmental services, or PES, has been the predominant name. However, critics have challenged both the payments and environmental components of this nomenclature, most commonly proposing markets, compensation, or rewards as alternatives for the former, and ecosystem for the latter. Additional questions arise regarding what to call the agents directly involved in the transaction: sellers and buyers, or stewards and beneficiaries? For some, concerns about this terminology have emerged from so-called "pro-poor PES" debates that ask if actors could and should incorporate poverty alleviation goals into PES instruments. This review of the modulating use of terms and the arguments about which best fit theory and experience points to the key policy and ethical issues at stake as PES programs face critical and timely questions about the direction they will head. The author contends that the choices of terms will influence that direction and proposes a new alternative-rewards for ecosystem service stewardship (RESS)-that better encompasses pro-poor options. © 2011 New York Academy of Sciences.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yuracko, K. L.; Parang, M.; Landguth, D. C.
2004-09-13
TOADS (Total On-line Access Data System) is a new generation of real-time monitoring and information management system developed to support unattended environmental monitoring and long-term stewardship of U.S. Department of Energy facilities and sites. TOADS enables project managers, regulators, and stakeholders to view environmental monitoring information in realtime over the Internet. Deployment of TOADS at government facilities and sites will reduce the cost of monitoring while increasing confidence and trust in cleanup and long term stewardship activities. TOADS: Reliably interfaces with and acquires data from a wide variety of external databases, remote systems, and sensors such as contaminant monitors, areamore » monitors, atmospheric condition monitors, visual surveillance systems, intrusion devices, motion detectors, fire/heat detection devices, and gas/vapor detectors; Provides notification and triggers alarms as appropriate; Performs QA/QC on data inputs and logs the status of instruments/devices; Provides a fully functional data management system capable of storing, analyzing, and reporting on data; Provides an easy-to-use Internet-based user interface that provides visualization of the site, data, and events; and Enables the community to monitor local environmental conditions in real time. During this Phase II STTR project, TOADS has been developed and successfully deployed for unattended facility, environmental, and radiological monitoring at a Department of Energy facility.« less
Jump, Robin L. P.; Olds, Danielle M.; Seifi, Nasim; Kypriotakis, Georgios; Jury, Lucy A.; Peron, Emily P.; Hirsch, Amy A.; Drawz, Paul E.; Watts, Brook; Bonomo, Robert A.; Donskey, Curtis J.
2014-01-01
Design We introduced a long-term care facility (LTCF) Infectious Disease (ID) consult service (LID) that provides on-site consultations to residents of a VA LTCF. We determined the impact of the LID service on antimicrobial use and Clostridium difficile infections at the LTCF. Setting A 160-bed Veterans Affairs (VA) LTCF. Methods Systemic antimicrobial use and the rate of positive C. difficile tests at the LTCF were compared for 36 months before and 18 months after the initiation of the ID consultation service using segmented regression analysis of an interrupted time-series. Results In contrast to the pre-intervention period, total systemic antibiotic administration decreased by 30% (P <.001) with a significant reduction in both oral (32%; P<.001) and intravenous agents (25%; P =.008). The greatest reductions were seen for tetracyclines (64%, P <.001), clindamycin (61%; P <.001), sulfamethoxazole/trimethoprim (38%; P <.001), fluoroquinolones (38%; P <.001) and beta-lactam/beta-lactamase inhibitor combinations (28%; P <.001). Rates of change for positive C. difficile tests at the LTCF declined in the post- vs. preintervention periods (P = .04). Conclusions Implementation of a LTCF ID service led to a significant reduction in total antimicrobial use. Bringing providers with infectious disease expertise to the LTCF represents a new and effective means to achieve antimicrobial stewardship. PMID:23143354
Graber, Christopher J; Jones, Makoto M; Chou, Ann F; Zhang, Yue; Goetz, Matthew Bidwell; Madaras-Kelly, Karl; Samore, Matthew H; Glassman, Peter A
2017-05-01
Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. To determine associations between ASPs and facility characteristics, and inpatient antimicrobial utilization measures in the Veterans Affairs (VA) system in 2012. In 2012, VA administered a survey on antimicrobial stewardship practices to designated ASP contacts at VA acute care hospitals. From the survey, we identified 34 variables across 3 domains (evidence, organizational context, and facilitation) that were assessed using multivariable least absolute shrinkage and selection operator regression against 4 antimicrobial utilization measures from 2012: aggregate acute care antimicrobial use, antimicrobial use in patients with non-infectious primary discharge diagnoses, missed opportunities to convert from parenteral to oral antimicrobial therapy, and double anaerobic coverage. All 130 VA facilities with acute care services. Variables associated with at least 3 favorable changes in antimicrobial utilization included presence of postgraduate physician/pharmacy training programs, number of antimicrobial-specific order sets, frequency of systematic de-escalation review, presence of pharmacists and/or infectious diseases (ID) attendings on acute care ward teams, and formal ID training of the lead ASP pharmacist. Variables associated with 2 unfavorable measures included bed size, the level of engagement with VA Antimicrobial Stewardship Task Force online resources, and utilization of antimicrobial stop orders. Formalization of ASP processes and presence of pharmacy and ID expertise are associated with favorable utilization. Systematic de-escalation review and order set establishment may be high-yield interventions. Journal of Hospital Medicine 2017;12:301-309. © 2017 Society of Hospital Medicine
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jarvis, T.T.; Andrews, W.B.; Buck, J.W.
1998-03-01
Since 1989, the Department of Energy`s (DOE) Environmental Management (EM) Program has managed the environmental legacy of US nuclear weapons production, research and testing at 137 facilities in 31 states and one US territory. The EM program has conducted several studies on the public risks posed by contaminated sites at these facilities. In Risks and the Risk Debate [DOE, 1995a], the Department analyzed the risks at sites before, during, and after remediation work by the EM program. The results indicated that aside from a few urgent risks, most hazards present little inherent risk because physical and active site management controlsmore » limit both the releases of site contaminants, and public access to these hazards. Without these controls, these sites would pose greater risks to the public. Past risk reports, however, provided little information about post-cleanup risk, primarily because of uncertainty about future site uses and site characteristics at the end of planned cleanup activities. This is of concern because in many cases current cleanup technologies, and remedies, will last a shorter period of time than the waste itself and the resulting contamination will remain hazardous.« less
Turner, R Brigg; Valcarlos, Elena; Loeffler, Ann M; Gilbert, Michael; Chan, Dominic
2017-09-01
Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated. We compared antibiotic use in the preintervention period (April 2012 to March 2013) with that in the postintervention period (April 2013 to March 2015) in all units except the neonatal intensive care unit and the emergency department. In addition, drug-acquisition costs, antibiotic-specific use, death, length of stay, and case-mix index were examined. Antibiotic use decreased by 16.8% (95% confidence interval, 18.0% to -9.2%; P < .001) in the postintervention period. Vancomycin use decreased by 38% (P = .001), whereas antipseudomonal β-lactam use was unaltered. Drug-acquisition cost savings were estimated to be $67 000/year over the 2-year postintervention period. Lengths of stay and mortality rates were unchanged in the postintervention period after adjusting for case-mix index. Implementation of a simple stewardship initiative with limited resources at a community nonfreestanding children's hospital effectively reduced antibiotic use without an overt negative impact on overall clinical outcomes. The results of this study suggest that nonfreestanding children's hospitals can achieve substantial reductions in antibiotic use despite limited resources. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.
The scope and value of an anticoagulation stewardship program at a community teaching hospital.
Wychowski, Maura K; Ruscio, Christina I; Kouides, Peter A; Sham, Ronald L
2017-04-01
To report the impact of an inpatient anticoagulation stewardship program at a community hospital to promote optimal anticoagulant use. The anticoagulation team (ACT) stewardship program consists of two clinical pharmacists and hematologists to provide oversight of anticoagulants, high cost reversal agents including prothrombin complex concentrate (PCC, Kcentra™), and heparin-induced thrombocytopenia (HIT) management. Intervention data and number of charts reviewed were collected. Average cost avoidance data was applied to ACT interventions to estimate cost savings. The PCC analysis was conducted via retrospective chart review during the pre-intervention period. Prospective monitoring continued in the post-intervention period to determine the percentage of PCC use within the institution's guidelines or approved by ACT or hematology. A total of 19,445 patient charts were reviewed, and 1930 (10%) contained stewardship opportunity. Of the interventions, 71% were provided to the medical service and 22% to surgical services with acceptance rates of 91 and 83%, respectively. Intervention cost-avoidance calculated to be $694,217. Regarding HIT interventions, 52% of interventions involved pharmacokinetic/pharmacodynamics optimization in 18 patients with suspected or confirmed HIT. Regarding PCC use, 55.8% of PCC orders were considered inappropriate in the pre-invention period versus 2.6% post-intervention. Appropriate PCC doses per month post-intervention were consistent with pre-intervention doses (7.67 vs. 6.73, respectively). The projected annual PCC cost savings is $385,473. The overall estimated financial impact of ACT is $799,690 saved. Implementation of an anticoagulation stewardship program reduced costs and improved clinical outcomes. It is also expected that anticoagulant optimization and provider education improved overall safety.
7 CFR 1469.7 - Benchmark condition inventory and conservation stewardship plan.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 10 2010-01-01 2010-01-01 false Benchmark condition inventory and conservation...) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM General Provisions § 1469.7 Benchmark condition inventory and conservation stewardship...
Robert J. Moulton; J. Dixon Esseks
2002-01-01
A 72 percent response rate was achieved in 1998 and 1999 national survey of 1,238 participants in the USDA Forest Service's Forest Stewardship Program, under which 130,000 individual multiple resource plans encompassing 16.5 million acres (6.5 million ha) of privately owned forest lands in the United States had been completed. Objectives were to determine if the...
[Impact of rational use of antibiotics in a third level clinic in Colombia].
Pallares, Christian J; Cataño, Juan C
2017-06-01
The increasing resistance of bacteria to antibiotics threatens the survival of patients and health costs. To determine the impact of an antimicrobial stewardship program in bacterial resistance and antibiotic consumption. Quasi experimental study in a third level clinic in the city of Medellin, that evaluate in two time periods (pre-intervention between October 2012 and September 2013 and post intervention between October 2013 and September 2014) the impact of an antimicrobial stewardship program in terms of antibiotic consumption and bacterial ecology. Adherence to institutional guidelines for management of infections in the post-intervention period was 82%. Antibiotic consumption of meropenem, ceftriaxone, vancomycin and colistin decreased, and imipenem, daptomycin and linezolid was increased. A significant decrease in antibiotic resistance in Pseudomonas aeruginosa was observed, including carbapenems. An increase of extended spectrum beta lactamase production (ESBL) in Enterobacteriaceae (especially E. coli) and piperacillin/tazobactam resistance was observed. The construction and implementation of a strategy in hospitals with guidelines for managing infectious diseases, restrictions in antibiotic use, a permanent monitoring system for the formulation of antibiotics, achieved a positive impact on reducing antibiotic use and bacterial resistance.
Stockpile Stewardship at Los Alamos(U)
DOE Office of Scientific and Technical Information (OSTI.GOV)
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 overviewmore » 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.« less
The NASA Distributed Active Archive Center Experience in Providing Trustworthy Digital Repositories
NASA Astrophysics Data System (ADS)
de Sherbinin, A. M.; Downs, R. R.; Chen, R. S.
2017-12-01
Since the early 1990s, NASA Earth Observation System Data and Information System (EOSDIS) has supported between 10 to 12 discipline-specific Distributed Active Archive Centers (DAACs) that have provided long-term preservation of Earth Science data records, particularly from satellite and airborne remote sensing. The focus of this presentation is on two of the DAACs - the Socioeconomic Data and Applications Center (SEDAC) and Oak Ridge National Laboratory (ORNL) DAAC - that provide archiving and dissemination of third party data sets. The presentation describes the community of interest for these two DAACs, their data management practices, and the benefits of certification to the DAACs and their user communities. It also describes the organizational, technical, financial, and legal challenges to providing trustworthy long-term data stewardship.
7 CFR 1470.22 - Conservation stewardship plan.
Code of Federal Regulations, 2011 CFR
2011-01-01
..., and (iii) Documenting the participant's conservation objectives to reach and exceed stewardship thresholds; (2) A plan map delineating enrolled land with associated acreage amounts; (3) In the case where a... participant's transition to or participation in the National Organic Program; (4) In the case where a...
Managing Records for the Long Term - 12363
DOE Office of Scientific and Technical Information (OSTI.GOV)
Montgomery, John V.; Gueretta, Jeanie
The U.S. Department of Energy (DOE) is responsible for managing vast amounts of information documenting historical and current operations. This information is critical to the operations of the DOE Office of Legacy Management. Managing legacy records and information is challenging in terms of accessibility and changing technology. The Office of Legacy Management is meeting these challenges by making records and information management an organizational priority. The Office of Legacy Management mission is to manage DOE post-closure responsibilities at former Cold War weapons sites to ensure the future protection of human health and the environment. These responsibilities include environmental stewardship andmore » long-term preservation and management of operational and environmental cleanup records associated with each site. A primary organizational goal for the Office of Legacy Management is to 'Preserve, Protect, and Share Records and Information'. Managing records for long-term preservation is an important responsibility. Adequate and dedicated resources and management support are required to perform this responsibility successfully. Records tell the story of an organization and may be required to defend an organization in court, provide historical information, identify lessons learned, or provide valuable information for researchers. Loss of records or the inability to retrieve records because of poor records management processes can have serious consequences and even lead to an organisation's downfall. Organizations must invest time and resources to establish a good records management program because of its significance to the organization as a whole. The Office of Legacy Management will continue to research and apply innovative ways of doing business to ensure that the organization stays at the forefront of effective records and information management. DOE is committed to preserving records that document our nation's Cold War legacy, and the Office of Legacy Management will keep records management as a high priority. (authors)« less
Service-Learning in the Environmental Sciences for Teaching Sustainability Science
NASA Astrophysics Data System (ADS)
Truebe, S.; Strong, A. L.
2016-12-01
Understanding and developing effective strategies for the use of community-engaged learning (service-learning) approaches in the environmental geosciences is an important research need in curricular and pedagogical innovation for sustainability. In 2015, we designed and implemented a new community-engaged learning practicum course through the Earth Systems Program in the School of Earth, Energy and Environmental Sciences at Stanford University focused on regional open space management and land stewardship. Undergraduate and graduate students partnered with three different regional land trust and environmental stewardship organizations to conduct quarter-long research projects ranging from remote sensing studies of historical land use, to fire ecology, to ranchland management, to volunteer retention strategies. Throughout the course, students reflected on the decision-making processes and stewardship actions of the organizations. Two iterations of the course were run in Winter and Fall 2015. Using coded and analyzed pre- and post-course student surveys from the two course iterations, we evaluate undergraduate and graduate student learning outcomes and changes in perceptions and understanding of sustainability science. We find that engagement with community partners to conduct research projects on a wide variety of aspects of open space management, land management, and environmental stewardship (1) increased an understanding of trade-offs inherent in sustainability and resource management and (2) altered student perceptions of the role of scientific information and research in environmental management and decision-making. Furthermore, students initially conceived of open space as purely ecological/biophysical, but by the end of the course, (3) their understanding was of open space as a coupled human/ecological system. This shift is crucial for student development as sustainability scientists.
Rosa, Rossana; Zavala, Bruno; Cain, Natalie; Anjan, Shweta; Aragon, Laura; Abbo, Lilian M
2018-03-01
Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.
Nurse and Medical Provider Perspectives on Antibiotic Stewardship in Nursing Homes.
Scales, Kezia; Zimmerman, Sheryl; Reed, David; Beeber, Anna Song; Kistler, Christine E; Preisser, John S; Weiner, Bryan J; Ward, Kimberly; Fann, Amy; Sloane, Philip D
2017-01-01
To examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs). Cross-sectional survey. NHs in North Carolina (N = 31). Nursing staff (n = 182) and medical providers (n = 50). Respondents completed a self-administered questionnaire about their perspectives on antibiotic use in their NH, the influence of residents and families on antibiotic prescribing decisions, and readiness to improve antibiotic stewardship. Open-ended questions on barriers to antibiotic stewardship were also asked. Linear mixed modeling was used to analyze differences between respondent groups and to test for associations with individual and organizational characteristics. All respondents supported reducing antibiotic use, although medical providers' support was significantly stronger (P = .005). When asked about their perception of residents' and family members' preference for antibiotic use in the case of suspected infection and the influence of that preference on antibiotic-prescribing decisions, respondents indicated that residents and families favor antibiotic use and influence prescribing decisions. Nurses reported a stronger perception than medical providers that families prefer antibiotics (P = .04) and influence prescribing decisions (P = .02). All respondents reported commitment and efficacy to change practices (mean 4.0-4.1 for nurses and 3.6-3.9 for medical providers on a 5-point scale). Four significant associations related to organizational and individual characteristics were found: directors of nursing and specialist nurses reported greater self-efficacy for changing practice than other nurses (P = .003), medical providers with a subspecialty (e.g., geriatrics) reported greater self-efficacy (P = .007) and commitment to change (P = .001) than those without a subspecialty, and medical providers specializing in hospice and palliative care rated family influence (P = .006) higher than those with other subspecialties. Nursing staff and medical providers share a commitment to reducing unnecessary antibiotic use. Antibiotic stewardship interventions should foster cooperation and build competency to implement alternative management approaches and to educate residents and families. Nurse leaders and medical providers with long-term care training may be especially effective champions for antibiotic stewardship. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.
Defense Experimentation and Stockpile Stewardship
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
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.
Defense Experimentation and Stockpile Stewardship
None
2018-01-16
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.
Eco-Visualization: Promoting Environmental Stewardship in the Museum
ERIC Educational Resources Information Center
Holmes, Tiffany
2007-01-01
Eco-visualizations are artworks that reinterpret environmental data with custom software to promote stewardship. Eco-visualization technology offers a new way to dynamically picture environmental data and make it meaningful to a museum population. The questions are: How might museums create new projects and programs around place-based information?…
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
An outpatient antibacterial stewardship intervention during the journey to JCI accreditation
2014-01-01
Background Antibacterial overuse, misuse and resistance have become a major global threat. The Joint Commission International (JCI) accreditation standards include quality improvement and patient safety, which is exemplified by antimicrobial stewardship. There are currently few reports on interventions to improve the quality of outpatient antibacterial prescribing. Methods A before-after intervention study, aiming at antibacterial use in outpatients, was performed in a university-affiliated hospital with 2.8 million outpatient visits annually during the journey to JCI accreditation (March of 2012 - March of 2013). Comprehensive intervention measures included formulary adjustment, classification management, motivational, information technological, educational and organizational measures. A defined daily dose (DDD) methodology was applied. Pharmacoeconomic data and drug-related problems (DRPs) were statistically compared between the two phases. Results The variety of antibacterials available in outpatient pharmacy decreased from 38 to 16. The proportion of antibacterial prescriptions significantly decreased (12.7% versus 9.9%, P < 0.01). The proportion of prescriptions containing the restricted antibacterials was 30.4% in the second phase, significantly lower than the value of 44.7% in the first phase (P < 0.01). The overall proportion of oral versus all antibacterial prescriptions increased (94.0% to 100%, P < 0.01) when measured as defined daily doses. Statistically significant increases in relative percentage of DDDs of oral antibacterials (i.e., DDDs of individual oral antibacterial divided by the sum of DDDs of all antibacterials) were observed with moxifloxacin, levofloxacin, cefuroxime axetil, ornidazole, clindamycin palmitate, cefaclor, amoxicillin and clarithromycin. Occurrence rate of DRPs decreased from 13.6% to 4.0% (P < 0.01), with a larger decrease seen in surgical clinics (surgical: 19.5% versus 5.6%; internal medicine: 8.4% versus 2.8%, P < 0.01). The total expenditure on antibacterials for outpatients decreased by 34.7% and the intervention program saved about 6 million Chinese Yuan Renminbi (CNY) annually. Conclusion The one-year intervention program on outpatient antibacterial use during the journey to JCI accreditation reduced the expenditure on antibacterials, improved the appropriateness of antibacterial prescriptions. Quality improvements need integrated multifaceted intervention measures and long-term adherence to the antibiotic stewardship. Approach of i.v. to oral antibacterial switch, classification management, and motivational measures may play the most efficient role in changing antibacterial prescription practices. PMID:24568120
MURMoT. Design and Application of Microbial Uranium Reduction Monitoring Tools
DOE Office of Scientific and Technical Information (OSTI.GOV)
Loeffler, Frank E.
2014-12-31
Uranium (U) contamination in the subsurface is a major remediation challenge at many DOE sites. Traditional site remedies present enormous costs to DOE; hence, enhanced bioremediation technologies (i.e., biostimulation and bioaugmentation) combined with monitoring efforts are being considered as cost-effective corrective actions to address subsurface contamination. This research effort improved understanding of the microbial U reduction process and developed new tools for monitoring microbial activities. Application of these tools will promote science-based site management decisions that achieve contaminant detoxification, plume control, and long-term stewardship in the most efficient manner. The overarching hypothesis was that the design, validation and application ofmore » a suite of new molecular and biogeochemical tools advance process understanding, and improve environmental monitoring regimes to assess and predict in situ U immobilization. Accomplishments: This project (i) advanced nucleic acid-based approaches to elucidate the presence, abundance, dynamics, spatial distribution, and activity of metal- and radionuclide-detoxifying bacteria; (ii) developed proteomics workflows for detection of metal reduction biomarker proteins in laboratory cultures and contaminated site groundwater; (iii) developed and demonstrated the utility of U isotopic fractionation using high precision mass spectrometry to quantify U(VI) reduction for a range of reduction mechanisms and environmental conditions; and (iv) validated the new tools using field samples from U-contaminated IFRC sites, and demonstrated their prognostic and diagnostic capabilities in guiding decision making for environmental remediation and long-term site stewardship.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sinars, Daniel; Scott, Kimberly Carole; Edwards, M. John
Major advances in pulsed power technology and applications over the last twenty years have expanded the mission areas for pulsed power and created compelling new opportunities for the Stockpile Stewardship Program (SSP). This summary document is a forward look at the development of pulsed power science and technology (PPS&T) capabilities in support of the next 20 years of the SSP. This outlook was developed during a three-month-long tri-lab study on the future of PPS&T research and capabilities in support of applications to: (1) Dynamic Materials, (2) Thermonuclear Burn Physics and Inertial Confinement Fusion (ICF), and (3) Radiation Effects and Nuclearmore » Survivability. It also considers necessary associated developments in next-generation codes and pulsed power technology as well as opportunities for academic, industry, and international engagement. The document identifies both imperatives and opportunities to address future SSP mission needs. This study was commissioned by the National Nuclear Security Administration (NNSA). A copy of the memo request is contained in the Appendix. NNSA guidance received during this study explicitly directed that it not be constrained by resource limitations and not attempt to prioritize its findings against plans and priorities in other areas of the national weapons program. That prioritization, including the relative balance amongst the three focus areas themselves, must of course occur before any action is taken on the observations presented herein. This unclassified summary document presents the principal imperatives and opportunities identified in each mission and supporting area during this study. Preceding this area-specific outlook, we discuss a cross-cutting opportunity to increase the shot capacity on the Z pulsed power facility as a near-term, cost-effective way to broadly impact PPS&T for SSP as well as advancing the science and technology to inform future SSMP milestones over the next 5-10 years. The final page of the summary presents two timelines that couch the opportunities discussed here in terms of the broader strategic timelines encapsulated in the fiscal year 2017 Stockpile Stewardship Management Plan (SSMP).« less
Code of Federal Regulations, 2011 CFR
2011-01-01
.... These programs include: Conservation Stewardship Program, Farm and Ranch Lands Protection Program, Grassland Reserve Program, Environmental Quality Incentives Program, Conservation Innovation Grants, Agricultural Water Enhancement Program, Conservation of Private Grazing Land, Wildlife Habitat Incentive...
Laboratory directed research and development FY98 annual report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Al-Ayat, R; Holzrichter, J
1999-05-01
In 1984, Congress and the Department of Energy (DOE) established the Laboratory Directed Research and Development (LDRD) Program to enable the director of a national laboratory to foster and expedite innovative research and development (R and D) in mission areas. The Lawrence Livermore National Laboratory (LLNL) continually examines these mission areas through strategic planning and shapes the LDRD Program to meet its long-term vision. The goal of the LDRD Program is to spur development of new scientific and technical capabilities that enable LLNL to respond to the challenges within its evolving mission areas. In addition, the LDRD Program provides LLNLmore » with the flexibility to nurture and enrich essential scientific and technical competencies and enables the Laboratory to attract the most qualified scientists and engineers. The FY98 LDRD portfolio described in this annual report has been carefully structured to continue the tradition of vigorously supporting DOE and LLNL strategic vision and evolving mission areas. The projects selected for LDRD funding undergo stringent review and selection processes, which emphasize strategic relevance and require technical peer reviews of proposals by external and internal experts. These FY98 projects emphasize the Laboratory's national security needs: stewardship of the U.S. nuclear weapons stockpile, responsibility for the counter- and nonproliferation of weapons of mass destruction, development of high-performance computing, and support of DOE environmental research and waste management programs.« less
Jump, Robin L P; Crnich, Christopher J; Mody, Lona; Bradley, Suzanne F; Nicolle, Lindsay E; Yoshikawa, Thomas T
2018-04-01
The diagnosis, treatment, and prevention of infectious diseases in older adults in long-term care facilities (LTCFs), particularly nursing facilities, remains a challenge for all health providers who care for this population. This review provides updated information on the currently most important challenges of infectious diseases in LTCFs. With the increasing prescribing of antibiotics in older adults, particularly in LTCFs, the topic of antibiotic stewardship is presented in this review. Following this discussion, salient points on clinical relevance, clinical presentation, diagnostic approach, therapy, and prevention are discussed for skin and soft tissue infections, infectious diarrhea (Clostridium difficile and norovirus infections), bacterial pneumonia, and urinary tract infection, as well as some of the newer approaches to preventive interventions in the LTCF setting. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.
Citizen monitoring and restoration: Volunteers and community involvement in wilderness stewardship
Laurie Yung
2007-01-01
Citizen monitoring and restoration is increasingly viewed as a means to involve local communities in wilderness stewardship. This paper examines research on volunteers participating in five monitoring and restoration programs in Western Montana. Volunteers reported that they gained valuable skills, felt more connected with local wilderness areas, and made an important...
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…
The Daniel K. Inouye College of Pharmacy Scripts
Goo, Roy Alan SH; Chu, Cherie HL; Yoneda, Melissa K; Ma, Carolyn SJ
2016-01-01
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. PMID:27437167
Los Alamos Neutron Science Center
DOE Office of Scientific and Technical Information (OSTI.GOV)
Kippen, Karen Elizabeth
For more than 30 years the Los Alamos Neutron Science Center (LANSCE) has provided the scientific underpinnings in nuclear physics and material science needed to ensure the safety and surety of the nuclear stockpile into the future. In addition to national security research, the LANSCE User Facility has a vibrant research program in fundamental science, providing the scientific community with intense sources of neutrons and protons to perform experiments supporting civilian research and the production of medical and research isotopes. Five major experimental facilities operate simultaneously. These facilities contribute to the stockpile stewardship program, produce radionuclides for medical testing, andmore » provide a venue for industrial users to irradiate and test electronics. In addition, they perform fundamental research in nuclear physics, nuclear astrophysics, materials science, and many other areas. The LANSCE User Program plays a key role in training the next generation of top scientists and in attracting the best graduate students, postdoctoral researchers, and early-career scientists. The U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) —the principal sponsor of LANSCE—works with the Office of Science and the Office of Nuclear Energy, which have synergistic long-term needs for the linear accelerator and the neutron science that is the heart of LANSCE.« less
Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions.
Stenehjem, Edward; Hyun, David Y; Septimus, Ed; Yu, Kalvin C; Meyer, Marc; Raj, Deepa; Srinivasan, Arjun
2017-08-15
Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. Seventy-three percent of US hospitals have <200 beds. Small hospitals (<200 beds) have similar rates of antibiotic prescribing compared to large hospitals, but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission, and the Centers for Medicare and Medicaid Services has proposed a similar requirement. Very few studies have described the successful implementation of ASPs in small hospitals. We describe barriers commonly encountered in small hospitals when constructing an antibiotic stewardship team, obtaining appropriate metrics of antibiotic prescribing, implementing antibiotic stewardship interventions, obtaining financial resources, and utilizing the microbiology laboratory. We propose potential solutions that tailor stewardship activities to the needs of the facility and the resources typically available. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Neeway, James J.; Pierce, Eric M.; Freedman, Vicky L.
