Antimicrobial Stewardship Programs: Comparison of a Program with Infectious Diseases Pharmacist Support to a Program with a Geographic Pharmacist Staffing Model

PubMed Central

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

EPA Pesticide Factsheets

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

A systematic review and critical assessment of incentive strategies for discovery and development of novel antibiotics

PubMed Central

Renwick, Matthew J; Brogan, David M; Mossialos, Elias

2016-01-01

Despite the growing threat of antimicrobial resistance, pharmaceutical and biotechnology firms are reluctant to develop novel antibiotics because of a host of market failures. This problem is complicated by public health goals that demand antibiotic conservation and equitable patient access. Thus, an innovative incentive strategy is needed to encourage sustainable investment in antibiotics. This systematic review consolidates, classifies and critically assesses a total of 47 proposed incentives. Given the large number of possible strategies, a decision framework is presented to assist with the selection of incentives. This framework focuses on addressing market failures that result in limited investment, public health priorities regarding antibiotic stewardship and patient access, and implementation constraints and operational realities. The flexible nature of this framework allows policy makers to tailor an antibiotic incentive package that suits a country's health system structure and needs. PMID:26464014

Social factors and private benefits influence landholders' riverine restoration priorities in tropical Australia.

PubMed

Januchowski-Hartley, Stephanie Renee; Moon, Katie; Stoeckl, Natalie; Gray, Sally

2012-11-15

Private land conservation is an essential component of conservation that requires organizing both protection and restoration actions accordingly. Yet private land conservation programs are often formulated to generate public benefits, with inadequate consideration of costs or benefits to private landholders. Landholders' willingness to participate in conservation programs depends on a complex set of social factors, and the benefits they expect from participation. However, these two attributes are commonly evaluated independent of one another. We addressed this limitation through interviews aimed at determining landholders': 1) willingness to participate in restoration programs; 2) barriers to participation; 3) prioritization of proposed riverine restoration actions; 4) expected public or private benefits for undertaking proposed riverine restoration actions; and 5) most preferred incentive for undertaking proposed restoration actions on their land. Our results revealed four main findings. First, landholders stated that biases towards ecological rather than production outcomes, impractical programs, and government mistrust (structural factors) were the major barriers that prevented them from participating in riverine restoration on their land. Second, private benefits influenced landholders' willingness to engage riverine restoration. Third, 'a sense of stewardship and improved landscape aesthetics' (an internal factor) was the most commonly reported private benefit. Fourth, the most preferred incentives for high priority restoration actions were cash for on-ground works, extension and community recognition. We highlight the importance of designing private land conservation programs that align with landholders' priorities and deliver public benefits. Copyright © 2012 Elsevier Ltd. 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,…

Feasibility and applicability of antimicrobial stewardship in immunocompromised patients.

PubMed

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.

A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

PubMed

Lindenmayer, David B; Zammit, Charles; Attwood, Simon J; Burns, Emma; Shepherd, Claire L; Kay, Geoff; Wood, Jeff

2012-01-01

We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

Antimicrobial Stewardship: How the Microbiology Laboratory Can Right the Ship

PubMed Central

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.

PubMed

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.

PubMed

Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

2016-01-01

There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

Reducing marine mammal bycatch in global fisheries: An economics approach

NASA Astrophysics Data System (ADS)

Lent, Rebecca; Squires, Dale

2017-06-01

The broader ecosystem impacts of fishing continue to present a challenge to scientists and resource managers around the world. Bycatch is of greatest concern for marine mammals, for which fishery bycatch and entanglement is the number one cause of direct mortality. Climate change will only add to the challenge, as marine species and fishing practices adapt to a changing environment, creating a dynamic pattern of overlap between fishing and species (both target and bycatch). Economists suggest policy instruments for reducing bycatch that move away from top-down, command-and-control measures (e.g. effort reduction, time/area closures, gear restrictions, bycatch quotas) towards an approach that creates incentives to reduce bycatch (e.g. transferable bycatch allowances, taxes, and other measures). The advantages of this flexible, incentive-oriented approach are even greater in a changing and increasingly variable environment, as regulatory measures would have to be adapted constantly to keep up with climate change. Unlike the regulatory process, individual operators in the fishery sector can make adjustments to their harvesting practices as soon as the incentives for such changes are apparent and inputs or operations can be modified. This paper explores policy measures that create economic incentives not only to reduce marine mammal bycatch, but also to increase compliance and induce technological advances by fishery operators. Economists also suggest exploration of direct economic incentives as have been used in other conservation programs, such as payments for economic services, in an approach that addresses marine mammal bycatch as part of a larger conservation strategy. Expanding the portfolio of mandatory and potentially, voluntary, measures to include novel approaches will provide a broader array of opportunities for successful stewardship of the marine environment.

Pesticide Environmental Stewardship Program Member Handbook

EPA Pesticide Factsheets

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

How can Multi-Professional Education Support Better Stewardship?

PubMed Central

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

Development of an antimicrobial stewardship-based infectious diseases elective that incorporates human patient simulation technology.

PubMed

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.

Antimicrobial stewardship in long term care facilities: what is effective?

PubMed

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.

Rangeland ecosystem goods and services: Values and evaluation of opportunities for ranchers and land managers

Treesearch

Kristie Maczko; John A. Tanaka; Robert Breckenridge; Lori Hidinger; H. Theodore Heintz; William E. Fox; Urs P. Kreuter; Clifford S. Duke; John E. Mitchell; Daniel W. McCollum

2011-01-01

Although the US Department of Agriculture's 2005 public commitment to use market-based incentives for environmental stewardship and cooperative conservation focused land managers' attention on the concept of ecosystem goods and services (EGS), this was not a new idea. Much earlier in the 20th century, Aldo Leopold embraced the value of open space, calling for...

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.

PubMed

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

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

PubMed Central

Meyer, Susan M.

2014-01-01

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

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

Treesearch

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

2017-01-01

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

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

ERIC Educational Resources Information Center

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

2003-01-01

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

Effective antibiotic stewardship in spinal cord injury: Challenges and a way forward.

PubMed

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.

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

PubMed

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

2016-09-01

Peptide nucleic acid fluorescence in situ hybridization (PNA FISH) is a rapid diagnostic assay that can identify certain organisms growing in blood cultures 30-90 min from the time of positive Gram-stain. Existing studies have demonstrated a clinical utility with this assay when antibiotic stewardship programs assist clinicians with interpreting the results. However, the benefit of these rapid assays in the absence of concomitant antibiotic stewardship involvement is unclear. In this randomized study of 220 patients with enterococcal or streptococcal bacteremia, we found that PNA FISH, in the absence of concomitant input from an antibiotic stewardship program, had no impact on time to effective or optimal therapy, length of hospital stay, or in-hospital mortality. Our results suggest that in the absence of guidance from an antibiotic stewardship program, the clinical benefits of rapid diagnostic microbiological tools may be reduced. Copyright © 2016 Elsevier Inc. All rights reserved.

Antimicrobial stewardship programs: interventions and associated outcomes.

PubMed

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.

A Report of the Efforts of the Veterans Health Administration National Antimicrobial Stewardship Initiative.

PubMed

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

ScienceCinema

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.

Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative

PubMed Central

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

Characteristics of Pediatric Antimicrobial Stewardship Programs: Current Status of the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) Collaborative.

PubMed

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.

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

Treesearch

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

2012-01-01

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

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

ScienceCinema

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

EPA Pesticide Factsheets

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

Core elements of hospital antibiotic stewardship programs from the Centers for Disease Control and Prevention.

PubMed

Pollack, Loria A; Srinivasan, Arjun

2014-10-15

The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals. 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.

PubMed

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

2015-12-01

Antimicrobial stewardship programs are mainly established by infectious diseases physicians and infectious diseases-trained clinical pharmacists with the goal of optimizing patients' outcomes while halting antimicrobial resistance, decreasing adverse events, and controlling health care cost. The role of the infectious diseases-trained clinical pharmacist in antimicrobial stewardship is well established; however, there are not enough formally trained pharmacists to assume the challenging responsibilities of the steward coordinator. The purpose of this article was to review the available literature and resources and propose a model to engage introductory pharmacy practice experience students, advanced pharmacy practice experience students, postgraduate year (PGY) 1 pharmacy residents, PGY2 infectious diseases pharmacy residents, and PGY2 or PGY3 infectious diseases pharmacy fellows in antimicrobial stewardship. Further studies are needed to assess and document the impact of pharmacy students and postgraduate trainees on antimicrobial stewardship programs. © The Author(s) 2013.

Antimicrobial stewardship

PubMed Central

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

2013-01-01

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

Antimicrobial stewardship: a review of prospective audit and feedback systems and an objective evaluation of outcomes.

PubMed

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

2013-02-15

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

Pharmacist-driven antimicrobial stewardship in intensive care units in East China: A multicenter prospective cohort study.

PubMed

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.

2010/2015 PFOA Stewardship Program - 2014 Annual Progress Reports

EPA Pesticide Factsheets

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

Effectiveness of landowner assistance activities: an examination of the USDA Forest Service's Forest Stewardship Program

Treesearch

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

Treesearch

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...

An In-depth Examination of Farmers' Perceptions of Targeting Conservation Practices

NASA Astrophysics Data System (ADS)

Kalcic, Margaret; Prokopy, Linda; Frankenberger, Jane; Chaubey, Indrajeet

2014-10-01

Watershed managers have largely embraced targeting of agricultural conservation as a way to manage strategically non-point source pollution from agricultural lands. However, while targeting of particular watersheds is not uncommon, targeting farms and fields within a specific watershed has lagged. In this work, we employed a qualitative approach, using farmer interviews in west-central Indiana to better understand their views on targeting. Interviews focused on adoption of conservation practices on farmers' lands and identified their views on targeting, disproportionality, and monetary incentives. Results show consistent support for the targeting approach, despite dramatic differences in farmers' views of land stewardship, in their views about disproportionality of water quality impacts, and in their trust in conservation programming. While the theoretical concept of targeting was palatable to all participants, many raised concerns about its practical implementation, pointing to the need for flexibility when applying targeting solutions and revealing misgivings about the government agencies that perform targeting.

A Clostridium difficile infection (CDI) stewardship initiative improves adherence to practice guidelines for management of CDI.

PubMed

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.

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,…

[Measurement of antimicrobial consumption using DDD per 100 bed-days versus DDD per 100 discharges after the implementation of an antimicrobial stewardship program].

PubMed

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

PubMed Central

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

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

PubMed Central

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

2016-01-01

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

Keepers of Our Digital Future: An Assessment of the National Digital Stewardship Residencies, 2013-2016

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…

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

ERIC Educational Resources Information Center

Yontz, Brian David

2010-01-01

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

Evaluating the forest stewardship program through a national survey of participants

Treesearch

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

ScienceCinema

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

PubMed Central

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

2015-01-01

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

A Novel and Cost-Effective Monitoring Approach for Outcomes in an Australian Biodiversity Conservation Incentive Program

PubMed Central

Lindenmayer, David B.; Zammit, Charles; Attwood, Simon J.; Burns, Emma; Shepherd, Claire L.; Kay, Geoff; Wood, Jeff

2012-01-01

We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme – the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program’s policy objective and desired outcomes and was applied to the Program’s initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program’s investment in the first four years and hence are in broad accord with the general rule of thumb that 5–10% of a program’s funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies. PMID:23236399

Taimi Lynne Hoag Award for Environmental Stewardship

EPA Pesticide Factsheets

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

A survey to optimize the design of an antimicrobial stewardship smartphone app at an academic medical center.

PubMed

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.

Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

PubMed

Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

2016-03-01

We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting. Published by Elsevier Inc.

Roadmap to MaRIE January 2015

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.

Right Size Determining the Staff Necessary to Sustain Simulation and Computing Capabilities for Nuclear Security

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.

PubMed

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.

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

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

Initiatives and resources to promote antimicrobial stewardship.

PubMed

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

2013-09-01

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

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".

PubMed

Allerberger, Franz; Frank, Annegret; Gareis, Roland

2008-01-01

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

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

PubMed

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

2016-06-01

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

Evaluating local benefits from conservation in Nepal's Annapurna Conservation Area.

PubMed

Spiteri, Arian; Nepal, Sanjay K

2008-09-01

Protected areas are integral to the global effort to conserve biodiversity, and, over the past two decades, protected area managers have begun to recognize that conservation objectives are next to impossible to achieve without considering the needs and concerns of local communities. Incentive-based programs (IBPs) have become a favored approach to protected area management, geared at fostering local stewardship by delivering benefits tied to conservation to local people. Effective IBPs require benefits to accrue to and be recognized by those experiencing the greatest consequences as a result of the protected area, and those likely to continue extractive activities if their livelihood needs are compromised. This research examines dispersal of IBP benefits, as perceived by local residents in Nepal's Annapurna Conservation Area. Results reported here are based on questionnaire interviews with 188 households conducted between September and December 2004. Results indicate that local residents primarily identify benefits from social development activities, provisions for resource extraction, and economic opportunities. Overall, benefits have been dispersed equally to households in villages on and off the main tourist route, and regardless of a household's participation in tourism. However, benefits are not effectively targeted to poorer residents, those highly dependent on natural resources, and those experiencing the most crop damage and livestock loss from protected wildlife. This article provides several suggestions for improving the delivery of conservation incentives.

CDC, TJC Urge Providers To Up Their Game on Antibiotic Stewardship.

PubMed

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.

Past, Present, and Future of Antibacterial Economics: Increasing Bacterial Resistance, Limited Antibiotic Pipeline, and Societal Implications.

PubMed

Luepke, Katherine H; Suda, Katie J; Boucher, Helen; Russo, Rene L; Bonney, Michael W; Hunt, Timothy D; Mohr, John F

2017-01-01

Growing antimicrobial resistance and a dwindling antibiotic pipeline have resulted in an emerging postantibiotic era, as patients are now dying from bacterial infections that were once treatable. The fast-paced "Golden Age" of antibiotic development that started in the 1940s has lost momentum; from the 1980s to the early 2000s, there was a 90% decline in the approval of new antibiotics as well as the discovery of few new novel classes. Many companies have shifted away from development due to scientific, regulatory, and economic hurdles that proved antibiotic development to be less attractive compared with more lucrative therapeutic areas. National and global efforts are focusing attention toward potential solutions for reinvigorating the antibiotic pipeline and include "push" incentives such as public-private partnerships and "pull" incentives such as reimbursement reform and market exclusivity. Hybrid models of incentives, global coordination among stakeholders, and the appropriate balance of antibiotic pricing, volume of drug used, and proper antimicrobial stewardship are key to maximizing efforts toward drug development to ensure access to patients in need of these therapies. © 2016 Pharmacotherapy Publications, Inc.

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

PubMed

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.

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

PubMed Central

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

2016-01-01

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

PubMed

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.

Accountability in the ontario cancer services system: a qualitative study of system leaders' perspectives.

PubMed

Bytautas, Jessica; Dobrow, Mark; Sullivan, Terrence; Brown, Adalsteinn

2014-09-01

Cancer Care Ontario (CCO), the provincial cancer agency, operates under a model of accountable governance that has been hailed as exemplary. We explored cancer system leaders' views on the balance and perceived efficacy of approaches to accountability in this context. Semi-structured interviews were conducted with 19 participants (MOHLTC=5, CCO=14). Adopting a qualitative descriptive approach, we coded data for four policy instruments used in approaches to accountability. Financial incentives are a key lever used by both parties to effect change. Cancer-specific regulations were somewhat weak, but agency-wide directives were a necessary nuisance that had great force. The effect of public reporting on mobilizing consumer sovereignty was questioned; however, transparency for its own sake was highly valued. Professionalism and stewardship, with an emphasis on trust-based partnerships and clinical engagement, were critical to CCO's success. These approaches were seen to work together, but what made each have force was reliance on professionalism and stewardship. Copyright © 2014 Longwoods Publishing.

Association of Inpatient Antimicrobial Utilization Measures with Antimicrobial Stewardship Activities and Facility Characteristics of Veterans Affairs Medical Centers.

PubMed

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

Alaska | Midmarket Solar Policies in the United States | Solar Research |

Science.gov Websites

developers may offer community solar programs. State Incentive Programs Program Administrator Incentive decisions. Utility Incentive Programs Check with local utilities for midscale solar incentives. Resources and utility policies and incentive programs. Net Metering and Interconnection Regulatory Commission of

Impact of an Antimicrobial Stewardship Program on Antibiotic Use at a Nonfreestanding Children's Hospital.

PubMed

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.

PubMed

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...

The Federal Forest Stewardship Program and its implications for sustainable forestry on private forest ownerships in the United States

Treesearch

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...

A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

PubMed

Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

2016-07-27

Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.

Alabama | Midmarket Solar Policies in the United States | Solar Research |

Science.gov Websites

statewide community solar policies or programs. State Incentive Programs Program Administrator Incentive solar systems. Eligible public entities may borrow up to $350,000 per project. Utility Incentive incentives. Program Incentive Limitations TVA: Green Power Providers program First 10 years: 0.02/kWh above

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

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...

West Virginia | Solar Research | NREL

Science.gov Websites

Incentive Programs West Virginia currently does not have any statewide financial incentives for midmarket solar. Utility Incentive Programs Check with local utility for utility incentive programs. Resources The utility policies and incentive programs. Net Metering and Interconnection West Virginia Public Service

75 FR 71325 - Wildlife Habitat Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... Wildlife Habitat Incentive Program AGENCY: Commodity Credit Corporation, Natural Resources Conservation... final rule for the Wildlife Habitat Incentive Program (WHIP). This final rule sets forth how NRCS, using... Albert Cerna, National Wildlife Habitat Incentive Program Manager, Financial Assistance Programs Division...

Antimicrobial Stewardship Program Implementation of a Quality Improvement Intervention Using Real-Time Feedback and an Electronic Order Set for the Management of Staphylococcus aureus Bacteremia.

PubMed

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.

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

ScienceCinema

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?…

Estimating Landholders’ Probability of Participating in a Stewardship Program, and the Implications for Spatial Conservation Priorities

PubMed Central

Adams, Vanessa M.; Pressey, Robert L.; Stoeckl, Natalie

2014-01-01

The need to integrate social and economic factors into conservation planning has become a focus of academic discussions and has important practical implications for the implementation of conservation areas, both private and public. We conducted a survey in the Daly Catchment, Northern Territory, to inform the design and implementation of a stewardship payment program. We used a choice model to estimate the likely level of participation in two legal arrangements - conservation covenants and management agreements - based on payment level and proportion of properties required to be managed. We then spatially predicted landholders’ probability of participating at the resolution of individual properties and incorporated these predictions into conservation planning software to examine the potential for the stewardship program to meet conservation objectives. We found that the properties that were least costly, per unit area, to manage were also the least likely to participate. This highlights a tension between planning for a cost-effective program and planning for a program that targets properties with the highest probability of participation. PMID:24892520

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

Wyoming | Solar Research | NREL

Science.gov Websites

There are currently no statewide community solar policies or programs in Wyoming. State Incentive Programs There are currently no statewide solar financial incentive programs in Wyoming. Utility Incentive Programs Please check with your distribution utility for utility incentive programs for midmarket solar

Arkansas | Solar Research | NREL

Science.gov Websites

programs. State Incentive Programs There are currently no statewide solar financial incentive programs in Wyoming. Program Administrator Incentive Arkansas Energy Technology Loans for Green Technology Arkansas for the most up-to-date and accurate information on state and utility policies and incentive programs

How to establish business office incentive programs.

PubMed

Wilkerson, L J

1991-01-01

Incentive programs to help increase collections or reduce days in receivables are becoming popular among healthcare business offices. A successful incentive program addresses major issues during the planning stage and includes realistic incentive goals, simple measurement tools, meaningful incentive payments, and proper monitoring of results.

Improving medicaid health incentives programs: lessons from substance abuse treatment research.

PubMed

Hand, Dennis J; Heil, Sarah H; Sigmon, Stacey C; Higgins, Stephen T

2014-06-01

This commentary addresses the efforts of Medicaid programs in several US states to employ financial incentives to increase healthy behavior among their beneficiaries. While these Medicaid incentive programs have been successful at boosting rates of less effortful behaviors, like semiannual dental visits, they have fallen short in promoting more complex behaviors, like smoking cessation, drug abstinence, and weight management. Incentives have been extensively studied as a treatment for substance use disorders for over 20years, with good success. We identify two variables shown by meta-analysis to moderate the efficacy of incentive interventions in substance abuse treatment, the immediacy of incentive delivery and size (or magnitude) of the incentive, that are lacking in current Medicaid incentive program. We also offer some guidance on how these moderating variables could be addressed within Medicaid programs. This is a critical time for such analysis, as more than 10 states are employing incentives in their Medicaid programs, and some are currently reevaluating their incentive strategies. Copyright © 2014 Elsevier Inc. All rights reserved.