2014-08-04
The federal facilities located on the Hanford Site in southeastern Washington State have been used extensively by the U.S. government to produce nuclear materials for the U.S. strategic defense arsenal. Currently, the Hanford Site is under the stewardship of the U.S. Department of Energy (DOE) Office of Environmental Management (EM). A large inventory of radioactive and mixed waste resulting from the production of nuclear materials has accumulated, mainly in 177 underground single- and double-shell tanks located in the central plateau of the Hanford Site (Mann et al., 2001). The DOE-EM Office of River Protection (ORP) is proceeding with plans tomore » immobilize and permanently dispose of the low-activity waste (LAW) fraction onsite in a shallow subsurface disposal facility (the Integrated Disposal Facility [IDF]). Pacific Northwest National Laboratory (PNNL) was contracted to provide the technical basis for estimating radionuclide release from the engineered portion of the IDF (the source term) as part of an immobilized low-activity waste (ILAW) glass testing program to support future IDF performance assessments (PAs).« less
Mody, Lona; Meddings, Jennifer; Edson, Barbara S.; McNamara, Sara E.; Trautner, Barbara W.; Stone, Nimalie D.; Krein, Sarah L.; Saint, Sanjay
2015-01-01
Preventing healthcare-associated infection (HAI) is a key contributor to enhancing resident safety in nursing homes. In 2013, the U.S. Department of Health and Human Services approved a plan to enhance resident safety by reducing HAIs in nursing homes, with particular emphasis on reducing indwelling catheter use and catheter-associated urinary tract infection (CAUTI). Lessons learned from a recent multimodal Targeted Infection Prevention program in a group of nursing homes as well as a national initiative to prevent CAUTI in over 950 acute care hospitals called “On the CUSP: STOP CAUTI” will now be implemented in nearly 500 nursing homes in all 50 states through a project funded by the Agency for Healthcare Research and Quality (AHRQ). This “AHRQ Safety Program in Long-Term Care: HAIs/CAUTI” will emphasize professional development in catheter utilization, catheter care and maintenance, and antimicrobial stewardship as well as promoting patient safety culture, team building, and leadership engagement. We anticipate that an approach integrating technical and socio-adaptive principles will serve as a model for future initiatives to reduce other infections, multidrug resistant organisms, and noninfectious adverse events among nursing home residents. PMID:25814630
Calendar Year 2016 Annual Groundwater Monitoring Report.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Copland, John R.; Jackson, Timmie Okchumpulla; Li, Jun
Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned/contractoroperated laboratory. National Technology and Engineering Solutions of Sandia, LLC, a wholly owned subsidiary of Honeywell International, Inc., manages and operates SNL/NM for the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA). The DOE/NNSA Sandia Field Office administers the contract and oversees contractor operations at the site. Two types of groundwater surveillance monitoring are conducted at SNL/NM: (1) on a site-wide basis as part of the SNL/NM Long-Term Stewardship (LTS) Program’s Groundwater Monitoring Program (GMP) Groundwater Surveillance Task and (2) on a site-specific groundwater monitoring at LTS/Environmental Restoration (ER) Operationsmore » sites with ongoing groundwater investigations. This Annual Groundwater Monitoring Report summarizes data collected during groundwater monitoring events conducted at GMP locations and at the following SNL/NM sites through December 31, 2016: Burn Site Groundwater Area of Concern (AOC); Chemical Waste Landfill; Mixed Waste Landfill; Technical Area-V Groundwater AOC; and the Tijeras Arroyo Groundwater AOC. Environmental monitoring and surveillance programs are required by the New Mexico Environment Department (NMED) and DOE Order 436.1, Departmental Sustainability, and DOE Order 231.1B, Environment, Safety, and Health Reporting.« less
ERIC Educational Resources Information Center
Friedlander, Amy; Adler, Prudence
2006-01-01
The rapid adoption of information technology and ubiquitous networking has transformed the research and education landscape. Central to this transformation are scientific and engineering digital data collections. The life cycle management challenges associated with these intellectual assets are substantial. This is a report of a two-day workshop…
Effects of pore-scale physics on uranium geochemistry in Hanford sediments
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hu, Qinhong; Ewing, Robert P.
Overall, this work examines a key scientific issue, mass transfer limitations at the pore-scale, using both new instruments with high spatial resolution, and new conceptual and modeling paradigms. The complementary laboratory and numerical approaches connect pore-scale physics to macroscopic measurements, providing a previously elusive scale integration. This Exploratory research project produced five peer-reviewed journal publications and eleven scientific presentations. This work provides new scientific understanding, allowing the DOE to better incorporate coupled physical and chemical processes into decision making for environmental remediation and long-term stewardship.
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 club…
Kathleen L. Wolf; Dale J. Blahna; Weston Brinkley; Michele Romolini
2013-01-01
Urbanization processes challenge ecosystem health in many metropolitan areas. New policy and program approaches are needed to restore and sustain natural systems as public agencies and organizations face greater demands and declining budgets. Environmental stewardship is an often overlooked intervention strategy, and the full potential of civic engagement by citizens...
Organizational ethics in Catholic health care: honoring stewardship and the work environment.
Magill, G
2001-04-01
Organizational ethics refers to the integration of values into decision making, policies, and behavior throughout the multi-disciplinary environment of a health care organization. Based upon Catholic social ethics, stewardship is at the heart of organizational ethics in health care in this sense: stewardship provides the hermeneutic filter that enables basic ethical principles to be realized practically, within the context of the Catholic theology of work, to concerns in health care. This general argument can shed light on the specific topic of non-executive compensation programs as an illustration of organizational ethics in health care.
Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J
2018-02-05
Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial resistance and antimicrobial stewardship. Governments, hospitals, and professional societies appear to be driving action on this front, sometimes working with other types of organizations. A broad range of resources have been made freely available; however, we have noted several opportunities for action, including increased engagement with students, improvements to pre-service education, recognition of antimicrobial resistance courses as continuing medical education, and better platforms for resource-sharing online.
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 supported by testing of the model. Finally, nature connection was tested as a full mediator of the relationship between outdoor play and environmental stewardship. There is support for the idea that direct experience in the outdoors facilitates environmental behaviors, but more research is needed to understand this relationship. Testing of the model failed to demonstrate that nature connection fully mediated the relationship between outdoor play and environmental stewardship; however, a feeling of connectedness to nature augmented the influence that outdoor play behavior exerts on environmental stewardship behavior.
Remote Antimicrobial Stewardship in Community Hospitals
Wood, Zachary H.; Nicolsen, Nicole C.; Allen, Nichole; Cook, Paul P.
2015-01-01
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. PMID:27025642
Antimicrobial Stewardship Programs: Appropriate Measures and Metrics to Study their Impact.
Morris, Andrew M
Antimicrobial stewardship is a new field that struggles to find the right balance between meaningful and useful metrics to study the impact of antimicrobial stewardship programs (ASPs). ASP metrics primarily measure antimicrobial use, although microbiological resistance and clinical outcomes are also important measures of the impact an ASP has on a hospital and its patient population. Antimicrobial measures looking at consumption are the most commonly used measures, and are focused on defined daily doses, days of therapy, and costs, usually standardized per 1,000 patient-days. Each measure provides slightly different information, with their own upsides and downfalls. Point prevalence measurement of antimicrobial use is an increasingly used approach to understanding consumption that does not entirely rely on sophisticated electronic information systems, and is also replicable. Appropriateness measures hold appeal and promise, but have not been developed to the degree that makes them useful and widely applicable. The primary reason why antimicrobial stewardship is necessary is the growth of antimicrobial resistance. Accordingly, antimicrobial resistance is an important metric of the impact of an ASP. The most common approach to measuring resistance for ASP purposes is to report rates of common or important community- or nosocomial-acquired antimicrobial-resistant organisms, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile. Such an approach is dependent on detection methods, community rates of resistance, and co-interventions, and therefore may not be the most accurate or reflective measure of antimicrobial stewardship interventions. Development of an index to reflect the net burden of resistance holds theoretical promise, but has yet to be realized. Finally, programs must consider patient outcome measures. Mortality is the most objective and reliable method, but has several drawbacks. Disease- or organism-specific mortality, or cure, are increasingly used metrics.
75 FR 31609 - Conservation Stewardship Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-03
...Section 2301 of the Food, Conservation, and Energy Act of 2008 (2008 Act) amended the Food Security Act of 1985 to establish the Conservation Stewardship Program (CSP). On July 29, 2009, the Natural Resources Conservation Service (NRCS) published an interim final rule for CSP with a 60-day public comment period. On September 21, 2009, the public comment period was extended 30 days. NRCS is publishing a final rule that addresses the comments received on the interim final rule and makes other minor adjustments to improve clarity of the rule.
ERIC Educational Resources Information Center
Johnson, Jerry; Thompson, Aaron; Naugle, Kim
2009-01-01
This paper sets forth a model of regional stewardship developed and implemented at a post-compulsory institution serving rural communities in central Appalachia, a region that is among the most impoverished in the United States. The model, termed place-conscious capacity-building, emphasises culturally-responsive methodologies and the strategic…
Informing rangeland stewardship with research: lessons learned from Yolo County, California
Vance Russell; Chris Rose; Miles DaPrato
2008-01-01
Approximately 70 percent of the contiguous United States is in private lands with half of this total in row crop or rangelands. Audubon Californiaâs Landowner Stewardship Program engages with farmers and ranchers on conservation and restoration projects in a manner compatible with existing agricultural operations. To assess the success of these efforts, Audubon,...
Anderson, Deverick J.; Cochran, Ronda L.; Hicks, Lauri A.; Srinivasan, Arjun; Dodds Ashley, Elizabeth S.
2017-01-01
Antimicrobial stewardship programs (ASPs) positively impact patient care, but metrics to assess ASP impact are poorly defined. We used a modified Delphi approach to select relevant metrics for assessing patient-level interventions in acute-care settings for the purposes of internal program decision making. An expert panel rated 90 candidate metrics on a 9-point Likert scale for association with 4 criteria: improved antimicrobial prescribing, improved patient care, utility in targeting stewardship efforts, and feasibility in hospitals with electronic health records. Experts further refined, added, or removed metrics during structured teleconferences and re-rated the retained metrics. Six metrics were rated >6 in all criteria: 2 measures of Clostridium difficile incidence, incidence of drug-resistant pathogens, days of therapy over admissions, days of therapy over patient days, and redundant therapy events. Fourteen metrics rated >6 in all criteria except feasibility were identified as targets for future development. PMID:27927866
Antibiotic prescribing in long-term care facilities: a qualitative, multidisciplinary investigation
Fleming, Aoife; Bradley, Colin; Cullinan, Shane; Byrne, Stephen
2014-01-01
Objectives To explore healthcare professionals’ views of antibiotic prescribing in long-term care facilities (LTCFs). To use the findings to recommend intervention strategies for antimicrobial stewardship in LTCFs. Design Qualitative semistructured interviews were conducted. The data were analysed by thematic content analysis. After the interviews, the emerging findings were mapped to the theoretical domains framework (TDF), and the behaviour change wheel and behaviour change technique (BCT) taxonomy were used to recommend future intervention strategies. Participants Interviews were conducted with 37 healthcare professionals who work in LTCFs (10 general practitioners, 4 consultants, 14 nurses, 9 pharmacists) between December 2012 and March 2013. Setting Interviews were conducted in the greater Cork region. Results The main domains from the TDF which emerged were: ‘Knowledge’, ‘Environmental context and resources’, ‘Social influences’, ‘Beliefs about consequences’, ‘Memory, attention and decision making’, with the findings identifying a need for ‘Behavioural regulation’. Many participants believed that antibiotic prescribing was satisfactory at their LTCF, despite the lack of surveillance activities. Conclusions This study, using the TDF and BCT taxonomy, has found that antibiotic prescribing in LTCFs is influenced by many social and contextual factors. The challenges of the setting and patient population, the belief about consequences to the patient, and the lack of implementation of guidelines and knowledge regarding antibiotic prescribing patterns are significant challenges to address. On the basis of the study findings and the application of the TDF and BCT taxonomy, we suggest some practical intervention functions for antimicrobial stewardship in LTCFs. PMID:25377014
76 FR 19683 - Conservation Program Recipient Reporting
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-08
... regulation that has application or plan due dates after October 1, 2010. The Watershed Operations and Flood Prevention Program, Emergency Watersheds Protection Program, Healthy Forests Reserve Program, Agricultural Management Assistance Program, and the Conservation Stewardship Program have application or plan due dates...
Berrevoets, Marvin Ah; Ten Oever, Jaap; Sprong, Tom; van Hest, Reinier M; Groothuis, Ingeborg; van Heijl, Inger; Schouten, Jeroen A; Hulscher, Marlies E; Kullberg, Bart-Jan
2017-08-15
The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of antibiotic use are monitored by antimicrobial stewardship teams (A-teams) and can be used as indicators for the stewardship registry. In this pilot study we aimed to determine which stewardship objectives are eligible for the envisioned registry. We performed an observational pilot study among five Dutch hospitals. We assessed which of the 14 validated stewardship objectives (11 process of care recommendations and 3 structure of care recommendations) the A-teams monitored and documented in individual patients. They provided, where possible, data to compute quality indicator (QI) performance scores in line with recently developed QIs to measure appropriate antibiotic use in hospitalized adults for the period of January 2015 through December 2015 RESULTS: All hospitals had a local antibiotic guideline describing recommended antimicrobial use. All A-teams monitored the performance of bedside consultations in Staphylococcus aureus bacteremia and the prescription of restricted antimicrobials. Documentation and reporting were the best for the use of restricted antimicrobials: 80% of the A-teams could report data. Lack of time and the absence of an electronic medical record system enabling documentation during the daily work flow were the main barriers hindering documentation and reporting. Five out of 11 stewardship objectives were actively monitored by A-teams. Without extra effort, 4 A-teams could report on the quality of use of restricted antibiotics. Therefore, this aspect of antibiotic use should be the starting point of the national antimicrobial stewardship registry. Our registry is expected to become a powerful tool to evaluate progress and impact of antimicrobial stewardship programs in hospitals.
7 CFR 610.24 - Responsibilities of State Technical Committees.
Code of Federal Regulations, 2011 CFR
2011-01-01
... programs under Title XII of the Food Security Act of 1985 including, but not limited to, the Conservation Reserve Program, Wetlands Reserve Program, Conservation Security Program, Conservation Stewardship Program, Farm and Ranch Lands Protection Program, Grassland Reserve Program, Environmental Quality Incentives...
7 CFR 610.24 - Responsibilities of State Technical Committees.
Code of Federal Regulations, 2010 CFR
2010-01-01
... programs under Title XII of the Food Security Act of 1985 including, but not limited to, the Conservation Reserve Program, Wetlands Reserve Program, Conservation Security Program, Conservation Stewardship Program, Farm and Ranch Lands Protection Program, Grassland Reserve Program, Environmental Quality Incentives...
7 CFR 610.24 - Responsibilities of State Technical Committees.
Code of Federal Regulations, 2012 CFR
2012-01-01
... programs under Title XII of the Food Security Act of 1985 including, but not limited to, the Conservation Reserve Program, Wetlands Reserve Program, Conservation Security Program, Conservation Stewardship Program, Farm and Ranch Lands Protection Program, Grassland Reserve Program, Environmental Quality Incentives...
7 CFR 610.24 - Responsibilities of State Technical Committees.
Code of Federal Regulations, 2013 CFR
2013-01-01
... programs under Title XII of the Food Security Act of 1985 including, but not limited to, the Conservation Reserve Program, Wetlands Reserve Program, Conservation Security Program, Conservation Stewardship Program, Farm and Ranch Lands Protection Program, Grassland Reserve Program, Environmental Quality Incentives...
Improving Wellbeing and Environmental Stewardship Through Volunteering in Nature.
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.
Fact Sheet: 2010/2015 PFOA Stewardship Program
EPA's existing chemicals programs address pollution prevention, risk assessment, hazard and exposure assessment and/or characterization, and risk management for chemicals substances in commercial use.
A national survey of pediatric dentists on antibiotic use in children.
Sivaraman, Sujatha S; Hassan, Mohamed; Pearson, Julie M
2013-01-01
The purposes of this study were to: (1) examine the antibiotic prescribing practices of pediatric dentists and adherence to professional guidelines; and (2) assess their knowledge of and attitudes toward antibiotic resistance. A cross-sectional survey regarding antibiotic use, resistance, and knowledge of antibiotic stewardship programs was emailed to 4,636 members of the American Academy of Pediatric Dentistry (AAPD). 987 surveys (21 percent) were completed; 984 were analyzed. Lack of adherence to AAPD antibiotic guidelines was noted. There was a trend toward overuse of antibiotics for the following conditions: irreversible pulpitis with (32 percent) and without vital pulp (42 percent); localized dentoalveolar abscess with (68 percent) and without draining fistula (39 percent); mitral valve relapse with regurgitation (43 percent); intrusion (15 percent); extrusion (13 percent); and rheumatoid arthritis (12 percent). Determinants of antibiotic use were: facial swelling (88 percent); pain relief (15 percent); unavailable appointment for several weeks (six percent); and parental satisfaction (four percent). Although 98 percent of respondents believed that antibiotic resistance is of growing concern, only 15 percent were aware of antibiotic stewardship programs. AAPD members overprescribe antibiotics. Educational programs to increase knowledge of antibiotic resistance and stewardship programs should be implemented to increase adherence to professional guidelines.
Antimicrobial Stewardship in a Community Hospital: Attacking the More Difficult Problems
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
Brenn, B Randall; Choudhry, Dinesh K; Sacks, Karen; Como-Fluehr, Sandra; Strain, Robert
2016-09-01
Despite increased focus on pediatric pain, uncontrolled pain is still a problem for hospitalized pediatric inpatients. A program was designed to find patients with uncontrolled pain and develop a framework to oversee their pain management. This report details the development of a pain stewardship program with data from the first year of its activity. Hospitalized inpatients in a tertiary care pediatric center in the mid-Atlantic region were included in the study. Pain scores are recorded every 4 hours in the hospital electronic health record. A report was constructed to find all patients with an average pain score ≥7 in the preceding 12 hours. The charts of these patients were reviewed by our anesthesia pain service, and all patients were grouped into 1 of the following action categories: (1) no action required; (2) telephone call to the patient's attending physician; (3) one-time consultation; (4) consultation with ongoing management; or (5) patient was already on the anesthesia pain service. Demographic data, pain regimens, and outcomes were recorded in a prospectively collected database. There were 843 records on 441 unique patients. Only 22% required action to be taken by the anesthesia pain service. The pain stewardship database revealed that patients with sickle cell disease or abdominal pain required more frequent attention. An electronic health record-based pain stewardship program is an important step in identifying all children in the hospital with undermanaged pain, and it provides a warning system that may improve patient care, outcomes, and satisfaction. Copyright © 2016 by the American Academy of Pediatrics.
Stenehjem, Edward; Hersh, Adam L; Buckel, Whitney R; Jones, Peter; Sheng, Xiaoming; Evans, R Scott; Burke, John P; Lopansri, Bert K; Srivastava, Rajendu; Greene, Tom; Pavia, Andrew T
2018-02-23
Studies on the implementation of antibiotic stewardship programs (ASPs) in small hospitals are limited. Accreditation organizations now require all hospitals to have ASPs. The objective of this cluster-randomized intervention was to assess the effectiveness of implementing ASPs in Intermountain Healthcare's 15 small hospitals. Each hospital was randomized to 1 of 3 ASPs of escalating intensity. Program 1 hospitals were provided basic antibiotic stewardship education and tools, access to an infectious disease hotline, and antibiotic utilization data. Program 2 hospitals received those interventions plus advanced education, audit and feedback for select antibiotics, and locally controlled antibiotic restrictions. Program 3 hospitals received program 2 interventions plus audit and feedback on the majority of antibiotics, and an infectious diseases-trained clinician approved restricted antibiotics and reviewed microbiology results. Changes in total and broad-spectrum antibiotic use within programs (intervention versus baseline) and the difference between programs in the magnitude of change in antibiotic use (eg, program 3 vs 1) were evaluated with mixed models. Program 3 hospitals showed reductions in total (rate ratio, 0.89; confidence interval, .80-.99) and broad-spectrum (0.76; .63-.91) antibiotic use when the intervention period was compared with the baseline period. Program 1 and 2 hospitals did not experience a reduction in antibiotic use. Comparison of the magnitude of effects between programs showed a similar trend favoring program 3, but this was not statistically significant. Only the most intensive ASP intervention was associated with reduction in total and broad-spectrum antibiotic use when compared with baseline. NCT03245879.
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.…
Rezaei-Hachesu, Peyman; Samad-Soltani, Taha; Yaghoubi, Sajad; GhaziSaeedi, Marjan; Mirnia, Kayvan; Masoumi-Asl, Hossein; Safdari, Reza
2018-07-01
Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step. As a result, this study aimed to design an AMR surveillance system for use in the NICUs in northwestern Iranian hospitals to cover these information gaps. The recommended system is compatible with the World Health Organization (WHO) guidelines. The business intelligence (BI) requirements were extracted in an interview with a product owner (PO) using a valid and reliable checklist. Following this, an AMR surveillance system was designed and evaluated in relation to user experiences via a user experience questionnaire (UEQ). Finally, an association analysis was performed on the database, and the results were reported by identifying the important multidrug resistances in the database. A customized software development methodology was proposed. The three major modules of the AMR surveillance are the data registry, dashboard, and decision support modules. The data registry module was implemented based on a three-tier architecture, and the Clinical Decision Support System (CDSS) and dashboard modules were designed based on the BI requirements of the Scrum product owner (PO). The mean values of UEQ measures were in a good range. This measures showed the suitable usability of the AMR surveillance system. Applying efficient software development methodologies allows for the systems' compatibility with users' opinions and requirements. In addition, the construction of interdisciplinary communication models for research and software engineering allows for research and development concepts to be used in operational environments. Copyright © 2018 Elsevier B.V. All rights reserved.
J. Daniel van Dijk; Gary T. Green; Craig A. Miller
2009-01-01
The Georgia Forestry Commission in conjunction with the U.S. Forest Service instituted the Forest Stewardship Program (FSP) in 1991. A growing component of the FSP is recreation, which is the component least understood by stewardship planners. A survey was developed to better understand the needs of planners with regard to developing forest recreation plans, and the...
Marc Coles-Ritchie; Stephen J. Solem; Abraham E. Springer; Burton Pendleton
2014-01-01
In the desert Southwest, springs are an important ecological feature and serve as a focal point for both biological and human interactions on the landscape. As a result, attention has been placed on the stewardship and protection of these important resources. Management has traditionally focused on the more accessible and heavily used eastern canyons within the Spring...
Stewardship of NASA's Earth Science Data and Ensuring Long-Term Active Archives
NASA Technical Reports Server (NTRS)
Ramapriyan, Hampapuram K.; Behnke, Jeanne
2016-01-01
Program, NASA has followed an open data policy, with non-discriminatory access to data with no period of exclusive access. NASA has well-established processes for assigning and or accepting datasets into one of 12 Distributed Active Archive Centers (DAACs) that are parts of EOSDIS. EOSDIS has been evolving through several information technology cycles, adapting to hardware and software changes in the commercial sector. NASA is responsible for maintaining Earth science data as long as users are interested in using them for research and applications, which is well beyond the life of the data gathering missions. For science data to remain useful over long periods of time, steps must be taken to preserve: (1) Data bits with no corruption, (2) Discoverability and access, (3) Readability, (4) Understandability, (5) Usability' and (6). Reproducibility of results. NASAs Earth Science data and Information System (ESDIS) Project, along with the 12 EOSDIS Distributed Active Archive Centers (DAACs), has made significant progress in each of these areas over the last decade, and continues to evolve its active archive capabilities. Particular attention is being paid in recent years to ensure that the datasets are published in an easily accessible and citable manner through a unified metadata model, a common metadata repository (CMR), a coherent view through the earthdata.gov website, and assignment of Digital Object Identifiers (DOI) with well-designed landing product information pages.
NASA Astrophysics Data System (ADS)
Elmer, Laura K.; Kelly, Lisa A.; Rivest, Stephanie; Steell, S. Clay; Twardek, William M.; Danylchuk, Andy J.; Arlinghaus, Robert; Bennett, Joseph R.; Cooke, Steven J.
2017-08-01
A new geological epoch, the "Anthropocene", has been defined as the period in which humans have had substantial geological and ecological influence on the planet. A positive future for this epoch can be referred to as the "good Anthropocene" and would involve effective management strategies and changes in human behavior that promote the sustainability and restoration of ecosystems. Recreational fisheries hold significant social, cultural, and economic value and can generate many benefits when managed sustainably and thus be an integral part of a "good Anthropocene". Here, we list ten commandments to facilitate persistence and long-term sustainability of recreational fisheries in the "good Anthropocene". This list includes fostering aquatic stewardship, promoting education, using appropriate capture gear, adopting evidence-based management approaches, promoting the concept of resilience, obtaining and using effort data in management, embracing the ecosystem approach, engaging in multilevel collaboration, enhancing accessibility, and embracing optimism. When used singly, or simultaneously, these ten commandments will contribute to the harmonization of sustainable fish populations and angling practices, to create recreational fisheries' "bright spots".
Data governance and stewardship: designing data stewardship entities and advancing data access.
Rosenbaum, Sara
2010-10-01
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. © Health Research and Educational Trust.
Data Governance and Stewardship: Designing Data Stewardship Entities and Advancing Data Access
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
Barlow, Giulia; Patterson, Julie; Stultz, Jeremy; Pakyz, Amy L
2017-12-01
Hospitals are categorized as better, no different, or worse at a national level based on their Clostridium difficile infection performance. Institutional antimicrobial stewardship programs seek to decrease the occurrence of C difficile by implementing strategies to address antibiotic usage; however, optimal structure and strategies for accomplishing this remain largely unknown. We found that a higher proportion of hospitals with either a worse or no different rank used a postprescription audit and feedback strategy than hospitals with a better rank. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Firestone, Mary
Objectives of proposed research were to; Determine if the trajectories of microbial community composition and function following organic carbon amendment can be related to, and predicted by, key environmental determinants; Assess the relative importance of the characteristics of the indigenous microbial community, sediment, groundwater, and concentration of organic carbon amendment as the major determinants of microbial community functional response and bioremediation capacity; and Provide a fundamental understanding of the microbial community ecology underlying subsurface metal remediation requisite to successful application of accelerated remediation and long-term stewardship of DOE-IFC sites.
Fleming, Dimitra; Ali, Karim F.; Matelski, John; D'Sa, Ryan; Powis, Jeff
2016-01-01
Prospective audit and feedback (PAF) is an effective strategy to optimize antimicrobial use in the critical care setting, yet whether skills gained during PAF influence future antimicrobial prescribing is uncertain. This multisite study demonstrates that knowledge learned during PAF is translated and incorporated into the practice of critical care physicians even when not supported by an antimicrobial stewardship program. PMID:27382599
NASA Astrophysics Data System (ADS)
Eichelberger, J.; Hill, G.; Patrick, M.; Freymueller, J.; Barnes, D.; Kelley, J.; Layer, P.
2001-12-01
The US Department of Energy (USDOE) is currently undertaking an ambitious program of environmental remediation of the surface of Amchitka Island in the western Aleutians, where three underground nuclear tests were conducted during 1963-1971. Among these tests was Cannikin, at approximately 5 megatons the largest nuclear device ever exploded underground by the United States and equivalent in seismic energy release to a magnitude 7 earthquake. The blast caused about 1 m of uplift of the Bering Sea coastline in the 3-km-wide fault-bounded block within which it was detonated. The impending final transfer of stewardship of this area to the US Fish and Wildlife Service as part of the Alaska Maritime National Wildlife Refuge raises anew the question of the potential for transport of radionuclides from the shot cavity, located at 1791 m depth in mafic laharic breccias, into the accessible environment. In particular, there is concern about whether such contaminants could become concentrated in the marine food chain that is used for subsistence by Alaskan Natives (and by the broader international community through the North Pacific and Bering Fisheries). Both possible transport pathways in the form of faults and transport medium in the form of abundant water are present. Since the pre-plate tectonics paradigm days of active testing, the scientific community's understanding of the tectonic context of the Aleutian Islands has grown tremendously. Recently, the first direct measurements of motion within the arc have been made. How this new understanding should guide plans for long-term monitoring of the site is an important question. Convergence due to subduction of the North Pacific plate beneath North America ranges from near-normal at the Alaska Peninsula and eastern Aleutian islands to highly oblique in the west. Amchitka itself can be seen as a subaerial portion of a 200-km-long Rat Island arc crest segment. This fragment has torn from the Andreanof Islands to the east at Amchitka Pass and has rotated 25 degrees clockwise about a pole near Kiska Volcano, in the right-lateral shear of the western arc. The island is cut by ENE trending normal faults that are down-dropped to the northwest and reflect arc-parallel extension. Quaternary-age normal faulting decreases in intensity northwestward from Amchitka Pass, but is nevertheless present in the vicinity of and was activated by the nuclear tests. Westward translation of the island is probably more than the rate of 1 cm/year measured at Umnak Island 900 km to the east, and less than 3 cm/year measured at Attu 400 km to the west. The University of Alaska is receiving support under the USDOE-funded CRESP II program (Consortium for Risk Evaluation with Stakeholder Participation; IRM, New Brunswick,NJ.) to develop a research plan leading to long term stewardship of the site in collaboration with key researchers and stakeholders. A GPS network was established by us to define movement of and deformation within Amchitka; the present state of test-induced ground fractures, up to 2 km in length and 5.7 m in vertical displacement, was documented; and deep core samples from the shot region, acquired 30 years ago, were shipped to the mainland for further analysis.
The Gateway Paper--stewardship and governance in the health sector in Pakistan.
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.
LP DAAC MEaSUREs Project Artifact Tracking Via the NASA Earthdata Collaboration Environment
NASA Astrophysics Data System (ADS)
Bennett, S. D.
2015-12-01
The Land Processes Distributed Active Archive Center (LP DAAC) is a NASA Earth Observing System (EOS) Data and Information System (EOSDIS) DAAC that supports selected EOS Community non-standard data products such as the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) Global Emissivity Database (GED), and also supports NASA Earth Science programs such as Making Earth System Data Records for Use in Research Environments (MEaSUREs) to contribute in providing long-term, consistent, and mature data products. As described in The LP DAAC Project Lifecycle Plan (Daucsavage, J.; Bennett, S., 2014), key elements within the Project Inception Phase fuse knowledge between NASA stakeholders, data producers, and NASA data providers. To support and deliver excellence for NASA data stewardship, and to accommodate long-tail data preservation with Community and MEaSUREs products, the LP DAAC is utilizing NASA's own Earthdata Collaboration Environment to bridge stakeholder communication divides. By leveraging a NASA supported platform, this poster describes how the Atlassian Confluence software combined with a NASA URS/Earthdata support can maintain each project's members, status, documentation, and artifact checklist. Furthermore, this solution provides a gateway for project communities to become familiar with NASA clients, as well as educating the project's NASA DAAC Scientists for NASA client distribution.
Community Involvement Training Program
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
The Pesticide Environmental Stewardship Program is a voluntary membership program that promotes the adoption of innovative, alternative pest control practices such as Integrated Pest Management. PESP has three membership tiers: Bronze, Silver, Gold.
Linking Big and Small Data Across the Social, Engineering, and Earth Sciences
NASA Astrophysics Data System (ADS)
Chen, R. S.; de Sherbinin, A. M.; Levy, M. A.; Downs, R. R.
2014-12-01
The challenges of sustainable development cut across the social, health, ecological, engineering, and Earth sciences, across a wide range of spatial and temporal scales, and across the spectrum from basic to applied research and decision making. The rapidly increasing availability of data and information in digital form from a variety of data repositories, networks, and other sources provides new opportunities to link and integrate both traditional data holdings as well as emerging "big data" resources in ways that enable interdisciplinary research and facilitate the use of objective scientific data and information in society. Taking advantage of these opportunities not only requires improved technical and scientific data interoperability across disciplines, scales, and data types, but also concerted efforts to bridge gaps and barriers between key communities, institutions, and networks. Given the long time perspectives required in planning sustainable approaches to development, it is also imperative to address user requirements for long-term data continuity and stewardship by trustworthy repositories. We report here on lessons learned by CIESIN working on a range of sustainable development issues to integrate data across multiple repositories and networks. This includes CIESIN's roles in developing policy-relevant climate and environmental indicators, soil data for African agriculture, and exposure and risk measures for hazards, disease, and conflict, as well as CIESIN's participation in a range of national and international initiatives related both to sustainable development and to open data access, interoperability, and stewardship.
IARC - Illinois Accelerator Research Center | Pilot Program
Toggle navigation Pilot Program Agenda Directions Registration Illinois Accelerator Research Center National Laboratory present Accelerator Stewardship Test Facility Pilot Program Use accelerator technology , energy and environment. With this pilot program, the DOE Office of Science National Laboratories are
The Pesticide Environmental Stewardship Program (PESP) is a voluntary membership program that promotes the adoption of innovative, alternative pest control practices such as Integrated Pest Management (IPM). Learn about membership benefits and how to join.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Correll, D
The continuing objective of Lawrence Livermore National Laboratory's (LLNL's) Inertial Confinement Fusion (ICF) Program is the demonstration of thermonuclear fusion ignition and energy gain in the laboratory and to support the nuclear weapons program in its use of ICF facilities. The underlying theme of all ICF activities as a science research and development program is the Department of Energy's (DOE's) Defense Programs (DP) science-based Stockpile Stewardship Program (SSP). The mission of the US Inertial Fusion Program is twofold: (1) to address high-energy-density physics issues for the SSP and (2) to develop a laboratory microfusion capability for defense and energy applications.more » In pursuit of this mission, the ICF Program has developed a state-of-the-art capability to investigate high-energy-density physics in the laboratory. The near-term goals pursued by the ICF Program in support of its mission are demonstrating fusion ignition in the laboratory and expanding the Program's capabilities in high-energy-density science. The National Ignition Facility (NIF) project is a cornerstone of this effort.« less
78 FR 4844 - Defense Programs Advisory Committee
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-23
... Management Secretariat, General Services Administration, notice is hereby given that the Defense Programs... Deputy Administrator for Defense Programs on the stewardship and maintenance of the Nation's nuclear... DP management issues, including facility operations and fiscal matters. e. Where appropriate...
Contacts in the Office of Pesticide Programs, Biopesticides and Pollution Prevention Division
Contact the Biopesticides and Pollution Prevention Division (BPPD) about regulatory activities associated with biologically-based pesticides, implementation of integrated pest management and the Pesticide Environmental Stewardship Program.
Gasoline toxicology: overview of regulatory and product stewardship programs.
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. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Standard terms and conditions applicable to foreign grant recipients
The recipient agrees to maintain appropriate systems, policies, and procedures for ensuring the proper stewardship and financial management of EPA grant funds in accordance with the terms and conditions of this award.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hecker, Siegfried; Gottemoeller, Rose; Reis, Victor H.
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.
Hale, LaDonna S; Votaw, Lindsey L; Mayer, Janell E; Sobota, Kristen F
2017-11-01
Describe knowledge, perceptions, and self-confidence of nurses in the long-term care setting before and after online antibiotic stewardship education, and assess effectiveness and satisfaction with the education. Pre-/postsurvey. Three long-term care facilities, Topeka, Kansas. Convenience sample of 140 licensed practical and registered nurses. Nurses viewed a 12-minute online module developed by long-term care consultant pharmacists. The module discussed risks of antibiotic use and the Loeb minimum criteria for initiation of antibiotics in long-term care residents for urinary and respiratory tract infections and explored other conditions contributing to suspicion of these infections. Knowledge, perceptions, and self-confidence were measured using a 5-point Likert-scale survey modified from the Minnesota Department of Health taken before and after the module. Response rate was 45% (63/140) pre-education and 41% (57/140) post-education. Nurses had high baseline self-confidence (mean 4.2 to 4.5/5.0) and pre/post scores did not change significantly. Statistically significant improvements in knowledge and perceptions were seen in 15 of the 33 indices related to assumptions regarding antibiotic use, risks, and indicators of urinary and respiratory bacterial infections. Nurses rated the education as high quality (95%), applicable to practice (95%), and felt very likely to change practice (91%). Although baseline self-confidence was high, key misperceptions were identified, indicating that nurses may not be aware of their knowledge deficits or misperceptions. This low-cost, 12-minute, online education was highly valued and effectively improved nurses' knowledge and perceptions.
NASA Astrophysics Data System (ADS)
Roberts, S. J.; Feeley, M. H.
2008-05-01
With the increasing stress on ocean and coastal resources, ocean resource management will require greater capacity in terms of people, institutions, technology and tools. Successful capacity-building efforts address the needs of a specific locale or region and include plans to maintain and expand capacity after the project ends. In 2008, the US National Research Council published a report that assesses past and current capacity-building efforts to identify barriers to effective management of coastal and marine resources. The report recommends ways that governments and organizations can strengthen marine conservation and management capacity. Capacity building programs instill the tools, knowledge, skills, and attitudes that address: ecosystem function and change; processes of governance that influence societal and ecosystem change; and assembling and managing interdisciplinary teams. Programs require efforts beyond traditional sector-by-sector planning because marine ecosystems range from the open ocean to coastal waters and land use practices. Collaboration among sectors, scaling from local community-based management to international ocean policies, and ranging from inland to offshore areas, will be required to establish coordinated and efficient governance of ocean and coastal ecosystems. Barriers Most capacity building activities have been initiated to address particular issues such as overfishing or coral reef degradation, or they target a particular region or country facing threats to their marine resources. This fragmentation inhibits the sharing of information and experience and makes it more difficult to design and implement management approaches at appropriate scales. Additional barriers that have limited the effectiveness of capacity building programs include: lack of an adequate needs assessment prior to program design and implementation; exclusion of targeted populations in decision- making efforts; mismanagement, corruption, or both; incomplete or 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.
Hydrographic Data Curation and Stewardship: GO-SHIP
NASA Astrophysics Data System (ADS)
Stephen, Diggs; Lynne, Talley; Martin, Kramp; Bernadette, Sloyan
2014-05-01
Expert data management (access, formats, data life-cycle) facilitates the successful re-use of information which address many important scientific questions such as detecting decadal and longer-term changes in global ocean heat and freshwater content. Modern hydrographic data management has its origins in the WOCE program where new and existing distributed resources were identified and organized into an effective "super DAC". Data from this program are referenced in hundreds of scientific papers. The distributed hydrographic data system, now under the name GO-SHIP, exists today and has adapted to the new geoscience demands of the 21st century. This presentation will describe science drivers and the required data center resources (CCHDO, CDIAC, JCOMMOPS) which together provide reliable access for the global research community.
Collins, Curtis D; Kabara, Jared J; Michienzi, Sarah M; Malani, Anurag N
2016-12-01
Implementation of an antimicrobial stewardship program bundle for urinary tract infections among 92 patients led to a higher rate of discontinuation of therapy for asymptomatic bacteriuria (52.4% vs 12.5%; P =.004), more appropriate durations of therapy (88.7% vs 63.6%; P =.001), and significantly higher overall bundle compliance (75% vs 38.2%; P < .001). Infect Control Hosp Epidemiol 2016;1499-1501.
Pesticide Environmental Stewardship Program (PESP)
PESP is an EPA partnership program that works with the nation's pesticide-user community to promote IPM practices. Pesticide users can reduce the risks from pests and pesticides. Members include organizations and companies in the pesticide-user community.
Overview of Sensors and Needs for Environmental Monitoring
Ho, Clifford K.; Robinson, Alex; Miller, David R.; Davis, Mary J.
2005-01-01
This paper 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. United States 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.
NATURAL RESOURCE MANAGEMENT PLAN FOR BROOKHAVEN NATIONAL LABORATORY.
DOE Office of Scientific and Technical Information (OSTI.GOV)
GREEN,T.ET AL.
2003-12-31
Brookhaven National Laboratory (BNL) is located near the geographic center of Long Island, New York. The Laboratory is situated on 5,265 acres of land composed of Pine Barrens habitat with a central area developed for Laboratory work. In the mid-1990s BNL began developing a wildlife management program. This program was guided by the Wildlife Management Plan (WMP), which was reviewed and approved by various state and federal agencies in September 1999. The WMP primarily addressed concerns with the protection of New York State threatened, endangered, or species of concern, as well as deer populations, invasive species management, and the revegetationmore » of the area surrounding the Relativistic Heavy Ion Collider (RHIC). The WMP provided a strong and sound basis for wildlife management and established a basis for forward motion and the development of this document, the Natural Resource Management Plan (NRMP), which will guide the natural resource management program for BNL. The body of this plan establishes the management goals and actions necessary for managing the natural resources at BNL. The appendices provide specific management requirements for threatened and endangered amphibians and fish (Appendices A and B respectively), lists of actions in tabular format (Appendix C), and regulatory drivers for the Natural Resource Program (Appendix D). The purpose of the Natural Resource Management Plan is to provide management guidance, promote stewardship of the natural resources found at BNL, and to integrate their protection with pursuit of the Laboratory's mission. The philosophy or guiding principles of the NRMP are stewardship, adaptive ecosystem management, compliance, integration with other plans and requirements, and incorporation of community involvement, where applicable.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
O'Brien, K H
Nuclear weapons play an essential role in United States (U.S.) National Security Policy and a succession of official reviews has concluded that nuclear weapons will continue to have a role for the foreseeable future. Under the evolving U.S. government policy, it is clear that role will be quite different from what it was during the Cold War. The nuclear-weapons stockpile as well as the nuclear-weapons enterprise needs to continue to change to reflect this evolving role. Stockpile reductions in the early 1990s and the Stockpile Stewardship Program (SSP), established after the cessation of nuclear testing in 1992, began this processmore » of change. Further evolution is needed to address changing security environments, to enable further reductions in the number of stockpiled weapons, and to create a nuclear enterprise that is cost effective and sustainable for the long term. The SSP has successfully maintained the U.S. nuclear stockpile for more than a decade, since the end of nuclear testing. Current plans foresee maintaining warheads produced in the 1980s until about 2040. These warheads continue to age and they are expensive to refurbish. The current Life Extension Program plans for these legacy warheads are straining both the nuclear-weapons production and certification infrastructure making it difficult to respond rapidly to problems or changes in requirements. Furthermore, refurbishing and preserving Cold-War-era nuclear weapons requires refurbishing and preserving an infrastructure geared to support old technology. Stockpile Stewardship could continue this refurbishment approach, but an alternative approach could be considered that is more focused on sustainable technologies, and developing a more responsive nuclear weapons infrastructure. Guided by what we have learned from SSP during the last decade, the stewardship program can be evolved to address this increasing challenge using its computational and experimental tools and capabilities. This approach must start with an improved vision of the future stockpile and enterprise, and find a path that moves us toward that future. The goal of this approach is to achieve a more affordable, sustainable, and responsive enterprise. In order to transform the enterprise in this way, the SSP warhead designs that drive the enterprise must change. Designs that emphasize manufacturability, certifiability, and increased safety and security can enable enterprise transformation. It is anticipated that such warheads can be certified and sustained with high confidence without nuclear testing. The SSP provides the tools to provide such designs, and can develop replacement designs and produce them for the stockpile. The Cold War currency of optimizing warhead yield-to-weight can be replaced by SSP designs optimizing margin-to-uncertainty. The immediate challenge facing the nuclear weapons enterprise is to find a credible path that leads to this vision of the future stockpile and enterprise. Reliable warheads within a sustainable enterprise can best be achieved by shifting from a program of legacy-warhead refurbishment to one of warhead replacement. The nuclear weapons stockpile and the nuclear weapons enterprise must transform together to achieve this vision. The current Reliable Replacement Warhead (RRW) program represents an approach that can begin this process of transformation. If the RRW program succeeds, the designs, manufacturing complex, and certification strategy can evolve together and in so doing come up with a more cost-efficient solution that meets today's and tomorrow's national security requirements.« less
Sustainable Seas Student Intertidal Monitoring Project at Duxbury Reef in Bolinas, CA
NASA Astrophysics Data System (ADS)
Soave, K.; Dean, A.; Yang, G.; Solli, E.; Dattels, C.; Wallace, K.; Boesel, A.; Steiger, C.; Buie, A.
2010-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of the project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species and the requirements for maintaining a healthy, diverse intertidal ecosystem; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects (A and B) and using randomly determined points within a permanent 100 m2 area, three times per year (fall, winter, and late spring). Using the data collected since 2004, we will compare population densities, seasonal abundance and long-term population trends of key algal and invertebrate species, including Tegula funebralis. Future analyses and investigations will include intertidal abiotic factors (including water temperature and human foot-traffic) to enhance insights into the workings of the Duxbury Reef ecosystem, in particular, the high intertidal zone which experiences the greatest amount of human impacts.
Sustainable Seas Student Monitoring Project
NASA Astrophysics Data System (ADS)
Soave, K.; Emunah, M.; Hatfield, J.; Kiyasu, J.; Packard, E.; Ching, L.; Zhao, K.; Sanderson, L.; Turmon, M.
2016-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 2000, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of this student-run project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Each fall student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects and, using randomly determined points, within two permanent 200 m2 areas, in fall, winter, and late spring. Using data from the previous years, we will compare population densities, seasonal abundance and long-term population trends of key algal and invertebrate species, including Tegula funebralis, three separate Anthopluera sea anemone species, and two rockweed species. Future analyses and investigations will include intertidal abiotic factors (including water temperature, pH and human foot-traffic) to enhance insights into the Duxbury Reef ecosystem, in particular, the high and mid-intertidal zones experiencing the greatest amount of human impacts.
Sustainable Seas Student Intertidal Monitoring Project at Duxbury Reef in Bolinas, CA
NASA Astrophysics Data System (ADS)
Rainsford, A.; Soave, K.; Gerraty, F.; Jung, G.; Quirke-Shattuck, M.; Kudler, J.; Hatfield, J.; Emunah, M.; Dean, A. F.
2014-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of this student-run project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Each fall student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects and, using randomly determined points, within two permanent 200 m2 areas, in fall, winter, and late spring. Using data from the previous years, we will compare population densities, seasonal abundance and long-term population trends of key algal and invertebrate species, including Tegula funebralis, Anthopluera elegantissima, Cladophora sp. and Fucus sp.. Future analyses and investigations will include intertidal abiotic factors (including water temperature, pH and human foot-traffic) to enhance insights into the Duxbury Reef ecosystem, in particular, the high and mid-intertidal zones experiencing the greatest amount of human impacts.
NASA Technical Reports Server (NTRS)
Kobler, Ben (Editor); Hariharan, P. C. (Editor)
2004-01-01
MSST2004, the Twelfth NASA Goddard / Twenty-first IEEE Conference on Mass Storage Systems and Technologies has as its focus long-term stewardship of globally-distributed storage. The increasing prevalence of e-anything brought about by widespread use of applications based, among others, on the World Wide Web, has contributed to rapid growth of online data holdings. A study released by the School of Information Management and Systems at the University of California, Berkeley, estimates that over 5 exabytes of data was created in 2002. Almost 99 percent of this information originally appeared on magnetic media. The theme for MSST2004 is therefore both timely and appropriate. There have been many discussions about rapid technological obsolescence, incompatible formats and inadequate attention to the permanent preservation of knowledge committed to digital storage. Tutorial sessions at MSST2004 detail some of these concerns, and steps being taken to alleviate them. Over 30 papers deal with topics as diverse as performance, file systems, and stewardship and preservation. A number of short papers, extemporaneous presentations, and works in progress will detail current and relevant research on the MSST2004 theme.
Stewplan: software for creating forest stewardship plans (Version 1.3)
Peter D. Knopp; Mark J. Twery
2003-01-01
Describes the purpose and function of the Stewplan computer program. Provides instructions for loading Stewplan, a tutorial for getting started, and instructions for use. A copy of the program is included. [User's manual; CD-ROM].
Impact of formulary restriction with prior authorization by an antimicrobial stewardship program
Reed, Erica E.; Stevenson, Kurt B.; West, Jessica E.; Bauer, Karri A.; Goff, Debra A.
2013-01-01
In an era of increasing antimicrobial resistance and few antimicrobials in the developmental pipeline, many institutions have developed antimicrobial stewardship programs (ASPs) to help implement evidence-based (EB) strategies for ensuring appropriate utilization of these agents. EB strategies for accomplishing this include formulary restriction with prior authorization. Potential limitations to this particular strategy include delays in therapy, prescriber pushback, and unintended increases in use of un-restricted antimicrobials; however, our ASP found that implementing prior authorization for select antimicrobials along with making a significant effort to educate clinicians on criteria for use ensured more appropriate prescribing of these agents, hopefully helping to preserve their utility for years to come. PMID:23154323
Impact of formulary restriction with prior authorization by an antimicrobial stewardship program.
Reed, Erica E; Stevenson, Kurt B; West, Jessica E; Bauer, Karri A; Goff, Debra A
2013-02-15
In an era of increasing antimicrobial resistance and few antimicrobials in the developmental pipeline, many institutions have developed antimicrobial stewardship programs (ASPs) to help implement evidence-based (EB) strategies for ensuring appropriate utilization of these agents. EB strategies for accomplishing this include formulary restriction with prior authorization. Potential limitations to this particular strategy include delays in therapy, prescriber pushback, and unintended increases in use of un-restricted antimicrobials; however, our ASP found that implementing prior authorization for select antimicrobials along with making a significant effort to educate clinicians on criteria for use ensured more appropriate prescribing of these agents, hopefully helping to preserve their utility for years to come.
Enani, Mushira A
2016-01-01
The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states.
2015-01-01
Objectives: The purpose of the current study is to describe the prevalence and characteristics of antimicrobial stewardship programs (ASP) in Gulf Cooperation Council (GCC) states to explore opportunities and overcome barriers to effective ASP implementation. Methods: A cross-sectional questionnaire survey was used to evaluate the current status of ASP: major stewardship components, barriers of implementation and program impact in acute care hospitals of GCC states. Results: Forty-seven healthcare professionals responded from four GCC states, the majority from Saudi Arabia (81%). Twenty-nine (62%) participating hospitals had ASP in place. Of these established programs, 35 (75%) reported lack of funding and personnel as major barriers to program implementation. The top three objectives cited for the hospital ASP were to reduce resistance (72.3%), improve clinical outcomes (70.2%) and reduce costs (44.7%). The reported impact of existing ASP was reduction of inappropriate prescribing (68%), reduction of broad spectrum antibiotic use (63.8%), reduction of healthcare-associated infections (61.7%), reduction of length of stay or mortality metrics (59.6%), reduction in direct antibiotic cost (57.4%) and reduction of reported antibiotic resistance (55.3%). Conclusion: Survey participants from GCC states who have implemented ASP report significant impacts in the reduction of broad spectrum antibiotic use, hospital-acquired infection, inappropriate prescribing and antimicrobial resistance. These findings suggest a promising opportunity to enhance existing ASP through sharing of best practices and support the development of regional guidelines across GCC states. PMID:28989448
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 identifiers to unambiguously identify resources of interest curated by and available from BCO-DMO have significantly enabled progress toward interoperability with partner systems. Several important components have emerged from early collaborative relationships: (1) identifying a trusted authoritative source of complementary content and the appropriate contact; (2) determining the globally unique, persistent identifier for resources of interest and (3) negotiating the requisite syntactic and semantic exchange systems. An added benefit is the ability to use globally unique, persistent resource identifiers to identify and compare related content in other repositories, thus enabling us to improve the accuracy of content in the BCO-DMO data collection. Results from a recent community discussion at the January 2013 Federation of Earth Science Information Partners (ESIP) meeting will be presented. Mindful of the NSF EarthCube initiative in the United States, the ESIP discussion was an effort to identify commonalities and differences in the way different communities meet the challenges of data stewardship throughout the full data life cycle and to determine any gaps that currently exist. BCO-DMO: http://bco-dmo.org ESIP: http://esipfed.org/
Stockpile stewardship past, present, and future
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adams, Marvin L., E-mail: mladams@tamu.edu
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) Doingmore » 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.« less
Challenges for a Sustainable Financial Foundation for Antimicrobial Stewardship.
Dik, Jan-Willem H; Sinha, Bhanu
2017-03-30
Antimicrobial resistance is a worldwide threat and a problem with large clinical and economic impact. Antimicrobial Stewardship Programs are a solution to curb resistance development. A problem of resistance is a separation of actions and consequences, financial and clinical. Such a separation makes it difficult to create support among stakeholders leading to a lack of sense of responsibility. To counteract the resistance development it is important to perform diagnostics and know how to interpret the results. One should see diagnostics, therapy and resistance as one single process. Within this process all involved stakeholders need to work together on a more institutional level. We suggest therefore a solution: combining diagnostics and therapy into one single financial product . Such a product should act as an incentive to perform correct diagnostics. It also makes it easier to cover the costs of an antimicrobial stewardship program, which is often overlooked. Finally, such a product involves all stakeholders in the process and does not lay the costs at one stakeholder and the benefits somewhere else, solving the misbalance that is present nowadays.
Laboratory directed research and development fy1999 annual report
DOE Office of Scientific and Technical Information (OSTI.GOV)
Al-Ayat, R A
2000-04-11
The Lawrence Livermore National Laboratory (LLNL) was founded in 1952 and has been managed since its inception by the University of California (UC) for the U.S. Department of Energy (DOE). Because of this long association with UC, the Laboratory has been able to recruit a world-class workforce, establish an atmosphere of intellectual freedom and innovation, and achieve recognition in relevant fields of knowledge as a scientific and technological leader. This environment and reputation are essential for sustained scientific and technical excellence. As a DOE national laboratory with about 7,000 employees, LLNL has an essential and compelling primary mission to ensuremore » that the nation's nuclear weapons remain safe, secure, and reliable and to prevent the spread and use of nuclear weapons worldwide. The Laboratory receives funding from the DOE Assistant Secretary for Defense Programs, whose focus is stewardship of our nuclear weapons stockpile. Funding is also provided by the Deputy Administrator for Defense Nuclear Nonproliferation, many Department of Defense sponsors, other federal agencies, and the private sector. As a multidisciplinary laboratory, LLNL has applied its considerable skills in high-performance computing, advanced engineering, and the management of large research and development projects to become the science and technology leader in those areas of its mission responsibility. The Laboratory Directed Research and Development (LDRD) Program was authorized by the U.S. Congress in 1984. The Program allows the Director of each DOE laboratory to fund advanced, creative, and innovative research and development (R&D) activities that will ensure scientific and technical vitality in the continually evolving mission areas at DOE and the Laboratory. In addition, the LDRD Program provides LLNL with the flexibility to nurture and enrich essential scientific and technical competencies, which attract the most qualified scientists and engineers. The LDRD Program also enables many collaborations with the scientific community in academia, national and international laboratories, and industry. The projects in the FY1999 LDRD portfolio were carefully selected to continue vigorous support of the strategic vision and the long-term goals of DOE and the Laboratory. Projects chosen for LDRD funding undergo stringent selection processes, which look for high-potential scientific return, emphasize strategic relevance, and feature technical peer reviews by external and internal experts. The FY1999 projects described in this annual report focus on supporting the Laboratory's national security needs: stewardship of the U.S. nuclear weapons stockpile, responsibility for the counter- and nonproliferation of weapons of mass destruction, development of high-performance computing, and support of DOE environmental research and waste management programs. In the past, LDRD investments have significantly enhanced LLNL scientific capabilities and greatly contributed to the Laboratory's ability to meet its national security programmatic requirements. Examples of past investments include technical precursors to the Accelerated Strategic Computing Initiative (ASCI), special-materials processing and characterization, and biodefense. Our analysis of the FY1999 portfolio shows that it strongly supports the Laboratory's national security mission. About 95% of the LDRD dollars have directly supported LLNL's national security activities in FY1999, which far exceeds the portion of LLNL's overall budget supported by National Security Programs, which is 63% for FY1999.« less
Current Approaches to Improving Marine Geophysical Data Discovery and Access
NASA Astrophysics Data System (ADS)
Jencks, J. H.; Cartwright, J.; Varner, J. D.; Anderson, C.; Robertson, E.; McLean, S. J.
2016-02-01
Exploring, understanding, and managing the global oceans is a challenge when hydrographic maps are available for only 5% of the world's oceans, even less of which have been mapped geologically or to identify benthic habitats. Seafloor mapping is expensive and most government and academic budgets continue to tighten. The first step for any mapping program, before setting out to map uncharted waters, should be to identify if data currently exist in the area of interest. There are many reasons why this seemingly simple suggestion is not commonplace. While certain datasets are accessible online (e.g., NOAA's NCEI, EMODnet, IHO-DCDB), many are not. In some cases, data that are publicly available are difficult to discover and access. No single agency can successfully resolve the complex and pressing demands of ocean and coastal mapping and the associated data stewardship. NOAA partners with other federal agencies to provide an integrated approach to carry out a coordinated and comprehensive ocean and coastal mapping program. In order to maximize the return on their mapping investment, legacy and newly acquired data must be easily discoverable and readily accessible by numerous applications and formats now and well into the future. At NOAA's National Centers for Environmental Information (NCEI), resources are focused on ensuring the security and widespread availability of the Nation's scientific marine geophysical data through long-term stewardship. The public value of these data and products is maximized by streamlining data acquisition and processing operations, minimizing redundancies, facilitating discovery, and developing common standards to promote re-use. For its part, NCEI draws on a variety of software technologies and adheres to international standards to meet this challenge. The result is a geospatial framework built on spatially-enabled databases, standards-based web services, and International Standards Organization (ISO) metadata. In order to maximize effectiveness in ocean and coastal mapping, we must be sure that limited funding is not being used to collect data in areas where data already exist. By making data more accessible, NCEI extends the use of, and therefore the value of, these data. Working together, we can ensure that valuable data are made available to the broadest community.
NASA Astrophysics Data System (ADS)
Jencks, J. H.; Cartwright, J.; Varner, J. D.
2016-12-01
Exploring, understanding, and managing the global oceans are a challenge when hydrographic maps are available for only 5% of the world's oceans. Seafloor mapping is expensive and most government and academic budgets continue to tighten. The first step for any mapping program, before setting out to map uncharted waters, should be to identify if data currently exist in the area of interest. There are many reasons why this seemingly simple suggestion is easier said than done.While certain datasets are accessible online (e.g., NOAA's NCEI, EMODnet, IHO-DCDB), many are not. In some cases, data that are publicly available are difficult to discover and access. No single agency can successfully resolve the complex and pressing demands of ocean and coastal mapping and the associated data stewardship. The National Oceanic and Atmospheric Administration (NOAA) is an active participant in numerous campaign mapping projects whose goals are to carry out coordinated and comprehensive ocean mapping efforts. One of these international programs is an outcome of the Galway Statement on Atlantic Ocean Cooperation signed by the European Union, Canada, and the United States in 2013. At NOAA's National Centers for Environmental Information (NCEI), resources are focused on ensuring the security and widespread availability of the Nation's scientific marine geophysical data through long-term stewardship. NCEI draws on a variety of software technologies and adheres to international standards to meet this challenge. The result is a geospatial framework built on spatially-enabled databases, standards-based web services, and International Standards Organization (ISO) metadata. Through the use of industry standards, the services are constructed such that they can be combined and re-used in a variety of contexts. For example, users may leverage the services in desktop analysis tools, web applications created by the hosting organizations (e.g. the North Atlantic Data Portal), or in custom applications they develop themselves. In order to maximize the return on campaign mapping investments, legacy and newly acquired data must be easily discoverable and readily accessible by numerous applications and formats now and well into the future. Working together, we can ensure that valuable data are made available to the broadest community.
Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit.
Nzegwu, Nneka I; Rychalsky, Michelle R; Nallu, Loren A; Song, Xuemei; Deng, Yanhong; Natusch, Amber M; Baltimore, Robert S; Paci, George R; Bizzarro, Matthew J
2017-10-01
OBJECTIVE To evaluate antimicrobial utilization and prescription practices in a neonatal intensive care unit (NICU) after implementation of an antimicrobial stewardship program (ASP). DESIGN Quasi-experimental, interrupted time-series study. SETTING A 54-bed, level IV NICU in a regional academic and tertiary referral center. PATIENTS AND PARTICIPANTS All neonates prescribed antimicrobials from January 1, 2011, to June 30, 2016, were eligible for inclusion. INTERVENTION Implementation of a NICU-specific ASP beginning July 2012. METHODS We convened a multidisciplinary team and developed guidelines for common infections, with a focus on prescriber audit and feedback. We conducted an interrupted time-series analysis to evaluate the effects of our ASP. Our primary outcome measure was days of antibiotic therapy (DOT) per 1,000 patient days for all and for select antimicrobials. Secondary outcomes included provider-specific antimicrobial prescription events for suspected late-onset sepsis (blood or cerebrospinal fluid infection at >72 hours of life) and guideline compliance. RESULTS Antibiotic utilization decreased by 14.7 DOT per 1,000 patient days during the stewardship period, although this decrease was not statistically significant (P=.669). Use of ampicillin, the most commonly antimicrobial prescribed in our NICU, decreased significantly, declining by 22.5 DOT per 1,000 patient days (P=.037). Late-onset sepsis evaluation and prescription events per 100 NICU days of clinical service decreased significantly (P<.0001), with an average reduction of 2.65 evaluations per year per provider. Clinical guidelines were adhered to 98.75% of the time. CONCLUSIONS Implementation of a NICU-specific antimicrobial stewardship program is feasible and can improve antibiotic prescribing practices. Infect Control Hosp Epidemiol 2017;38:1137-1143.