Effects of incentives programs

Treesearch

Duane L. Green

1977-01-01

Incentives have played an important role in forestry accomplishments on private forest lands. Direct cost-share assistance programs, such as the Forestry Incentives Program, stimulate additional accomplishments in greater proportion than their actual inputs. Two States currently operate their own "incentives" programs. In addition, the Pacific Northwest...

Estimating Acceptability of Financial Health Incentives.

PubMed

Bigsby, Elisabeth; Seitz, Holli H; Halpern, Scott D; Volpp, Kevin; Cappella, Joseph N

2017-08-01

A growing body of evidence suggests that financial incentives can influence health behavior change, but research on the public acceptability of these programs and factors that predict public support have been limited. A representative sample of U.S. adults ( N = 526) were randomly assigned to receive an incentive program description in which the funding source of the program (public or private funding) and targeted health behavior (smoking cessation, weight loss, or colonoscopy) were manipulated. Outcome variables were attitude toward health incentives and allocation of hypothetical funding for incentive programs. Support was highest for privately funded programs. Support for incentives was also higher among ideologically liberal participants than among conservative participants. Demographics and health history differentially predicted attitude and hypothetical funding toward incentives. Incentive programs in the United States are more likely to be acceptable to the public if they are funded by private companies.

42 CFR 414.92 - Electronic Prescribing Incentive Program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Electronic Prescribing Incentive Program. 414.92... Other Practitioners § 414.92 Electronic Prescribing Incentive Program. Link to an amendment published at... fee schedule which are furnished by an eligible professional. Electronic Prescribing Incentive Program...

Incentives, Program Configuration, and Employee Uptake of Workplace Wellness Programs.

PubMed

Huang, Haijing; Mattke, Soeren; Batorsky, Benajmin; Miles, Jeremy; Liu, Hangsheng; Taylor, Erin

2016-01-01

The aim of this study was to determine the effect of wellness program configurations and financial incentives on employee participation rate. We analyze a nationally representative survey on workplace wellness programs from 407 employers using cluster analysis and multivariable regression analysis. Employers who offer incentives and provide a comprehensive set of program offerings have higher participation rates. The effect of incentives differs by program configuration, with the strongest effect found for comprehensive and prevention-focused programs. Among intervention-focused programs, incentives are not associated with higher participation. Wellness programs can be grouped into distinct configurations, which have different workplace health focuses. Although monetary incentives can be effective in improving employee participation, the magnitude and significance of the effect is greater for some program configurations than others.

Citizen monitoring and restoration: Volunteers and community involvement in wilderness stewardship

Treesearch

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...

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

ERIC Educational Resources Information Center

Aspen Institute, 2009

2009-01-01

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

The Daniel K. Inouye College of Pharmacy Scripts

PubMed Central

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

An Argument for Early Retirement Incentive Planning.

ERIC Educational Resources Information Center

Baenen, Leonard B.; Ernest, Robert C.

1982-01-01

Early retirement incentive programs are discussed as a humanitarian way of reducing payroll costs and rewarding long-tenured employees. The incentives to be considered, program communication, and problems found in incentive programs are addressed. (Author/MLF)

33 CFR 402.5 - New Business Incentive Program

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false New Business Incentive Program..., DEPARTMENT OF TRANSPORTATION TARIFF OF TOLLS § 402.5 New Business Incentive Program (a) To be eligible for the rebate applicable under the New Business Incentive Program, a carrier must submit an application...

33 CFR 402.5 - New Business Incentive Program

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false New Business Incentive Program..., DEPARTMENT OF TRANSPORTATION TARIFF OF TOLLS § 402.5 New Business Incentive Program (a) To be eligible for the rebate applicable under the New Business Incentive Program, a carrier must submit an application...

F Reactor Inspection

ScienceCinema

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."

F Reactor Inspection

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

Antibiotic Stewardship in Small Hospitals: Barriers and Potential Solutions.

PubMed

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.

40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 2 2010-07-01 2010-07-01 false Examples of Economic Incentive Programs... Appendix X to Part 51—Examples of Economic Incentive Programs I. Introduction and Purpose This appendix.... Examples of Stationary and Mobile Source Economic Incentive Strategies There is a wide variety of programs...

40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 2 2014-07-01 2014-07-01 false Examples of Economic Incentive Programs... Appendix X to Part 51—Examples of Economic Incentive Programs I. Introduction and Purpose This appendix.... Examples of Stationary and Mobile Source Economic Incentive Strategies There is a wide variety of programs...

40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 2 2011-07-01 2011-07-01 false Examples of Economic Incentive Programs... Appendix X to Part 51—Examples of Economic Incentive Programs I. Introduction and Purpose This appendix.... Examples of Stationary and Mobile Source Economic Incentive Strategies There is a wide variety of programs...

40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 2 2012-07-01 2012-07-01 false Examples of Economic Incentive Programs... Appendix X to Part 51—Examples of Economic Incentive Programs I. Introduction and Purpose This appendix.... Examples of Stationary and Mobile Source Economic Incentive Strategies There is a wide variety of programs...

40 CFR Appendix X to Part 51 - Examples of Economic Incentive Programs

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 2 2013-07-01 2013-07-01 false Examples of Economic Incentive Programs... Appendix X to Part 51—Examples of Economic Incentive Programs I. Introduction and Purpose This appendix.... Examples of Stationary and Mobile Source Economic Incentive Strategies There is a wide variety of programs...

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Environmental stewardship footprint research: linking human agency and ecosystem health in the Puget Sound region

Treesearch

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.

PubMed

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.

Critical interactions between Global Fund-supported programmes and health systems: a case study in Indonesia.

PubMed

Desai, Monica; Rudge, James W; Adisasmito, Wiku; Mounier-Jack, Sandra; Coker, Richard

2010-11-01

The Global Fund to Fight AIDS, Tuberculosis and Malaria has played an important role in financing the response to HIV/AIDS and tuberculosis (TB) in Indonesia. As part of a series of case studies, we assessed the nature and extent of integration of Global Fund portfolios into the national HIV and TB programmes, integration of the HIV and TB programmes within the general health system, and system-wide effects of Global Fund support on the health care system in Indonesia. The study relied on a literature review and interviews with 22 key informants using the Systemic Rapid Assessment Toolkit and thematic analysis. Global Fund programmes in Indonesia are highly vertical and centralized, in contrast with the decentralized nature of the Indonesian health system. Consequently, there is more integration of all functions at local levels than centrally. There is a high level of integration of planning of Global Fund HIV and TB portfolios into the National AIDS and TB programmes and some limited integration of these programmes with other disease programmes, through joint working groups. Other synergies include strengthening of stewardship and governance and increased staff recruitment encouraged by incentive payments and training. Monitoring and evaluation functions of the Global Fund programmes are not integrated with the disease programmes, with parallel indicators and reporting systems. System-wide effects include greater awareness of governance and stewardship in response to the temporary suspension of Global Fund funding in 2008, and increased awareness of the need to integrate programme planning, financing and service delivery. Global Fund investment has freed up resources for other programmes, particularly at local levels. However, this may hinder a robust exit strategy from Global Fund funding. Furthermore, Global Fund monetary incentives may result in staff shifting into HIV and TB programmes.

Applying Fishers' Ecological Knowledge to Construct Past and Future Lobster Stocks in the Juan Fernández Archipelago, Chile

PubMed Central

Eddy, Tyler D.; Gardner, Jonathan P. A.; Pérez-Matus, Alejandro

2010-01-01

Over-exploited fisheries are a common feature of the modern world and a range of solutions including area closures (marine reserves; MRs), effort reduction, gear changes, ecosystem-based management, incentives and co-management have been suggested as techniques to rebuild over-fished populations. Historic accounts of lobster (Jasus frontalis) on the Chilean Juan Fernández Archipelago indicate a high abundance at all depths (intertidal to approximately 165 m), but presently lobsters are found almost exclusively in deeper regions of their natural distribution. Fishers' ecological knowledge (FEK) tells a story of serial depletion in lobster abundance at fishing grounds located closest to the fishing port with an associated decline in catch per unit effort (CPUE) throughout recent history. We have re-constructed baselines of lobster biomass throughout human history on the archipelago using historic data, the fishery catch record and FEK to permit examination of the potential effects of MRs, effort reduction and co-management (stewardship of catch) to restore stocks. We employed a bioeconomic model using FEK, fishery catch and effort data, underwater survey information, predicted population growth and response to MR protection (no-take) to explore different management strategies and their trade-offs to restore stocks and improve catches. Our findings indicate that increased stewardship of catch coupled with 30% area closure (MR) provides the best option to reconstruct historic baselines. Based on model predictions, continued exploitation under the current management scheme is highly influenced by annual fluctuations and unsustainable. We propose a community-based co-management program to implement a MR in order to rebuild the lobster population while also providing conservation protection for marine species endemic to the Archipelago. PMID:21079761

Mapping educational opportunities for healthcare workers on antimicrobial resistance and stewardship around the world.

PubMed

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.

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

NASA Astrophysics Data System (ADS)

Andrejewski, Robert G.

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

PubMed Central

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.

PubMed

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.

Challenges and Opportunities for Developing and Implementing Incentives to Improve Health-Related Behaviors in Older Adults

PubMed Central

Klein, Eran; Karlawish, Jason

2010-01-01

There is growing interest in using patient-directed incentives to change health-related behaviors. Advocates of incentive programs have proposed an ambitious research agenda for moving patient incentive programs forward. Older adults may pose a challenge to such a research agenda. The cognitive and psychological features of this population, in particular, age-related changes in emotional regulation, executive function and cognitive capacities, and a preference for collaborative decision-making raise questions about the suitability of these programs, particularly the structure of current financial incentives, to older adults. Differences in decision-making in older adults need to be accounted for in the design and implementation of financial incentive programs. Financial incentive programs tailored to characteristics of older adult populations may be more likely to improve the lives of older persons and the economic success of programs that serve them. PMID:20863335

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.

Coupons for Success: A Marketing Incentive in Academic Support

ERIC Educational Resources Information Center

Potacco, Donna R.; Chen, Peter; Desroches, Danielle; Chisholm, Daniel R.; De Young, Sandra

2013-01-01

How does a Coupon Incentive Program motivate students to seek academic support in high-risk courses? Results from this study demonstrated that the Coupon Incentive Program was effective in motivating voluntary student attendance and improving student outcomes. Recommendations related to implementation of the Coupon Incentive Program are discussed.…

The influence of financial incentive programs in promoting sustainable forestry on the nation's family forests

Treesearch

Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels

2007-01-01

Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nation’s family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...

The influence of financial incentive programs in promoting sustainable forestry on the nation's family forests

Treesearch

Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels

2006-01-01

Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nation’s family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...

Informing rangeland stewardship with research: lessons learned from Yolo County, California

Treesearch

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 California’s 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,...

Expert Consensus on Metrics to Assess the Impact of Patient-Level Antimicrobial Stewardship Interventions in Acute-Care Settings

PubMed Central

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

The Impact of an Incentive on the Use of an Online Self-Directed Wellness and Self-Management Program

PubMed Central

Greene, Jessica

2014-01-01

Background Those who pay for health care are increasingly looking for strategies to influence individuals to take a more active role in managing their health. Incenting health plan members and/or employees to participate in wellness programs is a widely used approach. Objective In this study, we examine financial incentives to health plan members to participate in an online self-management/wellness program—US $20 for completing the patient activation measure (PAM) and an additional US $40 for completing 8 learning modules. We examined whether the characteristics of plan members differed by the degree to which they responded to the incentives. Further, we examined whether participation in the wellness program was associated with improvements in PAM scores and changes in health care utilization. Methods This retrospective study compared demographic characteristics and change in PAM scores and health utilization for 144,625 health plan members in 2011. Four groups were compared: (1) those who were offered the incentives but chose not to participate (n=128,634), (2) those who received the initial incentive (PAM only) but did not complete 8 topics (n=7099), (3) those who received both incentives (completing 8 topics but no more) (n=2693), and (4) those who received both incentives and continued using the online program beyond what was required by the incentives (n=6249). Results The vast majority of health plan members did not participate in the program (88.91%, 128,634/144,675). Of those who participated, only 7099 of 16,041 (44.25%) completed the PAM for the first incentive, 2693 (16.79%) completed 8 topics for the second incentive, and 6249 (38.96%) received both incentives and continued using the program beyond the incentive requirements. Nonparticipants were more likely to be men and to have lower health risk scores on average than the other three groups of participants (P<.001). In multivariate regression models, those who used the online program (8 topics or beyond) increased their PAM score by approximately 1 point more than those who only took the PAM and did not use the wellness program (P<.03). In addition, emergency department visits were lower for all groups who responded to any level of the incentive as compared to those who did not (P<.01). No differences were found in other types of utilization. Conclusions The incentive was not sufficient to spark most health plan members to use the wellness program. However, the fact that many program participants went beyond the incentive in their use of the online wellness program suggests that the users of the online program found value in using it, and it was their own internal motivation that stimulated this additional use. Providing an incentive for program participation may be an effective pathway for working with less activated patients, particularly if the program is tailored to the needs of the less activated. PMID:25280348

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...

Monitoring, documenting and reporting the quality of antibiotic use in the Netherlands: a pilot study to establish a national antimicrobial stewardship registry.

PubMed

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.

Repairing the broken market for antibiotic innovation.

PubMed

Outterson, Kevin; Powers, John H; Daniel, Gregory W; McClellan, Mark B

2015-02-01

Multidrug-resistant bacterial diseases pose serious and growing threats to human health. While innovation is important to all areas of health research, it is uniquely important in antibiotics. Resistance destroys the fruit of prior research, making it necessary to constantly innovate to avoid falling back into a pre-antibiotic era. But investment is declining in antibiotics, driven by competition from older antibiotics, the cost and uncertainty of the development process, and limited reimbursement incentives. Good public health practices curb inappropriate antibiotic use, making return on investment challenging in payment systems based on sales volume. We assess the impact of recent initiatives to improve antibiotic innovation, reflecting experience with all sixty-seven new molecular entity antibiotics approved by the Food and Drug Administration since 1980. Our analysis incorporates data and insights derived from several multistakeholder initiatives under way involving governments and the private sector on both sides of the Atlantic. We propose three specific reforms that could revitalize innovations that protect public health, while promoting long-term sustainability: increased incentives for antibiotic research and development, surveillance, and stewardship; greater targeting of incentives to high-priority public health needs, including reimbursement that is delinked from volume of drug use; and enhanced global collaboration, including a global treaty. Project HOPE—The People-to-People Health Foundation, Inc.

42 CFR § 512.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2017-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.320 Treatment of incentive... under such models are independent of, and do not affect, any incentive programs or add-on payments under... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

WWC Quick Review of the Manuscript "Paying for A's: An Early Exploration of Student Reward and Incentive Programs in Charter Schools"

ERIC Educational Resources Information Center

What Works Clearinghouse, 2008

2008-01-01

This review examined a study designed to evaluate whether offering student reward and incentive programs in charter schools affects academic achievement. The study measured effects by comparing changes in average grade-level test scores in schools that had incentive programs to changes in schools that did not have incentive programs. The study…

Improving Wellbeing and Environmental Stewardship Through Volunteering in Nature.

PubMed

Molsher, Robyn; Townsend, Mardie

2016-03-01

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

Motivation for Participating in a Weight Loss Program and Financial Incentives: An Analysis from a Randomized Trial

PubMed Central

Crane, Melissa M.; Tate, Deborah F.; Finkelstein, Eric A.; Linnan, Laura A.

2012-01-01

This analysis investigated if changes in autonomous or controlled motivation for participation in a weight loss program differed between individuals offered a financial incentive for weight loss compared to individuals not offered an incentive. Additionally, the same relationships were tested among those who lost weight and either received or did not receive an incentive. This analysis used data from a year-long randomized worksite weight loss program that randomly assigned employees in each worksite to either a low-intensity weight loss program or the same program plus small financial incentives for weight loss ($5.00 per percentage of initial weight lost). There were no differences in changes between groups on motivation during the study, however, increases in autonomous motivation were consistently associated with greater weight losses. This suggests that the small incentives used in this program did not lead to increases in controlled motivation nor did they undermine autonomous motivation. Future studies are needed to evaluate the magnitude and timing of incentives to more fully understand the relationship between incentives and motivation. PMID:22577524

Fact Sheet: 2010/2015 PFOA Stewardship Program

EPA Pesticide Factsheets

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.

PubMed

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

PubMed Central

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

2014-01-01

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

Toward Better Pain Management: The Development of a "Pain Stewardship Program" in a Tertiary Children's Hospital.

PubMed

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.

Impact of Implementing Antibiotic Stewardship Programs in 15 Small Hospitals: A Cluster-Randomized Intervention.

PubMed

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.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bird, L.; Reger, A.; Heeter, J.

Based on lessons from recent program experience, this report explores best practices for designing and implementing incentives for small and mid-sized residential and commercial distributed solar energy projects. The findings of this paper are relevant to both new incentive programs as well as those undergoing modifications. The report covers factors to consider in setting and modifying incentive levels over time, differentiating incentives to encourage various market segments, administrative issues such as providing equitable access to incentives and customer protection. It also explores how incentive programs can be designed to respond to changing market conditions while attempting to provide a longer-termmore » and stable environment for the solar industry. The findings are based on interviews with program administrators, regulators, and industry representatives as well as data from numerous incentive programs nationally, particularly the largest and longest-running programs. These best practices consider the perspectives of various stakeholders and the broad objectives of reducing solar costs, encouraging long-term market viability, minimizing ratepayer costs, and protecting consumers.« less

Listening to your audience: developing an educational tool to assist with recreation planning on private lands

Treesearch

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...

Framework for Springs Stewardship Program and proposed action development: Spring Mountains National Recreation Area, Humboldt-Toiyabe National Forest

Treesearch

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...

The impact of including incentives and competition in a workplace smoking cessation program on quit rates.

PubMed

Koffman, D M; Lee, J W; Hopp, J W; Emont, S L

1998-01-01

To determine the effectiveness of a multicomponent smoking cessation program supplemented by incentives and team competition. A quasi-experimental design was employed to compare the effectiveness of three different smoking cessation programs, each assigned to separate worksite. The study was conducted from 1990 to 1991 at three aerospace industry worksites in California. All employees who were current, regular tobacco users were eligible to participate in the program offered at their site. The multicomponent program included a self-help package, telephone counseling, and other elements. The incentive-competition program included the multicomponent program plus cash incentives and team competition for the first 5 months of the program. The traditional program offered a standard smoking cessation program. Self-reported questionnaires and carbon monoxide tests of tobacco use or abstinence were used over a 12-month period. The incentive-competition program had an abstinence rate of 41% at 6 months (n = 68), which was significantly better than the multicomponent program (23%, n = 81) or the traditional program (8%, n = 36). At 12 months, the quit rates for the incentive and multicomponent-programs were statistically indistinguishable (37% vs. 30%), but remained higher than the traditional program (11%). Chi-square tests, t-tests, and logistic regression were used to compare smoking abstinence across the three programs. Offering a multicomponent program with telephone counseling may be just as effective for long-term smoking cessation as such a program plus incentives and competition, and more effective than a traditional program.

Financial Recruitment Incentive Programs for Nursing Personnel in Canada.

PubMed

Mathews, Maria; Ryan, Dana

2015-03-01

Financial incentives are increasingly offered to recruit nursing personnel to work in underserved communities. The authors describe and compare the characteristics of federal, provincial and territorial financial recruitment incentive programs for registered nurses (RNs), nurse practitioners (NPs), licensed practical nurses (LPNs), registered practical nurses or registered psychiatric nurses. The authors identified incentive programs from government, health ministry and student aid websites and by contacting program officials. Only government-funded recruitment programs providing funding beyond the normal employee wages and benefits and requiring a service commitment were included. The authors excluded programs offered by hospitals, regional or private firms, and programs that rewarded retention. All provinces and territories except QC and NB offer financial recruitment incentive programs for RNs; six provinces (BC, AB, SK, ON, QC and NL) offer programs for NPs, and NL offers a program for LPNs. Programs include student loan forgiveness, tuition forgiveness, education bursaries, signing bonuses and relocation expenses. Programs target trainees, recent graduates and new hires. Funding and service requirements vary by program, and service requirements are not always commensurate with funding levels. This snapshot of government-funded recruitment incentives provides program managers with data to compare and improve nursing workforce recruitment initiatives. Copyright © 2015 Longwoods Publishing.

Data governance and stewardship: designing data stewardship entities and advancing data access.

PubMed

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

PubMed Central

Rosenbaum, Sara

2010-01-01

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

Idaho | Midmarket Solar Policies in the United States | Solar Research |

Science.gov Websites

to develop a 500 kW community solar project. State Incentive Programs Program Administrator Incentive and incentive programs. Net metering and interconnection Idaho Power: Net Metering and Interconnection

Associations between antimicrobial stewardship program elements and Clostridium difficile infection performance.

PubMed

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.

20 CFR 637.210 - Incentive bonus program applications.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Incentive bonus program applications. 637.210 Section 637.210 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE V OF THE JOB TRAINING PARTNERSHIP ACT Program Planning and Operation § 637.210 Incentive...

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

The use and influence of employee incentives on participation and throughput in a telephonic disease management program.

PubMed

Wilhide, Calvin; Hayes, John R; Farah, J Ramsay

2008-08-01

Participation rates are often viewed by vendors and employer-based disease management (DM) services as an important benchmark of successful program implementation. Although participation is commonly understood to vary widely between and within employer groups, little is known about the role of incentives on rates of participation and graduation from DM programs. This study examined the use of incentives, employer characteristics, and perceptions of employee-employer communication on participation and program throughput. The relationship between incentive use and rates of participation and throughput among 87 employer groups from the 2004 company portfolio were assessed using existing account information. Detailed information on the highest and lowest third of the sample was obtained through interviews with account representatives. Wilcoxon, chi square, and regression analyses were used to examine the influence of employer characteristics and incentive factors on enrollee participation rates and program completion. Fifty-two percent of the accounts offered incentives for participation. From 1% to 23% of the eligible employees enrolled and completed the DM program. Incentives had a direct impact on participation, with amounts greater than $50 the most effective. Participation increased with communication tools including e-mail, high-blast (repeated) communications, and health fairs. Results suggest that cash incentives and communication play a significant role in rates of participation and program completion.

Impact of Provider Incentives on Quality and Value of Health Care.

PubMed

Doran, Tim; Maurer, Kristin A; Ryan, Andrew M

2017-03-20

The use of financial incentives to improve quality in health care has become widespread. Yet evidence on the effectiveness of incentives suggests that they have generally had limited impact on the value of care and have not led to better patient outcomes. Lessons from social psychology and behavioral economics indicate that incentive programs in health care have not been effectively designed to achieve their intended impact. In the United States, Medicare's Hospital Readmission Reduction Program and Hospital Value-Based Purchasing Program, created under the Affordable Care Act (ACA), provide evidence on how variations in the design of incentive programs correspond with differences in effect. As financial incentives continue to be used as a tool to increase the value and quality of health care, improving the design of programs will be crucial to ensure their success.

77 FR 46952 - Approval and Promulgation of Air Quality Implementation Plans; Wisconsin; Regional Haze

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-07

... ``its Draft Economic Incentives Program Guidance is relevant to this rulemaking.'' Sierra Club states... Economic Incentive Program Guidance and in program-specific guidance that more directly addresses specific... Economic Incentives Program Guidance. Comment: Sierra Club comments that, ``the emission limits proposed by...

Effectiveness of the Incentive Loan Program for Mathematics and Science Teachers--Washington State 1983-1986. Part III: Report to Washington State Legislature Incentive Loan Program for Mathematics and Science Teachers.

ERIC Educational Resources Information Center

Harder, Annie K.; And Others

The effectiveness of a loan program in providing an incentive for students to prepare for mathematics and/or science teaching in Washington State is described in this report. It is the third of a three part report to the Washington State Legislature regarding the Teacher Incentive Loan Program for Mathematics and Science. Recipients of forgiveness…

Impact of a Patient Incentive Program on Receipt of Preventive Care

PubMed Central

Mehrotra, Ateev; An, Ruopeng; Patel, Deepak N.; Sturm, Roland

2014-01-01

Objectives Patient financial incentives are being promoted as a mechanism to increase receipt of preventive care, encourage healthy behavior, and improve chronic disease management. However, few empirical evaluations have assessed such incentive programs. Study Design In South Africa, a private health plan has introduced a voluntary incentive program which costs enrollees approximately $20 per month. In the program, enrollees earn points when they receive preventive care. These points translate into discounts on retail goods such as airline tickets, movie tickets, or cell phones. Methods We compared the change in 8 preventive care services over the years 2005–11 between those who entered the incentive program and those that did not. We used multivariate regression models with individual random effects to try to address selection bias. Results Of the 4,186,047 unique individuals enrolled in the health plan, 65.5% (2,742,268) voluntarily enrolled in the incentive program. Joining the incentive program was associated with a statistically higher odds of receiving all 8 preventive care services. The odds ratio and estimated percentage point increase for receipt of cholesterol testing was 2.70 (8.9%), glucose testing 1.51 (4.7%), glaucoma screening 1.34 (3.9%), dental exam 1.64 (6.3%), HIV test 3.47 (2.6%), prostate specific antigen testing 1.39 (5.6%), Papanicolaou screening 2.17 (7.0%), and mammogram 1.90 (3.1%) (p<0.001 for all eight services). However, preventive care rates among those in the incentive program was still low. Conclusions Voluntary participation in a patient incentive program was associated with a significantly higher likelihood of receiving preventive care, though receipt of preventive care among those in the program was still lower than ideal. PMID:25180436

When Antimicrobial Stewardship Isn′t Watching: The Educational Impact of Critical Care Prospective Audit and Feedback

PubMed Central

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

Incentive program to strengthen motivation for increasing physical activity via conjoint analysis.

PubMed

Matsushita, Munehiro; Harada, Kazuhiro; Arao, Takashi

2017-01-01

Objectives　Promoting physical activity is a key public health issue. Incentive programs have attracted attention as a technique for promoting physical activity. For the use of effective incentives, there is a need to clarify the most effective incentive program conditions for the promotion of physical activity. Therefore, the present study used the conjoint analysis to examine the effective incentive program conditions for strengthening the motivation to increase physical activity.Methods　Data on 1,998 subjects (aged 40-74) were analyzed. The main variables in this study were physical activity (IPAQ-Short Form) and the strengthening of motivation to increase physical activity. The incentive programs that were implemented, comprised four factors: 1) cash equivalents (1,000 yen, 2,000 yen, and 3,000 yen); 2) duration between increase in physical activity and receipt of the incentive (1, 2, or 3 months); 3) method to record the physical activity (recording sheet, recording website, and automatic pedometer recording); and 4) lottery (yes or no). Eleven incentive programs were created, which was the minimum number required for comparison of these factors and levels. The average importance of each of the four factors was calculated to compare their contributions to the strengthening of the motivation to increase physical activity. The utility of each level was also calculated to compare their contributions to the strengthening of motivation. All statistics were stratified by age (≤65 years and 65+ years) and physical activity (<150 min/week, 150+ min/week) for additional analysis.Results　Cash incentives and the lottery ranked equally on average importance, followed by duration and recording methods. Utility was higher for each factor, as follows: 1) more valuable cash incentives, 2) shorter duration, 3) automatic pedometer recording, and 4) no lottery. There was no notable difference in the average importance and utility of age and physical activity.Conclusions　The results of this study suggest that no lottery and more valuable incentives were important for improving the effectiveness of incentive programs in increasing physical activity. Moreover, these two factors would be important regardless of age and physical activity levels. Further intervention studies on incentive programs for increasing physical activity considering the present results are needed.

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

PubMed

Nishtar, Sania

2006-12-01

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

Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

NASA Astrophysics Data System (ADS)

Gosman, Nathaniel

For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

Community Involvement Training Program

EPA Pesticide Factsheets

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.

Meet our PESP Partners

EPA Pesticide Factsheets

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.

75 FR 10843 - Special Summer Postal Rate Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-09

..., Pricing Strategy, as the official available to provide prompt responses to requests for clarification from... special volume pricing incentive for certain Standard Mail this summer. This document announces... Standard Mail Volume Incentive Pricing Program (Standard Mail Incentive Program) similar to the one...

IARC - Illinois Accelerator Research Center | Pilot Program

Science.gov Websites

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

Monetary incentives to reinforce engagement and achievement in a job-skills training program for homeless, unemployed adults.

PubMed

Koffarnus, Mikhail N; Wong, Conrad J; Fingerhood, Michael; Svikis, Dace S; Bigelow, George E; Silverman, Kenneth

2013-01-01

The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n=124) were randomized to a no-reinforcement group (n=39), during which access to the training program was provided but no incentives were given; a training reinforcement group (n=42), during which incentives were contingent on attendance and performance; or an abstinence and training reinforcement group (n=43), during which incentives were contingent on attendance and performance, but access was granted only if participants demonstrated abstinence from alcohol. abstinence and training reinforcement and training reinforcement participants advanced further in training and attended more hours than no-reinforcement participants. Monetary incentives were effective in promoting engagement and achievement in a job-skills training program for individuals who often do not take advantage of training programs. © Society for the Experimental Analysis of Behavior.

About PESP Membership

EPA Pesticide Factsheets

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.

42 CFR 414.92 - Electronic Prescribing Incentive Program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic Prescribing Incentive Program. 414.92... Physicians and Other Practitioners § 414.92 Electronic Prescribing Incentive Program. (a) Basis and scope... section, unless otherwise indicated— Certified electronic health record technology means an electronic...

42 CFR 414.92 - Electronic Prescribing Incentive Program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic Prescribing Incentive Program. 414.92... Physicians and Other Practitioners § 414.92 Electronic Prescribing Incentive Program. (a) Basis and scope... section, unless otherwise indicated— Certified electronic health record technology means an electronic...

42 CFR 414.92 - Electronic Prescribing Incentive Program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic Prescribing Incentive Program. 414.92... Physicians and Other Practitioners § 414.92 Electronic Prescribing Incentive Program. (a) Basis and scope... section, unless otherwise indicated— Certified electronic health record technology means an electronic...

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...

Evaluation of pharmacy generalists performing antimicrobial stewardship services.

PubMed

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.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Milostan, Catharina; Levin, Todd; Muehleisen, Ralph T.

Many electric utilities operate energy efficiency incentive programs that encourage increased dissemination and use of energy-efficient (EE) products in their service territories. The programs can be segmented into three broad categories—downstream incentive programs target product end users, midstream programs target product distributors, and upstream programs target product manufacturers. Traditional downstream programs have had difficulty engaging Small Business/Small Portfolio (SBSP) audiences, and an opportunity exists to expand Commercial Midstream Incentive Programs (CMIPs) to reach this market segment instead.

28 CFR 544.43 - Incentives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Mandatory English-as-a-Second Language Program (ESL) § 544.43 Incentives. The Warden or designee shall establish a system of incentives to encourage an inmate to meet the mandatory ESL program requirements. ...

Contacts in the Office of Pesticide Programs, Biopesticides and Pollution Prevention Division

EPA Pesticide Factsheets

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.

7 CFR 250.68 - Nutrition Services Incentive Program (NSIP).

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 4 2011-01-01 2011-01-01 false Nutrition Services Incentive Program (NSIP). 250.68 Section 250.68 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION... Donated Food Outlets § 250.68 Nutrition Services Incentive Program (NSIP). (a) Distribution of donated...

7 CFR 250.68 - Nutrition Services Incentive Program (NSIP).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 4 2012-01-01 2012-01-01 false Nutrition Services Incentive Program (NSIP). 250.68 Section 250.68 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION... Donated Food Outlets § 250.68 Nutrition Services Incentive Program (NSIP). (a) Distribution of donated...

7 CFR 250.68 - Nutrition Services Incentive Program (NSIP).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 4 2013-01-01 2013-01-01 false Nutrition Services Incentive Program (NSIP). 250.68 Section 250.68 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION... Donated Food Outlets § 250.68 Nutrition Services Incentive Program (NSIP). (a) Distribution of donated...

7 CFR 250.68 - Nutrition Services Incentive Program (NSIP).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 4 2014-01-01 2014-01-01 false Nutrition Services Incentive Program (NSIP). 250.68 Section 250.68 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION... Donated Food Outlets § 250.68 Nutrition Services Incentive Program (NSIP). (a) Distribution of donated...

7 CFR 250.68 - Nutrition Services Incentive Program (NSIP).

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Nutrition Services Incentive Program (NSIP). 250.68 Section 250.68 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION... Donated Food Outlets § 250.68 Nutrition Services Incentive Program (NSIP). (a) Distribution of donated...

42 CFR § 414.1460 - Monitoring and program integrity.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1460 Monitoring and program integrity. (a) Vetting eligible clinicians prior to payment of the APM Incentive Payment. Prior to...

South Dakota | Solar Research | NREL

Science.gov Websites

South Dakota. Utilities and developers may offer community solar programs. State Incentive Programs Program Administrator Incentive Renewable Energy System Exemption South Dakota Department of Revenue and more than $2 million. The incentive was designed for wind, but solar PV is also eligible. Utility

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.

Gasoline toxicology: overview of regulatory and product stewardship programs.

PubMed

Swick, Derek; Jaques, Andrew; Walker, J C; Estreicher, Herb

2014-11-01

Significant efforts have been made to characterize the toxicological properties of gasoline. There have been both mandatory and voluntary toxicology testing programs to generate hazard characterization data for gasoline, the refinery process streams used to blend gasoline, and individual chemical constituents found in gasoline. The Clean Air Act (CAA) (Clean Air Act, 2012: § 7401, et seq.) is the primary tool for the U.S. Environmental Protection Agency (EPA) to regulate gasoline and this supplement presents the results of the Section 211(b) Alternative Tier 2 studies required for CAA Fuel and Fuel Additive registration. Gasoline blending streams have also been evaluated by EPA under the voluntary High Production Volume (HPV) Challenge Program through which the petroleum industry provide data on over 80 refinery streams used in gasoline. Product stewardship efforts by companies and associations such as the American Petroleum Institute (API), Conservation of Clean Air and Water Europe (CONCAWE), and the Petroleum Product Stewardship Council (PPSC) have contributed a significant amount of hazard characterization data on gasoline and related substances. The hazard of gasoline and anticipated exposure to gasoline vapor has been well characterized for risk assessment purposes. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Retailer participation in cigarette company incentive programs is related to increased levels of cigarette advertising and cheaper cigarette prices in stores.

PubMed

Feighery, Ellen C; Ribisl, Kurt M; Schleicher, Nina C; Clark, Pamela I

2004-06-01

The retail outlet is the cigarette companies' major marketing channel to reach present and future customers. Of the $11.2 billion spent by them to market their products in 2001, approximately 85% was spent on retailer and consumer incentives to stimulate sales. This study examines the extent of retailer participation in these incentive programs, and the relationship between participation and the amount and placement of cigarette marketing materials and products, and prices in stores. Observational assessments of cigarette marketing materials, products, and prices were conducted in 468 stores in 15 U.S. states. Telephone interviews were conducted with store owners or managers of these stores to determine the details of their participation in incentive programs. Cigarette companies engaged 65% of retailers in an incentive program. Nearly 80% of participating retailers reported cigarette company control over placement of marketing materials in their stores. Stores that reported receiving over $3,000 from incentive programs in the past 3 months averaged 19.5 cigarette marketing materials, and stores receiving no money averaged only 8.2 marketing materials. In multivariate analyses, participation in incentive programs offered by Philip Morris and R.J. Reynolds was positively related to the number of cigarette marketing materials for each of these companies' brands in stores and the placement of their cigarettes on the top shelf. The price of Newports was significantly lower in stores that received incentives; no price difference was found for Marlboro. Stores that participate in cigarette company incentive programs feature more prominent placement of cigarettes and advertising, and may have cheaper cigarette prices.

On Supplementing “Foot in the Door” Incentives for eHealth Program Engagement

PubMed Central

2014-01-01

Financial health incentives, such as paying people to lose weight, are being widely implemented by Western nations and large corporations. A growing number of studies have tested the impact of incentives on health behaviors, though few have evaluated the approach on a population-scale. In this issue of the Journal of Medical Internet Research, Liu et al add to the evidence-base by examining whether a single incentive can motivate enrollment and engagement in a preventive eHealth program in a sample of 142,726 Canadian adults. While the incentives increased enrollment significantly (by a factor of about 28), a very high level of program attrition was noted (90%). The “foot in the door” incentive technique employed was insufficient; enrollees received incentives for signing-up for, but not for engaging with, the eHealth program. To supplement this technique and drive sustained behavior change, several theoretically- and empirically-based strategies are proposed. Specifically, incentives indexed to behavioral achievements over time are highlighted as one approach to boost engagement in this population in the future. PMID:25092221

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.

42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2017-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2017-10-01 2017-10-01 false Treatment of incentive programs or add-on payments...

42 CFR § 510.320 - Treatment of incentive programs or add-on payments under existing Medicare payment systems.

Code of Federal Regulations, 2010 CFR

2016-10-01

... INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.320 Treatment of incentive programs or add-on payments under existing Medicare payment systems. The CJR model... 42 Public Health 5 2016-10-01 2016-10-01 false Treatment of incentive programs or add-on payments...

Tree planting incentive programs: How you can make these programs work for you

Treesearch

Linda DePaul

2002-01-01

If you are like most people, the thought of dealing with bureaucratic, slow-moving, cumbersome, government programs does not excite you. And the thought of incentive programs is boring at best. However, I would like to challenge you to try to gain enough of a comfort level with the federal tree planting incentive programs that you will be able to see them as...

Long-Term Outcomes of an Antimicrobial Stewardship Program Implemented in a Hospital with Low Baseline Antibiotic Use

PubMed Central

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

Impact of an Antimicrobial Stewardship Care Bundle to Improve the Management of Patients with Suspected or Confirmed Urinary Tract Infection.

PubMed

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.

26 CFR 1.381(c)(24)-1 - Work incentive program credit carryovers in certain corporate acquisitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Work incentive program credit carryovers in... SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Insolvency Reorganizations § 1.381(c)(24)-1 Work incentive program credit carryovers in certain corporate acquisitions. The...

Building on Student Achievement through Incentive Programs

ERIC Educational Resources Information Center

Buchanan, Saneik

2015-01-01

The purpose of this study is to determine if incentive programs like Renaissance impact high school students and faculty. Incentives can go a long way for students in schools. At Lehigh Senior High School (LSHS), for example, students were introduced to the Renaissance Program this school year, by receiving goodies. Coupons at Dairy Queen,…

Pesticide Environmental Stewardship Program (PESP)

EPA Pesticide Factsheets

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.

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.

A Comparative Analysis of the Financial Incentives of Two Distinct Experience-Rating Programs.

PubMed

Tompa, Emile; McLeod, Chris; Mustard, Cam

2016-07-01

The aim of this study was to compare the association between insurance premium incentives and claim outcomes in two different workers' compensation programs. Regression models were run for claim outcomes using data from two Canadian jurisdictions with different experience-rating programs-one with prospective (British Columbia) and another with retrospective (Ontario) adjustment of premiums. Key explanatory variables were past premium adjustments. For both programs, past premium adjustments were significantly associated with claim outcomes, suggesting adjustments provided incentives for claims reduction. The magnitudes of effects in the prospective program were smaller than the retrospective one, though relative persistence of effects over time was larger. Having large and immediate employer responses to incentives may appear desirable, but insurers should consider the time required for employers to improve and sustain good practices, and create incentives that parallel such time lines.

Incentive Early Retirement Programs for Faculty: Innovative Responses to a Changing Environment. ASHE-ERIC Higher Education Report No. 1, 1987.

ERIC Educational Resources Information Center

Chronister, Jay L.; Kepple, Thomas R., Jr.

The literature on incentive early retirement for faculty members is reviewed, including the findings of studies that have assessed the effectiveness of such programs. In addition to describing different types of programs and the incentives offered, attention is directed to legal issues, costs and benefits, assessing whether a program is feasible,…

Evaluation of current incentive/disincentive procedures in construction.

DOT National Transportation Integrated Search

2004-10-01

This study was initiated to take an in-depth look at the current time and material incentive/disincentive program associated with highway construction projects in Kentucky. The current incentive/disincentive program was first initiated in the mid to ...

Workforce Downsizing and Restructuring in the Department of Defense: The Voluntary Separation Incentive Payment Program Versus Involuntary Separation

DTIC Science & Technology

2016-01-01

Workforce Downsizing and Restructuring in the Department of Defense The Voluntary Separation Incentive Payment Program Versus Involuntary...Voluntary Separation Incentive Payment (VSIP). The purposes of this research are to place VSIP in context relative to involuntary separation, determine...5 CHAPTER TWO Review of Severance Pay, Voluntary Separation Incentive Pay, and Voluntary

Teacher Attitudes about Performance Incentives in Texas: Early Reactions to the GEEG Program. Research Brief

ERIC Educational Resources Information Center

National Center on Performance Incentives, 2008

2008-01-01

A recent report published by the National Center on Performance Incentives (NCPI) presents findings from the first-year evaluation of the Governor's Educator Excellence Grant (GEEG) program, one of several statewide educator incentive programs in Texas. Findings are based on surveys administered to GEEG teachers during the 2006-07 school year, the…

The Design of Schools' Performance Incentive Programs in Texas: Findings from Year One of GEEG. Research Brief

ERIC Educational Resources Information Center

National Center on Performance Incentives, 2008

2008-01-01

A recent report published by the National Center on Performance Incentives (NCPI) presents findings from the first-year evaluation of the Governor's Educator Excellence Grant (GEEG) program, one of several statewide educator incentive programs in Texas. In this report, the authors provide an overview of 99 schools' locally designed educator…

Teacher Behaviors and Performance Incentives in Texas: Early Reactions to the GEEG Program. Research Brief

ERIC Educational Resources Information Center

National Center on Performance Incentives, 2008

2008-01-01

A recent report published by the National Center on Performance Incentives (NCPI) presents findings from the first-year evaluation of the Governor's Educator Excellence Grant (GEEG) program, one of several statewide performance incentive programs in Texas. The report provides an overview of changes to teacher behavior and instructional practices…

Stewplan: software for creating forest stewardship plans (Version 1.3)

Treesearch

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

PubMed Central

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

2013-01-01

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

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

PubMed

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.