NASA Astrophysics Data System (ADS)
Flowers, Alice Blood
Lack of personal connection to the natural world by most American youth builds reason for assessing effectiveness of conservation education programs. Place-based learning is important in helping youth understand how their personal and societal well-being are linked and dependent upon their local habitats. Across Montana 2277 students in grades 3--10 participate in an interactive year long fishing education program with their teachers called Hooked on Fishing (HOF). The purpose of my study was to assess the effectiveness of HOF, a place-based conservation education program established in 1996, and modeled after the national Hooked on Fishing, Not on Drugs program. Using a quasi-experimental nonequivalent group study design, students received a pre-survey during the beginning of the program, a post-survey after the program, and an extended post-survey 12 to 14 weeks later. Teachers voluntarily participated in an Internet survey during May 2006, and program instructors voluntarily participated in a structured open-ended telephone interview in June 2006. A key component of my study was the decision to conduct the evaluation process using an approach which included stakeholders in the development of the instruments to measure student outcomes. This approach is called utilization-focused evaluation and was developed by Michael Q. Patton. The motive of this approach is to promote the usability of the evaluation results. The results are considered to have a better chance to be applied by the program stakeholders to not only gauge program effectiveness, but to be used to improve the program. Two research questions were: (1) does the frequency of outdoor experiences have significant affects on students' knowledge, skills, attitudes, and intended stewardship behaviors; and (2) does improved knowledge of local natural resources have significant affects on students' skills, attitudes and intended stewardship behavior. Nonparametric statistical analyses calculated statistical significant results for most knowledge and skill outcomes in a positive direction of change with 2--3 HOF outdoor experiences. Attitudinal and intended behavior outcomes did not show similar results. Internet teacher survey and instructor interviews provided qualitative depth and insight to student self-reported responses.
Antimicrobial Stewardship: A Call to Action for Surgeons
Duane, Therese M.; Catena, Fausto; Tessier, Jeffrey M.; Coccolini, Federico; Kao, Lillian S.; De Simone, Belinda; Labricciosa, Francesco M.; May, Addison K.; Ansaloni, Luca; Mazuski, John E.
2016-01-01
Abstract Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients. PMID:27828764
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.
ERIC Educational Resources Information Center
Larese-Casanova, Mark
2011-01-01
The Utah Master Naturalist Program trains citizens who provide education, outreach, and service to promote citizen stewardship of natural resources within their communities. In 2007-2008, the Watersheds module of the program was evaluated for program success, and participant knowledge was assessed. Assessment and evaluation results indicated that…
Effects of Fishing Education Programs on Antecedents of Responsible Environmental Behavior.
ERIC Educational Resources Information Center
Siemer, William F.; Knuth, Barbara A.
2001-01-01
Investigates fishing and aquatic stewardship outcomes associated with different levels of program exposure among n=619 participants in a national fishing education program (Hooked on Fishing-Not on Drugs) designed for youth in Grades 6-8. Supports the assumption that such programs are more likely to influence antecedents to environmentally…
ERIC Educational Resources Information Center
Palmer, Dain; Dann, Shari L.
2004-01-01
Our evaluative approach used implementation theory and program theory, adapted from Weiss (1998) to examine communication processes and results for a national wildlife habitat stewardship education program. Using a mail survey of 1427 participants certified in National Wildlife Federation's (NWF) Backyard Wildlife Habitat (BWH) program and a study…
Advanced Technology System Scheduling Governance Model
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ang, Jim; Carnes, Brian; Hoang, Thuc
In the fall of 2005, the Advanced Simulation and Computing (ASC) Program appointed a team to formulate a governance model for allocating resources and scheduling the stockpile stewardship workload on ASC capability systems. This update to the original document takes into account the new technical challenges and roles for advanced technology (AT) systems and the new ASC Program workload categories that must be supported. The goal of this updated model is to effectively allocate and schedule AT computing resources among all three National Nuclear Security Administration (NNSA) laboratories for weapons deliverables that merit priority on this class of resource. Themore » process outlined below describes how proposed work can be evaluated and approved for resource allocations while preserving high effective utilization of the systems. This approach will provide the broadest possible benefit to the Stockpile Stewardship Program (SSP).« less
Agwu, Allison L; Lee, Carlton K K; Jain, Sanjay K; Murray, Kara L; Topolski, Jason; Miller, Robert E; Townsend, Timothy; Lehmann, Christoph U
2008-09-15
Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World Wide Web-based antimicrobial approval program, will effectively enhance antimicrobial stewardship programs.
Federal Register 2010, 2011, 2012, 2013, 2014
2011-09-12
... youth program participants. Since many of the YouthGo information collections ask similar questions to..., interviews, youth program observations, and pre-post youth program surveys. The information collections will... stewardship and the next generation of conservationists. By conducting focus groups, interviews, identical pre...
78 FR 36449 - State Long-Term Care Ombudsman Program
Federal Register 2010, 2011, 2012, 2013, 2014
2013-06-18
... 0985-AA08 State Long-Term Care Ombudsman Program AGENCY: Administration on Aging, Administration for... Act, the State Long-Term Care Ombudsman program. This proposed rule replaces AoA's 1994 Notice of... highlighted the difficulty of determining State compliance in carrying out the Long-Term Care Ombudsman...
Cardone, Franco; Cheung, Daphne; Han, Angela; Born, Karen B.; Alexander, Lisa; Levinson, Wendy; Wong, Brian M.
2017-01-01
Background: Resource stewardship is being increasingly recognized as an essential competency for physicians, but medical schools are just beginning to integrate this into education. We describe the evaluation of Choosing Wisely Canada's Students and Trainees Advocating for Resource Stewardship (STARS) campaign, a student-led campaign to advance resource stewardship education in medical schools across Canada. Methods: We evaluated the campaign 6 months after its launch, in November 2015. STARS students were administered a telephone survey eliciting a description of the initiatives that they had implemented or planned to implement at their schools to promote resource stewardship, and exploring their perceptions of facilitators of and barriers to successful implementation of their initiatives. We used a mixed-methods approach to analyze and summarize the data. Results: Twenty-seven (82%) of the 33 eligible students representing all 17 medical schools responded. In 14 schools (82%), students led various local activities (e.g., interest groups, campaign weeks) to raise awareness about resource stewardship among medical students and faculty. Students contributed to curriculum change (both planned and implemented) at 10 schools (59%). Thematic analysis revealed key program characteristics that facilitated success (e.g., pan-Canadian student network, local faculty champion) as well as barriers to implementing change (e.g., complex processes to change curriculum, hierarchical nature of medical school). Interpretation: This student-led campaign, with support from local faculty and Choosing Wisely Canada staff, led to awareness-building activities and early curricula change at medical schools across Canada. Future plans will build on the initial momentum created by the STARS campaign to sustain and spread local initiatives. PMID:29263153
The Italian Hub of Population Biobanks as a Potential Tool for Improving Public Health Stewardship
Napolitano, Mariarosaria; Santoro, Filippo; Belardelli, Filippo; Federici, Antonio
2013-01-01
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. PMID:23840926
ERIC Educational Resources Information Center
Plankis, Brian; Klein, Carolyn
2010-01-01
The Ocean, Reefs, Aquariums, Literacy, and Stewardship (CORALS) research program helps students connect global environmental issues to local concerns and personal choices. During the 18-week program, students strengthen their understanding of coral reef decline through a classroom aquarium activity, communicate with science experts, and create…
SOUTHWEST REGIONAL GAP LAND COVER
The Gap Analysis Program is a national inter-agency program that maps the distribution
of plant communities and selected animal species and compares these distributions with land
stewardship to identify gaps in biodiversity protection. GAP uses remote satellite imag...
Rolling Deck to Repository (R2R): Big Data and Standard Services for the Fleet Community
NASA Astrophysics Data System (ADS)
Arko, R. A.; Carbotte, S. M.; Chandler, C. L.; Smith, S. R.; Stocks, K. I.
2014-12-01
The Rolling Deck to Repository (R2R; http://rvdata.us/) program curates underway environmental sensor data from the U.S. academic oceanographic research fleet, ensuring data sets are routinely and consistently documented, preserved in long-term archives, and disseminated to the science community. Currently 25 in-service vessels contribute 7 terabytes of data to R2R each year, acquired from a full suite of geophysical, oceanographic, meteorological, and navigational sensors on over 400 cruises worldwide. To accommodate this large volume and variety of data, R2R has developed highly efficient stewardship procedures. These include scripted "break out" of cruise data packages from each vessel based on standard filename and directory patterns; automated harvest of cruise metadata from the UNOLS Office via Web Services and from OpenXML-based forms submitted by vessel operators; scripted quality assessment routines that calculate statistical summaries and standard ratings for selected data types; adoption of community-standard controlled vocabularies for vessel codes, instrument types, etc, provided by the NERC Vocabulary Server, in lieu of maintaining custom local term lists; and a standard package structure based on the IETF BagIt format for delivering data to long-term archives. Documentation and standard post-field products, including quality-controlled shiptrack navigation data for every cruise, are published in multiple services and formats to satisfy a diverse range of clients. These include Catalog Service for Web (CSW), GeoRSS, and OAI-PMH discovery services via a GeoNetwork portal; OGC Web Map and Feature Services for GIS clients; a citable Digital Object Identifier (DOI) for each dataset; ISO 19115-2 standard geospatial metadata records suitable for submission to long-term archives as well as the POGO global catalog; and Linked Open Data resources with a SPARQL query endpoint for Semantic Web clients. R2R participates in initiatives such as the Ocean Data Interoperability Platform (ODIP) and the NSF EarthCube OceanLink project to promote community-standard formats, vocabularies, and services among ocean data providers.
Long Island Sound Restoration and Stewardship Act
Rep. Israel, Steve [D-NY-2
2011-12-16
House - 01/03/2012 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Long Island Sound Restoration and Stewardship Act
Sen. Gillibrand, Kirsten E. [D-NY
2011-12-16
Senate - 07/16/2012 Placed on Senate Legislative Calendar under General Orders. Calendar No. 453. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Long Island Sound Restoration and Stewardship Act
Rep. Israel, Steve [D-NY-3
2013-05-23
House - 06/03/2013 Referred to the Subcommittee on Fisheries, Wildlife, Oceans, and Insular Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Long Island Sound Restoration and Stewardship Act
Sen. Gillibrand, Kirsten E. [D-NY
2010-03-16
Senate - 09/20/2010 Placed on Senate Legislative Calendar under General Orders. Calendar No. 575. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Long Island Sound Restoration and Stewardship Act
Sen. Gillibrand, Kirsten E. [D-NY
2013-05-23
Senate - 06/05/2014 Placed on Senate Legislative Calendar under General Orders. Calendar No. 421. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
DOE Office of Scientific and Technical Information (OSTI.GOV)
Feist, E.T.
2012-07-01
Cleanup of the Hanford River Corridor has been one of Hanford Site's top priorities since the early 1990's. This urgency is due to the proximity of hundreds of waste sites to the Columbia River and the groundwater that continues to threaten the Columbia River. In April 2005, the U.S. Department of Energy, Richland Operations Office (DOE-RL) awarded the Hanford River Corridor Closure Contract (RCCC), a cost-plus incentive-fee closure contract with a 2015 end date and first of its kind at Hanford Site, to Washington Closure Hanford (WCH), a limited-liability company owned by URS, Bechtel National, and CH2M HILL. WCH ismore » a single-purpose company whose goal is to safely, compliantly, and efficiently accelerate cleanup in the Hanford River Corridor and reduce or eliminate future obligations to DOE-RL for maintaining long-term stewardship over the site. Accelerated performance of the work-scope while keeping a perspective on contract completion presents challenges that require proactive strategies to support the remaining work-scope through the end of the RCCC. This paper outlines the processes to address the challenges of completing work-scope while planning for contract termination. WCH is responsible for cleanup of the River Corridor 569.8 km{sup 2} (220 mi{sup 2}) of the 1,517.7 km{sup 2} (586 mi{sup 2}) Hanford Site's footprint reduction. At the end of calendar year 2011, WCH's closure implementation is well underway. Fieldwork is complete in three of the largest areas within the RCCC scope (Segments 1, 2, and 3), approximately 44.5% of the River Corridor (Figure 3). Working together, DOE-RL and WCH are in the process of completing the 'paper work' that will document the completion of the work-scope and allow DOE-RL to relieve WCH of contractual responsibilities and transition the completed areas to the Long-Term Stewardship Program, pending final action RODs. Within the next 4 years, WCH will continue to complete cleanup of the River Corridor following the completion goals. As field work-scope is completed, progressive reductions of business processes, physical facilities, and staff will occur. Organizations will collapse and flatten commensurate with workload. WCH employees will move on to new endeavors, proud of their accomplishments and the legacy they are leaving behind as being the first and largest environmental cleanup closure contract at Hanford. (authors)« less
Taking Closure to the Next Level - 13030
DOE Office of Scientific and Technical Information (OSTI.GOV)
Feist, E.T.
2013-07-01
The River Corridor Closure Project (RCCP) is the Hanford Site's first closure project and when it is complete, in 2015, it will have cleaned up 220 mi{sup 2} of contaminated land adjacent to the Columbia River. Washington Closure Hanford (WCH) was selected by the DOE to manage the removal and cleanup of Hanford's nuclear legacy along the River Corridor. Work began in 2005 and is now more than 85% complete with more than 2 years left in the contract. A Closure Team was commissioned in December 2009 and has since issued a closure strategy and a disciplined three-phase approach tomore » transition land parcels to DOE, Richland Operations Office (DOE-RL) as cleanup is completed. This process supports DOE-RL objectives for progressive footprint reduction based on the division of the River Corridor into geographical land parcels. It also allows for incremental area-by-area transition and turnover to the Long-Term Stewardship program. Several important milestones stand between now and the successful end of the RCCP. They include overall funding impacts, working with DOE-RL on new scope additions, meeting regulatory milestones, and maintaining a strong safety performance. (authors)« less
Sustainability Science Needs Sustainable Data!
NASA Astrophysics Data System (ADS)
Downs, R. R.; Chen, R. S.
2013-12-01
Sustainability science (SS) is an 'emerging field of research dealing with the interactions between natural and social systems, and with how those interactions affect the challenge of sustainability: meeting the needs of present and future generations while substantially reducing poverty and conserving the planet's life support systems' (Kates, 2011; Clark, 2007). Bettencourt & Kaur (2011) identified more than 20,000 scientific papers published on SS topics since the 1980s with more than 35,000 distinct authors. They estimated that the field is currently growing exponentially, with the number of authors doubling approximately every 8 years. These scholars are undoubtedly using and generating a vast quantity and variety of data and information for both SS research and applications. Unfortunately we know little about what data the SS community is actually using, and whether or not the data that SS scholars generate are being preserved for future use. Moreover, since much SS research is conducted by cross-disciplinary, multi-institutional teams, often scattered around the world, there could well be increased risks of data loss, reduced data quality, inadequate documentation, and poor long-term access and usability. Capabilities and processes therefore need to be established today to support continual, reliable, and efficient preservation of and access to SS data in the future, especially so that they can be reused in conjunction with future data and for new studies not conceived in the original data collection activities. Today's long-term data stewardship challenges include establishing sustainable data governance to facilitate continuing management, selecting data to ensure that limited resources are focused on high priority SS data holdings, securing sufficient rights to allow unforeseen uses, and preparing data to enable use by future communities whose specific research and information needs are not yet known. Adopting sustainable models for archival infrastructures will reduce dependencies on changing priorities and sponsorship that may not continue. Implementing community-based appraisal criteria and selection procedures for data will ensure that limited resources for long-term data management are applied efficiently to data likely to have the most enduring value. Encouraging producers to provide rights for open access to data will support their replication, reuse, integration, and application in a range of SS research and applications in both the near and long term. Identifying modest changes to current data preparation activities to meet preservation goals should reduce expensive post-hoc data and documentation rescue efforts. The NASA Socioeconomic Data and Applications Center (SEDAC), an active archive in the NASA Earth Observing System Data and Information System (EOSDIS), established the SEDAC Long-Term Archive (LTA) in collaboration with the Columbia University Libraries to preserve selected data and information resources for future access and use. A case study of the LTA shows how archives can be organized to foster sustainable data stewardship in a university environment. Lessons learned from the organization planning and the preparation, appraisal, and selection of data for the LTA are described along with enhancements that have been applied to data management by the active archive.
Antimicrobial stewardship programs: how to start and steer a successful program.
Drew, Richard H
2009-03-01
Antimicrobial stewardship programs (ASPs) promote the appropriate use of antimicrobials by selecting the appropriate dose, duration, and route of administration. The appropriate use of antimicrobials has the potential to improve efficacy, reduce treatment-related costs, minimize drug-related adverse events, and limit the potential for emergence of antimicrobial resistance. To summarize ASP tactics that can improve the appropriate use of antimicrobials in the hospital setting. Several measures can be used to implement such programs and gain multidisciplinary support while addressing common barriers. Implementation of an ASP requires a multidisciplinary approach with an infectious diseases physician and a clinical pharmacist with infectious diseases training as its core team members. As identified by recently published guidelines, 2 proactive strategies for promoting antimicrobial stewardship include: (1) formulary restriction and pre-authorization, and (2) prospective audit with intervention and feedback. Other supplemental strategies involve education, guidelines and clinical pathways, antimicrobial order forms, de-escalation of therapy, intravenous-to-oral (IV-to-PO) switch therapy, and dose optimization. Several barriers exist to successful implementation of ASPs. These include obtaining adequate administrative support and compensation for team members. Gaining physician acceptance can also be challenging if there is a perceived loss of autonomy in clinical decision making. ASPs have the potential to reduce antimicrobial resistance, health care costs, and drug-related adverse events while improving clinical outcomes. The efforts and expense required to implement and maintain ASPs are more than justified given their potential benefits to both the hospital and the patient.
Code of Federal Regulations, 2010 CFR
2010-01-01
... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM General Administration § 1470.31 Appeals. A participant may obtain administrative review of an adverse decision under this part...
7 CFR 1470.7 - Enhancements and conservation practices.
Code of Federal Regulations, 2010 CFR
2010-01-01
... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM General Provisions § 1470.7 Enhancements and conservation practices. (a) Participant decisions describing...
36 CFR 230.4 - State program administration.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false State program administration. 230.4 Section 230.4 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE... the State Forester, shall establish a State Forest Stewardship Coordinating Committee whose...
OVERVIEW OF VOLUNTARY STEWARDSHIP EFFORTS TO ADDRESS PHARMACEUTICAL DISPOSAL
This presentation will provide an overview of current federal regulatory guidance for pharmaceutical disposal, currently funded pilot programs for take-back pilot studies, and state programs. The EPA Office of Water's role is to protect our Nation's watersheds and drinking water ...
Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.
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. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.
Tapping into the Forest Management Assistance Programs
John L. Greene; Terry K. Haines
1998-01-01
Use of federal and state forest management assistance programs can enable nonindustial private forest owners to reduce their management expenses and practice better stewardship. This paper summarizes six federal and twelve state assistance programs available to owners in the North Central states. It also describes how to calculate the amount of a government...
Developing a Volunteer Program for Public Environmental Education.
ERIC Educational Resources Information Center
Meehan, Donald B.; Berta, Susan
Volunteers can serve as a means to educate the public about environmental issues and increase stewardship ethic. This booklet is designed to provide much of the key information about designing and managing environmental volunteer programs to educate the general public. The booklet is based on the experiences of a volunteer program called Island…
ERIC Educational Resources Information Center
Peters, Richard O.
An environmental education-oriented global studies program to promote attitudes of environmental stewardship can be implemented in K-12 rural school systems, as an integrated part of social studies instruction, without overburdening the curriculum, by using the Curriculum Organization and Program Evaluation (COPE) model. The model provides…
The five goals related to the Border 2020 program: reducing air pollution, access to clean and safe water, promoting clean waste management, emergency preparedness and response, compliance assurance.and environmental stewardship
Poggio, Emilio D; Braun, William E; Davis, Connie
2009-10-01
Living kidney donor transplantation is now a common treatment for ESRD because it provides excellent outcomes to transplant recipients and is considered a safe procedure for prospective donors. The short- and long-term safety of prospective donors is paramount to the continued success of this procedure. Whereas the initial experiences with living kidney donors mostly included the healthiest, the increase in the need for organs and the changing demographic characteristics of the general population have subtly reshaped the suitability for donation. Kidney function assessment is a critical component of the evaluation of prospective donors; therefore, special emphasis is usually placed on this aspect of the evaluation. At the same time, consideration of kidney function after donation is important because it assists with the determination of renal health in donors. This review summarizes the process of predonation kidney function assessment, determinants of pre- and postdonation renal function, and, importantly, the potential implications of kidney function to the long-term outcomes of kidney donors.
Long-Term Care Ombudsman Program Annual Report: Oct. 1, 1989 through Sept. 30. 1990.
ERIC Educational Resources Information Center
Oklahoma State Dept. of Human Services, Oklahoma City.
This annual report of the Long-Term Care Ombudsmen Program of the Oklahoma Department of Human Services begins by stating the purpose of the program: to improve the quality of life and the quality of care of older residents of long-term care facilities in Oklahoma. It is noted that the Long-Term Care Ombudsman advocates for the rights of long-term…
ERIC Educational Resources Information Center
Kelly, Allyson
1996-01-01
Outlines the history and development of the Watershed Report Card, an integrated program that educates Ontario participants about the holistic nature of a watershed and fosters community stewardship of the local ecosystem. The program consists of the inventory level, assessment and monitoring level, and remediation level. Emphasizes partnerships…
Environmental practices for biomedical research facilities.
Medlin, E L; Grupenhoff, J T
2000-01-01
As a result of the Leadership Conference on Biomedical Research and the Environment, the Facilities Committee focused its work on the development of best environmental practices at biomedical research facilities at the university and independent research facility level as well as consideration of potential involvement of for-profit companies and government agencies. The designation "facilities" includes all related buildings and grounds, "green auditing" of buildings and programs, purchasing of furnishings and sources, energy efficiency, and engineering services (lighting, heating, air conditioning), among other activities. The committee made a number of recommendations, including development of a national council for environmental stewardship in biomedical research, development of a system of green auditing of such research facilities, and creation of programs for sustainable building and use. In addition, the committee recommended extension of education and training programs for environmental stewardship, in cooperation with facilities managers, for all research administrators and researchers. These programs would focus especially on graduate fellows and other students, as well as on science labs at levels K--12. PMID:11121360
Rosa, Rossana; Donskey, Curtis J; Munoz-Price, L Silvia
2018-06-07
Colonization resistance refers to the innate defense provided by the indigenous microbiota against colonization by pathogenic organisms. We aim to describe how this line of defense is deployed against Clostridium difficile and what the implications are for interventions directed by Antimicrobial Stewardship Programs. The indigenous microbiota provides colonization resistance through depletion of nutrients, prevention of access to adherence sites within the gut mucosa, production of inhibitory substances, and stimulation of the host's immune system. The ability to quantify colonization resistance could provide information regarding periods of maximal vulnerability to colonization with pathogens and also allow the identification of mechanisms of restoration of colonization resistance. Methods utilized to determine the composition of the gut microbiota include sequencing technologies and measurement of concentration of specific bacterial metabolites. Use of innovations in the quantification of colonization resistance can expand the role of Antimicrobial Stewardship from prevention of disruption of the indigenous microbiota to restoration of colonization resistance.
Antifungal stewardship considerations for adults and pediatrics.
Hamdy, Rana F; Zaoutis, Theoklis E; Seo, Susan K
2017-08-18
Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via post-prescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.
Science and technology in the stockpile stewardship program, S & TR reprints
DOE Office of Scientific and Technical Information (OSTI.GOV)
Storm, E
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;more » 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« less
Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA
NASA Astrophysics Data System (ADS)
Rainsford, A.; Soave, K.; Costolo, R.; Kudler, J.; Emunah, M.; Hatfield, J.; Kiyasu, J.
2015-12-01
Alina Rainsford, Kathy Soave, Julia Kudler, Jane Hatfield, Melea Emunah, Rose Costelo, Jenna Kiyasu, Amy Dean and Sustainable Seas Monitoring Project, Branson School, Ross, CA, United States, Farallones Marine Sanctuary Association, San Francisco, CA, United StatesAbstract:The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of this student-run project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Each fall student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects and, using randomly determined points, within two permanent 200 m2 areas, in fall, winter, and late spring. Using data from the previous years, we will compare population densities, seasonal abundance and long-term population trends of key algal and invertebrate species, including Tegula funebralis, Anthopluera elegantissima, Cladophora sp. and Fucus sp.. Future analyses and investigations will include intertidal abiotic factors (including water temperature, pH and human foot-traffic) to enhance insights into the Duxbury Reef ecosystem, in particular, the high and mid-intertidal zones experiencing the greatest amount of human impacts.
Burger, Joanna
2014-01-01
Ecological evaluation is essential for remediation, restoration, and Natural Resource Damage Assessment (NRDA), and forms the basis for many management practices. These include determining status and trends of biological, physical, or chemical/radiological conditions, conducting environmental impact assessments, performing remedial actions should remediation fail, managing ecosystems and wildlife, and assessing the efficacy of remediation, restoration, and long-term stewardship. The objective of this paper is to explore the meanings of these assessments, examine the relationships among them, and suggest methods of integration that will move environmental management forward. While remediation, restoration, and NRDA, among others, are often conducted separately, it is important to integrate them for contaminated land where the risks to ecoreceptors (including humans) can be high, and the potential damage to functioning ecosystems great. Ecological evaluations can range from inventories of local plants and animals, determinations of reproductive success of particular species, levels of contaminants in organisms, kinds and levels of effects, and environmental impact assessments, to very formal ecological risk assessments for a chemical or other stressor. Such evaluations can range from the individual species to populations, communities, ecosystems or the landscape scale. Ecological evaluations serve as the basis for making decisions about the levels and kinds of remediation, the levels and kinds of restoration possible, and the degree and kinds of natural resource injuries that have occurred because of contamination. Many different disciplines are involved in ecological evaluation, including biologists, conservationists, foresters, restoration ecologists, ecological engineers, economists, hydrologist, and geologists. Since ecological evaluation forms the basis for so many different types of environmental management, it seems reasonable to integrate management options to achieve economies of time, energy, and costs. Integration and iteration among these disciplines is possible only with continued interactions among practitioners, regulators, policy-makers, Native American Tribes, and the general public. PMID:18687455
The President's Environmental Youth Award is a recognition program for K-12 students who conduct an environmental stewardship and community service project. One winner or group is recognized from each of EPA's 10 regions.
Andreu-Perez, Javier; Poon, Carmen C Y; Merrifield, Robert D; Wong, Stephen T C; Yang, Guang-Zhong
2015-07-01
This paper provides an overview of recent developments in big data in the context of biomedical and health informatics. It outlines the key characteristics of big data and how medical and health informatics, translational bioinformatics, sensor informatics, and imaging informatics will benefit from an integrated approach of piecing together different aspects of personalized information from a diverse range of data sources, both structured and unstructured, covering genomics, proteomics, metabolomics, as well as imaging, clinical diagnosis, and long-term continuous physiological sensing of an individual. It is expected that recent advances in big data will expand our knowledge for testing new hypotheses about disease management from diagnosis to prevention to personalized treatment. The rise of big data, however, also raises challenges in terms of privacy, security, data ownership, data stewardship, and governance. This paper discusses some of the existing activities and future opportunities related to big data for health, outlining some of the key underlying issues that need to be tackled.
New Chemicals Program Review of Alternatives for PFOA and Related Chemicals
In 2006, EPA and the eight major companies in the industry launched the 2010/15 PFOA Stewardship Program, in which companies committed to reduce global facility emissions and product content of PFOA and related chemicals by 95 percent by 2010, and to work
A review of antimicrobial stewardship training in medical education
Silverberg, Sarah L.; Zannella, Vanessa E.; Countryman, Drew; Ayala, Ana Patricia; Lenton, Erica; Friesen, Farah
2017-01-01
Objectives We reviewed the published literature on antimicrobial stewardship training in undergraduate and postgraduate medical education to determine which interventions have been implemented, the extent to which they have been evaluated, and to understand which are most effective. Methods We searched Ovid MEDLINE and EMBASE from inception to December 2016. Four thousand three hundred eighty-five (4385) articles were identified and underwent title and abstract review. Only those articles that addressed antimicrobial stewardship interventions for medical trainees were included in the final review. We employed Kirkpatrick’s four levels of evaluation (reaction, learning, behaviour, results) to categorize intervention evaluations. Results Our review included 48 articles. The types of intervention varied widely amongst studies worldwide. Didactic teaching was used heavily in all settings, while student-specific feedback was used primarily in the postgraduate setting. The high-level evaluation was sparse, with 22.9% reporting a Kirkpatrick Level 3 evaluation; seventeen reported no evaluation. All but one article reported positive results from the intervention. No articles evaluated the impact of an intervention on undergraduate trainees’ prescribing behaviour after graduation. Conclusions This study enhances our understanding of the extent of antimicrobial stewardship in the context of medical education. While our study demonstrates that medical schools are implementing antimicrobial stewardship interventions, rigorous evaluation of programs to determine whether such efforts are effective is lacking. We encourage more robust evaluation to establish effective, evidence-based approaches to training prescribers in light of the global challenge of antimicrobial resistance. PMID:29035872
Remote-Reading Safety and Safeguards Surveillance System for 3013 Containers
DOE Office of Scientific and Technical Information (OSTI.GOV)
Lechelt, W. M.; Skorpik, J. R.; Silvers, K. L.