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey.

PubMed

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.

The antimicrobial stewardship program in Gulf Cooperation Council (GCC) states: insights from a regional survey

PubMed Central

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

Wellness Programs With Financial Incentives Through Disparities Lens.

PubMed

Cuellar, Alison; LoSasso, Anthony T; Shah, Mona; Atwood, Alicia; Lewis-Walls, Tanya R

2018-02-01

To examine wellness programs with financial incentives and their effect on disparities in preventive care. Financial incentives were introduced by 15 large employers, from 2010 to 2013. Fifteen private employers. A total of 299 436 employees and adult dependents. Preventive services and participation in financial incentives. Multivariate linear regression. Disparities in preventive services widened after introduction of financial incentives. Asians were 3% more likely and African Americans were 3% less likely to receive wellness rewards than whites and non-Hispanics, controlling for other factors. Federal law limits targeting of wellness financial incentives by subgroups; thus, employers should consider outreach and culturally appropriate messaging.

Scientific evidence and research in antimicrobial stewardship.

PubMed

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

2013-09-01

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

A Simulation Modeling Framework to Optimize Programs Using Financial Incentives to Motivate Health Behavior Change.

PubMed

Basu, Sanjay; Kiernan, Michaela

2016-01-01

While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: To generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly collected data on health behaviors and associated costs. We integrated "demand curves" capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated: that is, the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3000 worksite physical activity programs across the nation. For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment. © The Author(s) 2015.

A simulation modeling framework to optimize programs using financial incentives to motivate health behavior change

PubMed Central

Basu, Sanjay; Kiernan, Michaela

2015-01-01

Introduction While increasingly popular among mid- to large-size employers, using financial incentives to induce health behavior change among employees has been controversial, in part due to poor quality and generalizability of studies to date. Thus, fundamental questions have been left unanswered: to generate positive economic returns on investment, what level of incentive should be offered for any given type of incentive program and among which employees? Methods We constructed a novel modeling framework that systematically identifies how to optimize marginal return on investment from programs incentivizing behavior change by integrating commonly-collected data on health behaviors and associated costs. We integrated “demand curves” capturing individual differences in response to any given incentive with employee demographic and risk factor data. We also estimated the degree of self-selection that could be tolerated, i.e., the maximum percentage of already-healthy employees who could enroll in a wellness program while still maintaining positive absolute return on investment. In a demonstration analysis, the modeling framework was applied to data from 3,000 worksite physical activity programs across the nation. Results For physical activity programs, the incentive levels that would optimize marginal return on investment ($367/employee/year) were higher than average incentive levels currently offered ($143/employee/year). Yet a high degree of self-selection could undermine the economic benefits of the program; if more than 17% of participants came from the top 10% of the physical activity distribution, the cost of the program would be expected to always be greater than its benefits. Discussion Our generalizable framework integrates individual differences in behavior and risk to systematically estimate the incentive level that optimizes marginal return on investment. PMID:25977362

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

Understanding the Relationship Between Incentive Design and Participation in U.S. Workplace Wellness Programs.

PubMed

Batorsky, Benjamin; Taylor, Erin; Huang, Crystal; Liu, Hangsheng; Mattke, Soeren

2016-01-01

We aimed to understand how employer characteristics relate to the use of incentives to promote participation in wellness programs and to explore the relationship between incentive type and participation rates. A cross-sectional analysis of nationally representative survey data combined with an administrative business database was employed. Random sampling of U.S. companies within strata based on industry and number of employees was used to determine a final sample of 3000 companies. Of these, 19% returned completed surveys. The survey asked about employee participation rate, incentive type, and gender composition of employees. Incentive types included any incentives, high-value rewards, and rewards plus penalties. Logistic regressions of incentive type on employer characteristics were used to determine what types of employers are more likely to offer which type of incentives. A generalized linear model of participation rate was used to determine the relationship between incentive type and participation. Employers located in the Northeast were 5 to 10 times more likely to offer incentives. Employers with a large number of employees, particularly female employees, were up to 1.25 times more likely to use penalties. Penalty and high-value incentives were associated with participation rates of 68% and 52%, respectively. Industry or regional characteristics are likely determinants of incentive use for wellness programs. Penalties appear to be effective, but attention should be paid to what types of employees they affect.

Implementation of an Antimicrobial Stewardship Program in a Neonatal Intensive Care Unit.

PubMed

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.

Communicating with Facility Leadership; Metrics for Successful Antimicrobial Stewardship Programs (Asp) in Acute Care and Long-Term Care Facilities.

PubMed

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].

Reducing Food Insecurity and Improving Fruit and Vegetable Intake Among Farmers' Market Incentive Program Participants.

PubMed

Savoie-Roskos, Mateja; Durward, Carrie; Jeweks, Melanie; LeBlanc, Heidi

2016-01-01

To determine whether participation in a farmers' market incentive pilot program had an impact on food security and fruit and vegetable (F&V) intake of participants. Participants in the Supplemental Nutrition Assistance Program were eligible to receive a dollar-per-dollar match up to $10/wk in farmers' market incentives. The researchers used a pretest-posttest design to measure F&V intake and food security status of 54 adult participants before and after receiving farmers' market incentives. The 6-item Behavior Risk Factor Surveillance System questionnaire and US Household Food Security Survey Module were used to measure F&V intake and food security, respectively. Wilcoxon signed-rank test was used to compare scores of F&V intake. After receiving incentives, fewer individuals reported experiencing food insecurity-related behaviors. A significantly increased intake (P < .05) was found among selected vegetables. Participation in a farmers' market incentive program was positively related to greater food security and intake of select vegetables among participants in the Supplemental Nutrition Assistance Program. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Antimicrobial Stewardship: A Call to Action for Surgeons

PubMed Central

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

The Design of Schools' Performance Incentive Programs in Texas: Findings from Year One of TEEG. Research Brief

ERIC Educational Resources Information Center

National Center on Performance Incentives, 2008

2008-01-01

A recent report published by the National Center on Performance Incentives (NCPI) presents findings from the first-year evaluation of the Texas Educator Excellence Grant (TEEG) program, one of several statewide educator incentive programs in Texas. This report provides an overview of over 1,000 schools' locally designed TEEG performance incentive…

Teacher Attitudes about Performance Incentives in Texas: Early Reactions to the TEEG Program. Research Brief

ERIC Educational Resources Information Center

National Center on Performance Incentives, 2008

2008-01-01

A recent report published by the National Center on Performance Incentives (NCPI) presents findings from the first-year evaluation of the Texas Educator Excellence Grant (TEEG) program, one of several statewide educator incentive programs in Texas. Findings are based on the responses of full-time instructional personnel at over 1,000 TEEG schools…

26 CFR 301.6511(d)-7 - Overpayment of income tax on account of work incentive program credit carryback.

Code of Federal Regulations, 2010 CFR

2010-04-01

... or refund related to an overpayment of income tax attributable to a work incentive program (WIN... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Overpayment of income tax on account of work incentive program credit carryback. 301.6511(d)-7 Section 301.6511(d)-7 Internal Revenue INTERNAL REVENUE...

Effects of Monetary Incentives on Engagement in the PACE Parenting Program

ERIC Educational Resources Information Center

Dumas, Jean E.; Begle, Angela Moreland; French, Brian; Pearl, Amanda

2010-01-01

This study evaluated parental engagement in an 8-week parenting program offered through daycare centers that were randomly assigned to a monetary incentive or nonincentive condition. Of an initial sample of 1,050 parents who rated their intent to enroll in the program, 610 went on to enroll--319 in the incentive and 291 in the nonincentive…

Monetary Incentives to Reinforce Engagement and Achievement in a Job-Skills Training Program for Homeless, Unemployed Adults

ERIC Educational Resources Information Center

Koffarnus, Mikhail N.; Wong, Conrad J.; Fingerhood, Michael; Svikis, Dace S.; Bigelow, George E.; Silverman, Kenneth

2013-01-01

The current study examined whether monetary incentives could increase engagement and achievement in a job-skills training program for unemployed, homeless, alcohol-dependent adults. Participants (n?=?124) were randomized to a no-reinforcement group (n?=?39), during which access to the training program was provided but no incentives were given; a…

26 CFR 301.6501(o)-1 - Work incentive program credit carrybacks, taxable years beginning after December 31, 1971.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Work incentive program credit carrybacks, taxable years beginning after December 31, 1971. 301.6501(o)-1 Section 301.6501(o)-1 Internal Revenue... ADMINISTRATION Limitations Limitations on Assessment and Collection § 301.6501(o)-1 Work incentive program credit...

Small sustainable monetary incentives versus charitable donations to promote exercise: Rationale, design, and baseline data from a randomized pilot study.

PubMed

Williams, David M; Lee, Harold H; Connell, Lauren; Boyle, Holly; Emerson, Jessica; Strohacker, Kelley; Galárraga, Omar

2018-03-01

Regular physical activity (PA) enhances weight-loss and reduces risk of chronic disease. However, as few as 10% of U.S. adults engage in regular PA. Incentive programs to promote PA have shown some promise, but have typically used incentives that are too large to sustain over time and have not demonstrated habit formation or been tested in community settings. This report presents the rationale and design of a randomized pilot study testing the feasibility and preliminary efficacy of small monetary incentives for PA (n=25) versus charitable donations in the same amount (n=25) versus control (n=25) over 12months among 75 low-active but otherwise healthy adults at a local YMCA. Incentives are based on YMCA attendance, which is verified by electronic swipe card data and is the primary study outcome, with self-reported minutes/week of PA assessed as a secondary outcome. Incentives are intentionally small enough-$1/session, maximum of $5/week-such that they could be indefinitely sustained by community organizations, privately-owned health clubs, healthcare organizations, or employers (e.g., employer fitness facilities). Costs of the incentive program for the sponsoring organization may be partially offset by increases in membership resulting from the appeal of the program. Moreover, if efficacious, the charitable donation incentive program may have the added benefit of building social capital for the sponsoring organization and potentially serving as a tax write-off, thus further offsetting the cost of the incentives. Findings will also have implications for the use of financially sustainable community-based incentive programs for other health-related behaviors (e.g., weight loss, smoking). Copyright © 2018 Elsevier Inc. All rights reserved.

Assessment and Evaluation of the Utah Master Naturalist Program: Implications for Targeting Audiences

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…

77 FR 24301 - Revision of the Commission's Program Access Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

... programmers had the incentive and ability to favor their affiliated cable operators over other, unaffiliated... at the time, cable-affiliated programmers retained the incentive and ability to withhold programming... ability and incentive to favor affiliated cable operators over nonaffiliated cable operators and...

Using Implementation and Program Theory to Examine Communication Strategies in National Wildlife Federation's Backyard Wildlife Habitat Program

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

Effects of financial incentives on motivating physical activity among older adults: results from a discrete choice experiment.

PubMed

Farooqui, Muhammad Assad; Tan, Yock-Theng; Bilger, Marcel; Finkelstein, Eric A

2014-02-10

There is extensive evidence that regular physical activity confers numerous health benefits. Despite this, high rates of physical inactivity prevail among older adults. This study aimed to ascertain if incentives could be effective in motivating physical activity through improving uptake of walking programs, either with or without an enrolment fee to cover corresponding costs. A discrete-choice conjoint survey was fielded to a national sample of older adults in Singapore. Each respondent was given ten pairs of hypothetical walking programs and asked to choose the option they preferred. Each option varied along several dimensions, including the level and type (cash, voucher, or health savings credit) of incentive and an enrolment fee. For each option, they were asked how likely they would be to join their preferred program. A random utility model (RUM) was used to analyze the responses. Results suggest that a free 6-month program with a $500 cash incentive would generate enrolment rates of 58.5%; charging $50 to enroll lowers this to 55.7%. In terms of incentive type, cash payments were the most preferred incentive but not significantly different from supermarket vouchers. Both were preferred to health savings credits and sporting goods vouchers. Concerns of adverse selection were minimal because those who were inactive represented at least 72% of new participants for any offered program(s) and were the majority. Study results demonstrate the potential for even modest incentives to increase program uptake among inactive older adults. Moreover, although cash was the most preferred option, supermarket vouchers, which could potentially be purchased at a discount, were a close alternative. Results also suggest that an enrolment fee is a viable option to offset the costs of incentives as it has only minimal impact on participation.

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

PubMed

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

2008-09-15

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

A Proposed Incentive System for Jefferson County Teachers.

ERIC Educational Resources Information Center

Schlechty, Phillip C.; Ingwerson, Donald W.

1987-01-01

Outlines a teacher incentive plan developed for the Jefferson County (Kentucky) Public Schools and scheduled for pilot testing during the 1987-88 school year. The program is modeled after airline frequent flyer programs and is designed to encourage cooperative action and individual incentive among teachers. (MD)

28 CFR 550.54 - Incentives for RDAP participation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Incentives for RDAP participation. 550.54 Section 550.54 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.54 Incentives for RDAP participation. (a) An inmate...

28 CFR 550.54 - Incentives for RDAP participation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Incentives for RDAP participation. 550.54 Section 550.54 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.54 Incentives for RDAP participation. (a) An inmate...

28 CFR 550.54 - Incentives for RDAP participation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Incentives for RDAP participation. 550.54 Section 550.54 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.54 Incentives for RDAP participation. (a) An inmate...

28 CFR 550.54 - Incentives for RDAP participation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Incentives for RDAP participation. 550.54 Section 550.54 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.54 Incentives for RDAP participation. (a) An inmate...

28 CFR 550.54 - Incentives for RDAP participation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Incentives for RDAP participation. 550.54 Section 550.54 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.54 Incentives for RDAP participation. (a) An inmate...

Indiana | Solar Research | NREL

Science.gov Websites

Incentive Programs Indiana exempts solar PV modules, racking, and inverter from state sales and use taxes . The entire solar generating system is exempt from property taxation. Utility Incentive Programs Utility Incentive Limitations Northern Indiana Public Service Company (Solar PV feed-in-tariff) $0.1564

76 FR 56214 - 60-Day Notice of Intention To Request Clearance for Information Collection: Opportunity for...

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...

Choosing Wisely Canada Students and Trainees Advocating for Resource Stewardship (STARS) campaign: a descriptive evaluation

PubMed Central

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

Predictors of Middle School Students' Interest in Participating in an Incentive-Based Tobacco Prevention and Cessation Program in Connecticut

PubMed Central

Morean, Meghan E.; Camenga, Deepa R.; Kong, Grace; Cavallo, Dana A.; Schepis, Ty S.

2014-01-01

Behavioral incentives have been used to encourage smoking cessation in older adolescents, but the acceptability of incentives to promote a smoke-free lifestyle in younger adolescents is unknown. To inform the development of novel, effective, school-based interventions for youth, we assessed middle school students' interest in participating in an incentive-based tobacco abstinence program. We surveyed 988 students (grades 6–8) attending three Connecticut middle schools to determine whether interest in program participation varied as a function of (1) intrapersonal factors (i.e., demographic characteristics (sex, age, race), smoking history, and trait impulsivity) and/or (2) aspects of program design (i.e., prize type, value, and reward frequency). Primary analyses were conducted using multiple regression. A majority of students (61.8%) reported interest in program participation. Interest did not vary by gender, smoking risk status, or offering cash prizes. However, younger students, non-Caucasian students, behaviorally impulsive students, and students with higher levels of self-regulation were more likely to report interest. Inexpensive awards (e.g., video games) offered monthly motivated program interest. In sum, middle school students reported high levels of interest in an incentive-based program to encourage a tobacco-free lifestyle. These formative data can inform the design of effective, incentive-based smoking cessation and prevention programs in middle schools. PMID:25147747

The CORALS Connection

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

EPA Science Inventory

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...

Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

PubMed Central

Halpern, Scott D.; French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Brennan, Troyen A.; Asch, David A.; Volpp, Kevin G.

2015-01-01

BACKGROUND Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. METHODS We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids. RESULTS Overall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (P<0.001). In intention-to-treat analyses, rates of sustained abstinence from smoking through 6 months were higher with each of the four incentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (P<0.05 for all comparisons); the superiority of reward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, P<0.001). However, in instrumental-variable analyses that accounted for differential acceptance, the rate of abstinence at 6 months was 13.2 percentage points (95% confidence interval, 3.1 to 22.8) higher in the deposit-based programs than in the reward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program. CONCLUSIONS Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs. (Funded by the National Institutes of Health and CVS Caremark; ClinicalTrials.gov number, NCT01526265.) PMID:25970009

Estimating Acceptability of Financial Health Incentives

ERIC Educational Resources Information Center

Bigsby, Elisabeth; Seitz, Holli H.; Halpern, Scott D.; Volpp, Kevin; Cappella, Joseph N.

2017-01-01

A growing body of evidence suggests that financial incentives can influence health behavior change, but research on the public acceptability of these programs and factors that predict public support have been limited. A representative sample of U.S. adults (N = 526) were randomly assigned to receive an incentive program description in which the…

A case study of a workplace wellness program that offers financial incentives for weight loss.

PubMed

Cawley, John; Price, Joshua A

2013-09-01

Employers are increasingly adopting workplace wellness programs designed to improve employee health and decrease employer costs associated with health insurance and job absenteeism. This paper examines the outcomes of 2635 workers across 24 worksites who were offered financial incentives for weight loss that took various forms, including fixed payments and forfeitable bonds. We document extremely high attrition and modest weight loss associated with the financial incentives in this program, which contrasts with the better outcomes associated with pilot programs. We conclude by offering suggestions, motivated by behavioral economics, for increasing the effectiveness of financial incentives for weight loss. Copyright © 2013 Elsevier B.V. All rights reserved.

Marine Corps Pay Incentives

DTIC Science & Technology

Marines from 2000 to 2017. The thesis includes a literature review on economic theory related to pay incentives in the Department of Defense, a...The purpose of this thesis to provide the Marine Corps with a comprehensive report on pay incentive programs and special pay that were available to...summarization of pay incentive categories, a data analysis on take-up rates and average annual amounts at the end of each fiscal year, and a program review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barbose, Galen; Wiser, Ryan; Bolinger, Mark

Increasing levels of financial support for customer-sited photovoltaic (PV) systems, provided through publicly-funded incentive programs, has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in ensuring that PV systems receiving incentives perform well. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approachesmore » to encouraging PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address performance issues, and highlight important differences in the implementation of these strategies among programs.« less

Paying physician group practices for quality: A statewide quasi-experiment.

PubMed

Conrad, Douglas A; Grembowski, David; Perry, Lisa; Maynard, Charles; Rodriguez, Hector; Martin, Diane

2013-12-01

This article presents the results of a unique quasi-experiment of the effects of a large-scale pay-for-performance (P4P) program implemented by a leading health insurer in Washington state during 2001-2007. The authors received external funding to provide an objective impact evaluation of the program. The program was unique in several respects: (1) It was designed dynamically, with two discrete intervention periods-one in which payment incentives were based on relative performance (the "contest" period) and a second in which payment incentives were based on absolute performance compared to achievable benchmarks. (2) The program was designed in collaboration with large multispecialty group practices, with an explicit run-in period to test the quality metrics. Public reporting of the quality scorecard for all participating medical groups was introduced 1 year before the quality incentive payment program's inception, and continued throughout 2002-2007. (3) The program was implemented in stages with distinct medical groups. A control group of comparable group practices also was assembled, and difference-in-differences methodology was applied to estimate program effects. Case mix measures were included in all multivariate analyses. The regression design permitted a contrast of intervention effects between the "contest" approach in the sub-period of 2003-2004 and the absolute standard, "achievable benchmarks of care" approach in sub-period 2005-2007. Most of the statistically significant quality incentive program coefficients were small and negative (opposite to program intent). A consistent pattern of differential intervention impact in the sub-periods did not emerge. Cumulatively, the probit regression estimates indicate that neither the quality scorecard nor the quality incentive payment program had a significant positive effect on general clinical quality. Based on key informant interviews with medical leaders, practicing physicians, and administrators of the participating groups, the authors conclude that several factors likely combined to dampen program effects: (1) modest size of the incentive; (2) use of rewards only, rather than a balance of rewards and penalties; (3) targeting incentive payments to the group, thus potentially weakening incentive effects at the individual level. Copyright © 2013 Elsevier Inc. All rights reserved.