2002-02-26
At Hanford's Plutonium Finishing Plant (PFP), plutonium oxide is being loaded into stainless steel containers for long-term storage on the Hanford Site. These containers consist of two weld-sealed stainless steel cylinders nested one within the other. A third container holds the plutonium within the inner cylinder. This design meets the U.S. Department of Energy (DOE) storage standard, DOE-STD- 3013-2000, which anticipates a 50-year storage lifetime. The 3013 standard also requires a container surveillance program to continuously monitor pressure and to assure safeguards are adequate. However, the configuration of the container system makes using conventional measurement and monitoring methods difficult. Tomore » better meet the 3013 monitoring requirements, a team from Fluor Hanford (who manages the PFP), Pacific Northwest National Laboratory (PNNL), and Vista Engineering Technologies, LLC, developed a safer, cost-efficient, remote PFP 3013 container surveillance system. This new surveillance system is a combination of two successfully deployed technologies: (1) a magnetically coupled pressure gauge developed by Vista Engineering and (2) a radio frequency (RF) tagging device developed by PNNL. This system provides continuous, 100% monitoring of critical parameters with the containers in place, as well as inventory controls. The 3013 container surveillance system consists of three main elements: (1) an internal magnetic pressure sensor package, (2) an instrument pod (external electronics package), and (3) a data acquisition storage and display computer. The surveillance system described in this paper has many benefits for PFP and DOE in terms of cost savings and reduced personnel exposure. In addition, continuous safety monitoring (i.e., internal container pressure and temperature) of every container is responsible nuclear material stewardship and fully meets and exceeds DOE's Integrated Surveillance Program requirements.« less
2009 Community Involvement Training Conference
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
2011 Community Involvement Training Conference
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
2006 Community Involvement Training Conference
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
2013 Community Involvement Training Conference
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
2007 Community Involvement Training Conference
A dynamic training conference that brings together more than 450 people from EPA and the Agency’s partners and stakeholders who plan and implement environmental community involvement, partnership, stewardship, outreach, and education programs.
Antimicrobial Stewardship in the Emergency Department and Guidelines for Development
May, Larissa; Cosgrove, Sara; L’Archeveque, Michelle; Talan, David A.; Payne, Perry; Rothman, Richard E.
2013-01-01
Antimicrobial resistance is a mounting public health concern. Emergency departments (EDs) represent a particularly important setting for addressing inappropriate antimicrobial prescribing practices, given the frequent use of antibiotics in this setting that sits at the interface of the community and the hospital. This article outlines the importance of antimicrobial stewardship in the ED setting and provides practical recommendations drawn from existing evidence for the application of various strategies and tools that could be implemented in the ED including advancement of clinical guidelines, clinical decision support systems, rapid diagnostics, and expansion of ED pharmacist programs. PMID:23122955
Stewardship matters: Case studies in establishment success of urban trees
Lara A. Roman; Lindsey A. Walker; Catherine M. Martineau; David J. Muffly; Susan A. MacQueen; Winnie Harris
2015-01-01
Urban tree planting initiatives aim to provide ecosystem services that materialize decades after planting, therefore understanding tree survival and growth is essential to evaluating planting program performance. Tree mortality is relatively high during the establishment phase, the first few years after planting. Qualitative assessments of programs with particularly...
The Gap Analysis Program (GAP) is a national interagency program that maps the distribution of plant communities and selected animal species and compares these distributions with land stewardship to identify biotic elements at potential risk of endangerment. Acquisition of primar...
Gardening with Children: My Summers at Beanstalk Children's Garden
ERIC Educational Resources Information Center
Stoecklin, Vicki L.
2009-01-01
There has been increased interest in recent years on gardening with children and a variety of programs have been started to support different types of programmatic goals. Goals of gardening programs include environmental stewardship, personal growth/social skills, an integrated learning environment, nutrition/health, science education, practical…
Wilderness education: The ultimate commitment to quality wilderness stewardship
Gregory F. Hansen; Tom Carlson
2007-01-01
The effective planning, implementation, and monitoring of a wilderness education program will ultimately produce measurable results that can be instrumental in achieving wilderness management goals and objectives. This paper will provide a simple step-by-step overview of how to develop and maintain a successful wilderness education program through planning,...
ERIC Educational Resources Information Center
Momatiuk, Yva; Eastcott, John
1998-01-01
The Pribilof Islands Stewardship Program aims to preserve the rich species diversity of the islands and recover the sense of connectedness that once linked local Aleuts and their environment. The summer program draws on both science and traditional knowledge, offering Aleut youth the chance to assist scientists, protect the seals, and participate…
A Perspective on Carnegie Corporation's Program, 1983-1997.
ERIC Educational Resources Information Center
Hamburg, David A.
The Carnegie Corporation's mission is to continue Andrew Carnegie's philanthropic preoccupations with promoting education and world peace. In this essay, retiring Carnegie Corporation President David A. Hamburg provides a detailed accounting of his stewardship of the foundation since 1983, when he set forth new program directions in the context of…
ERIC Educational Resources Information Center
Lemus, Judith D.; Bishop, Kristina; Walters, Howard
2010-01-01
The QuikSCience Challenge science education program combines a cooperative team project emphasizing community service with an academic competition for middle and high school students. The program aims to develop leadership abilities, motivate interest in ocean sciences, engage students in community service and environmental stewardship, and…
Business Students' Choice of Short-Term or Long-Term Study Abroad Opportunities
ERIC Educational Resources Information Center
Fitzsimmons, Stacey R.; Flanagan, David J.; Wang, Xiaodan
2013-01-01
Recent years have seen a proliferation of short-term study abroad opportunities. Although they are both supplementing and replacing semester-long study abroad programs, research has focused primarily on semester (long-term) programs. We draw on the theory of planned behavior (TPB) to explore factors that predict why students choose long-term and…
Sustainable Seas Student Intertidal Monitoring Project, Duxbury Reef, Bolinas, CA
NASA Astrophysics Data System (ADS)
Soave, K.; Dean, A.; Prescutti, K.; Ball, O.; Chang, E.; Darakananda, K.; Jessup, K.; Poutian, J.; Schwalbe, H.; Storm, E.
2008-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of the project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species and requirements for maintaining a healthy, diverse intertidal ecosystem; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program and Experiential Training for Students). Student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal ecology, interpretation and monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects (A and B), and using randomly determined points within a permanent 100 m2 area, three times per year (fall, winter, and late spring). Using the data collected since 2004, we will analyze the population densities of aggregating anemones, Anthopleura elegantissima, for seasonal abundance variations as well as long-term population trends. We will also follow the seasonal and long-term population fluctuations of red algal turf, Endocladia muricata and Gelidium coulteri, and black turban snails, Tegula funebralis. Comparing populations of turf algae and the herbivorous black turban snails gathered before and after the November 7, 2007 San Francisco Bay oil spill shows very little impact on the Duxbury Reef intertidal inhabitants. Future analyses will include intertidal abiotic factors to enhance insights into the workings of the Duxbury Reef ecosystem. Kathy Soave The Branson School 39 Fernhill Rd. Ross, CA 94957 (415) 454-3612 x 323 Amy Dean Farallones Marine Sanctuary Association, PO Box 29386 San Francisco, CA 94129, 415-561-6625 x 303 AGU Sponsor, Ines Cifuentes, AGU membership number 10189667
76 FR 65121 - Community Forest and Open Space Conservation Program
Federal Register 2010, 2011, 2012, 2013, 2014
2011-10-20
... broad range of citizens in forest conservation, stewardship, and governance. Where situated near Federal... conservation of a tract but does not have the capacity to effectively oversee management and governance issues...
75 FR 34924 - Conservation Stewardship Program
Federal Register 2010, 2011, 2012, 2013, 2014
2010-06-21
... the words of ``issuance'' at the end of the preamble. DATES: Effective Date: The rule is effective...: Words of Issuance [Corrected] (1) On page 31653, in the second column, the Words of Issuance that read...
Edmiston, Charles E; Leaper, David; Spencer, Maureen; Truitt, Karen; Litz Fauerbach, Loretta; Graham, Denise; Johnson, Helen Boehm
2017-11-01
The global push to combat the problem of antimicrobial resistance has led to the development of antimicrobial stewardship programs (ASPs), which were recently mandated by The Joint Commission and the Centers for Medicare and Medicaid Services. However, the use of topical antibiotics in the open surgical wound is often not monitored by these programs nor is it subject to any evidence-based standardization of care. Survey results indicate that the practice of using topical antibiotics intraoperatively, in both irrigation fluids and powders, is widespread. Given the risks inherent in their use and the lack of evidence supporting it, the practice should be monitored as a core part of ASPs, and alternative agents, such as antiseptics, should be considered. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Vohra, Yogesh, K.
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 superconductorsmore » under high pressures. The growth chemistry developed under NNSA support can be adapted for commercial production of designer diamonds.« less
Intergenerational equity and environmental restoration cleanup levels.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hocking, E. K.; Environmental Assessment
2001-01-01
The United States Department of Energy environmental restoration program faces difficult decisions about the levels of cleanup to be achieved at its many contaminated sites and has acknowledged the need for considering intergenerational equity in its decision making. Intergenerational equity refers to the fairness of access to resources across generations. Environmental restoration cleanup levels can have unintended and unfair consequences for future generations access to resources. The potentially higher costs associated with using low, non-risk-based cleanup levels for remediation may divert funding from other activities that could have a greater beneficial impact on future generations. Low, non-risk-based cleanup levels couldmore » also result in more damage to the nation's resources than would occur if a higher cleanup level were used. The loss or impairment of these resources could have an inequitable effect on future generations. However, intergenerational inequity could arise if sites are not completely restored and if access to and use of natural and cultural resources are unfairly limited as a result of residual contamination. In addition to concerns about creating possible intergenerational inequities related to selected cleanup levels, the tremendous uncertainties associated with sites and their restoration can lead site planners to rely on stewardship by default. An ill-conceived stewardship program can contribute to intergenerational inequity by limiting access to resources while passing on risks to future generations and not preparing them for those risks. This paper presents a basic model and process for designing stewardship programs that can achieve equity among generations.« less
Lin, Yu-Shiuan; Lin, I-Fen; Yen, Yung-Feng; Lin, Pei-Ching; Shiu, Yu-Chih; Hu, Hsing-Yi; Yang, Ying-Pi
2013-11-01
Reports of antimicrobial stewardship programs (ASPs) in community hospitals are limited, with the major focus on specific agents, small settings, or short time periods. Here we present the outcomes of cost control, consumption restraint, and quality of care after a 3-year multidisciplinary ASP in a 415-bed community public teaching hospital. Three strategies for improving antimicrobial stewardship were implemented: education, clinical pharmacists-based intervention, and regular outcome announcement. The steering panel of the program was a committee composed of infection specialists, attending physicians, clinical pharmacists, nurses, and medical laboratorists. Semiannual data from July 2009 to June 2012 was analyzed. Antibiotic costs declined from $21,464 to $12,146 per 1,000 patient-days (-43.4%). Approximately $2.5 million was saved in 3 years, and estimated labor cost was $3,935 per month. Defined daily dose per 1,000 patient-days were diminished from 906.7 to 717.5 (-20.9%). Significant reductions were found in the consumption of aminoglycosides, first-generation cephalosporins, and aminopenicillins. However, through comprehensive auditing, increasing consumption of fourth-generation cephalosporins and fluoroquinolones was noticed. No significant difference in the quality of care (ie, length of stay, incidence of health care associated infections, and mortality) was observed. The multidisciplinary ASP was beneficial to reduce antibiotic cost and consumption. The strategies were practical and worthy to be recommended to community health care settings. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
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
Forni, Silvia; Toccafondi, Giulio; Viaggi, Bruno; Grazzini, Maddalena; D'Arienzo, Sara; Gemmi, Fabrizio; Vannucci, Andrea; Tulli, Giorgio
2018-02-01
Antimicrobial resistance is a global threat caused by the rapid spread of multiresistant microorganisms. Antimicrobial stewardship (AS) is a coordinated intervention designed to improve the appropriate use of antimicrobials by promoting the selection of the optimal drug regimen, dose, duration of therapy and route of administration. AS programs have proved effective in reducing antimicrobial resistance, inappropriate antimicrobial use and in improving patient outcomes. Recently developed rapid diagnostic technologies in microbiology (RDTM) allows a faster and etiological diagnosis of infection and a reduction in the use of unnecessary empirical therapies. This may result in important advancement in time-critical care pathways for septic patients. Nevertheless, RDTM are costly and if not rationally positioned may consume resources and hinder the efficacy of AS programs. In this regard, Tuscany Region is engaged in designing, through a systemic approach, an effective high-quality clinical microbiological service grid. In order to develop a sustainable and equitable model for integrating diagnostic and antimicrobial stewardship we conducted a survey in the regional network of 14 microbiological laboratories. The results shows that in order to develop a sustainable service we need to improve the communication at the interface between laboratories and care unit, harmonize the time windows for processing samples and to devise a robust score for stratifying patient with suspected sepsis.
Bishop, Bryan M
2016-12-01
Antimicrobial resistance is a national public health concern. Misuse of antimicrobials for conditions such as upper respiratory infection, urinary tract infections, and cellulitis has led to increased resistance to antimicrobials commonly utilized to treat those infections, such as sulfamethoxazole/trimethoprim and flouroquinolones. The emergency department (ED) is a site where these infections are commonly encountered both in ambulatory patients and in patients requiring admission to a hospital. The ED is uniquely positioned to affect the antimicrobial use and resistance patterns in both ambulatory settings and inpatient settings. However, implementing antimicrobial stewardship programs in the ED is fraught with challenges including diagnostic uncertainty, distractions secondary to patient or clinician turnover, and concerns with patient satisfaction to name just a few. However, this review article highlights successful interventions that have stemmed inappropriate antimicrobial use in the ED setting and warrant further study. This article also proposes other, yet to be validated proposals. Finally, this article serves as a call to action for pharmacists working in antimicrobial stewardship programs and in emergency medicine settings. There needs to be further research on the implementation of these and other interventions to reduce inappropriate antimicrobial use to prevent patient harm and curb the development of antimicrobial resistance. © The Author(s) 2015.
Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.
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. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ERIC Educational Resources Information Center
Bires, Nancy K.
2013-01-01
There have been a limited number of studies on the short-term influence of environmental and earth education programs, however, not much information is available about the long-term influence of these programs on participants' environmental attitudes and actions. This mixed methods study explores the long-term influence of the earth education…
Batura, Deepak; Gopal Rao, G; Foran, Marion; Brempong, Fatmata
2018-01-01
Bacteria adherent to long-term urinary catheters (LTUC) may give misleading urine culture results. Guidelines in the USA recommend changing LTUC before urine collection to diagnose UTI and before commencing appropriate antimicrobial treatment. However, in the UK there is no such guidance. In this study, we evaluated differences in urine cultures before and after changing LTUC. In a prospective study in a UK urology department, we made a quantitative and qualitative comparison between paired urines collected before and after catheter change in patients with LTUC. We measured culture growth on a four-point ordinal scale as nil, scanty (< 10 7 cfu/L), moderate (10 7 -10 8 cfu/L) or heavy (> 10 8 cfu/L) and recorded the range of bacterial species isolated. Statistical analysis was by Wilcoxon matched-pairs test. Sixty-six patients (55 males, 11 females) took part in the study. Urines with no growth increased from 7/66 (11%) before change of catheter to 21/66(32%) after change of catheter. Cultures reported as heavy growth (> 10 8 cfu/L) reduced from 48/66 (73%) to 25/66 (38%) after catheter change (p < 0.001). Except for Pseudomonas spp., other organisms were isolated less frequently after catheter change. No Proteus spp. was isolated after catheter change. This study confirms that failure to change long-term catheters before collecting urine for culture may give misleading results. In the interest of accurate diagnosis and antimicrobial stewardship, UK guidelines should recommend changing long-term urinary catheters before collection of urine for culture.
Minnesota anglers' fisheries-related value orientations and their stewardship of fish resources
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.
ACHP | News | ACHP Considers Program Comment for Select GSA Repairs and
) legislation has provided GSA with significant stewardship opportunities for its historic public buildings . However, the rigid spending deadline associated with the legislation has prompted the need for this
Code of Federal Regulations, 2013 CFR
2013-01-01
... associated waste transport or transfer devices for animal feeding operations; or (3) Conservation activities... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments... additional conservation activities, and improving, maintaining, and managing existing conservation activities...
Code of Federal Regulations, 2012 CFR
2012-01-01
... associated waste transport or transfer devices for animal feeding operations; or (3) Conservation activities... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments... additional conservation activities, and improving, maintaining, and managing existing conservation activities...
Code of Federal Regulations, 2011 CFR
2011-01-01
... associated waste transport or transfer devices for animal feeding operations; or (3) Conservation activities... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments... additional conservation activities, and improving, maintaining, and managing existing conservation activities...
Code of Federal Regulations, 2014 CFR
2014-01-01
... associated waste transport or transfer devices for animal feeding operations; or (3) Conservation activities... AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION STEWARDSHIP PROGRAM Contracts and Payments... additional conservation activities, and improving, maintaining, and managing existing conservation activities...
Science-based stockpile stewardship at Los Alamos National Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
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 overmore » 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.« less
Penicillin skin testing: potential implications for antimicrobial stewardship.
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. © 2013 Pharmacotherapy Publications, Inc.
The Development of NOAA Education Common Outcome Performance Measures (Invited)
NASA Astrophysics Data System (ADS)
Baek, J.
2013-12-01
The National Oceanic and Atmospheric Administration (NOAA) Education Council has embarked on an ambitious Monitoring and Evaluation (M&E) project that will allow it to assess education program outcomes and impacts across the agency, line offices, and programs. The purpose of this internal effort is to link outcome measures to program efforts and to evaluate the success of the agency's education programs in meeting the strategic goals. Using an outcome-based evaluation approach, the NOAA Education Council is developing two sets of common outcome performance measures, environmental stewardship and professional development. This presentation will examine the benefits and tradeoffs of common outcome performance measures that collect program results across a portfolio of education programs focused on common outcomes. Common outcome performance measures have a few benefits to our agency and to the climate education field at large. The primary benefit is shared understanding, which comes from our process for writing common outcome performance measures. Without a shared and agreed upon set of definitions for the measure of an outcome, the reported results may not be measuring the same things and would incorrectly indicate levels of performance. Therefore, our writing process relies on a commitment to developing a shared set of definitions based on consensus. We hope that by taking the time to debate and coming to agreement across a diverse set of programs, the strength of our common measures can indicate real progress towards outcomes we care about. An additional benefit is that these common measures can be adopted and adapted by other agencies and organizations that share similar theories of change. The measures are not without their drawbacks, and we do make tradeoffs as part of our process in order to continue making progress. We know that any measure is necessarily a narrow slice of performance. A slice that may not best represent the unique and remarkable contribution of an individual program, but does reflect a variety of contributions along a single dimension across a large portfolio of programs. The process has ended up pushing our working group to call for even more measures, to capture an increasing number of dimensions that reflect the nature of the portfolio of programs. This past year we have been working on developing two sets of common outcome performance measures for professional development (PD) and stewardship education programs. The outcome we chose for PD programs was the use of what was learned in the educator's practice. The outcome we chose for stewardship programs was the stewardship behaviors that participants learn and practice. The measurement of these outcomes will inform whether our strategies are having their intended impact. By knowing how and how much these outcomes are occurring as a result of our program, we can improve program performance over time. The common outcome performance measures help demonstrate how these programs engage audiences in supporting NOAA's mission. As AGU climate literacy community continues to grow, it is important to consider an approach to demonstrate the community's contribution to the Nation's climate literacy. Development of common outcome performance measures is one approach that could help focus the community in meeting its goals.
Pawluk, Shane; Black, Emily; El-Awaisi, Alla
2015-02-01
The objectives of this study were to identify antimicrobial stewardship activities in Qatar, identify pharmacist involvement in activities and summarize perceived barriers for implementation of antimicrobial stewardship programs (ASPs). A cross-sectional survey was developed based on study objectives and completed by pharmacists in Qatar. Most hospital settings have implemented components of ASP. Lack of infectious disease specialists and training of healthcare providers was the most common barrier to implementation or expansion of ASP identified in the hospital and community settings respectively. Pharmacists report some components of ASP have been implemented; however, barriers must be overcome to further expand ASPs. © 2014 Royal Pharmaceutical Society.
Antimicrobial Therapy for Legionnaire's Disease: Antibiotic Stewardship Implications.
Cunha, Cheston B; Cunha, Burke A
2017-03-01
Legionnaire's disease is a common cause of community-acquired pneumonia (CAP). Although no single clinical feature is diagnostic, if characteristic extrapulmonary findings are present a presumptive clinical syndromic diagnosis is possible. Depending on geographic location, season, and physician awareness, Legionnaire's disease may be included in the differential diagnosis of CAP. Some antibiotics effective against Legionella sp are also effective in treating the typical bacterial causes of CAP. From an antimicrobial stewardship program (ASP) perspective, monotherapy is preferred to double-drug therapy. From an ASP and pharmacoeconomic standpoint, monotherapy with doxycycline or a respiratory quinolone provides optimal cost effective therapy. Copyright © 2016 Elsevier Inc. All rights reserved.
Waters, C Dustin
2015-03-15
Improved drug-utilization and cost outcomes achieved by a pharmacist-led antimicrobial stewardship program (ASP) are described. Pharmacists may be tasked to lead ASP development and implementation with little or no support from an infectious diseases (ID) physician and other hospital personnel whose involvement on ASP teams is recommended (e.g., clinical microbiologists, infection control specialists, hospital epidemiologists). Several years ago, Intermountain Healthcare's 325-bed McKay-Dee Hospital in Utah implemented an ASP led by an antimicrobial stewardship pharmacist. In addition to reviewing patient profiles and meeting with physicians to discuss cases daily (Monday-Friday), the pharmacist was available to provide afterhours phone consultations; support was provided by an infection prevention nurse, two physician ASP champions, the pharmacy leadership, pharmacy informatics and hospital laboratory personnel, and the chief medical officer. In the program's first 33 months, the pharmacist made a total of 2,457 interventions or recommendations, with an acceptance rate of 91.8%. Comparison of selected outcomes during one-year periods before and after ASP implementation indicated substantial decreases in the utilization of four commonly used antimicrobial agents and classes (carbapenems, daptomycin, echinocandins, and levofloxacin) in the postimplementation period, with a significant decline in the average length of stay for community-acquired pneumonia (mean ± S.D., 2.69 ± 0.10 days versus 3.40 ± 0.23 days; p = 0.03). Two years after ASP implementation, annual cost savings attributed to the program were estimated at $355,000. In the absence of ID physician support and oversight, the pharmacist-led ASP achieved substantial reductions in antimicrobial utilization and associated expenditures. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.
Containment Prospectus for the PIANO Experiment
DOE Office of Scientific and Technical Information (OSTI.GOV)
Burkhard, N R
2001-03-23
PIANO is a dynamic, subcritical, zero-yield experiment intended for execution in the U1a.102C drift of the U1a complex at the Nevada Test Site (NTS) (Figure 1). The data from the PIANO experiment will be used in the Stockpile Stewardship Program to assess the aging of nuclear weapon components and to better model the long-term performance of the weapons in the enduring stockpile. The PIANO experiment is composed of one experimental package. The experimental package will have high explosive (HE) and special nuclear material (SNM) in a subcritical assembly. The containment plan for the PIANO series of experiments utilizes a two-containment-vesselmore » concept. The first Containment vessel is formed by the primary containment barrier that seals the U1a.102C drift. The second containment vessel is formed by the secondary containment barrier in the U100 drift. The PIANO experiment is the final experiment to be conducted in the U1a.102C alcove. It will be an ''open'' experiment--meaning that PIANO will not utilize a confinement vessel as the previous OBOE experiments in this alcove did. We expect that the SNM from the PIANO experiment will be fully contained within the first containment vessel.« less
Science Data Preservation: Implementation and Why It Is Important
NASA Technical Reports Server (NTRS)
Kempler, Steven J.; Moses, John F.; Gerasimov, Irina V.; Johnson, James E.; Vollmer, Bruce E.; Theobald, Michael L.; Ostrenga, Dana M.; Ahmad, Suraiya; Ramapriyan, Hampapuram K.; Khayat, Mohammad G.
2013-01-01
Remote Sensing data generation by NASA to study Earth s geophysical processes was initiated in 1960 with the launch of the first Television Infrared Observation Satellite Program (TIROS), to develop a meteorological satellite information system. What would be deemed as a primitive data set by today s standards, early Earth science missions were the foundation upon which today s remote sensing instruments have built their scientific success, and tomorrow s instruments will yield science not yet imagined. NASA Scientific Data Stewardship requirements have been documented to ensure the long term preservation and usability of remote sensing science data. In recent years, the Federation of Earth Science Information Partners and NASA s Earth Science Data System Working Groups have organized committees that specifically examine standards, processes, and ontologies that can best be employed for the preservation of remote sensing data, supporting documentation, and data provenance information. This presentation describes the activities, issues, and implementations, guided by the NASA Earth Science Data Preservation Content Specification (423-SPEC-001), for preserving instrument characteristics, and data processing and science information generated for 20 Earth science instruments, spanning 40 years of geophysical measurements, at the NASA s Goddard Earth Sciences Data and Information Services Center (GES DISC). In addition, unanticipated preservation/implementation questions and issues in the implementation process are presented.
Linking Fine-Scale Observations and Model Output with Imagery at Multiple Scales
NASA Astrophysics Data System (ADS)
Sadler, J.; Walthall, C. L.
2014-12-01
The development and implementation of a system for seasonal worldwide agricultural yield estimates is underway with the international Group on Earth Observations GeoGLAM project. GeoGLAM includes a research component to continually improve and validate its algorithms. There is a history of field measurement campaigns going back decades to draw upon for ways of linking surface measurements and model results with satellite observations. Ground-based, in-situ measurements collected by interdisciplinary teams include yields, model inputs and factors affecting scene radiation. Data that is comparable across space and time with careful attention to calibration is essential for the development and validation of agricultural applications of remote sensing. Data management to ensure stewardship, availability and accessibility of the data are best accomplished when considered an integral part of the research. The expense and logistical challenges of field measurement campaigns can be cost-prohibitive and because of short funding cycles for research, access to consistent, stable study sites can be lost. The use of a dedicated staff for baseline data needed by multiple investigators, and conducting measurement campaigns using existing measurement networks such as the USDA Long Term Agroecosystem Research network can fulfill these needs and ensure long-term access to study sites.
NASA Astrophysics Data System (ADS)
Brown, H.; Ritchey, N. A.
2017-12-01
NOAA National Centers for Environmental Information (NCEI) once was three separate data centers (NGDC, NODC, and NCDC). In 2015 the three centers merged into NCEI. NCEI has refined the art of long term preservation and stewardship practices throughout the life-cycle of various types of data. NCEI can help you navigate and make the complicated world of preserving your data user-friendly. Using tools at NCEI, data providers can request data to be archived, submit data for archival and create complete International Organization for Standardization (ISO) metadata records with ease. To ensure traceability, Digital Object Identifiers (DOIs) are minted for published data sets. The services offered at NCEI follow standards and NOAA directives such as the Open Archival Information System (OAIS) - Reference Model (ISO 14721) to ensure consistent long-term preservation for the Nation's resource of global environmental data for a broad spectrum of users. The implementation of these standards supports the data to be accessible, independently understandable and reproducible in an easy to understand format for all types of users. Insights from combined knowledge of 100+years of various domain and data management and preservation and the tools supporting these functions will be shared.
Stewardship of NASA's Earth Science Data and Ensuring Long-Term Active Archives
NASA Astrophysics Data System (ADS)
Ramapriyan, H.; Behnke, J.
2016-12-01
NASA's Earth Observing System Data and Information System (EOSDIS) has been in operation since 1994. EOSDIS manages data from pre-EOS missions dating back to 1960s, EOS missions that started in 1997, and missions from the post-EOS era. Its data holdings come from many different sources - satellite and airborne instruments, in situ measures, field experiments, science investigations, etc. Since the beginning of the EOS Program, NASA has followed an open data policy, with non-discriminatory access to data with no period of exclusive access. NASA has well-established processes for assigning and/or accepting datasets into one of 12 Distributed Active Archive Centers (DAACs) that are parts of EOSDIS. EOSDIS has been evolving through several information technology cycles, adapting to hardware and software changes in the commercial sector. NASA is responsible for maintaining Earth science data as long as users are interested in using them for research and applications, which is well beyond the life of the data gathering missions. For science data to remain useful over long periods of time, steps must be taken to preserve: 1. Data bits with no corruption, 2. Discoverability and access, 3. Readability, 4. Understandability, 5. Usability and 6. Reproducibility of results. NASA's Earth Science data and Information System (ESDIS) Project, along with the 12 EOSDIS Distributed Active Archive Centers (DAACs), has made significant progress in each of these areas over the last decade, and continues to evolve its active archive capabilities. Particular attention is being paid in recent years to ensure that the datasets are "published" in an easily accessible and citable manner through a unified metadata model, a common metadata repository (CMR), a coherent view through the earthdata.gov website, and assignment of Digital Object Identifiers (DOI) with well-designed landing/product information pages.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Carpenter, Cliff; Castillo, Darina; Fatherly, Nicki
The US Department of Energy (DOE) expects to receive the transfer of 10 FUSRAP Sites from the US Army Corps of Engineers (USACE) over the next 10 years; however, the timing of the transfers is highly dependent upon federal funding of the ongoing remedial actions. When remediation for each site is complete and the 2-year operations and maintenance period has concluded, each site will transfer from USACE to DOE for long-term surveillance and maintenance (LTS&M). US DOE’s Office of Legacy Management (LM) will accept program responsibility for these sites and conduct LTS&M activities required to maintain protectiveness, preserve site-specific knowledge,more » and retain the cleanup and stewardship records while keeping stakeholders informed. Since the last FUSRAP site transfer occurred in 2007, LM in coordination with USACE intends to establish a transition process to promote the seamless transfer of sites from the time when the first record of decision is signed to the completion of FUSRAP activities. The approach to transfer active FUSRAP sites to completed sites status has been historically outlined in foundational documents such as the 1999 Memorandum of Understanding and supporting letters of agreement between the two agencies. As more complex FUSRAP sites are completed, this transition process will provide a model between the two agencies to communicate future long-term care liabilities. Ultimately, the FUSRAP transition process is structured to acquire and preserve site knowledge and information necessary for protecting the environment and public health. As of 2015, LM has transitioned and accepted programmatic responsibility for over 90 sites. From LM’s perspective, successful transition of any site includes understanding the long-term environmental liabilities. LM uses site transition framework requirements from past transitions to develop site-specific transition plans. Site-specific transition plans are developed by LM in coordination with USACE and executed during the 2-year operations and maintenance period. An integrated project team of subject matter experts is assembled to address the conditions of the transitioning site; acquire a site records collection; evaluate site operations and final site conditions and associated risks; identify and contact stakeholders; and document the basis for site LTS&M requirements. While the majority of the transition activities are completed by LM, close coordination between US DOE LM and USACE throughout this process is essential for an effective and seamless transfer to assure that there is no lapse in site protectiveness.« less
75 FR 43199 - Notice of Public Meeting; Central Montana Resource Advisory Council
Federal Register 2010, 2011, 2012, 2013, 2014
2010-07-23
... sage grouse study project; A presentation about the Undaunted Stewardship Program; A field visit to an... details (next meeting date, location, travel vouchers, etc.). All RAC meetings are open to the public. The...