Antimicrobial stewardship programs: how to start and steer a successful program.

PubMed

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.

Using the lessons of behavioral economics to design more effective pay-for-performance programs.

PubMed

Mehrotra, Ateev; Sorbero, Melony E S; Damberg, Cheryl L

2010-07-01

To describe improvements in the design of pay-for-performance (P4P) programs that reflect the psychology of how people respond to incentives. Investigation of the behavioral economics literature. We describe 7 ways to improve P4P program design in terms of frequency and types of incentive payments. After discussing why P4P incentives can have unintended adverse consequences, we outline potential ways to mitigate these. Although P4P incentives are increasingly popular, the healthcare literature shows that these have had minimal effect. Design improvements in P4P programs can enhance their effectiveness. Lessons from behavioral economics may greatly enhance the design and effectiveness of P4P programs in healthcare, but future work is needed to demonstrate this empirically.

7 CFR 1470.31 - Appeals.

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

EPA Science Inventory

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.

PubMed

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

2016-01-01

Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Outcome-based and Participation-based Wellness Incentives

PubMed Central

Barleen, Nathan A.; Marzec, Mary L.; Boerger, Nicholas L.; Moloney, Daniel P.; Zimmerman, Eric M.; Dobro, Jeff

2017-01-01

Objective: This study examined whether worksite wellness program participation or achievement of health improvement targets differed according to four incentive types (participation-based, hybrid, outcome-based, and no incentive). Methods: The study included individuals who completed biometric health screenings in both 2013 and 2014 and had elevated metrics in 2013 (baseline year). Multivariate logistic regression modeling tested for differences in odds of participation and achievement of health improvement targets between incentive groups; controlling for demographics, employer characteristics, incentive amounts, and other factors. Results: No statistically significant differences between incentive groups occurred for odds of participation or achievement of health improvement target related to body mass index, blood pressure, or nonhigh-density lipoprotein cholesterol. Conclusions: Given the null findings of this study, employers cannot assume that outcome-based incentives will result in either increased program participation or greater achievement of health improvement targets than participation-based incentives. PMID:28146041

Incentives and Disincentives in the Work Incentive Program: Final Report.

ERIC Educational Resources Information Center

Hokenson, Earl; And Others

Research identifying the differences, and the relative importance of those differences, between successful and unsuccessful participants in the Work Incentive (WIN) Program is presented in terms of both successful employment at termination from WIN and employment after WIN participation. Over 800 former and current WIN 1 and 2 participants in…

1985 Winners of the Cost Reduction Incentive Awards. Tenth Anniversary.

ERIC Educational Resources Information Center

National Association of College and University Business Officers, Washington, DC.

Fifty-two cost reduction efforts on college and university campuses are described, as part of the Cost Reduction Incentive Awards Program sponsored by the National Association of College and University Business Officers and the United States Steel Foundation. The incentive program is designed to stimulate cost-effective ideas and awareness of the…

Study of the Incentive Program for Washington's National Board Certified Teachers

ERIC Educational Resources Information Center

Plecki, Margaret L.; Elfers, Ana M.; St. John, Elise; Finster, Matthew; Emry, Terese; Nishida, Nasue; Harmon, Jeanne

2010-01-01

This study examines the impact of Washington state's incentives for teachers to attain National Board Certification and to work in challenging schools. Using surveys and secondary analyses of state databases, we examine the workforce both prior to and following recent changes in the incentive program. The study considers the nature of National…

Effect of Incentives and Mailing Features on Online Health Program Enrollment

PubMed Central

Alexander, Gwen L.; Divine, George W.; Couper, Mick P.; McClure, Jennifer B.; Stopponi, Melanie A.; Fortman, Kristine K.; Tolsma, Dennis D.; Strecher, Victor J.; Johnson, Christine Cole

2008-01-01

Background With the growing use of Internet-based interventions, strategies are needed to encourage broader participation. This study examined the effects of combinations of monetary incentives and mailing characteristics on enrollment, retention, and cost effectiveness for an online health program. Methods In 2004, a recruitment letter was mailed to randomly selected Midwestern integrated health system members aged 21–65 and stratified by gender and race/ethnicity; recipients were randomly pre-assigned to one of 24 combinations of incentives and various mailing characteristics. Enrollment and 3-month retention rates were measured by completion of online surveys. Analysis, completed in 2005, compared enrollment and retention factors using t tests and chi-square tests. Multivariate logistic regression modeling assessed the probability of enrollment and retention. Results Of 12,289 subjects, 531 (4.3%) enrolled online, ranging from 1% to 11% by incentive combination. Highest enrollment occurred with unconditional incentives, and responses varied by gender. Retention rates ranged from 0% to 100%, with highest retention linked to higher-value incentives. The combination of a $2 bill prepaid incentive and the promise of $20 for retention (10% enrollment and 71% retention) was optimal, considering per-subject recruitment costs ($32 enrollment, $70 retention) and equivalent enrollment by gender and race/ethnicity. Conclusions Cash incentives improved enrollment in an online health program. Men and women responded differently to mailing characteristics and incentives. Including a small prepaid monetary incentive ($2 or $5) and revealing the higher promised-retention incentive was cost effective and boosted enrollment. PMID:18407004

Tapping into the Forest Management Assistance Programs

Treesearch

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…

COPEing With Environmental Education Program Development and Infusion into the Global Studies Curricula of Rural Schools.

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…

Goals and Objectives

EPA Pesticide Factsheets

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

A Global Review of Incentive Programs to Accelerate Energy-Efficient Appliances and Equipment

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; Phadke, Amol; Leventis, Greg

Incentive programs are an essential policy tool to move the market toward energy-efficient products. They offer a favorable complement to mandatory standards and labeling policies by accelerating the market penetration of energy-efficient products above equipment standard requirements and by preparing the market for increased future mandatory requirements. They sway purchase decisions and in some cases production decisions and retail stocking decisions toward energy-efficient products. Incentive programs are structured according to their regulatory environment, the way they are financed, by how the incentive is targeted, and by who administers them. This report categorizes the main elements of incentive programs, using casemore » studies from the Major Economies Forum to illustrate their characteristics. To inform future policy and program design, it seeks to recognize design advantages and disadvantages through a qualitative overview of the variety of programs in use around the globe. Examples range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-Points that reward customers for buying efficient appliances under a government recovery program (Japan). We found that evaluations have demonstrated that financial incentives programs have greater impact when they target highly efficient technologies that have a small market share. We also found that the benefits and drawbacks of different program design aspects depend on the market barriers addressed, the target equipment, and the local market context and that no program design surpasses the others. The key to successful program design and implementation is a thorough understanding of the market and effective identification of the most important local factors hindering the penetration of energy-efficient technologies.« less

Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation.

PubMed

Kim, Annice; Kamyab, Kian; Zhu, Jingsan; Volpp, Kevin

2011-01-01

Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P < 0.01). Most quitters (69.8%) in the incentive group who were already motivated to quit and reported that they would have quit for less money, said incentives were "not at all" or only "somewhat" important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.

Problems in the Development of Incentive Programs

ERIC Educational Resources Information Center

Rhodes, Warren

1977-01-01

Discusses problems that often occur in the implementation and maintenance of incentive programs in residential institutions for adolescents. Suggests recommendations for overcoming these problems. (MS)

78 FR 79613 - Final Requirement-Migrant Education Program Consortium Incentive Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... DEPARTMENT OF EDUCATION 34 CFR Chapter II [CFDA Number 84.144F] Final Requirement--Migrant Education Program Consortium Incentive Grant Program AGENCY: Office of Elementary and Secondary Education, Department of Education. ACTION: Final requirement. SUMMARY: The Assistant Secretary for Elementary and...

Sustainability of quality improvement following removal of pay-for-performance incentives.

PubMed

Benzer, Justin K; Young, Gary J; Burgess, James F; Baker, Errol; Mohr, David C; Charns, Martin P; Kaboli, Peter J

2014-01-01

Although pay-for-performance (P4P) has become a central strategy for improving quality in US healthcare, questions persist about the effectiveness of these programs. A key question is whether quality improvement that occurs as a result of P4P programs is sustainable, particularly if incentives are removed. To investigate sustainability of performance levels following removal of performance-based incentives. Observational cohort study that capitalized on a P4P program within the Veterans Health Administration (VA) that included adoption and subsequent removal of performance-based incentives for selected inpatient quality measures. The study sample comprised 128 acute care VA hospitals where performance was assessed between 2004 and 2010. VA system managers set annual performance goals in consultation with clinical leaders, and report performance scores to medical centers on a quarterly basis. These scores inform performance-based incentives for facilities and their managers. Bonuses are distributed based on the attainment of these performance goals. Seven quality of care measures for acute coronary syndrome, heart failure, and pneumonia linked to performance-based incentives. Significant improvements in performance were observed for six of seven quality of care measures following adoption of performance-based incentives and were maintained up to the removal of the incentive; subsequently, the observed performance levels were sustained. This is a quasi-experimental study without a comparison group; causal conclusions are limited. The maintenance of performance levels after removal of a performance-based incentive has implications for the implementation of Medicare's value-based purchasing initiative and other P4P programs. Additional research is needed to better understand human and system-level factors that mediate sustainability of performance-based incentives.

Perspectives of HIV Clinic Staff on the Implementation of a Client Financial Incentives Program Targeting Viral Suppression.

PubMed

Anderson, Susannah; Jenner, Eric; Lass, Katherine; Burgess, Samuel

We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. Many providers and staff welcomed the program, but some were concerned about sustainability and the ethics of a program that paid patients to receive care. Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future. Copyright © 2017 Association of Nurses in AIDS Care. All rights reserved.

Infection prevention and control practices related to Clostridium difficile infection in Canadian acute and long-term care institutions.

PubMed

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.

The Watershed Report Card.

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.

PubMed Central

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

42 CFR § 414.1450 - APM incentive payment.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1450 APM incentive payment. (a) In... 42 Public Health 3 2017-10-01 2017-10-01 false APM incentive payment. § 414.1450 Section § 414...

The Promise of Tailoring Incentives for Healthy Behaviors.

PubMed

Kullgren, Jeffrey T; Williams, Geoffrey C; Resnicow, Kenneth; An, Lawrence C; Rothberg, Amy; Volpp, Kevin G; Heisler, Michele

2016-01-01

To describe how tailoring financial incentives for healthy behaviors to employees' goals, values, and aspirations might improve the efficacy of incentives. We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee's life goals, values, or aspirations. Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees' autonomous motivation for sustained health improvements. Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors.

Colombia's discharge fee program: incentives for polluters or regulators?

PubMed

Blackman, Allen

2009-01-01

Colombia's discharge fee system for water effluents is often held up as a model of a well-functioning, economic incentive pollution control program in a developing country. Yet few objective evaluations of the program have appeared. Based on a variety of primary and secondary data, this paper finds that in its first 5 years, the program was beset by a number of serious problems including limited implementation in many regions, widespread noncompliance by municipal sewerage authorities, and a confused relationship between discharge fees and emissions standards. Nevertheless, in some watersheds, pollution loads dropped significantly after the program was introduced. While proponents claim the incentives that discharge fees created for polluters to cut emissions in a cost-effective manner were responsible, this paper argues that the incentives they created for regulatory authorities to improve permitting, monitoring, and enforcement were at least as important.

The Intersection Between Colonization Resistance, Antimicrobial Stewardship, and Clostridium difficile.

PubMed

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.

PubMed

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

Existing and Potential Incentives for Practicing Sustainable Forestry on Non-industrial Private Forest Lands

Treesearch

John L. Greene; Michael A. Kilgore; Michael G. Jacobson; Steven E. Daniels; Thomas J. Straka

2007-01-01

This study examined the compatibility between sustainable forestry practices and the framework of public and private financial incentive programs directed toward nonindustrial private forest (NIPF) owners. The incentives include tax, cost-share, and other types of programs. The study consisted of four components: a literature review, a mail survey of selected...

Incentive and Disincentive to Participation in the Work Incentive Program. Final Report.

ERIC Educational Resources Information Center

Garvin, Charles D., Ed.

Initially this report presents a summary of three Work Incentive Programs (WIN) undertaken by a consortium of schools of social work at the University of Chicago, University of Michigan, and Case Western Reserve University, discussing in detail the design, major findings, and recommendations made. The next two chapters are devoted to discussions…

Teacher Incentive Pay Programs in the United States: Union Influence and District Characteristics

ERIC Educational Resources Information Center

Liang, Guodong; Zhang, Ying; Huang, Haigen; Qiao, Zhaogang

2015-01-01

This study examined the characteristics of teacher incentive pay programs in the United States. Using the 2007-08 SASS data set, it found an inverse relationship between union influence and districts' incentive pay offerings. Large and ethnically diverse districts in urban areas that did not meet the requirements for Adequate Yearly Progress as…

Improving School Leadership through Support, Evaluation, and Incentives: The Pittsburgh Principal Incentive Program. Monograph

ERIC Educational Resources Information Center

Hamilton, Laura S.; Engberg, John; Steiner, Elizabeth D.; Nelson, Catherine Awsumb; Yuan, Kun

2012-01-01

In 2007, the Pittsburgh Public Schools (PPS) received funding from the U.S. Department of Education's Teacher Incentive Fund (TIF) program to implement the Pittsburgh Urban Leadership System for Excellence (PULSE), a set of reforms designed to improve the quality of school leadership throughout the district. A major component of PULSE is the…

TIPP. Training Incentive Payments Program. Five Year's Operations. Final Report.

ERIC Educational Resources Information Center

Institute of Public Administration, New York, NY.

A report is made of the first operating phase from March 1970 through May 1971 of a test of the feasibility of using financial incentives to stimulate more effective upgrading of the skills and earnings of low income workers in the private sector. TIPP provides incentive payments to employers based on results achieved. Program administration…

Results of a State Incentive Program on the Supply and Distribution of National Board Certified Teachers

ERIC Educational Resources Information Center

Elfers, Ana M.; Plecki, Margaret L.

2014-01-01

Investment in state incentive policies to support National Board Certified Teachers (NBCTs) prompt consideration of their distribution and retention. This study examines the results of a state's incentive program for NBCTs, including a targeted bonus for those working in high-poverty schools. A quantitative analysis was conducted of state data…

7 CFR 1466.6 - State allocation and management.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS ENVIRONMENTAL QUALITY INCENTIVES PROGRAM... the State and local level; (2) The availability of human resources, incentive programs, educational...

Participant Satisfaction with a Food Benefit Program with Restrictions and Incentives.

PubMed

Rydell, Sarah A; Turner, Rachael M; Lasswell, Tessa A; French, Simone A; Oakes, J Michael; Elbel, Brian; Harnack, Lisa J

2018-02-01

Policy makers are considering changes to the Supplemental Nutrition Assistance Program (SNAP). Proposed changes include financially incentivizing the purchase of healthier foods and prohibiting the use of funds for purchasing foods high in added sugars. SNAP participant perspectives may be useful in understanding the consequences of these proposed changes. To determine whether food restrictions and/or incentives are acceptable to food benefit program participants. Data were collected as part of an experimental trial in which lower-income adults were randomly assigned to one of four financial food benefit conditions: (1) Incentive: 30% financial incentive on eligible fruits and vegetables purchased using food benefits; (2) Restriction: not allowed to buy sugar-sweetened beverages, sweet baked goods, or candies with food benefits; (3) Incentive plus Restriction; or (4) Control: no incentive/restriction. Participants completed closed- and open-ended questions about their perceptions on completion of the 12-week program. Adults eligible or nearly eligible for SNAP were recruited between 2013 and 2015 by means of events or flyers in the Minneapolis/St Paul, MN, metropolitan area. Of the 279 individuals who completed baseline measures, 265 completed follow-up measures and are included in these analyses. χ 2 analyses were conducted to assess differences in program satisfaction. Responses to open-ended questions were qualitatively analyzed using principles of content analysis. There were no statistically significant or meaningful differences between experimental groups in satisfaction with the program elements evaluated in the study. Most participants in all conditions found the food program helpful in buying nutritious foods (94.1% to 98.5%) and in buying the kinds of foods they wanted (85.9% to 95.6%). Qualitative data suggested that most were supportive of restrictions, although a few were dissatisfied. Participants were uniformly supportive of incentives. Findings suggest a food benefit program that includes incentives for purchasing fruits and vegetables and/or restrictions on the use of program funds for purchasing foods high in added sugars appears to be acceptable to most participants. Copyright © 2018 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

PEYA Winners

EPA Pesticide Factsheets

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.

Incentive-Based Conservation Programs in Developing Countries: A Review of Some Key Issues and Suggestions for Improvements

NASA Astrophysics Data System (ADS)

Spiteri, Arian; Nepalz, Sanjay K.

2006-01-01

Biodiversity conservation in developing countries has been a challenge because of the combination of rising human populations, rapid technological advances, severe social hardships, and extreme poverty. To address the social, economic, and ecological limitations of people-free parks and reserves, incentives have been incorporated into conservation programs in the hopes of making conservation meaningful to local people. However, such incentive-based programs have been implemented with little consideration for their ability to fulfill promises of greater protection of biodiversity. Evaluations of incentive-based conservation programs indicate that the approach continually falls short of the rhetoric. This article provides an overview of the problems associated with incentive-based conservation approaches in developing countries. It argues that existing incentive-based programs (IBPs) have yet to realize that benefits vary greatly at different “community” scales and that a holistic conceptualization of a community is essential to incorporate the complexities of a heterogeneous community when designing and implementing the IBPs. The spatial complexities involved in correctly identifying the beneficiaries in a community and the short-term focus of IBPs are two major challenges for sustaining conservation efforts. The article suggests improvements in three key areas: accurate identification of “target” beneficiaries, greater inclusion of marginal communities, and efforts to enhance community aptitudes.

28 CFR 544.72 - Incentives.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Incentives. 544.72 Section 544.72 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT EDUCATION Literacy Program § 544.72 Incentives. The Warden shall establish a system of incentives to encourage an...

28 CFR 544.72 - Incentives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Incentives. 544.72 Section 544.72 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT EDUCATION Literacy Program § 544.72 Incentives. The Warden shall establish a system of incentives to encourage an...

New Chemicals Program Review of Alternatives for PFOA and Related Chemicals

EPA Pesticide Factsheets

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barbose, Galen; Wiser, Ryan; Bolinger, Mark

In the U.S., the increasing financial support for customer-sited photovoltaic (PV) systems provided through publicly-funded incentive programs has heightened concerns about the long-term performance of these systems. Given the barriers that customers face to ensuring that their PV systems perform well, and the responsibility that PV incentive programs bear to ensure that public funds are prudently spent, these programs should, and often do, play a critical role in addressing PV system performance. To provide a point of reference for assessing the current state of the art, and to inform program design efforts going forward, we examine the approaches to encouragingmore » PV system performance used by 32 prominent PV incentive programs in the U.S. We identify eight general strategies or groups of related strategies that these programs have used to address factors that affect performance, and describe key implementation details. Based on this review, we then offer recommendations for how PV incentive programs can be effectively designed to mitigate potential performance issues.« less

Financial incentives and purchase restrictions in a food benefit program affect the types of foods and beverages purchased: results from a randomized trial.

PubMed

French, Simone A; Rydell, Sarah A; Mitchell, Nathan R; Michael Oakes, J; Elbel, Brian; Harnack, Lisa

2017-09-16

This research evaluated the effects of financial incentives and purchase restrictions on food purchasing in a food benefit program for low income people. Participants (n=279) were randomized to groups: 1) Incentive- 30% financial incentive for fruits and vegetables purchased with food benefits; 2) Restriction- no purchase of sugar-sweetened beverages, sweet baked goods, or candies with food benefits; 3) Incentive plus Restriction; or 4) Control- no incentive or restrictions. Participants received a study-specific debit card where funds were added monthly for 12-weeks. Food purchase receipts were collected over 16 weeks. Total dollars spent on grocery purchases and by targeted food categories were computed from receipts. Group differences were examined using general linear models. Weekly purchases of fruit significantly increased in the Incentive plus Restriction ($4.8) compared to the Restriction ($1.7) and Control ($2.1) groups (p <.01). Sugar-sweetened beverage purchases significantly decreased in the Incentive plus Restriction (-$0.8 per week) and Restriction ($-1.4 per week) groups compared to the Control group (+$1.5; p< .0001). Sweet baked goods purchases significantly decreased in the Restriction (-$0.70 per week) compared to the Control group (+$0.82 per week; p < .01). Paired financial incentives and restrictions on foods and beverages purchased with food program funds may support more healthful food purchases compared to no incentives or restrictions. Clinicaltrials.gov Identifier: NCT02643576 .

Provider and Patient Directed Financial Incentives to Improve Care and Outcomes for Patients with Diabetes

PubMed Central

Lorincz, Ilona S.; Lawson, Brittany C. T.

2012-01-01

Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

TRIP : The Transportation Remuneration and Incentive Program in West Virginia, 1974-1979

DOT National Transportation Integrated Search

1982-07-01

Between July 1974 and June 1979, the State of West Virginia was host to the largest Federal demonstration program for improving rural transit service called Transportation Remuneration Incentive Program (TRIP). The remuneration part of TRIP (ticket s...

Financial Incentives and Diabetes Disease Control in Employees: A Retrospective Cohort Analysis.

PubMed

Misra-Hebert, Anita D; Hu, Bo; Taksler, Glen; Zimmerman, Robert; Rothberg, Michael B

2016-08-01

Many employers offer worksite wellness programs, including financial incentives to achieve goals. Evidence supporting such programs is sparse. To assess whether diabetes and cardiovascular risk factor control in employees improved with financial incentives for participation in disease management and for attaining goals. Retrospective cohort study using insurance claims linked with electronic medical record data from January 2008-December 2012. Employee patients with diabetes covered by the organization's self-funded insurance and propensity-matched non-employee patient comparison group with diabetes and commercial insurance. Financial incentives for employer-sponsored disease management program participation and achieving goals. Change in glycosylated hemoglobin (HbA1c), low-density lipoprotein (LDL), systolic blood pressure (SBP), and weight. A total of 1092 employees with diabetes were matched to non-employee patients. With increasing incentives, employee program participation increased (7 % in 2009 to 50 % in 2012, p < 0.001). Longitudinal mixed modeling demonstrated improved diabetes and cardiovascular risk factor control in employees vs. non-employees [HbA1c yearly change -0.05 employees vs. 0.00 non-employees, difference in change (DIC) p <0.001]. In their first participation year, employees had larger declines in HbA1c and weight vs. non-employees (0.33 vs. 0.14, DIC p = 0.04) and (2.3 kg vs. 0.1 kg, DIC p < 0.001), respectively. Analysis of employee cohorts corresponding with incentive offerings showed that fixed incentives (years 1 and 2) or incentives tied to goals (years 3 and 4) were not significantly associated with HbA1c reductions compared to non-employees. For each employee cohort offered incentives, SBP and LDL also did not significantly differ in employees compared with non-employees (DIC p > 0.05). Financial incentives were associated with employee participation in disease management and improved cardiovascular risk factors over 5 years. Improvements occurred primarily in the first year of participation. The relative impact of specific incentives could not be discerned.

A review of antimicrobial stewardship training in medical education

PubMed Central

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

Regulating the Behavior of Nursing Homes through Positive Incentives: An Analysis of Illinois' Quality Incentive Program (QUIP).

ERIC Educational Resources Information Center

Geron, Scott Miyake

1991-01-01

Nursing homes in Illinois Quality Incentive Program receive separate bonus payment per Medicaid day for achieving each of six quality standards. Of 809 participating homes (1985-88), over 90 percent of eligible facilities chose to participate annually. Success in achieving bonus payments in multiple standards increased over time, with 27 percent…

Optimal Incentives for Public Sector Workers: The Case of Teacher-Designed Incentive Pay in Texas. Working Paper 2009-05

ERIC Educational Resources Information Center

Taylor, Lori L.; Springer, Matthew G.

2009-01-01

Pay for performance is a popular public education reform, and millions of dollars are currently being targeted for pay for performance programs. These reforms are popular because economic and management theories suggest that well-designed incentive pay programs could improve teacher effectiveness. There is little evidence about the characteristics…

42 CFR § 512.700 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL CR Incentive Payment Model... implements the cardiac rehabilitation (CR) and intensive cardiac rehabilitation (ICR) incentive payment model... in the CR incentive payment model. (2) The CR/ICR services that count toward CR incentive payments...

Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

PubMed

Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

2016-01-19

Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

Growth Of New York Physician Participation In Meaningful Use Of Electronic Health Records Was Variable, 2011-12.

PubMed

Jung, Hye-Young; Unruh, Mark A; Kaushal, Rainu; Vest, Joshua R

2015-06-01

The federal government has invested $30 billion to promote the adoption and use of electronic health records (EHRs) through the Medicare and Medicaid EHR Incentive Programs. However, the associations between the characteristics of physicians, practices, and markets and the patterns of provider participation in ongoing federal meaningful-use incentive programs over time have been largely unexplored. In this article we describe the participation of New York physicians during the first two years of the meaningful-use initiative. We examined longitudinal patterns to identify characteristics associated with nonparticipation, late adoption of EHRs, noncontinuous participation, and switching programs. We found that 8.1 percent of 26,368 New York physicians participated in the Medicare incentive program in 2011, and 6.1 percent participated in the Medicaid program. Physician participation in the programs grew to 23.9 percent and 8.5 percent, respectively, in 2012. Many physicians in the Medicaid incentive program in 2011 did not participate in either program in 2012. Prior EHR use, access to financial resources, and organizational capacity were physician characteristics associated with early and consistent participation in the meaningful-use initiative. Annual participation requirements, coupled with different options to meet meaningful-use criteria under the incentive programs, create disparate groups of physicians, which illustrates the need to monitor participants for continued participation. Project HOPE—The People-to-People Health Foundation, Inc.

Cradle-to-cradle stewardship of drugs for minimizing their environmental disposition while promoting human health. I. Rationale for and avenues toward a green pharmacy.

PubMed Central

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

Financial incentives: only one piece of the workplace wellness puzzle comment on "corporate wellness programs: implementation challenges in the modern american workplace".

PubMed

Busum, Kristin Van; Mattke, Soeren

2013-11-01

In this commentary, we argue that financial incentives are only one of many key components that employers should consider when designing and implementing a workplace wellness program. Strategies such as social encouragement and providing token rewards may also be effective in improving awareness and engagement. Should employers choose to utilize financial incentives, they should tailor them to the goals for the program as well as the targeted behaviors and health outcomes.

The Promise of Tailoring Incentives for Healthy Behaviors

PubMed Central

Kullgren, Jeffrey T.; Williams, Geoffrey C.; Resnicow, Kenneth; An, Lawrence C.; Rothberg, Amy; Volpp, Kevin G.; Heisler, Michele

2017-01-01

Purpose To describe how tailoring financial incentives for healthy behaviors to employees’ goals, values, and aspirations might improve the efficacy of incentives. Design/methodology/approach We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee’s life goals, values, or aspirations. Findings Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Research implications Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Practical implications Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees’ autonomous motivation for sustained health improvements. Social implications Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Originality/value Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors. PMID:29242715

2009 Community Involvement Training Conference

EPA Pesticide Factsheets

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

EPA Pesticide Factsheets

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

EPA Pesticide Factsheets

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

EPA Pesticide Factsheets

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

EPA Pesticide Factsheets

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

PubMed Central

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

Treesearch

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 SOUTHWEST REGIONAL GAP PROJECT: A DATABASE MODEL FOR REGIONAL LANDSCAPE ASSESSMENT, RESOURCE PLANNING, AND VULNERABILITY ANALYSIS

EPA Science Inventory

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

Treesearch

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,...

Keepers of the Seals.

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…

QuikSCience: Effective Linkage of Competitive, Cooperative, and Service Learning in Science Education

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…

Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study.

PubMed

McGill, Bronwyn; O'Hara, Blythe J; Grunseit, Anne C; Bauman, Adrian; Osborne, Dale; Lawler, Luke; Phongsavan, Philayrath

2018-02-13

Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire for external supports to motivate and sustain weight loss maintenance.

Alternative Fuels Data Center

Science.gov Websites

administers the Ethanol Infrastructure Incentive Program, providing grants to offset the cost of installing Ethanol Infrastructure Incentive Program website. (Reference South Dakota Statutes 10-47B-162 and 10-47B

A work-site weight control program using financial incentives collected through payroll deduction.

PubMed

Forster, J L; Jeffery, R W; Sullivan, S; Snell, M K

1985-11-01

In a work-site weight control program using a self-motivational program of financial incentives implemented through payroll deduction, 131 university employees chose weight loss goals (0 to 60 lb) and incentives (+5 to +30) to be deducted from each paycheck for six months. Return of incentive money was contingent on progress toward weight goals. Participants were assigned randomly to one of four protocols, involving group educational sessions v self-instruction only and required v optional attendance at weigh-ins and sessions. Overall, dropout rates (21.4%) and mean weight loss (12.2 lb) were encouraging, especially compared with those of other work-site programs. Weight loss was positively associated with attendance at weigh-ins and educational sessions. However, requiring attendance did not increase program effectiveness and seemed also to discourage enrollment among men. The weight control program was equally effective when offered with professionally led educational sessions or when accompanied by self-instructional materials only.

Implementing a Farmers’ Market Incentive Program: Perspectives on the New York City Health Bucks Program

PubMed Central

Wethington, Holly; Olsho, Lauren; Jernigan, Jan; Farris, Rosanne; Walker, Deborah Klein

2013-01-01

Introduction One strategy for lowering the prevalence of obesity is to increase access to and affordability of fruits and vegetables through farmers’ markets. However, little has been documented in the literature on the implementation of such efforts. To address this gap, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) sponsored an evaluation of the New York City Health Bucks program, a farmers’ market coupon incentive program intended to increase access to fresh fruits and vegetables in underserved neighborhoods while supporting local farmers. Methods We conducted a process evaluation of Health Bucks program implementation. We interviewed 6 farmer/vendors, 3 market managers, and 4 program administrators, and collected data on site at 86 farmers’ markets, including surveys of 81 managers and 141 farmer/vendors on their perspectives on promotion and redemption of the incentive coupons; knowledge and attitudes regarding the program; experiences with markets and products; and facilitators and barriers to program participation. Results Results indicate that respondents view Health Bucks as a positive program model. Farmers’ market incentive coupon programs like Health Bucks are one strategy to address the problem of obesity and were associated with higher fruit and vegetable access and purchases in low-income communities. Conclusions This evaluation identified some areas for improving implementation of the Health Bucks program. Farmers’ market incentive programs like Health Bucks may be one avenue to increase access to and affordability of fruits and vegetables among low-income persons. Further research is needed to assess the potential effects of these programs on access and health outcomes. PMID:23987251

Marketing to Nurses through an Incentive Program.

ERIC Educational Resources Information Center

Campbell, Jeanne Phillips; Williams, Trudy

1983-01-01

Describes the Incentive Career Mobility Plan, a program for improving employee morale and retention by rewarding self-improvement. Discusses its use by nurse administrators for marketing their institutions to current and potential employees. (JOW)

Incentives for Excellence: Agendas and Arenas.

ERIC Educational Resources Information Center

Gress, James R., Ed.

The articles in this monograph focus on issues identified during participation in the U.S. Department of Education 1984 Teacher Incentive Structures Program, and the 1986 Project to Design Teacher Incentive Structures. Emphasis was on designing or adapting incentive structures for possible use in the school, community, or university. The following…

78 FR 64916 - Circular Welded Carbon Steel Pipes and Tubes From Turkey: Final Results of Countervailing Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

...: Land Allocation National Restructuring Program Regional Incentive Scheme: Reduced Corporate Tax Rates Regional Incentive Scheme: Social Security Premium Contribution for Employees Regional Incentive Scheme: Allocation of State Land Regional Incentive Scheme: Interest Support OIZ: Waste Water Charges OIZ: Exemptions...

Determining Safety Inspection Thresholds for Employee Incentives Programs on Construction Sites

PubMed Central

Sparer, Emily; Dennerlein, Jack

2017-01-01

The goal of this project was to evaluate approaches of determining the numerical value of a safety inspection score that would activate a reward in an employee safety incentive program. Safety inspections are a reflection of the physical working conditions at a construction site and provide a safety score that can be used in incentive programs to reward workers. Yet it is unclear what level of safety should be used when implementing this kind of program. This study explored five ways of grouping safety inspection data collected during 19 months at Harvard University-owned construction projects. Each approach grouped the data by one of the following: owner, general contractor, project, trade, or subcontractor. The median value for each grouping provided the threshold score. These five approaches were then applied to data from a completed project in order to calculate the frequency and distribution of rewards in a monthly safety incentive program. The application of each approach was evaluated qualitatively for consistency, competitiveness, attainability, and fairness. The owner-specific approach resulted in a threshold score of 96.3% and met all of the qualitative evaluation goals. It had the most competitive reward distribution (only 1/3 of the project duration) yet it was also attainable. By treating all workers equally and maintaining the same value throughout the project duration, this approach was fair and consistent. The owner-based approach for threshold determination can be used by owners or general contractors when creating leading indicator incentives programs and by researchers in future studies on incentive program effectiveness. PMID:28638178

Measuring Provider Performance for Physicians Participating in the Merit-Based Incentive Payment System.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2017, the Centers for Medicare and Medicaid Services began requiring all eligible providers to participate in the Quality Payment Program or face financial reimbursement penalty. The Quality Payment Program outlines two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. For the first performance period beginning in January of 2017, the Centers for Medicare and Medicaid Services estimates that approximately 83 to 90 percent of eligible providers will not qualify for participation in an Advanced Alternative Payment Model and therefore must participate in the Merit-Based Incentive Payment System program. The Merit-Based Incentive Payment System path replaces existing quality-reporting programs and adds several new measures to evaluate providers using four categories of data: (1) quality, (2) cost/resource use, (3) improvement activities, and (4) advancing care information. These categories will be combined to calculate a weighted composite score for each provider or provider group. Composite Merit-Based Incentive Payment System scores based on 2017 performance data will be used to adjust reimbursed payment in 2019. In this article, the authors provide relevant background for understanding value-based provider performance measurement. The authors also discuss Merit-Based Incentive Payment System reporting requirements and scoring methodology to provide plastic surgeons with the necessary information to critically evaluate their own practice capabilities in the context of current performance metrics under the Quality Payment Program.

Massachusetts | Midmarket Solar Policies in the United States | Solar

Science.gov Websites

Research | NREL Massachusetts Massachusetts An arrow graphic shows that Massachusetts's retail rate. State Incentive Programs Program Administrator Incentive Leading By Example Solar PV Canopy Environmental Affairs: Leading by Example Program Other MassSolar: Solar Policies and Resources Massachusetts

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.

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...

Considering a new domain for antimicrobial stewardship: Topical antibiotics in the open surgical wound.

PubMed

Edmiston, Charles E; Leaper, David; Spencer, Maureen; Truitt, Karen; Litz Fauerbach, Loretta; Graham, Denise; Johnson, Helen Boehm

2017-11-01

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.

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

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

Impact of an antimicrobial stewardship program with multidisciplinary cooperation in a community public teaching hospital in Taiwan.

PubMed

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.

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

PubMed Central

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

2016-01-01

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

Antimicrobial Stewardship: The Need to Cover All Bases

PubMed Central

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

[The interplay of diagnostic and antimicrobial stewardship for the management of septic patients: the Tuscan model.

PubMed

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.

Antimicrobial Stewardship in the Emergency Department: Challenges, Opportunities, and a Call to Action for Pharmacists.

PubMed

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.

Is Exposure to an Effective Contingency Management Intervention Associated with More Positive Provider Beliefs?

PubMed Central

Kirby, Kimberly C.; Carpenedo, Carolyn M.; Stitzer, Maxine L.; Dugosh, Karen L.; Petry, Nancy M.; Roll, John M.; Saladin, Michael E.; Cohen, Allan J.; Hamilton, John; Reese, Karen; Sillo, Gina R.; Stabile, Patricia Quinn; Sterling, Robert C.

2011-01-01

This study empirically examined opinions of treatment providers regarding Contingency Management (CM) programs while controlling for experience with a specific efficacious CM program. In addition to empirically describing provider opinions, we examined whether the opinions of providers at the sites that implemented the CM program were more positive than those of matched providers at sites that did not implement it. Participants from 7 CM treatment sites (n = 76) and 7 matched non-participating sites (n = 69) within the same nodes of NIDA's Clinical Trials Network completed the Provider Survey of Incentives (PSI), which assesses positive and negative beliefs about incentive programs. An intent-to-treat analysis found no differences in the PSI summary scores of providers in CM program vs. matched sites, but correcting for experience with tangible incentives showed significant differences, with providers from CM sites reporting more positive opinions than those from matched sites. Some differences were found in opinions regarding costs of incentives and these generally indicated that participants from CM sites were more likely to see the costs as worthwhile. The results from the study suggest that exposing community treatment providers to incentive programs may itself be an effective strategy in prompting the dissemination of CM interventions. PMID:22116009

Cradle-to-cradle stewardship of drugs for minimizing their environmental disposition while promoting human health. II. Drug disposal, waste reduction, and future directions.

PubMed Central

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

Long-term outcomes of an antimicrobial stewardship program implemented in a hospital with low baseline antibiotic use.

PubMed

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.

Implementing Welfare-Employment Programs: An Institutional Analysis of the Work Incentive (WIN) Program.

ERIC Educational Resources Information Center

Mitchell, John J.; And Others

Factors that influence the effectiveness of state and local units of the federal Work Incentive (WIN) program were examined to suggest ways to improve the program, which is designed to move recipients of Aid to Families with Dependent Children (AFDC) into productive jobs. Factors studied were organizational, managerial, and service delivery…

An Analysis of Medicare's Incentive Payment Program for Physicians in Health Professional Shortage Areas

ERIC Educational Resources Information Center

Chan, Leighton; Hart, L. Gary; Ricketts III, Thomas C.; Beaver, Shelli K.

2004-01-01

Medicare's Incentive Payment (MIP) program provides a 10% bonus payment to providers who treat Medicare patients in rural and urban areas where there is a shortage of generalist physicians. Purpose: To examine the experience of Alaska, Idaho, North Carolina, South Carolina, and Washington with the MIP program. We determined the program's…

The affordable care ACT on loyalty programs for federal beneficiaries.

PubMed

Piacentino, Justin J; Williams, Karl G

2014-02-01

To discuss changes in the law that allow community pharmacy loyalty programs to include and offer incentives to Medicare and Medicaid beneficiaries. The retailer rewards exception of the Patient Protection and Affordable Care Act of 2010 and its change to the definition of remuneration in the civil monetary penalties of the Anti-Kickback Statute now allow incentives to be earned on federal benefit tied prescription out-of-pocket costs. The criteria required to design a compliant loyalty program are discussed. Community pharmacies can now include Medicare and Medicaid beneficiaries in compliant customer loyalty programs, where allowed by state law. There is a need for research directly on the influence of loyalty programs and nominal incentives on adherence.

Performance-based financial incentives for diabetes care: an effective strategy?

PubMed

Latham, Lesley P; Marshall, Emily Gard

2015-02-01

The use of financial incentives provided to primary care physicians who achieve target management or clinical outcomes has been advocated to support the fulfillment of care recommendations for patients with diabetes. This article explores the characteristics of incentive models implemented in the context of universal healthcare systems in the United Kingdom, Australia, Taiwan and Canada; the extent to which these interventions have been successful in improving diabetes outcomes; and the key challenges and concerns around implementing incentive models. Research in the effect of incentives in the United Kingdom demonstrates some improvements in process outcomes and achievement of cholesterol, blood pressure and glycated hemoglobin (A1C) targets. Evidence of the efficacy of programs implemented outside of the United Kingdom is very limited but suggests that physicians participating in these enhanced billing incentive programs were already completing the guideline-recommended care prior to the introduction of the incentive. A shift to pay-for-performance programs may have important implications for professionalism and patient-centred care. In the absence of definitive evidence that financial incentives drive the quality of diabetes management at the level of primary care, policy makers should proceed with caution. It is important to look beyond simply modifying physicians' behaviours and address the factors and systemic barriers that make it challenging for patients and physicians to manage diabetes in partnership. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

An Analysis of the California State University and Colleges Early Retirement Incentive Program: A Report Pursuant to Chapter 656 of the Statutes of 1979.

ERIC Educational Resources Information Center

Reinhard, Raymond M.

The California State University and Colleges' (CSUC) Early Retirement Incentive (ERI) Program is described, and information is presented of those who retire during a three-month period with an incentive bonus of two additional years of (unearned) retirement service credit. During the eligibility period 1,047 CSUC employees retired, and it appears…

Allocation of State Funds for Construction and Renovation of Schools in Georgia.

ERIC Educational Resources Information Center

Walker, Mary Beth; Sjoquist, David L.

1996-01-01

Examines Georgia's model capital outlay program for public schools. Despite the current program's many positive aspects, incentives provided to local school districts can lead to inefficiencies, contradictions, and inequities for districts with older physical plants. The program also contains an incentive to use debt financing, rather than…

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) Unless a qualifying MA EP is entitled to a maximum payment for a year under the Medicare FFS EHR incentive program, payment for such an individual is only made under the MA EHR incentive program...