Struble, Marie Boyle; Aomari, Laurie Lindsay
2003-08-01
It is the position of the American Dietetic Association (ADA) that access to adequate amounts of safe, nutritious, and culturally appropriate food at all times is a fundamental human right. Hunger continues to be a worldwide problem of staggering proportions. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, and are environmentally and economically sustainable. The Association is aware that hunger exists in a world of plenty and that poverty, gender inequity, ethnocentrism, racism, and the lack of political will are key constraints to solving the problems of global hunger and malnutrition. Recognizing that simplistic approaches are inadequate, the ADA identifies sustainable development as the long-term strategy to ending world hunger and achieving food security. Sustainable development requires political, economic, and social changes that include empowering the disenfranchised, widening access to assets and other resources, narrowing the gap between rich and poor, and adjusting consumption patterns so as to foster good stewardship of nature. Additionally, because the health status of future generations is related to the well-being of their mothers, achieving food security will also require increased access for women to education, adequate health care and sanitation, and economic opportunities. This position paper reviews the complex issues of global food insecurity and discusses long-term solutions for achieving world food security. Achieving the end of world hunger has been and is now within our grasp. There is sufficient food to feed everyone, and solutions can be realized now that will benefit all of humanity. As noted in the paper, most people who examine the costs of ending versus not ending world hunger are bewildered by the question of why humanity did not solve the problem a long time ago. The Association supports programs and encourages practices that combat hunger and malnutrition, produce food security, promote self-sufficiency, respect local cultures, and are environmentally and economically sustainable. The ADA recognizes that decisions and actions that dietetics professionals make as practitioners and consumers can help reduce the extent of poverty and hunger both here and abroad. This paper provides information, resources, and strategies to assist dietetics professionals in improving the public's understanding of key issues, becoming advocates of the poor, and influencing the political will to end world hunger.
Long-Term Bridge Performance (LTBP) Program Protocols, Version 1
DOT National Transportation Integrated Search
2016-01-01
The Long-Term Bridge Performance (LTBP) Program is a long-term research effort to collect scientific performance data from a representative sample of bridges in the United States. Data will be collected for in-service bridges using a variety of techn...
NASA Astrophysics Data System (ADS)
Jardine, P. M.; Mehlhorn, T. L.
2006-05-01
The following research investigated the effectiveness of an aggressive, large scale remedial action that is occurring to subsurface waste trenches containing radioactive and organic waste at the Oak Ridge National Laboratory. The site is being remediated as one of the top cleanup prioritization for the Oak Ridge Accelerated Remediation endeavor. Site landlords, Bechtel Jacobs Co., LLC (BJC) are installing a minimal RCRA cap with the primary objective of controlling the infiltration of storm water into the hundreds of unconfined waste trenches containing radioactive and organic waste. The site now offers a unique scientific opportunity to track the kinetic evolution of post-cap processes influencing contaminant migration and immobilization, because we have many years of pre-cap coupled processes information and knowledge. Since the cap is certain to disrupt the near steady-state contaminant discharge profiles that have existed for many years from the site, we have been quantifying the influence of post-cap hydrological, geochemical, and microbial processes on contaminant discharge as a function of scale and time in an effort to assess local-scale cap influences versus regional scale groundwater flow influences on contaminant discharge. We have been allowed to maintain numerous groundwater monitoring wells at a field site and these have a rich historical data set with regard to hydrology, geochemistry, microbiology, and contaminant flux. Our objectives are to investigate cap induced changes in (1) groundwater and surface hydrology and contaminant flux, (2) geochemistry and contaminant speciation, and (3) microbial community structure and organic contaminant degradation and inorganic contaminant immobilization. Our approach monitors coupled processes during base-flow and during storm events in both the groundwater and surface water discharge from the site and the surrounding watershed. Pre- and post-cap data will than be modeled with a multiprocess, multicomponent, transport model which is linked to pre- and post-cap surface water hydrograph analysis from the site and the surrounding watershed. Our goal is to provide an improved fundamental understanding of the long-term fate and transport of contaminants and an improved ability to predict system response to remedial actions. The experimental and numerical results from this investigation will provide knowledge and information in previously unexplored areas of cap performance with regard to coupled hydrology, geochemistry, microbiology, and contaminant flux in humid regimes. The products will support DOE's mission of long-term stewardship of contaminated environments and be transferable to other site where similar remediation exists or is planned.
Long-term Outcomes among Drug Dependent Mothers Treated in Women-only versus Mixed-gender Programs
Hser, Yih-Ing; Evans, Elizabeth; Huang, David; Messina, Nena
2011-01-01
This study examined the long-term outcomes of women who were pregnant or parenting at admission to women-only (WO; n=500) versus mixed-gender (MG; a matched sample of 500) substance abuse treatment programs. Administrative records on arrests, incarcerations, mental health services utilization, and drug treatment participation were collected, covering 3 years pre-admission and 8 years post-admission. Women treated in WO programs had lower levels of arrest, mental health services utilization rates, and drug treatment participation during the first year after drug treatment. No differences were found between the two groups in the long-term trajectories except that WO program participants had lower incarceration rates during the third year after treatment. The study findings suggest a positive short-term impact of WO versus MG programs with regard to arrest and mental health service utilization. Limited long-term gain is shown in the reductions in post-treatment incarceration. The study findings suggest the added value of specialized WO programs and begin to address the gap in knowledge regarding long-term outcomes for substance-abusing women. PMID:21466942
Burger, J; Sanchez, J; Roush, D; Gochfeld, M
2001-04-01
With the ending of the Cold War, the Department of Energy (DOE) is evaluating mission, future land use and stewardship of departmental facilities. This paper compares the environmental concerns and future use preferences of 351 people interviewed at Lewiston, Idaho, about the Hanford Site and Idaho National Engineering and Environmental Laboratory (INEEL), two of DOE's largest sites. Although most subjects lived closer to Hanford than INEEL, most resided in the same state as INEEL. Therefore their economic interests might be more closely allied with INEEL, while their health concerns might be more related to Hanford. Few lived close enough to either site to be directly affected economically. We test the null hypotheses that there are no differences in environmental concerns and future land-use preferences as a function of DOE site, sex, age and education. When asked to list their major concerns about the sites, more people listed human health and safety, and environmental concerns about Hanford compared to INEEL. When asked to list their preferred future land uses, 49% of subjects did not have any for INEEL, whereas only 35% did not know for Hanford. The highest preferred land uses for both sites were as a National Environmental Research Park (NERP), and for camping, hunting, hiking, and fishing. Except for returning the land to the tribes and increased nuclear storage, subjects rated all future uses as more preferred at INEEL than Hanford. Taken together, these data suggest that the people interviewed know more about Hanford, are more concerned about Hanford, rate recreational uses and NERP as their highest preferred land use, and feel that INEEL is more suited for most land uses than Handford. Overall rankings for future land uses were remarkably similar between the sites, indicating that for these stakeholders, DOE lands should be preserved for research and recreation. These preferences should be taken into account when planning for long-term stewardship at these two DOE sites.
The Gap Analysis Program (GAP) is a national inter-agency program that maps the distribution of plant communities and selected animal species and compares these distributions with land stewardship to identify biotic elements at potential risk of endangerment. GAP uses remote sens...
ERIC Educational Resources Information Center
Stern, Marc J.; Powell, Robert B.; Ardoin, Nicole M.
2008-01-01
The authors explored the influences of 3- and 5-day residential environmental education programs at the Great Smoky Mountains Institute at Tremont (TN) on participants' connections with nature, environmental stewardship, interest in learning and discovery, and awareness of the Great Smoky Mountains National Park and biodiversity. The authors found…
Recording the LHCb data and software dependencies
NASA Astrophysics Data System (ADS)
Trisovic, Ana; Couturier, Ben; Gibson, Val; Jones, Chris
2017-10-01
In recent years awareness of the importance of preserving the experimental data and scientific software at CERN has been rising. To support this effort, we are presenting a novel approach to structure dependencies of the LHCb data and software to make it more accessible in the long-term future. In this paper, we detail the implementation of a graph database of these dependencies. We list the implications that can be deduced from the graph mining (such as a search for the legacy software), with emphasis on data preservation. Furthermore, we introduce a methodology of recreating the LHCb data, thus supporting reproducible research and data stewardship. Finally, we describe how this information is made available to the users on a web portal that promotes data and analysis preservation and good practise with analysis documentation.
Roach, Kathryn E; Tappen, Ruth M; Kirk-Sanchez, Neva; Williams, Christine L; Loewenstein, David
2011-01-01
To determine whether an activity specific exercise program could improve ability to perform basic mobility activities in long-term care residents with Alzheimer disease (AD). Randomized, controlled, single-blinded clinical trial. Residents of 7 long-term care facilities. Eighty-two long-term care residents with mild to severe AD. An activity specific exercise program was compared to a walking program and to an attention control. Ability to perform bed mobility and transfers was assessed using the subscales of the Acute Care Index of Function; functional mobility was measured using the 6-Minute Walk test. Subjects receiving the activity specific exercise program improved in ability to perform transfers, whereas subjects in the other 2 groups declined.
Establishing Long Term Data Management Research Priorities via a Data Decadal Survey
NASA Astrophysics Data System (ADS)
Wilson, A.; Uhlir, P.; Meyer, C. B.; Robinson, E.
2013-12-01
We live in a time of unprecedented collection of and access to scientific data. Improvements in sensor technologies and modeling capabilities are constantly producing new data sources. Data sets are being used for unexpected purposes far from their point of origin, as research spans projects, discipline domains, and temporal and geographic boundaries. The nature of science is evolving, with more open science, open publications, and changes to the nature of peer review and data "publication". Data-intensive, or computational science, has been identified as a new research paradigm. There is recognition that the creation of a data set can be a contribution to science deserving of recognition comparable to other scientific publications. Federally funded projects are generally expected to make their data open and accessible to everyone. In this dynamic environment, scientific progress is ever more dependent on good data management practices and policies. Yet current data management and stewardship practices are insufficient. Data sets created at great, and often public, expense are at risk of being lost for technological or organizational reasons. Insufficient documentation and understanding of data can mean that the data are used incorrectly or not at all. Scientific results are being scrutinized and questioned, and occasionally retracted due to problems in data management. The volume of data is greatly increasing while funding for data management is meager and generally must be found within existing budgets. Many federal government agencies, including NASA, USGS, NOAA and NSF are already making efforts to address data management issues. Executive memos and directives give substantial impetus to those efforts, such as the May 9 Executive Order directing agencies to implement Open Data Policy requirements and regularly report their progress. However, these distributed efforts risk duplicating effort, lack a unifying, long-term strategic vision, and too often work in competition with other priorities of the research enterprise. This presentation will introduce the Data Decadal Survey, an initial concept created in collaboration between the Federation of Earth Science Information Partners (ESIP) and of the National Research Council's Board on Research Data and Information (BRDI). Consistent with Executive open data policies, the Survey will provide a coordinating platform to address overarching issues and identify research needs and funding priorities in scientific data management and stewardship for the long term. The Survey would address at the broadest level gaps in data management knowledge and practices that hold back scientific progress, and recommend a strategy to address them. The goal is to provide a long term strategic vision that will
Andersson, E; Steneby, S; Karlsson, K; Ljótsson, B; Hedman, E; Enander, J; Kaldo, V; Andersson, G; Lindefors, N; Rück, C
2014-10-01
As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.
Federal Register 2010, 2011, 2012, 2013, 2014
2013-11-05
...-Term Training Program--Vocational Rehabilitation Counseling AGENCY: Office of Special Education and...: Rehabilitation Long- Term Training Program--Vocational Rehabilitation Counseling Notice inviting applications for... in the priority area of rehabilitation counseling. Absolute Priority 2: This priority is from the...
Messacar, Kevin; Parker, Sarah K; Todd, James K; Dominguez, Samuel R
2017-03-01
New rapid molecular diagnostic technologies for infectious diseases enable expedited accurate microbiological diagnoses. However, diagnostic stewardship and antimicrobial stewardship are necessary to ensure that these technologies conserve, rather than consume, additional health care resources and optimally affect patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and to direct testing toward appropriate patients. Antimicrobial stewardship is needed to ensure prompt appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside. This minireview outlines the roles of diagnostic stewardship and antimicrobial stewardship in the implementation of rapid molecular infectious disease diagnostics. Copyright © 2017 American Society for Microbiology.
Making WaterSense in Charlottesville
From a 5K race to $100 toilet rebates to an “Imagine a Day without Water” campaign, the City of Charlottesville, Virginia, is a leader in working with EPA’s WaterSense program to promote water conservation and resource stewardship.
7 CFR 1469.5 - Eligibility requirements.
Code of Federal Regulations, 2012 CFR
2012-01-01
... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM General...) Land must meet the definition of eligible land; and (3) The application must meet the conservation...-up. Producers who are participants in an existing conservation stewardship contract are not eligible...
7 CFR 1469.5 - Eligibility requirements.
Code of Federal Regulations, 2013 CFR
2013-01-01
... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM General...) Land must meet the definition of eligible land; and (3) The application must meet the conservation...-up. Producers who are participants in an existing conservation stewardship contract are not eligible...
7 CFR 1469.5 - Eligibility requirements.
Code of Federal Regulations, 2014 CFR
2014-01-01
... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS CONSERVATION SECURITY PROGRAM General...) Land must meet the definition of eligible land; and (3) The application must meet the conservation...-up. Producers who are participants in an existing conservation stewardship contract are not eligible...
Alaska Department of Natural Resources
and Commissions Board of Agriculture Board of Forestry Community Forest Council Forest Stewardship Development Advisory Board Media Releases Public Notices Divisions/Offices Divisions Agriculture Forestry Programs and Services Agriculture Forestry Geological & Geophysical Surveys Mining, Land & Water
Alaska Department of Natural Resources
Commissions Board of Agriculture Board of Forestry Community Forest Council Forest Stewardship Coordinating Development Advisory Board Media Releases Public Notices Divisions/Offices Divisions Agriculture Forestry divisions reflect its major programs: Agriculture, Forestry, Geological & Geophysical Surveys, Mining
Alaska Department of Natural Resources
Commissions Board of Agriculture Board of Forestry Community Forest Council Forest Stewardship Coordinating Development Advisory Board Media Releases Public Notices Divisions/Offices Divisions Agriculture Forestry major programs: Agriculture, Forestry, Geological & Geophysical Surveys, Mining, Land & Water
THE POTENTIAL ROLE OF REMOTE SENSING IN TRANSGENIC CROP MONITORING PROGRAMS
Sustainable agriculture combines efficient production with wise stewardship of the earth's resources. Development of environmentally benign production techniques is one focus of sustainable agriculture. The new transgenic crops producing toxic proteins that target specific crop p...
DOT National Transportation Integrated Search
2010-02-01
Washington State Department of Transportation Local Programs Division requested the creation of a : Resource Planning Index (or Index) for use in benchmarking and tracking the stewardship : performance of investments associated with Washington...
ERIC Educational Resources Information Center
Blanchard, Pam
2000-01-01
Describes Louisiana Sea Grant's most recent marine education program, the coastal Ecosystem Stewardship project. Its purpose is to provide students with background information on wetlands management issues; training in basic water quality monitoring methods, data collection, and manipulation; and opportunities to participate in a restoration…
Brown, Kevin A; Jones, Makoto; Daneman, Nick; Adler, Frederick R; Stevens, Vanessa; Nechodom, Kevin E; Goetz, Matthew B; Samore, Matthew H; Mayer, Jeanmarie
2016-06-21
Although clinical factors affecting a person's susceptibility to Clostridium difficile infection are well-understood, little is known about what drives differences in incidence across long-term care settings. To obtain a comprehensive picture of individual and regional factors that affect C difficile incidence. Multilevel longitudinal nested case-control study. Veterans Health Administration health care regions, from 2006 through 2012. Long-term care residents. Individual-level risk factors included age, number of comorbid conditions, and antibiotic exposure. Regional risk factors included importation of cases of acute care C difficile infection per 10 000 resident-days and antibiotic use per 1000 resident-days. The outcome was defined as a positive result on a long-term care C difficile test without a positive result in the prior 8 weeks. 6012 cases (incidence, 3.7 cases per 10 000 resident-days) were identified in 86 regions. Long-term care C difficile incidence (minimum, 0.6 case per 10 000 resident-days; maximum, 31.0 cases per 10 000 resident-days), antibiotic use (minimum, 61.0 days with therapy per 1000 resident-days; maximum, 370.2 days with therapy per 1000 resident-days), and importation (minimum, 2.9 cases per 10 000 resident-days; maximum, 341.3 cases per 10 000 resident-days) varied substantially across regions. Together, antibiotic use and importation accounted for 75% of the regional variation in C difficile incidence (R2 = 0.75). Multilevel analyses showed that regional factors affected risk together with individual-level exposures (relative risk of regional antibiotic use, 1.36 per doubling [95% CI, 1.15 to 1.60]; relative risk of importation, 1.23 per doubling [CI, 1.14 to 1.33]). Case identification was based on laboratory criteria. Admission of residents with recent C difficile infection from non-Veterans Health Administration acute care sources was not considered. Only 25% of the variation in regional C difficile incidence in long-term care remained unexplained after importation from acute care facilities and antibiotic use were accounted for, which suggests that improved infection control and antimicrobial stewardship may help reduce the incidence of C difficile in long-term care settings. U.S. Department of Veterans Affairs and Centers for Disease Control and Prevention.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nelson, Jody K.
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 tomore » 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 insects have been released to assist with control of different target weed species. Monitoring is conducted to evaluate the effectiveness of control efforts and to provide information for future control efforts. The effective implementation of this integrated approach has reduced the infestation levels of many species and has kept several newly discovered invasive species from spreading and becoming larger problems at the site. (authors)« less
ERIC Educational Resources Information Center
Urban, Emily; Navarro, Maria; Borron, Abigail
2017-01-01
Faculty development programs for internationalization of the curriculum in higher education are often evaluated for short- and medium-term outcomes, but more long-term assessments are needed to determine impact. This study examined the long-term (6 years) impacts on faculty from colleges of agriculture after participating in a one-year…
Transition and closeout of the Fernald Closure Project
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bilson, H.E.; Terry, T.; Reising, J.
The U.S. Department of Energy (DOE) and Fluor Fernald have completed the majority of the cleanup of the Fernald Site. The over 1,000 acre complex for processing uranium has been demolished and soil contamination has been remediated. With acres of wetlands and prairies replacing the buildings and waste pits. At the end of the project the focus shifted to developing demonstrating the completion of the project and the contract, as well as ensuring a smooth transition of the facility from the DOE's Environmental Management (EM) Program to the DOE's Legacy Management (LM) Program. Working with the DOE, each portion ofmore » the closure contract was examined for specific closure definition. From this negotiation effort the Comprehensive Exit and Transition Plan (CE/T Plan) was written. The CE/T Plan is intended to assist DOE in the analysis that the site is ready for transfer into long-term stewardship (LTS) (also referred to as legacy management) and that Fluor Fernald, Inc. has satisfactorily completed the closure contract statement of work elements. Following the Lessons Learned from the closure of the Rocky Flats Site, the DOE's Legacy Management Program created a matrix of Transition Elements required to ensure adequate information was in place to allow the new prime contractor to perform the Legacy Management scope of work. The transition plan included over 1,000 elements broken down into functional areas and relied on specific Fernald Responsibility Transition Packages (RTPs) for detailed transition actions. The template for Closure and Transition Planning used at the Fernald Site was developed using the best Lessons Learned from across the DOE Complex. The template could be used for other sites, and lessons learned from this closure and transition will be appropriate for all closure projects. (authors)« less
NASA Astrophysics Data System (ADS)
Schloss, J. A.
2009-12-01
While it began as a citizen water quality monitoring program to document long-term trends and find problem areas impacting lake watersheds the New Hampshire Lakes Lay Monitoring Program soon evolved into a model effort for engaging the participants to help investigate a wide range of scientific questions primarily derived through their concerns. As a true participatory effort, community members were involved in the design as well as the implementation of the research and also in the interpretation of the results. The research outcomes have provided benefits to both the local and scientific communities. In many cases productive partnerships between the research community and participants were initiated that continue to last to this day. In addition, participants have been empowered through their experience and have become local experts and community leaders. Collaborative research projects to date have explored fish condition, recreational impacts, nutrient loadings from watershed land use, morphometric determinants of lake productivity, ground truth for remote sensing of water quality, biological controls for invasive aquatic plants, in-lake resource co-occurrences, and cyanobacteria bloom toxin ecology. Participants were also instrumental in confirming a more accurate method for water clarity measurement. Results have not only provided the community with the information they require for the informed local stewardship of their resources but also have been useful to state agencies and decision-makers. Our success can be attributed to the development of quality assured methods acceptable to regional and state agencies, the cost efficiencies of using volunteer scientists, support from the University and Cooperative Extension, capturing the "local expertise" of our participants, providing timely feedback and support, and making sure the study results are reported back to the local community through the participants involved.
76 FR 17180 - Meeting of the Regional Resource Stewardship Council
Federal Register 2010, 2011, 2012, 2013, 2014
2011-03-28
.... The management of the Tennessee Valley reservoirs and the lands adjacent to them has long been an... developing a Natural Resource Plan (NRP) that will help prioritize techniques for the management of TVA's biological and cultural resource management activities, recreation management activities, water resource...
2016 Annual Progress Report: DOE Hydrogen and Fuel Cells Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Satyapal, Sunita
In the past year, the DOE Hydrogen Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
2010 Annual Progress Report: DOE Hydrogen Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
In the past year, the DOE Hydrogen Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
2015 Annual Progress Report: DOE Hydrogen and Fuel Cells Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Popovich, Neil
In the past year, the DOE Hydrogen Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
2012 Annual Progress Report: DOE Hydrogen and Fuel Cells Program
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
In the past year, the DOE Hydrogen Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
Measurement of Fission Product Yields from Fast-Neutron Fission
NASA Astrophysics Data System (ADS)
Arnold, C. W.; Bond, E. M.; Bredeweg, T. A.; Fowler, M. M.; Moody, W. A.; Rusev, G.; Vieira, D. J.; Wilhelmy, J. B.; Becker, J. A.; Henderson, R.; Kenneally, J.; Macri, R.; McNabb, D.; Ryan, C.; Sheets, S.; Stoyer, M. A.; Tonchev, A. P.; Bhatia, C.; Bhike, M.; Fallin, B.; Gooden, M. E.; Howell, C. R.; Kelley, J. H.; Tornow, W.
2014-09-01
One of the aims of the Stockpile Stewardship Program is a reduction of the uncertainties on fission data used for analyzing nuclear test data [1,2]. Fission products such as 147Nd are convenient for determining fission yields because of their relatively high yield per fission (about 2%) and long half-life (10.98 days). A scientific program for measuring fission product yields from 235U,238U and 239Pu targets as a function of bombarding neutron energy (0.1 to 15 MeV) is currently underway using monoenergetic neutron beams produced at the 10 MV Tandem Accelerator at TUNL. Dual-fission chambers are used to determine the rate of fission in targets during activation. Activated targets are counted in highly shielded HPGe detectors over a period of several weeks to identify decaying fission products. To date, data have been collected at neutron bombarding energies 4.6, 9.0, 14.5 and 14.8 MeV. Experimental methods and data reduction techniques are discussed, and some preliminary results are presented.
ERIC Educational Resources Information Center
Ayala, Erika
2016-01-01
The purpose of this sequential explanatory embedded mixed methods study was to: (a) investigate and describe the academic performance of eighth grade students in the Falcon School District (FSD) who were designated as Long Term English Learners (LTELs) and participants in FSD's reading intervention program during their fourth through eighth grade…
The DOD Humanitarian and Civic Assistance Program Concepts, Trends, Medical Challenges
1997-03-01
program improvements; measuring program performance and effectiveness; and defining military roles relevant to training, long term benefits, and the...support conclusions relevant to trends, benefits, challenges, suggested improvements, and suggested areas for future research. 15. SUBJECT TERMS 16...a Long Term Medical Benefit ................ 28 CONCLUSION
Endangered Species and Human Survival.
ERIC Educational Resources Information Center
Regenstein, Lewis
1984-01-01
In wiping out the natural heritage over which we were given dominion and stewardship responsibilities, we are sowing the seeds of our own destruction. With the advent of the Reagan administration, the government's endangered species program has all but ceased to function. (RM)
Andriy V. Zhalnin; Shorna R. Broussard; Richard L. Farnsworth
2008-01-01
Forest ecosystems are a dominant component of the nation's landscape but are a challenge to manage because of diverse ownership and policy objectives. Privately owned, nonindustrial lands comprise nearly half of all forests in the United States (42 percent); nearly 10.3 million citizens own 393 million acres. A number of landowner assistance programs are designed...
Forestry in U.S. Climate Change Action Plans: From the Arch to Kyoto
Robert J. Moulton
1998-01-01
The international community has played a major role in prompting actions to address global climate change. The 1989 Summit of the Arch in Paris resulted in President Bush's announcement in his 1990 State of the Union message of the America the Beautiful (ATB) program, which greatly expanded federal funding for urban forestry and for forest stewardship programs...
Which Factors Contribute to Environmental Behaviour of Landowners in Southwestern Ontario, Canada?
Nebel, Silke; Brick, Jeff; Lantz, Van A; Trenholm, Ryan
2017-09-01
Loss of natural heritage is a problem that is particularly prevalent in areas of high population density. We used a survey to understand the factors that drive environmental behavior of landowners in southwestern Ontario, Canada. The survey, which contained questions about environmental attitude, pro-environmental behavior and demographics, was mailed to 18,090 rural route addresses, and we received 3256 completed surveys (18% response rate). Two types of environmental behavior, namely voluntarily increasing the area of land set aside for conservation, and enrollment in a conservation stewardship program, were significantly correlated with a positive attitude towards conservation. Financial considerations also played a role. We showed that the biggest motivator to enroll in a wetland enhancement program was access to 'more information on how the decline in wetland area affects them personally', while 'public recognition' was the least motivating factor. We suggest that enrollment in voluntary land stewardship programs might be increased by providing information about the effects of ecosystem loss, and by providing financial incentives for participation. In a larger social context, outreach programs by government agencies could focus on improving pro-environmental attitudes, which in turn is likely to result in more pro-environmental behavior of landowners.
Which Factors Contribute to Environmental Behaviour of Landowners in Southwestern Ontario, Canada?
NASA Astrophysics Data System (ADS)
Nebel, Silke; Brick, Jeff; Lantz, Van A.; Trenholm, Ryan
2017-09-01
Loss of natural heritage is a problem that is particularly prevalent in areas of high population density. We used a survey to understand the factors that drive environmental behavior of landowners in southwestern Ontario, Canada. The survey, which contained questions about environmental attitude, pro-environmental behavior and demographics, was mailed to 18,090 rural route addresses, and we received 3256 completed surveys (18% response rate). Two types of environmental behavior, namely voluntarily increasing the area of land set aside for conservation, and enrollment in a conservation stewardship program, were significantly correlated with a positive attitude towards conservation. Financial considerations also played a role. We showed that the biggest motivator to enroll in a wetland enhancement program was access to `more information on how the decline in wetland area affects them personally', while `public recognition' was the least motivating factor. We suggest that enrollment in voluntary land stewardship programs might be increased by providing information about the effects of ecosystem loss, and by providing financial incentives for participation. In a larger social context, outreach programs by government agencies could focus on improving pro-environmental attitudes, which in turn is likely to result in more pro-environmental behavior of landowners.
Fehrenbacher, Lynne; McDevitt, Kimberly; Palmer, Matthew; Traynor, Laura; Boero, Joe; Crnich, Christopher
2017-01-01
Abstract Background One of the CDC core elements of antimicrobial stewardship in nursing homes emphasizes the promotion of clinical practice change and integration of the dispensing and consultant pharmacist to improve antibiotic use. An opportunity to support this element is via collaborative practice agreements (CPA). A CPA is a voluntary agreement between one or more prescribers and pharmacists which delegates physician authority under defined conditions and/or limitations toward a common goal. The Wisconsin Healthcare-Associated Infections (HAI) in Long-term Care (LTC) Coalition aims to reduce and eliminate HAIs among LTC residents. A coalition emphasis has been to educate caregivers about appropriate evaluation and treatment of suspected urinary tract infection (UTI). Given this focus, we targeted the same cohort for CPA design. Methods A literature review resulted in no report of CPAs being applied to LTC residents on antibiotics for UTI. Recognizing the dispensing and consultant pharmacist role varies by organization, we drafted a multi-layered CPA that can be customized by facility. The draft was reviewed by physicians, pharmacists, and nurses with expertise in infectious diseases, LTC, and CPAs. Through frequent meetings and collaborative editing, consensus was achieved. The final CPA includes antibiotic renal dose adjustment, discontinuation of antibiotics in asymptomatic patients with negative urinalysis or culture, and oral antibiotic modification based on organism susceptibility. Results The CPA template is supported by the WI HAI in LTC Coalition. It has been presented at the state level and is available for use by LTC facilities and pharmacists that may apply any/all level(s) of the CPA. An organization policy template and initial CPA competency for pharmacists have been designed to support implementation. Committed pilot sites have been identified. Conclusion A CPA is an innovative approach to expand the role of the dispensing and consultant pharmacist in antimicrobial stewardship initiatives in the LTC setting. Using an expert panel to develop templated resources that can be customized at the facility level may assist pharmacists and LTC providers in moving forward with this type of clinical practice change. Disclosures All authors: No reported disclosures.
Long-Term Monitoring of Pavement Maintenance Materials Test Sites
DOT National Transportation Integrated Search
1998-06-01
The Strategic Highway Research Program's {SHRP) H-106 pothole repair experiment was part of the most extensive pavement maintenance experiment ever conducted. Started under SHRP and continued under the Long-Term Pavement Performance program's Long-Te...
Are herbicides a once in a century method of weed control?
USDA-ARS?s Scientific Manuscript database
Economists have long viewed pesticide resistance as a natural resource problem, in which the stock of pest susceptibility to pesticides is finite, and subject to user costs. Many of the economic approaches to encouraging pesticide stewardship are built on this assumption. Our analysis of public data...
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…
77 FR 18879 - Meeting of the Regional Resource Stewardship Council
Federal Register 2010, 2011, 2012, 2013, 2014
2012-03-28
... TENNESSEE VALLEY AUTHORITY Meeting of the Regional Resource Stewardship Council AGENCY: Tennessee Valley Authority (TVA). ACTION: Notice of meeting. SUMMARY: The TVA Regional Resource Stewardship Council... Stewardship Council, Tennessee Valley Authority, 400 West Summit Hill Drive, WT-11 B, Knoxville, Tennessee...
National Aeronautics and Space Administration: 1998 Accountability Report
NASA Technical Reports Server (NTRS)
1999-01-01
This Accountability Report summarizes NASA's program accomplishments and its stewardship over budget and financial resources. The report is the culmination of NASA's management process, which begins with mission definition and program planning, continues with formulation and justification of NASA's budgets for the President and Congress, and ends with NASA scientific and engineering program accomplishments. This report covers NASA's activities from October 1, 1997, through September 30, 1998, with discussion of some subsequent events.
General Summary of the National Long-Term Care Channeling Demonstration. Revised.
ERIC Educational Resources Information Center
Office of the Assistant Secretary for Planning and Evaluation (DHHS), Washington, DC.
This paper summarizes the National Long-Term Care Channeling Demonstration Program, a project designed to test the feasibility and cost effectiveness of an alternative community-based long-term care service delivery concept for the frail elderly which integrated health and social services. Program management and early federal planning efforts are…
Long-Term Outcomes for the Promoting CARE Suicide Prevention Program
ERIC Educational Resources Information Center
Hooven, Carole; Herting, Jerald R.; Snedker, Karen A.
2010-01-01
Objectives: To provide a long-term look at suicide risk from adolescence to young adulthood for former participants in Promoting CARE, an indicated suicide prevention program. Methods: Five hundred ninety-three suicide-vulnerable high school youth were involved in a long-term follow-up study. Latent class growth models identify patterns of change…
Goals and Characteristics of Long-Term Care Programs: An Analytic Model.
ERIC Educational Resources Information Center
Braun, Kathryn L.; Rose, Charles L.
1989-01-01
Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…
Leis, Jerome A; Palmay, Lesley; Ho, Grace; Raybardhan, Sumit; Gill, Suzanne; Kan, Tiffany; Campbell, Jackie; Kiss, Alex; McCready, Janine B; Das, Pavani; Minnema, Brian; Powis, Jeff E; Walker, Sandra A N; Ferguson, Heather; Wong, Benny; Weber, Elizabeth
2017-06-01
Beta-lactam allergy skin testing (BLAST) is recommended by antimicrobial stewardship program (ASP) guidelines, yet few studies have systematically evaluated its impact when delivered at point-of-care. We conducted a pragmatic multicenter prospective evaluation of the use of point-of-care BLAST by ASPs. In staggered 3-month intervals, ASP teams at three hospitals received training by allergists to offer BLAST for eligible patients with infectious diseases receiving non-preferred beta-lactam therapy due to severity of their allergy. The primary outcome was the proportion of patients receiving the preferred beta-lactam therapy. Of 827 patients with reported beta-lactam allergy over 15-months, beta-lactam therapy was preferred among 632(76%). During baseline periods, 50% (124/246) received preferred beta-lactam therapy based on history, compared with 60% (232/386) during the intervention periods (p=0.02), which improved further to 81% (313/386) upon provision of BLAST (p<0.001) without any increase in incidence of adverse drug reactions (4% vs. 3%; p=0.4). After adjusting for patient variables and the correlation between hospitals, the intervention period was associated with a 4.5-fold greater odds of receiving preferred beta-lactam therapy (95% CI, 2.4-8.2; p<0.0001). The use of BLAST at the point-of-care across three hospital ASPs resulted in greater use of preferred beta-lactam therapy without increasing the risk of adverse drug reactions. Longer term studies are needed to better assess the safety and clinical impact of this ASP intervention. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
A Long History of Supercomputing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Grider, Gary
As part of its national security science mission, Los Alamos National Laboratory and HPC have a long, entwined history dating back to the earliest days of computing. From bringing the first problem to the nation’s first computer to building the first machine to break the petaflop barrier, Los Alamos holds many “firsts” in HPC breakthroughs. Today, supercomputers are integral to stockpile stewardship and the Laboratory continues to work with vendors in developing the future of HPC.
Pollack, Lori A; van Santen, Katharina L; Weiner, Lindsey M; Dudeck, Margaret A; Edwards, Jonathan R; Srinivasan, Arjun
2016-08-15
The National Action Plan to Combat Antibiotic Resistant Bacteria calls for all US hospitals to improve antibiotic prescribing as a key prevention strategy for resistance and Clostridium difficile Antibiotic stewardship programs (ASPs) will be important in this effort but implementation is not well understood. We analyzed the 2014 National Healthcare Safety Network Annual Hospital Survey to describe ASPs in US acute care hospitals as defined by the Center for Disease Control and Prevention's (CDC) Core Elements for Hospital ASPs. Univariate analyses were used to assess stewardship infrastructure and practices by facility characteristics and a multivariate model determined factors associated with meeting all ASP core elements. Among 4184 US hospitals, 39% reported having an ASP that met all 7 core elements. Although hospitals with greater than 200 beds (59%) were more likely to have ASPs, 1 in 4 (25%) of hospitals with less than 50 beds reported achieving all 7 CDC-defined core elements of a comprehensive ASP. The percent of hospitals in each state that reported all seven elements ranged from 7% to 58%. In the multivariate model, written support (adjusted relative risk [RR] 7.2 [95% confidence interval [CI], 6.2-8.4]; P < .0001) or salary support (adjusted RR 1.5 [95% CI, 1.4-1.6]; P < .0001) were significantly associated with having a comprehensive ASP. Our findings show that ASP implementation varies across the United States and provide a baseline to monitor progress toward national goals. Comprehensive ASPs can be established in facilities of any size and hospital leadership support for antibiotic stewardship appears to drive the establishment of ASPs. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.
ERIC Educational Resources Information Center
Benz, Stephen
2006-01-01
Schools and universities recognize that many of the people and neighborhoods they serve expect education institutions to embrace environmental stewardship and sustainable design. Standards such as the LEED-registered facility program, managed by the U.S. Green Building Council, are receiving more attention. Schools can demonstrate their commitment…
MULTI-FACETED SUSTAINABILITY ON ITHACA COLLEGE NATURAL LANDS
This student-generated proposal presents a multi-faceted program for sustainable stewardship of the natural areas south of the built campus of Ithaca College. Our challenge is to use student research and class projects to enhance biodiversity, support education and research, and...
None
2018-01-16
Some of the most sophisticated experiments in the stockpile stewardship program are conducted in an environmentally safe manner, nearly 1000 feet below the ground at the site. The U1a complex a sprawling underground laboratory and tunnel complex is home to a number of unique capabilities.
Roach, Kathryn E.; Tappen, Ruth M.; Kirk-Sanchez, Neva; Williams, Christine L.; Loewenstein, David
2011-01-01
Objective To determine whether an activity specific exercise program could improve ability to perform basic mobility activities in long-term care residents with Alzheimer disease (AD). Design Randomized, controlled, single-blinded clinical trial. Setting Residents of 7 long-term care facilities. Participants Eighty-two long-term care residents with mild to severe AD. Intervention An activity specific exercise program was compared to a walking program and to an attention control. Measurements Ability to perform bed mobility and transfers were assessed using the subscales of the Acute Care Index of Function; functional mobility was measured using the 6-Minute Walk test. Results Subjects receiving the activity specific exercise program improved in ability to perform transfers, whereas subjects in the other 2 groups declined. PMID:21937893
Long-term Internship through Cooperative Education with Regional Industries
NASA Astrophysics Data System (ADS)
Takahashi, Kenzo; Hase, Hiroyuki
The long term internship is one of special educational programs for graduate students of Graduate School of Engineering in University of Fukui. This is a collaborative program between university and industries where selected post-graduate students are dispatched to companies for a long term and educated in real business environments. It is the final goal of the program to develop sophisticated specialists who would be able to catch the business strategy in industries and solve any problems by themselves. The program is managed in a semester (6 months) and contains 1.5 month prior education of preliminary special knowledge, ethics and secrecy, about 3 month dispatch with long-term internship, and 1.5 month post-education for complementary education and presentation. This paper presents the effect of this program which has been evolving since 2005.
Abdi, Kianoush; Arab, Mohammad; Rashidian, Arash; Kamali, Mohammad; Khankeh, Hamid Reza; Farahani, Farideh Khalajabadi
2015-01-01
Introduction The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran. Methods This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10. Results “Barriers” were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation. Conclusions An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research. PMID:26767101
Egan, Aine; Lennon, Olive; Power, Camillus K; Fullen, Brona M
2017-02-01
To determine patients’ perceptions regarding cognitive behavioral pain management programs, and to determine what, if any, strategies learned on the program patients continue to use long-term to manage their pain. A qualitative, focus-group based study. An outpatient multidisciplinary pain management program in a university teaching hospital. Patients with chronic pain who had previously completed a 4-week cognitive behavioral pain management program (2001–2014). Sixteen patients attended one of four focus groups. A battery of semi-structured questions explored their perceptions of the cognitive behavioral program, and which strategies they found useful and continued to use long-term to manage their pain. Six key themes emerged: 1) universal long-term positive feedback on the utility of the program; 2) the program facilitated long-term changes in daily life; 3) participants now considered themselves as the “new me”; 4) request for more updates on emerging new treatments/pain knowledge; 5) recognizing that the key to maximizing gain from the program was to be open, to listen, and accept; and 6) participants sharing pain management knowledge with others in pain. There was universal positive feedback for the pain management program. Despite the years since they participated in one, patients continue to use key strategies to effectively manage their pain (pacing, relaxation), embedding them in their daily lives to maximize their quality of life.
Planning long-term vegetation studies at landscape scales
Stohlgren, Thomas J.
1995-01-01
Long-term ecological research is receiving more attention now than ever before. Two recent books, Long-term Studies in Ecology: Approaches and Alternatives, edited by Gene Likens (1989), and Long-term Ecological Research: An International Perspective, edited by Paul Risser (1991), prompt the question, “Why are these books so thin?” Except for data from paleoecological, retrospective studies (see below), there are exceptionally few long-term data sets in terrestrial ecology (Strayer et al. 1986; Tilman 1989; this volume). In a sample of 749 papers published in Ecology, Tilman (1989) found that only 1.7% of the studies lasted at least five field seasons. Only one chapter in each of the review books dealt specifically with expanding both the temporal and the spatial scales of ecological research (Berkowitz et al. 1989; Magnuson et al. 1991). Judging by the growing number of landscape-scale long-term studies, however, such as the Long-Term Ecological Research (LTER) Program (Callahan 1991), the U.S. Environmental Protection Agency’s Environmental Monitoring and Assessment Program (EMAP; Palmer et al. 1991), the U.S. Army’s Land Condition-Trend Analysis (LCTA) Program (Diersing et al. 1992), and various agencies’ global change research programs (CEES 1993), there is a growing interest to expand ecological research both temporally and spatially.
Slayton, Rachel B; Scott, R Douglas; Baggs, James; Lessa, Fernanda C; McDonald, L Clifford; Jernigan, John A
2015-06-01
To determine the potential epidemiologic and economic value of the implementation of a multifaceted Clostridium difficile infection (CDI) control program at US acute care hospitals Markov model with a 5-year time horizon Patients whose data were used in our simulations were limited to hospitalized Medicare beneficiaries ≥65 years old. CDI is an important public health problem with substantial associated morbidity, mortality, and cost. Multifaceted national prevention efforts in the United Kingdom, including antimicrobial stewardship, patient isolation, hand hygiene, environmental cleaning and disinfection, and audit, resulted in a 59% reduction in CDI cases reported from 2008 to 2012. Our analysis was conducted from the federal perspective. The intervention we modeled included the following components: antimicrobial stewardship utilizing the Antimicrobial Use and Resistance module of the National Healthcare Safety Network (NHSN), use of contact precautions, and enhanced environmental cleaning. We parameterized our model using data from CDC surveillance systems, the AHRQ Healthcare Cost and Utilization Project, and literature reviews. To address uncertainty in our parameter estimates, we conducted sensitivity analyses for intervention effectiveness and cost, expenditures by other federal partners, and discount rate. Each simulation represented a cohort of 1,000 hospitalized patients over 1,000 trials. RESULTS In our base case scenario with 50% intervention effectiveness, we estimated that 509,000 CDI cases and 82,000 CDI-attributable deaths would be prevented over a 5-year time horizon. Nationally, the cost savings across all hospitalizations would be $2.5 billion (95% credible interval: $1.2 billion to $4.0 billion). The potential benefits of a multifaceted national CDI prevention program are sizeable from the federal perspective.
Horikoshi, Yuho; Higuchi, Hiroshi; Suwa, Junichi; Isogai, Mihoko; Shoji, Takayo; Ito, Kenta
2016-08-01
The spread of antimicrobial-resistant organisms is a global concern. To stem this tide, an antimicrobial stewardship program at hospitals is essential to optimize the prescription of broad spectrum antibiotics. In this study we examined the impact of computerized pre-authorization for broad spectrum antibiotics for Pseudomonas aeruginosa at a children's hospital. An antimicrobial stewardship program at Tokyo Metropolitan Children's Medical Center was assessed between March 2010 and March 2015. A paper-based post-prescription audit was switched to computerized pre-authorization for broad antipseudomonal agents in October 2011. The prescriber was required to obtain approval from physicians in the pediatric infectious diseases division before prescribing restricted antimicrobial agents. Approved prescriptions were processed and logged electronically. We evaluated days of therapy per 1000 patient-days, the cost of antibiotics, and the susceptibility of P. aeruginosa to piperacillin, ceftazidime, cefepime, piperacillin/tazobactam, carbapenems, and ciprofloxacin. Also, the average length of admission and infection-related mortality at 30 days were compared pre- and post-intervention. Administration of carbapenems, piperacillin/tazobactam, and ceftazidime decreased significantly after the introduction of computerized pre-authorization. Antibiotic costs were reduced by JPY2.86 million (USD 26,000) annually. None of the antipseudomonal agents showed decreased sensitivity. The average length of admission was shorter in post-intervention. Infection-related mortality at 30 days showed no difference between the pre- and post-intervention periods. An antimicrobial stewardship program using computerized pre-authorization decreased the use and cost of broad spectrum antibiotics without significant difference in infection-related mortality at 30 days, although our study did not improve susceptibilities of P. aeruginosa. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Federal Register 2010, 2011, 2012, 2013, 2014
2012-06-05
... Stewardship Plan/Environmental Impact Statement, San Juan Island National Historical Park AGENCY: National... Prairie Stewardship Plan, San Juan Island National Historical Park, Washington. SUMMARY: Pursuant to the... initiating the preparation of an Environmental Impact Statement (EIS) for a Prairie Stewardship Plan, as...
Evolution of collaboration within the US long term ecological research network
Jeffrey C. Johnson; Robert R. Christian; James W. Brunt; Caleb R. Hickman; Robert B. Waide
2010-01-01
The US Long Term Ecological Research (LTER) program began in 1980 with the mission of addressing long-term ecological phenomena through research at individual sites, as well as comparative and synthetic activities among sites. We applied network science measures to assess how the LTER program has achieved its mission using intersite publications as the measure of...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Ruggiero, C. E.; Twary, S. N.; Deladurantaye, E.
2003-01-01
In recognition of the need for a safe, effective technology for long term Pu/Th/Actinide stabilization or removal from soils, we have begun an investigation of the potential for phytoremediation (phytostabilization and/or phytoextraction) of Pu and other actinide soil contaminants at DOE sites using phytosiderophore producing plants, and are investigating the contribution of phytosiderophores to actinide mobility in the subsurface environment. Phytoremediation and Phytostabilization have been proven to be a cost-effective, safe, efficient, and publicly acceptable technology for clean up and/or stabilization of contaminant metals . However, no phyto-based technologies have been developed for stabilization or removal of plutonium from soilsmore » and groundwater, and very few have been investigated for other actinides . Current metal-phytostabilization and phytoremediation techniques, predominately based around lead, nickel, and other soft-metal phytoextraction, will almost certainly be inadequate for plutonium due its distinct chemical properties . Phytosiderophore-based phytoremediation may provide technically and financially practical methods for remediation and long-term stewardship of soils that have low to moderate, near surface actinide contamination . We plan to demonstrate potential benefits of phytosiderophore-producing plants for long-term actinide contaminant stabilization by the plant's prevention of soil erosion and actinide migration through hydraulic control and/or through actinide removal through phytoextraction . We may also show possible harm caused by these plants through increased presence of actinide chelators that could increase actinide mobilization and migration in the subsurface environment. This information can then be directly applied by either removal of harmful plants, or be used to develop plant-based soil stabilization/remediation technologies .« less
Sustainable Seas Student Intertidal Monitoring Project at Duxbury Reef in Bolinas, CA
NASA Astrophysics Data System (ADS)
Broad, C.; Soave, K.; Ericson, W.; Raabe, B.; Glazer, R.; Ahuatzi, A.; Pereira, M.; Rainsford, A.
2013-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of this student-run project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species and the requirements for maintaining a healthy, diverse intertidal ecosystem; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal monitoring techniques, and history of the sanctuary. Students identify and count key invertebrate and algae species along two permanent transects and, using randomly determined points, within two permanent 100 m2 areas, three times per year (fall, winter, and late spring). Using the data collected since 2004, we will once again compare population densities, seasonal abundance and long-term population trends of key algal and invertebrate species, including Tegula funebralis, Anthopluera elegantissima and Fucus spp. We will continue to closely monitor algal population densities in within our site in light of the November 2007 San Francisco Bay oil spill that leaked heavy bunker fuel into intertidal habitats around the SF Bay. Future analyses and investigations will include intertidal abiotic factors (including water temperature and human foot-traffic) to enhance insights into the workings of the Duxbury Reef ecosystem, in particular, the high and mid-intertidal zones experiencing the greatest amount of human impacts.
Sustainable Seas Intertidal Monitoring Project at Duxbury Reef
NASA Astrophysics Data System (ADS)
Soave, K. S.; Dean, A.; Gusman, V.; McCracken, K.; Solli, S.; Storm, E.; Placeholder, P.
2007-12-01
The Sustainable Seas Student Monitoring Project at the Branson School in Ross, CA has monitored Duxbury Reef in Bolinas, CA since 1999, in cooperation with the Farallones Marine Sanctuary Association and the Gulf of Farallones National Marine Sanctuary. Goals of the project include: 1) To monitor the rocky intertidal habitat and develop a baseline database of invertebrates and algal density and abundance; 2) To contribute to the conservation of the rocky intertidal habitat through education of students and visitors about intertidal species and requirements for maintaining a healthy, diverse intertidal ecosystem; 3) To increase stewardship in the Gulf of the Farallones National Marine Sanctuary; and 4) To contribute abundance and population data on key algae and invertebrate species to the national database, LiMPETS (Long Term Monitoring Program & Experiential Training for Students). Student volunteers complete an intensive training course on the natural history of intertidal invertebrates and algae, identification of key species, rocky intertidal ecology, interpretation and monitoring techniques, and history of the sanctuary. Students conduct two baseline-monitoring surveys three times per year (fall, winter, and late spring) to identify and count key invertebrate and algae species. Seasonal abundance of the algae species Mastocarpus and Fucus revealed lower populations in the spring monitoring events. Turban snails, Tegula funebralis, also showed dramatic population variation with respect to tidal zone. One of our project goals is to monitor this area long enough to obtain trends and to begin to connect these patterns to contributing factors (specific weather events, anthropogenic impacts, etc). Replicate counts of all species are regularly performed. Replicate counts for invertebrate and algae species within the same quadrat along the permanent transects revealed a very small amount of variability, giving us confidence that our monitoring program is providing reliable data. The Branson School 39 Fernhill Rd. Ross, CA 94957 (415) 454-3612 x 323 Farallones Marine Sanctuary Association, PO Box 29386 San Francisco, CA 94129, 415-561-6625 x 303
ERIC Educational Resources Information Center
Wenger-Schulman, A. R. S.; Hoffman, Lauren
2018-01-01
Middle School 88 in Brooklyn, New York serves a community of students often considered at high risk for dropping out of high school and other socially undesirable behaviors. In this high-need setting, the authors designed and implemented an environmental education program designed to meet the needs of urban youth of color. The approach they used,…
Training Program for Practical Engineering Design through the Collaboration with Regional Companies
NASA Astrophysics Data System (ADS)
Gofuku, Akio; Tabata, Nobuhisa; Tomita, Eiji; Funabiki, Nobuo
An education program to bring up engineering design capabilities through long-term internship by the collaboration with regional companies has been put in practice for five years. The program is composed of two types of long-term internships and several lectures for patent systems and engineering ethics. This paper describes the outline of the program, educational effects, and our experiences. The program was improved into two educational programs in 2011. The one is a special course to educate engineers and scientists who can lead the technologies of their domains. The other is a long-term internship program for master students in engineering divisions of graduate school. This paper also describes the current activities of the latter program.
Conservation Education Timber Management Wildland Fire & Aviation Burn Permits Firewise Alaska Brochure (PDF) Fire Management Plans Fire Assignments Annual Fire Statistics Fire Terms Glossary Incident Business Management Grants Become an Alaska Firewise Community Community Wildland Fire Protection Plans
Nonnative Fishes in the Upper Mississippi River System
Irons, Kevin S.; DeLain, Steven A.; Gittinger, Eric; Ickes, Brian S.; Kolar, Cindy S.; Ostendort, David; Ratcliff, Eric N.; Benson, Amy J.; Irons, Kevin S.
2009-01-01
The introduction, spread, and establishment of nonnative species is widely regarded as a leading threat to aquatic biodiversity and consequently is ranked among the most serious environmental problems facing the United States today. This report presents information on nonnative fish species observed by the Long Term Resource Monitoring Program on the Upper Mississippi River System a nexus of North American freshwater fish diversity for the Nation. The Long Term Resource Monitoring Program, as part of the U.S. Army Corps of Engineers' Environmental Management Plan, is the Nation's largest river monitoring program and stands as the primary source of standardized ecological information on the Upper Mississippi River System. The Long Term Resource Monitoring Program has been monitoring fish communities in six study areas on the Upper Mississippi River System since 1989. During this period, more than 3.5 million individual fish, consisting of 139 species, have been collected. Although fish monitoring activities of the Long Term Resource Monitoring Program focus principally on entire fish communities, data collected by the Program are useful for detecting and monitoring the establishment and spread of nonnative fish species within the Upper Mississippi River System Basin. Sixteen taxa of nonnative fishes, or hybrids thereof, have been observed by the Long Term Resource Monitoring Program since 1989, and several species are presently expanding their distribution and increasing in abundance. For example, in one of the six study areas monitored by the Long Term Resource Monitoring Program, the number of established nonnative species has increased from two to eight species in less than 10 years. Furthermore, contributions of those eight species can account for up to 60 percent of the total annual catch and greater than 80 percent of the observed biomass. These observations are critical because the Upper Mississippi River System stands as a nationally significant pathway for nonnative species expansion between the Mississippi River and the Great Lakes Basin. This report presents a synthesis of data on nonnative fish species observed during Long Term Resource Monitoring Program monitoring activities.
ORION laser target diagnostics.
Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P
2012-10-01
The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.
Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson
2014-05-01
Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions' participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. © The Royal Society of Medicine.
Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson
2014-01-01
Summary Objective: To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions’ participation in setting the national health research agenda. Institutional research priorities, scientific reviews and governance structure. Results: During the previous 12 months, the heads of 49% of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes, producing new knowledge, influencing health policies and conducting operational research. For 78% of respondent institutions, scientific review was required for research funded directly by the institution, and for 73% of respondent institutions, scientific review was required for research not funded by the institution. However, most respondent institutions did not have written policies or guidelines, either for the scientific review of proposals (70%) or regarding conflict of interest on scientific review committees (80%). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship, many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region. PMID:24914129
Technical note: Open-paleo-data implementation pilot - the PAGES 2k special issue
NASA Astrophysics Data System (ADS)
Kaufman, Darrell S.; Pages 2k Special-Issue Editorial Team
2018-05-01
Data stewardship is an essential element of the publication process. Knowing how to enact data polices that are described only in general terms can be difficult, however. Examples are needed to model the implementation of open-data polices in actual studies. Here we explain the procedure used to attain a high and consistent level of data stewardship across a special issue of the journal Climate of the Past. We discuss the challenges related to (1) determining which data are essential for public archival, (2) using data generated by others, and (3) understanding data citations. We anticipate that open-data sharing in paleo sciences will accelerate as the advantages become more evident and as practices that reduce data loss become the accepted convention.
7 CFR 1470.23 - Conservation activity operation and maintenance.
Code of Federal Regulations, 2011 CFR
2011-01-01
... 7 Agriculture 10 2011-01-01 2011-01-01 false Conservation activity operation and maintenance. 1470... STEWARDSHIP PROGRAM Contracts and Payments § 1470.23 Conservation activity operation and maintenance. The participant will maintain and manage existing conservation activities on the agricultural operation to at...
7 CFR 1470.23 - Conservation activity operation and maintenance.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 10 2010-01-01 2010-01-01 false Conservation activity operation and maintenance. 1470... STEWARDSHIP PROGRAM Contracts and Payments § 1470.23 Conservation activity operation and maintenance. The participant will operate and maintain existing conservation activities on the agricultural operation to at...
Connecticut: New Haven City Government (A Former EPA CARE Project)
The City of New Haven is the recipient of a citywide Level II CARE cooperative agreement. The City of New Haven will use CARE funding to expand the existing air toxics initiative into a more comprehensive air, water and land stewardship program.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-04-12
...'s strategic goals (safety, reduced congestion, global connectivity, environmental stewardship and..., as well as other governmental agencies, to survey the public about current transportation issues, and... transit (subway, streetcar, or light rail) Commuter rail Water transportation (taxis, ferries, ships...
ERIC Educational Resources Information Center
Harvey, Elizabeth
2009-01-01
Principal gifts are very large donations that take years to cultivate and potentially can have a major impact on an institution. Venerable private research universities have sought principal gifts for decades with well-staffed, systematic cultivation and stewardship programs. Until recently, however, principal gifts were not necessarily considered…
A database application for wilderness character monitoring
Ashley Adams; Peter Landres; Simon Kingston
2012-01-01
The National Park Service (NPS) Wilderness Stewardship Division, in collaboration with the Aldo Leopold Wilderness Research Institute and the NPS Inventory and Monitoring Program, developed a database application to facilitate tracking and trend reporting in wilderness character. The Wilderness Character Monitoring Database allows consistent, scientifically based...
The Nature of Scatter at the DARHT Facility and Suggestions for Improved Modeling of DARHT Facility
DOE Office of Scientific and Technical Information (OSTI.GOV)
Morneau, Rachel Anne
This report describes the US Stockpile Stewardship Program which is meant to sustain and evaluate nuclear weapon stockpile with no underground nuclear tests. This research will focus on DARHT, the Dual Axis Radiographic Hydrodynamic Test facility.
Blind inlets: Conservation practices to reduce herbicide losses from closed depressional areas
USDA-ARS?s Scientific Manuscript database
Pesticides are designed to benefit agricultural production and may inadvertently affect water quality if environmental stewardship programs are not implemented. Closed depressional areas (potholes) are typical in the US Midwest and are usually drained with tile risers, however sediment and contamina...
Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program
Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.
2014-01-01
Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659
O'Donnell, Lauren A; Guarascio, Anthony J
2017-01-01
With the alarming rise of antibiotic resistance, clinical professionals are called upon to manage antibiotic therapies using the most relevant and recent clinical and laboratory data. To this end, antimicrobial stewardship (AMS) programs aim to reduce unnecessary or suboptimal use of antibiotics while maximizing outcomes for the patient. For AMS programs to succeed, the active participation of clinical professionals at all levels of patient care is required. Although programs exist to train established clinicians in AMS, there is a paucity of literature on how and when to integrate AMS concepts and skills in pre-clinical and clinical coursework. Here, we discuss the crucial microbiology concepts and proficiencies that are necessary for building and supporting an AMS program. We provide recommendations for key points to include in clinical curricula in order to develop the necessary microbiology interpretation skills to participate in AMS. The influence of AMS programs on local organism susceptibility patterns is emphasized. The importance of antibiograms, rapid diagnostic testing and the practical interpretations of microbiology laboratory reporting are discussed in regard to prioritization in clinical curricula. We also review the current literature on instructional strategies for introducing AMS into clinical programs, and propose concepts that should be included in didactic coursework in order to provide a foundation for AMS education. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
A Systematic Review of Antimicrobial Stewardship Interventions in the Emergency Department.