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) Unless a qualifying MA EP is entitled to a maximum payment for a year under the Medicare FFS EHR incentive program, payment for such an individual is only made under the MA EHR incentive program...

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) Unless a qualifying MA EP is entitled to a maximum payment for a year under the Medicare FFS EHR incentive program, payment for such an individual is only made under the MA EHR incentive program...

75 FR 39135 - Voluntary Public Access and Habitat Incentive Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... Public Access and Habitat Incentive Program AGENCY: Farm Service Agency and Commodity Credit Corporation... available through the Farm Service Agency (FSA) home page at http://www.fsa.usda.gov/ . FOR FURTHER... Program (CREP) land; (4) Supplement funding and services from other Federal, State, tribal government, or...

75 FR 63147 - Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

...] Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global Climate Change... Program; and (iii) Global Climate Change Mitigation Incentive Fund (GCCMIF) Program. To enhance the...; and (iii) Global Climate Change Mitigation Incentive Fund (GCCMIF) Program. EDA will publish separate...

Utility Incentives for Combined Heat and Power

EPA Pesticide Factsheets

This report describes the results of EPA's research and analysis into utility incentives for CHP. It provides information about utility-initiated policies, programs, and incentives for CHP systems, and includes case studies and tools and resources.

42 CFR § 512.703 - CR incentive payment model participants.

Code of Federal Regulations, 2010 CFR

2017-10-01

... 42 Public Health 5 2017-10-01 2017-10-01 false CR incentive payment model participants. § 512.703... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL CR Incentive Payment Model for EPM and Medicare Fee-for-Service Participants § 512.703 CR incentive payment model...

42 CFR § 512.710 - Determination of CR incentive payments.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL CR Incentive Payment Model for EPM and Medicare Fee-for-Service Participants § 512.710 Determination of CR incentive... 42 Public Health 5 2017-10-01 2017-10-01 false Determination of CR incentive payments. § 512.710...

77 FR 46713 - Circular Welded Carbon Steel Pipes and Tubes From Turkey: Final Results of Countervailing Duty...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... Support. L. IEP: Land Allocation. M. National Restructuring Program. N. Regional Incentive Scheme: Reduced Corporate Tax Rates. O. Regional Incentive Scheme: Social Security Premium Contribution for Employees. P. Regional Incentive Scheme: Allocation of State Land. Q. Regional Incentive Scheme: Interest Support. R. OIZ...

Financial incentives for healthy behavior: ethical safeguards for behavioral economics.

PubMed

Lunze, Karsten; Paasche-Orlow, Michael K

2013-06-01

Economic incentives to promote healthy behavior are becoming increasingly common and have been suggested as an approach to decreasing healthcare costs. Ethical concerns about programs with such incentives are that they may contribute to inequities, be coercive, interfere with therapeutic relationships, undermine personal responsibility for health, and decrease social solidarity. Additionally, they may be a source of stigma or discrimination, promote dependence, and be unfair for those already engaged in targeted health behaviors or those who cannot fulfill the incentivized behaviors. Incentive programs need to incorporate appropriate safeguards to monitor these risks and support fairness in offering economic incentives to promote healthy behavior. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Employee incentives in the healthcare industry.

PubMed

McKinnies, Richard C; Collins, Sandra K; Collins, Kevin S

2008-01-01

*Employee incentives are an important part of a radiology department's ability to attract and maintain employees. For incentive programs to be successful, radiology managers must diligently look for the incentives that motivate each particular employee. *The types of incentives being used frequently in the field of healthcare vary between technical, managerial, and executive positions. The process of identifying the right employee incentive for each group of individuals may be challenging, but if the result is a more productive and satisfied group of employees, the process is worth the effort.

The effects of different recruitment and incentive strategies for body acceptance programs on college women.

PubMed

Perez, Marisol; Ohrt, Tara K; Bruening, Amanda B

2016-01-01

The objective of this study-getting individuals to participate in eating disorder prevention programs-is difficult yet crucial for dissemination efforts. Little research has investigated what incentive strategies can be particularly efficacious, and even less is published on their cost-effectiveness. The following study examined two types of email advertisements and six incentive strategies in an empirically supported body acceptance program disseminated at a large university. A total of 5,978 undergraduate women received email advertisements, of which 430 signed up to participate. An additional 588 who did not participate were assessed. Results suggest the most effective incentives were offering gift certificates for free manicure services and free personal fashion style training gift certificates from a student organization. Undergraduate women were least likely to attend due to lack of knowledge about the program, not having a friend to attend with them, or inconvenient times. Implications for future research are explored.

Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.

PubMed

Patel, Mitesh S; Asch, David A; Troxel, Andrea B; Fletcher, Michele; Osman-Koss, Rosemary; Brady, Jennifer; Wesby, Lisa; Hilbert, Victoria; Zhu, Jingsan; Wang, Wenli; Volpp, Kevin G

2016-01-01

Employers commonly use adjustments to health insurance premiums as incentives to encourage healthy behavior, but the effectiveness of those adjustments is controversial. We gave 197 obese participants in a workplace wellness program a weight loss goal equivalent to 5 percent of their baseline weight. They were randomly assigned to a control arm, with no financial incentive for achieving the goal, or to one of three intervention arms offering an incentive valued at $550. Two intervention arms used health insurance premium adjustments, beginning the following year (delayed) or in the first pay period after achieving the goal (immediate). A third arm used a daily lottery incentive separate from premiums. At twelve months there were no statistically significant differences in mean weight change either between the control group (whose members had a mean gain of 0.1 pound) and any of the incentive groups (delayed premium adjustment, -1.2 pound; immediate premium adjustment, -1.4 pound; daily lottery incentive, -1.0 pound) or among the intervention groups. The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both. Project HOPE—The People-to-People Health Foundation, Inc.

Influence of a 5-year serial infection control and antibiotic stewardship intervention on cardiac surgical site infections.

PubMed

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.

ACHP | News | ACHP Considers Program Comment for Select GSA Repairs and

Science.gov Websites

) 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

7 CFR 1470.24 - Payments.

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...

7 CFR 1470.24 - Payments.

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...

7 CFR 1470.24 - Payments.

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...

7 CFR 1470.24 - Payments.

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.

PubMed

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

2013-08-01

As the progression of multidrug-resistant organisms and lack of novel antibiotics move us closer toward a potential postantibiotic era, it is paramount to preserve the longevity of current therapeutic agents. Moreover, novel interventions for antimicrobial stewardship programs are integral to combating antimicrobial resistance worldwide. One unique method that may decrease the use of second-line antibiotics (e.g., fluoroquinolones, vancomycin) while facilitating access to a preferred β-lactam regimen in numerous health care settings is a penicillin skin test. Provided that up to 10% of patients have a reported penicillin allergy, of whom ~10% have true IgE-mediated hypersensitivity, significant potential exists to utilize a penicillin skin test to safely identify those who may receive penicillin or a β-lactam antibiotic. In this article, we provide information on the background, associated costs, currently available literature, pharmacists' role, antimicrobial stewardship implications, potential barriers, and misconceptions, as well as future directions associated with the penicillin skin test. © 2013 Pharmacotherapy Publications, Inc.

Beyond Widgets -- Systems Incentive Programs for Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Regnier, Cindy; Mathew, Paul; Robinson, Alastair

Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasinglymore » stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.« less

Development of industry-based strategies for motivating seat-belt usage

DOT National Transportation Integrated Search

1983-03-01

A variety of incentive-based programs to motivate safety belt use were tested during the 18-month grant period in order to define optimal incentive strategies for particular corporate settings. Initial programs provoked important research questions w...

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.

Strategies for improving antibiotic use in Qatar: a survey of pharmacists' perceptions and experiences.

PubMed

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.

PubMed

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.

Pharmacist-driven antimicrobial stewardship program in an institution without infectious diseases physician support.

PubMed

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.

48 CFR 519.7004 - Incentives for prime contractors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS GSA Mentor-Protégé Program 519.7004 Incentives for prime...) Costs incurred by a mentor to provide developmental assistance, as described in section 519.7012 to... under a GSA contract. If GSA is the mentor's responsible audit agency under FAR 42.703-1, GSA will...

Alternative Fuels Data Center: Voucher Incentive Programs: Lessons From the

Science.gov Websites

. For example, most programs provide funding on a first-come, first-served basis. Programs to date have incentives for HVIP to increase regional fuel and emissions reductions. For example, the San Joaquin Valley Energy Research and Development Authority (NYSERDA) is administering the New York Truck - Voucher

The Work Incentive Program and Its Role and Effectiveness in Reducing Welfare Costs.

ERIC Educational Resources Information Center

Trinler, Kenneth T.

The report discusses how effective the Work Incentive Program (WIN), has been in breaking the cycle of poverty for public assistance recipients. Following a discussion of shortcomings the author states that the basically sound program may still accomplish its original objectives if problem areas are rectified by Congressional action. (Author)

78 FR 69512 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-19

... (``QMM'') and NBBO Setter Incentive pricing incentive programs under Rule 7014 and the pricing for its... persistent low trading volumes. Retail Price Improvement Program Pricing Under the RPI Program, a member (or... remain unchanged. The change is designed to eliminate ``inverted'' pricing that was introduced at the...

Implementation of the Career Education Incentive Act. First Interim Report on the Evaluability Assessment.

ERIC Educational Resources Information Center

Jung, Steven M.; And Others

Survey activities are reported which were designed to provide the foundation for a national evaluation of the effectiveness of programs assisted under the Career Education Incentive Act of 1977 (PL 95-207). The methodology described, called "program evaluability assessment," focuses on detailed analysis of program assumptions in order to…

78 FR 3482 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Withdrawal of Proposed Rule Change...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-16

... Program To Create a Lead Market Maker Issuer Incentive Program for Issuers of Certain Exchange-Traded... and implement, on a pilot basis, a Lead Market Maker Issuer Incentive Program for issuers of certain... Medero, Managing Director, BlackRock, Inc., dated July 11, 2012; Letter from Stanislav Dolgopolov...

State Enterprise Zone Programs: Have They Worked?

ERIC Educational Resources Information Center

Peters, Alan H.; Fisher, Peter S.

The effectiveness of state enterprise zone programs was examined by using a hypothetical-firm model called the Tax and Incentives Model-Enterprise Zones (TAIM-ez) model to analyze the value of enterprise zone incentives to businesses across the United States and especially in the 13 states that had substantial enterprise zone programs by 1990. The…

Characteristics of Teacher Incentive Pay Programs: A Statewide District Survey

ERIC Educational Resources Information Center

Liang, Guodong; Akiba, Motoko

2015-01-01

Purpose: The purpose of this paper is to examine the characteristics of teacher incentive pay programs used by midsize to large school districts in Missouri. Design/methodology/approach: This study primarily used the Teacher Compensation Programs (TCP) survey data. The TCP survey was developed by the authors to understand the nature and…

75 FR 7228 - Fisheries of the Exclusive Economic Zone Off Alaska; Chinook Salmon Bycatch Management Measures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-18

... that combines a limit on the amount of Chinook salmon that may be caught incidentally with an incentive... limit on the amount of Chinook salmon that may be caught incidentally with an incentive plan agreement... arrangement, called an incentive plan agreement (IPA), that establishes an incentive program to minimize...

Designing Incentives for Public School Teachers: Evidence from a Texas Incentive Pay Program

ERIC Educational Resources Information Center

Springer, Matthew G.; Taylor, Lori L.

2016-01-01

Pay-for-performance is a popular public education reform, but there is little evidence about the characteristics of a well-designed incentive pay plan for teachers. Some of the literature suggests that effective incentive plans must offer relatively large awards to induce behavioral changes. On the other hand, the experimental economics literature…

Influence and effectiveness of financial incentive programs in programs in promoting sustainable forestry in the South

Treesearch

John L. Greene; Thomas J. Straka; Steven E. Daniels; Michael G. Jacobson; Michael A. Kilgore

2009-01-01

Selected state agency foresters in each of the 13 southern states were surveyed about the financial incentive programs available to nonindustrial private forest owners. The foresters were asked to name and describe the public and private programs available in their state, to assess forest owners’ awareness of each program, its appeal among the owners aware of it, its...

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

7 CFR 636.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVES PROGRAM § 636.1 Applicability. (a) The purpose of the Wildlife Habitat Incentives Program (WHIP) is to help participants develop fish and wildlife habitat on private agricultural land, nonindustrial private forest land, and Indian land. (b) The...

Provider perceptions of the electronic health record incentive programs: a survey of eligible professionals who have and have not attested to meaningful use.

PubMed

Weeks, Douglas L; Keeney, Benjamin J; Evans, Peggy C; Moore, Quincy D; Conrad, Douglas A

2015-01-01

The HITECH Act of 2009 enabled the Centers for Medicare & Medicaid Services (CMS) to provide financial incentives to health care providers who demonstrate "meaningful use" (MU) of their electronic health records (EHRs). Despite stakeholder involvement in the rule-making phase, formal input about the MU program from a cross section of providers has not been reported since incentive payments began. To examine the perspectives and experiences of a random sample of health care professionals eligible for financial incentives (eligible professionals or EPs) for demonstrating meaningful use of their EHRs. It was hypothesized that EPs actively participating in the MU program would generally view the purported benefits of MU more positively than EPs not yet participating in the incentive program. Survey data were collected by mail from a random sample of EPs in Washington State and Idaho. Two follow-up mailings were made to non-respondents. The sample included EPs who had registered for incentive payments or attested to MU (MU-Active) and EPs not yet participating in the incentive program (MU-Inactive). The survey assessed perceptions of general realities and influences of MU on health care; views on the influence of MU on clinics; and personal views about MU. EP opinions were assessed with close- and open-ended items. Close-ended responses indicated that MU-Active providers were generally more positive about the program than MU-Inactive providers. However, the majority of respondents in both groups felt that MU would not reduce care disparities or improve the accuracy of patient information. The additional workload on EPs and their staff was viewed as too great a burden on productivity relative to the level of reimbursement for achieving MU goals. The majority of open-ended responses in each group reinforced the general perception that the MU program diverted attention from treating patients by imposing greater reporting requirements. Survey results indicate the need by CMS to step up engagement with EPs in future planning for the MU program, while also providing support for achieving MU standards.

Lowering employee health care costs through the Healthy Lifestyle Incentive Program.

PubMed

Merrill, Ray M; Hyatt, Beverly; Aldana, Steven G; Kinnersley, Dan

2011-01-01

To evaluate the impact of the Healthy Lifestyle Incentive Program (HLIP), a worksite health program, on lowering prescription drug and medical costs. Health care cost data for Salt Lake County employees during 2004 through 2008 were linked with HLIP enrollment status. Additional program information was obtained from a cross-sectional survey administered in 2008. The program includes free annual screenings, tailored feedback on screening results, financial incentives for maintaining and modifying certain behaviors, and periodic educational programs and promotions to raise awareness of health topics. Frequency and cost of prescription drug and medical claims. Participation increased from 16% to 23% in men and 34% to 45% in women over the 5-year study period and was associated with a significantly greater level of physical activity and improved general health. Participants were generally satisfied with the HLIP (43% were very satisfied, 51% satisfied, 5% dissatisfied, and 1% very dissatisfied). The primary factors contributing to participation were financial incentives (more so among younger employees), followed by a desire to improve health (more so among older employees). Over the study period, the cost savings in lower prescription drug and medical costs was $3,568,837. For every dollar spent on the HLIP the county saved $3.85. Financial incentives and then a desire for better health were the primary reasons for participation. The HLIP resulted in substantial health care cost savings for Salt Lake County Government.

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...

Y-12 Site Sustainability Plan

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

Is More Always Better in Designing Workplace Wellness Programs?: A Comparison of Wellness Program Components Versus Outcomes.

PubMed

Batorsky, Benjamin; Van Stolk, Christian; Liu, Hangsheng

2016-10-01

Assess whether adding more components to a workplace wellness program is associated with better outcomes by measuring the relationship of program components to one another and to employee participation and perceptions of program effectiveness. Data came from a 2014 survey of 24,393 employees of 81 employers about services offered, leadership, incentives, and promotion. Logistic regressions were used to model the relationship between program characteristics and outcomes. Components individually are related to better outcomes, but this relationship is weaker in the presence of other components and non-significant for incentives. Within components, a moderate level of services and work time participation opportunities are associated with higher participation and effectiveness. The "more of everything" approach does not appear to be advisable for all programs. Programs should focus on providing ample opportunities for employees to participate and initiatives like results-based incentives.

California Publicly-Owned Utilities (POUs) – LBNL ‘Beyond Widgets’ Project. Task: ambient lighting and occupancy-based plug load control. System Program Manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robinson, Alastair; Mathew, Paul A.; Regnier, Cynthia

This program manual contains detailed technical information for implementing an incentive program for task-ambient lighting and occupancy-based plug load control. This manual was developed by Lawrence Berkeley National Laboratory, in collaboration with the California Publicly-Owned Utilities (CA POUs) as a partner in the ‘Beyond Widgets’ program funded by the U.S. Department of Energy Building Technologies Office. The primary audience for this manual is the program staff of the various CA POUs. It may also be used by other utility incentive programs to help develop similar programs. It is anticipated that the content of this manual be utilized by the CAmore » POU staff for developing related documents such as the Technical Resource Manual and other filings pertaining to the rollout of an energy systems-based rebate incentive program.« less

Design of capacity incentive and energy compensation for demand response programs

NASA Astrophysics Data System (ADS)

Liu, Zhoubin; Cui, Wenqi; Shen, Ran; Hu, Yishuang; Wu, Hui; Ye, Chengjin

2018-02-01

Variability and Uncertainties caused by renewable energy sources have called for large amount of balancing services. Demand side resources (DSRs) can be a good alternative of traditional generating units to provide balancing service. In the areas where the electricity market has not been fully established, e.g., China, DSRs can help balance the power system with incentive-based demand response programs. However, there is a lack of information about the interruption cost of consumers in these areas, making it hard to determine the rational amount of capacity incentive and energy compensation for the participants of demand response programs. This paper proposes an algorithm to calculate the amount of capacity incentive and energy compensation for demand response programs when there lacks the information about interruption cost. Available statistical information of interruption cost in referenced areas is selected as the referenced data. Interruption cost of the targeted area is converted from the referenced area by product per electricity consumption. On this basis, capacity incentive and energy compensation are obtained to minimize the payment to consumers. Moreover, the loss of consumers is guaranteed to be covered by the revenue they earned from load serving entities.

Engagement in health and wellness: An online incentive-based program.

PubMed

Gibson, Teresa B; Maclean, J Ross; Carls, Ginger S; Moore, Brian J; Ehrlich, Emily D; Fener, Victoria; Goldberg, Jordan; Mechanic, Elaine; Baigel, Colin

2017-09-01

Increasingly, corporate health promotion programs are implementing wellness programs integrating principles of behavioral economics. Employees of a large firm were provided a customized online incentive program to design their own commitments to meet health goals. This study examines patterns of program participation and engagement in health promotion activities. Subjects were US-based employees of a large, nondurable goods manufacturing firm who were enrolled in corporate health benefits in 2010 and 2011. We assessed measures of engagement with the workplace health promotion program (e.g., incentive points earned, weight loss). To further examine behaviors indicating engagement in health promotion activities, we constructed an aggregate, employee-level engagement index. Regression models were employed to assess the association between employee characteristics and the engagement index, and the engagement index and spending. 4220 employees utilized the online program and made 25,716 commitments. Male employees age 18-34 had the highest level of engagement, and male employees age 55-64 had the lowest level of engagement overall. Prior year health status and prior year spending did not show a significant association with the level of engagement with the program ( p  > 0.05). Flexible, incentive-based behavioral health and lifestyle programs may reach the broader workforce including those with chronic conditions and higher levels of health spending.

AN INTER-AGENCY APPROACH FOR DETERMINING REGIONAL LAND COVER AND SPECIES HABITAT CONSERVATION STATUS IN THE AMERICAN SOUTHWEST: THE SOUTHWEST REGIONAL GAP ANALYSIS PROJECT

EPA Science Inventory

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...

What Difference Does It Make? Assessing Outcomes from Participation in a Residential Environmental Education Program

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…

Quantitative Financial Analysis of Alternative Energy Efficiency Shareholder Incentive Mechanisms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cappers, Peter; Goldman, Charles; Chait, Michele

2008-08-03

Rising energy prices and climate change are central issues in the debate about our nation's energy policy. Many are demanding increased energy efficiency as a way to help reduce greenhouse gas emissions and lower the total cost of electricity and energy services for consumers and businesses. Yet, as the National Action Plan on Energy Efficiency (NAPEE) pointed out, many utilities continue to shy away from seriously expanding their energy efficiency program offerings because they claim there is insufficient profit-motivation, or even a financial disincentive, when compared to supply-side investments. With the recent introduction of Duke Energy's Save-a-Watt incentive mechanism andmore » ongoing discussions about decoupling, regulators and policymakers are now faced with an expanded and diverse landscape of financial incentive mechanisms, Determining the 'right' way forward to promote deep and sustainable demand side resource programs is challenging. Due to the renaissance that energy efficiency is currently experiencing, many want to better understand the tradeoffs in stakeholder benefits between these alternative incentive structures before aggressively embarking on a path for which course corrections can be time-consuming and costly. Using a prototypical Southwest utility and a publicly available financial model, we show how various stakeholders (e.g. shareholders, ratepayers, etc.) are affected by these different types of shareholder incentive mechanisms under varying assumptions about program portfolios. This quantitative analysis compares the financial consequences associated with a wide range of alternative incentive structures. The results will help regulators and policymakers better understand the financial implications of DSR program incentive regulation.« less

The Incentive Grant Approach in Higher Education: A 15 Year Record. Institute for Educational Leadership Reports: Nine.