Losier, Mia; Ramsey, Tasha D; Wilby, Kyle John; Black, Emily K
2017-09-01
To improve antimicrobial utilization, development and implementation of antimicrobial stewardship programs in the emergency department (ED) has been recommended. The primary objective of this review was to characterize antimicrobial stewardship (AMS) in the ED and to identify interventions that improve patient outcomes or process of care and/or reduce consequences of antimicrobial use. This study was completed as a systematic review. The following databases were searched from inception through November, 2016: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science. Randomized controlled trials, nonrandomized controlled trials, controlled and uncontrolled before-and-after studies, interrupted time series studies, and repeated-measures studies evaluating AMS interventions in the ED were included in the review. Studies published in languages other than English were excluded. A total of 43 studies meeting inclusion criteria were identified from our search. Patient or provider education and guideline or clinical pathway implementation were the most commonly reported interventions. Few studies reported on audit and feedback, and no study evaluated preauthorization. Impact of interventions showed variable results. Where identified, benefits of AMS interventions primarily included improvement in delivery of care or a decrease in antimicrobial utilization; however, most studies were rated as having unclear or high risk of bias. AMS interventions in the ED may improve patient care. However, the optimal combination of interventions is unclear. Additional studies with more rigorous design evaluating core components of AMS programs, including prospective audit and feedback are needed.
Understanding social influences on wilderness fire stewardship decisions
Katie Knotek
2006-01-01
Federal land managers and the public engage in many decisions about stewardship of wilderness in the United States, including decisions about stewardship of fire. To date, social science research lacks a holistic examination of the decision-making context of managers and the public about stewardship of fire inside wilderness and across its boundaries. A conceptual...
The organisational structure of urban environmental stewardship
Dana R. Fisher; Lindsay Campbell; Erika S. Svendsen
2012-01-01
How is the organisational structure of urban environmental stewardship groups related to the diverse ways that civic stewardship is taking place in urban settings? The findings of the limited number of studies that have explored the organisational structure of civic environmentalism are combined with the research on civic stewardship to answer this question. By...
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…
2011 Annual Progress Report: DOE Hydrogen and Fuel Cells Program (Book)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
In the past year, the DOE Hydrogen and Fuel Cells Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
ERIC Educational Resources Information Center
Faircloth, W. Brad; Schermerhorn, Alice C.; Mitchell, Patricia M.; Cummings, Jennifer S.; Cummings, E. Mark
2011-01-01
Family-focused prevention programs for community samples have potentially broad, clinically relevant implications but few studies have examined whether any program benefits continue to be observed over the long term. Although benefits of a marital conflict focused parent education program, the Happy Couples and Happy Kids (i.e., HCHK) program,…
Jump, Robin L. P.; Olds, Danielle M.; Jury, Lucy A.; Sitzlar, Brett; Saade, Elie; Watts, Brook; Bonomo, Robert A.; Donskey, Curtis J.
2013-01-01
Background Residents of long-term care facilities (LTCFs) are a population vulnerable to infections and to the adverse effects of inappropriate antimicrobial prescribing. To improve the care of residents with possible infections, we initiated a LTCF Infectious Disease (LID) service that provides on-site consultations to LTCF residents. Design Clinical demonstration project Setting A 160-bed LTCF affiliated with a tertiary care Veterans Affairs (VA) hospital. Participants Residents referred to the LID Team. Measurements The reason for and source of LTCF residents’ referral to the LID team as well as their demographics, infectious disease diagnoses, interventions and hospitalizations were determined. Results Between July 2009 and December 2010, the LID consult service provided 291 consults for 250 LTCF residents. Referrals came from either the LTCF staff (75%) or the VA hospital’s ID consult service (25%). The most common diagnoses were Clostridium difficile infection (14%), asymptomatic bacteriuria (10%), and urinary tract infection (10%). More than half of referred patients were on antibiotic therapy when first seen by the LID team; 46% of patients required an intervention. The most common interventions, stopping (32%) or starting (26%) antibiotics, were made in accordance with principles of antibiotic stewardship. Conclusion The LID team represents a novel and effective means to bring subspecialty care to LTCF residents. PMID:23590125
3 CFR 8449 - Proclamation 8449 of October 30, 2009. National Native American Heritage Month, 2009
Code of Federal Regulations, 2010 CFR
2010-01-01
... of the United States of America A Proclamation The indigenous peoples of North America—the First... long history on this great land, they have faced moments of profound triumph and tragedy alike. During.... They have guided our land stewardship policies, added immeasurably to our cultural heritage, and...
Long-Term Outcome of the Lidcombe Program for Early Stuttering Intervention
ERIC Educational Resources Information Center
Miller, Barbara; Guitar, Barry
2009-01-01
Purpose: To report long-term outcomes of the first 15 preschool children treated with the Lidcombe Program by speech-language pathologists (SLPs) who were inexperienced with the program and independent of the program developers. Research questions were: Would the treatment have a similar outcome with inexperienced SLPs compared to outcomes when…
Conceptual Model of Climate Change Impacts at LANL
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dewart, Jean Marie
Goal 9 of the LANL FY15 Site Sustainability Plan (LANL 2014a) addresses Climate Change Adaptation. As part of Goal 9, the plan reviews many of the individual programs the Laboratory has initiated over the past 20 years to address climate change impacts to LANL (e.g. Wildland Fire Management Plan, Forest Management Plan, etc.). However, at that time, LANL did not yet have a comprehensive approach to climate change adaptation. To fill this gap, the FY15 Work Plan for the LANL Long Term Strategy for Environmental Stewardship and Sustainability (LANL 2015) included a goal of (1) establishing a comprehensive conceptual modelmore » of climate change impacts at LANL and (2) establishing specific climate change indices to measure climate change and impacts at Los Alamos. Establishing a conceptual model of climate change impacts will demonstrate that the Laboratory is addressing climate change impacts in a comprehensive manner. This paper fulfills the requirement of goal 1. The establishment of specific indices of climate change at Los Alamos (goal 2), will improve our ability to determine climate change vulnerabilities and assess risk. Future work will include prioritizing risks, evaluating options/technologies/costs, and where appropriate, taking actions. To develop a comprehensive conceptual model of climate change impacts, we selected the framework provided in the National Oceanic and Atmospheric Administration (NOAA) Climate Resilience Toolkit (http://toolkit.climate.gov/).« less
FY 2017 Stockpile Stewardship and Management Plan - Biennial Plan Summary
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
2016-03-01
This year’s summary report updates the Fiscal Year 2016 Stockpile Stewardship and Management Plan (FY 2016 SSMP), the 25-year strategic program of record that captures the plans developed across numerous NNSA programs and organizations to maintain and modernize the scientific tools, capabilities, and infrastructure necessary to ensure the success of NNSA’s nuclear weapons mission. The SSMP is a companion to the Prevent, Counter, and Respond: A Strategic Plan to Reduce Global Nuclear Threats (FY 2017-2021) report, the planning document for NNSA’s nuclear threat reduction mission. New versions of both reports are published each year in response to new requirements andmore » challenges. Much was accomplished in FY 2015 as part of the program of record described in this year’s SSMP. The science-based Stockpile Stewardship Program allowed the Secretaries of Energy and Defense to certify for the twentieth time that the stockpile remains safe, secure, and effective without the need for underground nuclear explosive testing. The talented scientists, engineers, and technicians at the three national security laboratories, the four nuclear weapons production plants, and the national security site are primarily responsible for this continued success. Research, development, test, and evaluation programs have advanced NNSA’s understanding of weapons physics, component aging, and material properties through first-of-a-kind shock physics experiments, along with numerous other critical experiments conducted throughout the nuclear security enterprise. The multiple life extension programs (LEPs) that are under way made progress toward their first production unit dates. The W76-1 LEP is past the halfway point in total production, and the B61-12 completed three development flight tests. Critical to this success is the budget. The Administration’s budget request for NNSA’s Weapons Activities has increased for all but one of the past seven years, resulting in a total increase of approximately 45 percent since 2010. If adopted by Congress, the FY 2017 budget request will increase funding by $396 million (about 4.5 percent) from the enacted FY 2016 level. A significant portion of the increase would fund the research for multiple life extension programs, support the programs in Directed Stockpile Work, and modernize the physical infrastructure of the nuclear security enterprise.« less
Organizing urban ecosystem services through environmental stewardship governance in New York City
James J. Connolly; Erika S. Svendsen; Dana R. Fisher; Lindsay K. Campbell
2013-01-01
How do stewardship groups contribute to the management of urban ecosystem services? In this paper, we integrate the research on environmental stewardship with the social-ecological systems literature to explain how stewardship groups serve as bridge organizations between public agencies and civic organizations, working across scales and sectors to build the flexible...
UBIQUITOUS POLLUTION FROM HEALTH AND COSMETIC CARE: SIGNIFICANCE, CONCERN, SOLUTIONS, STEWARDSHIP
Those chemical pollutants that are regulated under various international, federal, and state programs represent but a small fraction of the universe of chemicals that occur in the environment as a result of both natural processses and human influence. Although this galaxy of ta...
Big Explosives Experimental Facility - BEEF
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
The Big Explosives Experimental Facility or BEEF is a ten acre fenced high explosive testing facility that provides data to support stockpile stewardship and other national security programs. At BEEF conventional high explosives experiments are safely conducted providing sophisticated diagnostics such as high speed optics and x-ray radiography.
Big Explosives Experimental Facility - BEEF
None
2018-01-16
The Big Explosives Experimental Facility or BEEF is a ten acre fenced high explosive testing facility that provides data to support stockpile stewardship and other national security programs. At BEEF conventional high explosives experiments are safely conducted providing sophisticated diagnostics such as high speed optics and x-ray radiography.
US Policy approaches for assessing soil health
USDA-ARS?s Scientific Manuscript database
There is worldwide recognition for a more holistic vision of soil health and tools to guide soil conservation policy, management and restoration. To meet this need, U.S. conservation programs in the US Food, Conservation, and Energy Act of 2008 (the farm bill), including the Conservation Stewardship...
Status of Iran's nuclear program and negotiations
DOE Office of Scientific and Technical Information (OSTI.GOV)
Albright, David
2014-05-09
Iran's nuclear program poses immense challenges to international security. Its gas centrifuge program has grown dramatically in the last several years, bringing Iran close to a point where it could produce highly enriched uranium in secret or declared gas centrifuge plants before its breakout would be discovered and stopped. To reduce the risk posed by Iran's nuclear program, the P5+1 have negotiated with Iran short term limits on the most dangerous aspects of its nuclear programs and is negotiating long-term arrangements that can provide assurance that Iran will not build nuclear weapons. These long-term arrangements need to include a farmore » more limited and transparent Iranian nuclear program. In advance of arriving at a long-term arrangement, the IAEA will need to resolve its concerns about the alleged past and possibly on-going military dimensions of Iran's nuclear program.« less
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
This report, in fulfillment of a license requirement, presents the results of long-term surveillance and maintenance activities conducted by the U.S. Department of Energy (DOE) Office of Legacy Management (LM) in 2013 at 19 uranium mill tailings disposal sites established under Title I of the Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978.1 These activities verified that the UMTRCA Title I disposal sites remain in compliance with license requirements. DOE operates 18 UMTRCA Title I sites under a general license granted by the U.S. Nuclear Regulatory Commission (NRC) in accordance with Title 10 Code of Federal Regulations Part 40.27more » (10 CFR 40.27). As required under the general license, a long-term surveillance plan (LTSP) for each site was prepared by DOE and accepted by NRC. The Grand Junction, Colorado, Disposal Site, one of the 19 Title I sites, will not be included under the general license until the open, operating portion of the cell is closed. The open portion will be closed either when it is filled or in 2023. This site is inspected in accordance with an interim LTSP. Long-term surveillance and maintenance services for these disposal sites include inspecting and maintaining the sites; monitoring environmental media and institutional controls; conducting any necessary corrective actions; and performing administrative, records, stakeholder relations, and other regulatory stewardship functions. Annual site inspections and monitoring are conducted in accordance with site-specific LTSPs and procedures established by DOE to comply with license requirements. Each site inspection is performed to verify the integrity of visible features at the site; to identify changes or new conditions that may affect the long-term performance of the site; and to determine the need, if any, for maintenance, follow-up or contingency inspections, or corrective action in accordance with the LTSP. LTSPs and site compliance reports are available on the Internet at http://www.lm.doe.gov/.« less
Long-term mass transfer and mixing-controlled reactions of a DNAPL plume from persistent residuals
NASA Astrophysics Data System (ADS)
Liu, Yuan; Illangasekare, Tissa H.; Kitanidis, Peter K.
2014-02-01
Understanding and being able to predict the long-term behavior of DNAPL (i.e., PCE and TCE) residuals after active remediation has ceased have become increasingly important as attention at many sites turns from aggressive remediation to monitored natural attenuation and long-term stewardship. However, plume behavior due to mass loading and reactions during these later phases is less studied as they involve large spatial and temporal scales. We apply both theoretical analysis and pore-scale simulations to investigate mass transfer from DNAPL residuals and subsequent reactions within the generated plume, and, in particular, to show the differences between early- and late-time behaviors of the plume. In the zone of entry of the DNAPL entrapment zone where the concentration boundary layer in the flowing groundwater has not fully developed, the pore-scale simulations confirm the past findings based on laboratory studies that the mass transfer increases as a power-law function of the Peclét number, and is enhanced due to reactions in the plume. Away from the entry zone and further down gradient, the long-term reactions are limited by the available additive and mixing in the porous medium, thereby behave considerably differently from the entry zone. For the reaction between the contaminant and an additive with intrinsic second-order bimolecular kinetics, the late-time reaction demonstrates a first-order decay macroscopically with respect to the mass of the limiting additive, not with respect to that of the contaminant. The late-time decay rate only depends on the intrinsic reaction rate and the solubility of the entrapped DNAPL. At the intermediate time, the additive decays exponentially with the square of time (t2), instead of time (t). Moreover, the intermediate decay rate also depends on the initial conditions, the spatial distribution of DNAPL residuals, and the effective dispersion coefficient.
Ensuring Sustainable Data Interoperability Across the Natural and Social Sciences
NASA Astrophysics Data System (ADS)
Downs, R. R.; Chen, R. S.
2015-12-01
Both the natural and social science data communities are attempting to address the long-term sustainability of their data infrastructures in rapidly changing research, technological, and policy environments. Many parts of these communities are also considering how to improve the interoperability and integration of their data and systems across natural, social, health, and other domains. However, these efforts have generally been undertaken in parallel, with little thought about how different sustainability approaches may impact long-term interoperability from scientific, legal, or economic perspectives, or vice versa, i.e., how improved interoperability could enhance—or threaten—infrastructure sustainability. Scientific progress depends substantially on the ability to learn from the legacy of previous work available for current and future scientists to study, often by integrating disparate data not previously assembled. Digital data are less likely than scientific publications to be usable in the future unless they are managed by science-oriented repositories that can support long-term data access with the documentation and services needed for future interoperability. We summarize recent discussions in the social and natural science communities on emerging approaches to sustainability and relevant interoperability activities, including efforts by the Belmont Forum E-Infrastructures project to address global change data infrastructure needs; the Group on Earth Observations to further implement data sharing and improve data management across diverse societal benefit areas; and the Research Data Alliance to develop legal interoperability principles and guidelines and to address challenges faced by domain repositories. We also examine emerging needs for data interoperability in the context of the post-2015 development agenda and the expected set of Sustainable Development Goals (SDGs), which set ambitious targets for sustainable development, poverty reduction, and environmental stewardship by 2030. These efforts suggest the need for a holistic approach towards improving and implementing strategies, policies, and practices that will ensure long-term sustainability and interoperability of scientific data repositories and networks across multiple scientific domains.
FY 2014 Annual Progress Report - Advanced Combustion Engine Research and Development (Book)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
In the past year, the DOE Hydrogen Program (the Program) made substantial progress toward its goals and objectives. The Program has conducted comprehensive and focused efforts to enable the widespread commercialization of hydrogen and fuel cell technologies in diverse sectors of the economy. With emphasis on applications that will effectively strengthen our nation's energy security and improve our stewardship of the environment, the Program engages in research, development, and demonstration of critical improvements in the technologies. Highlights of the Program's accomplishments can be found in the sub-program chapters of this report.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chrzanowski, P; Walter, K
For the Laboratory and staff, 2006 was a year of outstanding achievements. As our many accomplishments in this annual report illustrate, the Laboratory's focus on important problems that affect our nation's security and our researchers breakthroughs in science and technology have led to major successes. As a national laboratory that is part of the Department of Energy's National Nuclear Security Administration (DOE/NNSA), Livermore is a key contributor to the Stockpile Stewardship Program for maintaining the safety, security, and reliability of the nation's nuclear weapons stockpile. The program has been highly successful, and our annual report features some of the Laboratory'smore » significant stockpile stewardship accomplishments in 2006. A notable example is a long-term study with Los Alamos National Laboratory, which found that weapon pit performance will not sharply degrade from the aging effects on plutonium. The conclusion was based on a wide range of nonnuclear experiments, detailed simulations, theoretical advances, and thorough analyses of the results of past nuclear tests. The study was a superb scientific effort. The continuing success of stockpile stewardship enabled NNSA in 2006 to lay out Complex 2030, a vision for a transformed nuclear weapons complex that is more responsive, cost efficient, and highly secure. One of the ways our Laboratory will help lead this transformation is through the design and development of reliable replacement warheads (RRWs). Compared to current designs, these warheads would have enhanced performance margins and security features and would be less costly to manufacture and maintain in a smaller, modernized production complex. In early 2007, NNSA selected Lawrence Livermore and Sandia National Laboratories-California to develop ''RRW-1'' for the U.S. Navy. Design efforts for the RRW, the plutonium aging work, and many other stockpile stewardship accomplishments rely on computer simulations performed on NNSA's Advanced Simulation and Computing (ASC) Program supercomputers at Livermore. ASC Purple and BlueGene/L, the world's fastest computer, together provide nearly a half petaflop (500 trillion operations per second) of computer power for use by the three NNSA national laboratories. Livermore-led teams were awarded the Gordon Bell Prize for Peak Performance in both 2005 and 2006. The winning simulations, run on BlueGene/L, investigated the properties of materials at the length and time scales of atomic interactions. The computing power that makes possible such detailed simulations provides unprecedented opportunities for scientific discovery. Laboratory scientists are meeting the extraordinary challenge of creating experimental capabilities to match the resolution of supercomputer simulations. Working with a wide range of collaborators, we are developing experimental tools that gather better data at the nanometer and subnanosecond scales. Applications range from imaging biomolecules to studying matter at extreme conditions of pressure and temperature. The premier high-energy-density experimental physics facility in the world will be the National Ignition Facility (NIF) when construction is completed in 2009. We are leading the national effort to perform the first fusion ignition experiments using NIF's 192-beam laser and prepare to explore some of the remaining important issues in weapons physics. With scientific colleagues from throughout the nation, we are also designing revolutionary experiments on NIF to advance the fields of astrophysics, planetary physics, and materials science. Mission-directed, multidisciplinary science and technology at Livermore is also focused on reducing the threat posed by the proliferation of weapons of mass destruction as well as their acquisition and use by terrorists. The Laboratory helps this important national effort by providing its unique expertise, integration analyses, and operational support to the Department of Homeland Security. For this vital facet of the Laboratory's national security mission, we are developing advanced technologies, such as a pocket-size explosives detector and an airborne persistent surveillance system, both of which earned R&D 100 Awards. Altogether, Livermore won seven R&D 100 Awards in 2006, the most for any organization. Emerging threats to national and global security go beyond defense and homeland security. Livermore pursues major scientific and technical advances to meet the need for a clean environment; clean, abundant energy; better water management; and improved human health. Our annual report highlights the link between human activities and the warming of tropical oceans, as well as techniques for imaging biological molecules and detecting bone cancer in its earliest stages. In addition, we showcase many scientific discoveries: distant planets, the composition of comets, a new superheavy element.« less
Yekang Ko; Jun-Hak Lee; E. Gregory McPherson; Lara A. Roman
2015-01-01
Long-term survival and growth of urban forests are critical to achieve the targeted benefits of urban tree planting programs, such as building energy savings from tree shade. However, little is known about how trees perform in the long-term, especially in residential areas. Given this gap in the literature, we monitored 22-years of post-planting survival, growth, and...
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.
NASA FY 2000 Accountability Report
NASA Technical Reports Server (NTRS)
2000-01-01
This Accountability Report consolidates reports required by various statutes and summarizes NASA's program accomplishments and its stewardship over budget and financial resources. It is a culmination of NASA's management process, which begins with mission definition and program planning, continues with the formulation and justification of budgets for the President and Congress, and ends with scientific and engineering program accomplishments. The report covers activities from October 1, 1999, through September 30, 2000. Achievements are highlighted in the Statement of the Administrator and summarized in the Report.
Laible, Brad R; Nazir, Jawad; Assimacopoulos, Aris P; Schut, Jennifer
2010-12-01
Antimicrobial stewardship is an important process proven to combat antimicrobial resistance, improve patient outcomes, and reduce costs. The Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) have provided guidelines for the provision of antimicrobial stewardship. According to these recommendations, antimicrobial stewardship teams should be multidisciplinary in nature, with core members consisting of an infectious disease physician and an infectious disease-trained clinical pharmacist. Due to limited resources, our institution chose to implement a pharmacist-led antimicrobial stewardship service on 1 medical/surgical ward, with the existing clinical pharmacist and 3 infectious disease physicians as core members. This clinical pharmacist was not trained in infectious disease specialty, and stewardship activities were only one part of his daily activities. Pharmacy residents and students were extensively utilized to assist in the stewardship process. Approximately two thirds of stewardship recommendations were accepted using primarily a prospective audit and feedback approach.
This paper compares lake chemistry in the Adirondack region of New York measured by the Temporally Integrated Monitoring of Ecosystems (TIME) and Adirondack Long-Term Monitoring (ALTM) programs by examining the data from six lakes common to both programs. Both programs were initi...
Brains Rule!: a model program for developing professional stewardship among neuroscientists.
Zardetto-Smith, Andrea M; Mu, Keli; Carruth, Laura L; Frantz, Kyle J
2006-01-01
Brains Rule! Neuroscience Expositions, funded through a National Institute on Drug Abuse Science Education Drug Abuse Partnership Award, has developed a successful model for informal neuroscience education. Each Exposition is a "reverse science fair" in which neuroscientists present short neuroscience teaching modules to students. This study focuses on results of assessments conducted with neuroscientist presenters during Expositions at two sites, Atlanta, Georgia and Corpus Christi, Texas. The effects of participating in the Expositions on presenters' perceptions of their own presentation and communication skills were evaluated, as was the potential for increased active participation by neuroscientists in future outreach programs. In four of the five Expositions studied, pre- versus post-event surveys demonstrated significant changes in presenters' perceptions of their own abilities to explain neuroscience concepts to children. Over the course of an Exposition, presenters learned to fit their approaches to conveying neuroscience concepts to fifth through eighth graders and learned to link information they presented about the brain and nervous system to children's past experiences to improve comprehension. The present data suggest that Brains Rule! Neuroscience Expositions are effective in improving communication and teaching skills among neuroscience professionals and contribute to professional stewardship by increasing motivation to participate in future informal education programs.
ERIC Educational Resources Information Center
Lante, Kerrie A.; Walkley, Jeff W.; Gamble, Merrilyn; Vassos, Maria V.
2011-01-01
Background: Physical activity (PA) programs for adults with intellectual disability (ID) have positive impacts, at least in the short term. No research has been reported on the effect of long-term engagement in PA programs for adults with ID. This paper explores the physical and psychosocial benefits gained by two individuals with mild ID who…
Berkes, Fikret; Doubleday, Nancy C; Cumming, Graeme S
2012-09-01
Health approaches to ecology have a strong basis in Aldo Leopold's thinking, and contemporary ecohealth in turn has a strong philosophical basis in Leopold. To commemorate the 125th anniversary of Leopold's birth (1887-1948), we revisit his ideas, specifically the notions of stewardship (land ethic), productive use of ecosystems (land), and ecosystem renewal. We focus on Leopold's perspective on the self-renewal capacity of the land, as understood in terms of integrity and land health, from the contemporary perspective of resilience theory and ecological theory more generally. Using a broad range of literature, we explore insights and implications of Leopold's work for today's human-environment relationships (integrated social-ecological systems), concerns for biodiversity, the development of agency with respect to stewardship, and key challenges of his time and of ours. Leopold's seminal concept of land health can be seen as a triangulation of productive use, self-renewal, and stewardship, and it can be reinterpreted through the resilience lens as the health of social-ecological systems. In contemporary language, this involves the maintenance of biodiversity and ecosystem services, and the ability to exercise agency both for conservation and for environmental justice.
Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context
Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George
2015-01-01
Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563
Using wilderness character to improve wilderness stewardship
Peter Landres; Wade M. Vagias; Suzy Stutzman
2012-01-01
This article describes how understanding wilderness character leads to improved communication among staff and with the public, helping park staff make more informed decisions about park planning, management, and monitoring in wilderness. Wilderness character is defined in terms of five qualities: natural, solitude or primitive and unconfined recreation, undeveloped,...
Determinants of Private Long-Term Care Insurance Purchase in Response to the Partnership Program.
Lin, Haizhen; Prince, Jeffrey T
2016-04-01
To assess three possible determinants of individuals' response in their private insurance purchases to the availability of the Partnership for Long-Term Care (PLTC) insurance program: bequest motives, financial literacy, and program awareness. The health and retirement study (HRS) merged with data on states' implementation of the PLTC program. Individual-level decision on private long-term care insurance is regressed on whether the PLTC program is being implemented for a given state-year, asset dummies, policy determinant variable, two-way and three-way interactions of these variables, and other controls, using fixed effects panel regression. Analysis used a sample between 50 and 69 years of age from 2002 to 2010, resulting in 12,695 unique individuals with a total of 39,151 observations. We find mild evidence that intent to bequest influences individual purchase of insurance. We also find that program awareness is necessary for response, while financial literacy notably increases responsiveness. Increasing response to the PLTC program among the middle class (the stated target group) requires increased efforts to create awareness of the program's existence and increased education about the program's benefits, and more generally, about long-term care risks and needs. © Health Research and Educational Trust.
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.
Planned Programming Pays Dividends
ERIC Educational Resources Information Center
Geraldi, Kevin M.
2008-01-01
In this article, the author explains that before beginning to create concert programs, it is important that ensemble conductors first develop a long-term curricular plan to which each individual program will contribute. He continues that if an ensemble curriculum is devised so that students make progress over the long term, dynamic growth can take…
North American long-term soil productivity research program
Allan E. Tiarks; Robert F. Powers; Jerry F. Ragus; Deborah S. Page-Dumroese; Felix, Jr. Ponder; Douglas M. Stone
1997-01-01
The National Long-term Soil Productivity research program was chartered to address National Forest Management Act concerns over possible losses in soil productivity on National Forest lands. The program supports validation of soil quality monitoring standards and process-level productivity research. Summarized results are supplied to Forests as collected. National...
34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?
Code of Federal Regulations, 2010 CFR
2010-07-01
...; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Long-Term Training program? 386.1 Section 386.1 Education Regulations of the Offices of the Department of Education (Continued...
North American long-term soil productivity research program
Allan E. Tiarks; Robert F. Powers; Jerry F. Ragus; Deborah S. Page-Dumroese; Felix Ponder; Douglas M. Stone
1997-01-01
The National Long-term Soil Productivity research program was chartered to address National Forest Management Act concerns over possible losses n soil productivity on national forest lands. The program supports validation of soil quality monitoring standards and process-level productivity research. Summarized results are supplied to forests as collected. National...
A Long History of Supercomputing
Grider, Gary
2018-06-13
As part of its national security science mission, Los Alamos National Laboratory and HPC have a long, entwined history dating back to the earliest days of computing. From bringing the first problem to the nationâs first computer to building the first machine to break the petaflop barrier, Los Alamos holds many âfirstsâ in HPC breakthroughs. Today, supercomputers are integral to stockpile stewardship and the Laboratory continues to work with vendors in developing the future of HPC.
ERIC Educational Resources Information Center
Miner, Jennifer; Elshof, Leo; Redden, Anna; Terry, John
2004-01-01
The Gulf of Maine Institute (GOMI) is striving to empower youth to take on stewardship roles in their communities. Through its Community Based Initiative (CBI) program, GOMI addresses environmental degradation by working with teams of students, teachers, and community members from around the Gulf of Maine to inspire youth to be stewards of the…
Energy Service Companies as a Component of a Comprehensive University Sustainability Strategy
ERIC Educational Resources Information Center
Pearce, Joshua M.; Miller, Laura L.
2006-01-01
Purpose: This paper aims to quantify and critically analyze the best practices of a comprehensive environmental stewardship strategy (ESS), which included a guaranteed energy savings program (GESP) that utilized an energy service company (ESCO). Design/methodology/approach: The environmental and economic benefits and limitations of an approach…
Socially Responsible Investing: It's Time for Schools to Get on Board
ERIC Educational Resources Information Center
Armoza, Natalia
2011-01-01
Whether it is in their professional development programs, admissions materials, or curricula, independent schools have a lot to say about environmental stewardship, equity, community service, and justice. When they send their students to rebuild post-Katrina New Orleans or construct LEED-certified structures, the schools and their constituents…
Making a Difference College Guide. Third Edition.
ERIC Educational Resources Information Center
Weinstein, Miriam
This book profiles those unique institutions or departments that are committed to public service, social change and environmental stewardship. Colleges in this guide engage in the major issues of today, especially environmental, women's, peace and ethnic studies. The programs are varied, such as marine biology, social work, outdoor education,…
36 CFR 230.1 - Purpose and scope.
Code of Federal Regulations, 2010 CFR
2010-07-01
... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Purpose and scope. 230.1 Section 230.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND... by which the Stewardship Incentive Program will be administered by the Forest Service to establish...
36 CFR 230.1 - Purpose and scope.
Code of Federal Regulations, 2011 CFR
2011-07-01
... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Purpose and scope. 230.1 Section 230.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE STATE AND... by which the Stewardship Incentive Program will be administered by the Forest Service to establish...
The Southwest Regional Gap Analysis project (SWReGAP) is a 5-state (Arizona, Colorado, Nevada, New Mexico, and Utah) inter-agency program that maps the distribution of plant communities and selected animal species and compares these distributions with land stewardship to identify...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Barnes, Cris William
Los Alamos National Laboratory (LANL) hosted the Stewardship Science Academic Programs Symposium, which is designed to foster relationships among young scientists, sponsors and the National Nuclear Security Administration national laboratories. The event highlights much of the work done by prominent scientists and allows attendees to view the multiple on site facilities at LANL.