ERIC Educational Resources Information Center

Finkelstein, Martin

The incentive grant approach in higher Education is a resource allocation strategy that may have significant positive impact on educational performance. This document covers: (1) the incentive grant approach to resource allocation; (2) the evolution during the past 15 years of types of incentive grant programs and the contrasting roles played by…

The Effects of Incentives on Workplace Performance: A Meta-Analytic Review of Research Studies

ERIC Educational Resources Information Center

Condly, Steven J.; Clark, Richard E.; Stolovitch, Harold D.

2003-01-01

A meta-analytic review of all adequately designed field and laboratory research on the use of incentives to motivate performance is reported. Of approximately 600 studies, 45 qualified. The overall average effect of all incentive programs in all work settings and on all work tasks was a 22% gain in performance. Team-directed incentives had a…

7 CFR 636.1 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.1 Applicability. (a) The purpose of the Wildlife Habitat Incentive Program (WHIP) is to help participants develop fish and wildlife habitat on private agricultural land, nonindustrial private forest land (NIPF), and Indian land. (b) The...

7 CFR 636.1 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.1 Applicability. (a) The purpose of the Wildlife Habitat Incentive Program (WHIP) is to help participants develop fish and wildlife habitat on private agricultural land, nonindustrial private forest land (NIPF), and Indian land. (b) The...

7 CFR 636.1 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.1 Applicability. (a) The purpose of the Wildlife Habitat Incentive Program (WHIP) is to help participants develop fish and wildlife habitat on private agricultural land, nonindustrial private forest land (NIPF), and Indian land. (b) The...

7 CFR 636.1 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE LONG TERM CONTRACTING WILDLIFE HABITAT INCENTIVE PROGRAM § 636.1 Applicability. (a) The purpose of the Wildlife Habitat Incentive Program (WHIP) is to help participants develop fish and wildlife habitat on private agricultural land, nonindustrial private forest land (NIPF), and Indian land. (b) The...

Accomplishments and economic evaluations of the Forestry Incentives Program: A review

Treesearch

Deborah A. Gaddis; Barry D. New; Fredrick W. Cubbage; Robert C. Abt; Robert J. Moulton

1995-01-01

The Forestry Incentives Program (FIP) is a federal financial cost-share program that is intended to increase the nation's timber supply by increasing tree planting and timber stand improvement on nonindustrial private forest lands. Timber harvest reductions on public lands in the West, environmental constraints on private lands throughout the U.S., and increased...

Teacher Incentive Pay Programs: Characteristics and Association with Instructional Practices

ERIC Educational Resources Information Center

Liang, Guodong

2011-01-01

This dissertation research examined the characteristics of teacher incentive pay programs in the state of Missouri and across the nation in the United States. The purposes of this study were (a) to examine the characteristics of districts that offered performance-related pay (PRP) programs and teachers who received PRP awards in 2007 using the…

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

PubMed

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

45 CFR 305.31 - Amount of incentive payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROGRAM PERFORMANCE MEASURES, STANDARDS, FINANCIAL INCENTIVES, AND PENALTIES § 305.31 Amount of incentive... establishment, support order, and current collections performance measures and 75 percent of the State's collections base for the fiscal year for the arrearage collections and cost-effectiveness performance measures...

28 CFR 544.43 - Incentives.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Incentives. 544.43 Section 544.43 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT EDUCATION Mandatory English-as-a-Second Language Program (ESL) § 544.43 Incentives. The Warden or designee shall...

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

PubMed

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

2017-03-01

New rapid molecular diagnostic technologies for infectious diseases enable expedited accurate microbiological diagnoses. However, diagnostic stewardship and antimicrobial stewardship are necessary to ensure that these technologies conserve, rather than consume, additional health care resources and optimally affect patient care. Diagnostic stewardship is needed to implement appropriate tests for the clinical setting and to direct testing toward appropriate patients. Antimicrobial stewardship is needed to ensure prompt appropriate clinical action to translate faster diagnostic test results in the laboratory into improved outcomes at the bedside. This minireview outlines the roles of diagnostic stewardship and antimicrobial stewardship in the implementation of rapid molecular infectious disease diagnostics. Copyright © 2017 American Society for Microbiology.

Making WaterSense in Charlottesville

EPA Pesticide Factsheets

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

Science.gov Websites

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

Science.gov Websites

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

Science.gov Websites

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

EPA Science Inventory

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...

Development of a resource planning index for Washington's February 2010 scenic and recreational highways.

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...

Science Matters.

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…

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

Benefits of adding small financial incentives or optional group meetings to a web-based statewide obesity initiative.

PubMed

Leahey, Tricia M; Subak, Leslee L; Fava, Joseph; Schembri, Michael; Thomas, Graham; Xu, Xiaomeng; Krupel, Katie; Kent, Kimberly; Boguszewski, Katherine; Kumar, Rajiv; Weinberg, Brad; Wing, Rena

2015-01-01

To examine whether adding either small, variable financial incentives or optional group sessions improves weight losses in a community-based, Internet behavioral program. Participants (N = 268) from Shape Up Rhode Island 2012, a 3-month Web-based community wellness initiative, were randomized to: Shape Up+Internet behavioral program (SI), Shape Up+Internet program+incentives (SII), or Shape Up+Internet program+group sessions (SIG). At the end of the 3-month program, SII achieved significantly greater weight losses than SI (SII: 6.4% [5.1-7.7]; SI: 4.2% [3.0-5.6]; P = 0.03); weight losses in SIG were not significantly different from the other two conditions (SIG: 5.8% [4.5-7.1], P's ≥ 0.10). However, at the 12-month no-treatment follow-up visit, both SII and SIG had greater weight losses than SI (SII: 3.1% [1.8-4.4]; SIG: 4.5% [3.2-5.8]; SI: 1.2% [-0.1-2.6]; P's ≤ 0.05). SII was the most cost-effective approach at both 3 (SII: $34/kg; SI: $34/kg; SIG: $87/kg) and 12 months (SII: $64/kg; SI: $140/kg; SIG: $113/kg). Modest financial incentives enhance weight losses during a community campaign, and both incentives and optional group meetings improved overall weight loss outcomes during the follow-up period. However, the use of the financial incentives is the most cost-effective approach. © 2014 The Obesity Society.

42 CFR § 414.1310 - Applicability.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1310 Applicability. (a) Program Implementation. Except as specified in paragraph (b) of this section, MIPS applies to payments for items and...

76 FR 76977 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... Program LIHEAP Leveraging Report. OMB No.: 0970-0121. Description: The LIHEAP leveraging incentive program rewards LIHEAP grantees that have leveraged non-federal home energy resources for low- income households. The LIHEAP leveraging report is the application for leveraging incentive funds that these LIHEAP...

30 CFR 204.213 - May I obtain relief for a property that benefits from other Federal or State incentive programs?

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROPERTIES Accounting and Auditing Relief § 204.213 May I obtain relief for a property that benefits from other Federal or State incentive programs? You may obtain accounting and auditing relief for production...

77 FR 66025 - Program Access Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-31

... distribution market if the prohibition were lifted.'' Accordingly, we rely on ``economic theory and predictive... incentive and the ability to harm competition and diversity in the distribution of video programming by entering into exclusive contracts. We undertake the same analysis here. Below, we consider the ``incentive...

Further Evidence on the Effect of Acquisition Policy and Process on Cost Growth of Major Defense Acquisition Programs

DTIC Science & Technology

2016-06-01

Total Package Procurement (TPP) when it was judged to be practicable and, when not, Fixed Price Incentive Fee (FPIF) or Cost Plus Incentive Fee (CPIF...development contracts in favor of CPIF. ( Cost Plus Award Fee may not have been included in the contracting play book yet.) As a general matter, Packard’s...Group CAPE Cost Assessment and Program Evaluation CD Compact Disc CE Current Estimate CLC Calibrated Learning Curve CPIF Cost Plus Incentive Fee

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

Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

Retail trade incentives: how tobacco industry practices compare with those of other industries.

PubMed Central

Feighery, E C; Ribisl, K M; Achabal, D D; Tyebjee, T

1999-01-01

OBJECTIVES: This study compared the incentive payments for premium shelf space and discounts on volume purchases paid to retailers by 5 types of companies. METHODS: Merchants were interviewed at 108 randomly selected small retail outlets that sell tobacco in Santa Clara County, California. RESULTS: Significantly more retailers reported receiving slotting/display allowances for tobacco (62.4%) than for any other product type. An average store participating in a retailer incentive program received approximately $3157 annually from all sampled product types, of which approximately $2462 (78%) came from tobacco companies. CONCLUSIONS: Future research should assess the impact of tobacco industry incentive programs on the in-store marketing and sales practices of retailers. PMID:10511841

Retail trade incentives: how tobacco industry practices compare with those of other industries.

PubMed

Feighery, E C; Ribisl, K M; Achabal, D D; Tyebjee, T

1999-10-01

This study compared the incentive payments for premium shelf space and discounts on volume purchases paid to retailers by 5 types of companies. Merchants were interviewed at 108 randomly selected small retail outlets that sell tobacco in Santa Clara County, California. Significantly more retailers reported receiving slotting/display allowances for tobacco (62.4%) than for any other product type. An average store participating in a retailer incentive program received approximately $3157 annually from all sampled product types, of which approximately $2462 (78%) came from tobacco companies. Future research should assess the impact of tobacco industry incentive programs on the in-store marketing and sales practices of retailers.

State property tax programs promoting sustainable forests in the United States: A review of program structure and administration

Treesearch

Michael Kilgore; Paul Ellefson; Travis Funk; Gregory E. Frey

2018-01-01

Financial incentives offered by state property tax programs are a means of promoting goods and services from private forestland. Identified by a 50-state review in 2014–2015, these incentives often require adherence to several conditions including valid ownership and use of forestland, correct size of parcel and suitable forest...

Economic potential of agroforestry and forestry in the lower Mississippi Alluvial Valley with incentive programs and carbon payments

Treesearch

Gregory E. Frey; D. Evan Mercer; Frederick W. Cubbage; Robert C. Abt

2011-01-01

Conversion of bottomland hardwood forests in the Lower Mississippi Alluvial Valley (LMAV) to agricultural land has caused a loss of ecosystem services. The primary approaches to reverse this have been the Wetlands Reserve Program and the Conservation Reserve Program, which provide financial incentives to landowners to reforest. However, other forest production regimes...

Developing and Implementing an Early Retirement Incentive Program for Marin County School Districts. Vol. 1 and 2.

ERIC Educational Resources Information Center

Mauzy, Byron W.

In creating an early retirement incentive program for the Marin County (California) schools, the author examined the early retirement ethic, other early retirement plans in the public and private sectors, the impact of early retirement on Social Security benefits, opposition to such programs, and the factors in the California school districts that…

Making Teacher Incentives Work: Lessons from North Carolina's Teacher Bonus Program. Education Outlook. No. 5

ERIC Educational Resources Information Center

Ahn, Thomas; Vigdor, Jacob L.

2011-01-01

North Carolina has operated one of the country's largest pay-for-performance teacher-bonus programs since the late 1990s. New research shows that a North Carolina-style incentive-pay program has the potential to improve student learning by encouraging teachers to exert more effort on the job. The North Carolina model avoids three pitfalls…

Financial incentive programs' influence in promoting sustainable forestry in the northern region

Treesearch

Michael G. Jacobson; Thomas J. Straka; John L. Greene; Michael A. Kilgore; Steven E. Daniels

2009-01-01

Selected forestry officials in each of the 20 northern states were surveyed concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners' awareness of each one, its appeal among the owners aware...

A win-win on agricultural lands: creating wildlife habitat through agroforestry

Treesearch

Gary Bentrup

2014-01-01

The 2014 Farm Bill reduces conservation program spending by $6 billion—the first decrease in conservation funding by a Farm Bill since the inclusion of conservation incentives in 1985. These funding cuts will impact habitat enhancement on private lands, typically accomplished through Farm Bill incentive programs such as the Conservation Reserve Program (CRP) and the...

Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education

ERIC Educational Resources Information Center

Ullman, Ellen

2013-01-01

Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

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.

The Cornell Staff Retirement Incentive Program

ERIC Educational Resources Information Center

Whelan, Kenneth T.; Ehrenberg, Ronald G.; Hallock, Kevin F.; Seeber, Ronald L.

2011-01-01

We evaluate potential determinants of enrollment in an early retirement incentive program for non-tenure-track employees at a large university. Using administrative records on the eligible, population of employees not covered by collective bargaining agreements, historical employee count and layoff data by budget units, and public information on…

Influence and effectiveness of financial incentive programs in promoting sustainable forestry in the south

Treesearch

Michael G. Jacobson; John L. Greene; Thomas J. Straka; Steven E. Daniels; Michael A. Kilgore

2009-01-01

State forestry officials responsible for forestry incentive programs in each of the 13 southern states were surveyed concerning their opinions on financial incentiveprograms available to nonindustrial private forest owners. The forestry officials were asked to name and describe the public and...

Cost Reduction Incentive Awards. 1981 Winners.

ERIC Educational Resources Information Center

National Association of College and University Business Officers, Washington, DC.

Brief descriptions of 47 college programs recognized for awards in the National Association of College and University Officers/U. S. Steel Foundation Cost Reduction Incentive Awards Program are given. They include awards for: shower stall repair; chemical waste exchange; vibrating alarms for hearing-imparied; self-funding insurance consortium;…

48 CFR 719.273-3 - Incentives for prime contractor participation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... INTERNATIONAL DEVELOPMENT SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS The U.S. Agency for International...) Under the Small Business Act, 15 U.S.C. 637(d)(4)(E), USAID is authorized to provide appropriate incentives to encourage subcontracting opportunities for small business consistent with the efficient and...

20 CFR 637.225 - Determination of incentive bonus.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Determination of incentive bonus. 637.225 Section 637.225 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE V OF THE JOB TRAINING PARTNERSHIP ACT Program Planning and Operation § 637.225 Determination...

42 CFR 495.106 - Incentive payments to CAHs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAM Requirements Specific to the Medicare Program § 495.106 Incentive payments to CAHs. (a... computers and associated hardware and software, necessary to administer certified EHR technology as defined... determining if a CAH is a qualifying CAH under this section; (3) Specification of EHR reporting periods, cost...

42 CFR 495.106 - Incentive payments to CAHs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAM Requirements Specific to the Medicare Program § 495.106 Incentive payments to CAHs. (a... computers and associated hardware and software, necessary to administer certified EHR technology as defined... determining if a CAH is a qualifying CAH under this section; (3) Specification of EHR reporting periods, cost...

Property-tax incentives for implementing soil-conservation programs under constitutional taxing limitations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Massey, D.T.; Silver, M.B.

1982-01-01

This article describes how property-tax incentives can be used to implement soil-conservation programs on agricultural and open-space lands under the differential-assessment statutes and other exceptions to constitutional limitations on taxation powers. The article describes restrictions imposed on taxing powers by the constitutional uniformity clauses and methods for circumventing those limitations; various property-tax incentives available for conservation programs; types of differential or use-value assessments providing property-tax relief for farm, forest, and open-space land preservation; eligibility of lands for differential assessments; methods available to landowners for participation in differential assessments; and determination of value under differential assessment. The article next details howmore » each of the three primary types of differential or use-value assessment statutes for farm, forest, and open-space land preservation provides exceptions to the uniformity clauses for property tax incentives to implement soil-conservation programs. Other methods available for providing exceptions to the uniformity clauses to permit property-tax incentives are also described for each of the three states. Each of these states has statutes giving favorable tax treatment to certain types of property, such as pollution-abatement equipment, alternative energy-producing devices, and even country clubs. These statutes can be used as examples of finding a constitutional method for providing favorabe tax treatment to promote participation in soil-conservation programs.« less

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)

R&D incentives for neglected diseases.

PubMed

Dimitri, Nicola

2012-01-01

Neglected diseases are typically characterized as those for which adequate drug treatment is lacking, and the potential return on effort in research and development (R&D), to produce new therapies, is too small for companies to invest significant resources in the field. In recent years various incentives schemes to stimulate R&D by pharmaceutical firms have been considered. Broadly speaking, these can be classified either as 'push' or 'pull' programs. Hybrid options, that include push and pull incentives, have also become increasingly popular. Supporters and critics of these various incentive schemes have argued in favor of their relative merits and limitations, although the view that no mechanism is a perfect fit for all situations appears to be widely held. For this reason, the debate on the advantages and disadvantages of different approaches has been important for policy decisions, but is dispersed in a variety of sources. With this in mind, the aim of this paper is to contribute to the understanding of the economic determinants behind R&D investments for neglected diseases by comparing the relative strength of different incentive schemes within a simple economic model, based on the assumption of profit maximizing firms. The analysis suggests that co-funded push programs are generally more efficient than pure pull programs. However, by setting appropriate intermediate goals hybrid incentive schemes could further improve efficiency.

Effectiveness of the forest stewardship program in conserving natural resources on private lands in Indiana

Treesearch

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

Treesearch

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...

Initiation and Maintenance of Fitness Center Utilization in an Incentive-Based Employer Wellness Program

PubMed Central

Abraham, Jean Marie; Crespin, Daniel; Rothman, Alexander

2015-01-01

Objective Investigate the initiation and maintenance of participation in an employer-based wellness program that provides financial incentives for fitness center utilization. Methods Using multivariate analysis, we investigated how employees’ demographics, health status, exercise-related factors, and lifestyle change preferences affect program participation. Results Forty-two percent of eligible employees participated in the program and 24% earned a $20 incentive at least once by utilizing a gym 8 times or more in a month. On average, participants utilized fitness centers 7.0 months each year and earned credit 4.5 months. Participants’ utilization diminished after their first year in the program. Conclusions Factors associated with initiation and maintenance of fitness center utilization were similar. Declining utilization over time raises concern about the long-run effectiveness of fitness-focused wellness programs. Employers may want to consider additional levers to positively reinforce participation. PMID:26340283

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program

PubMed Central

Harnack, Lisa; Oakes, J. Michael; Elbel, Brian; Beatty, Timothy; Rydell, Sarah; French, Simone

2018-01-01

IMPORTANCE Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers. OBJECTIVE To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants’ diets. DESIGN, SETTING, AND PARTICIPANTS Lower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits); (2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period. MAIN OUTCOMES AND MEASURES Primary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality. RESULTS A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (−96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (−64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (−0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms. CONCLUSIONS AND RELEVANCE A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. CLINICAL TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02643576 PMID:27653735

Effects of Subsidies and Prohibitions on Nutrition in a Food Benefit Program: A Randomized Clinical Trial.

PubMed

Harnack, Lisa; Oakes, J Michael; Elbel, Brian; Beatty, Timothy; Rydell, Sarah; French, Simone

2016-11-01

Strategies to improve the nutritional status of those participating in the Supplemental Nutrition Assistance Program (SNAP) are of interest to policymakers. To evaluate whether the proposed policy of incentivizing the purchase of fruits and vegetables and prohibiting the purchase of less nutritious foods in a food benefit program improves the nutritional quality of participants' diets. Lower income participants (n = 279) not currently enrolled in SNAP were randomized to 1 of 4 experimental financial food benefit conditions: (1) incentive (30% financial incentive for fruits and vegetables purchased using food benefits); (2) restriction (not allowed to buy sugar sweetened beverages, sweet baked goods, or candies with food benefits); (3) incentive plus restriction (30% financial incentive on fruits and vegetables and restriction of purchase of sugar sweetened beverages, sweet baked goods, or candy with food benefits); or (4) control (no incentive or restrictions on foods purchased with food benefits). Participants in all conditions were given a study-specific debit card where funds were added every 4 weeks for a 12-week period. Outcome measures were collected at baseline and in the final 4 weeks of the experimental period. Primary outcomes (from 24-hour dietary recalls) included intake of energy, discretionary calories, and overall diet quality. A number of favorable changes were observed in the incentive plus restriction condition that were significantly different from changes in the control condition. These included (1) reduced intake of energy (-96 kcal/d, standard error [SE], 59.9); (2) reduced intake of discretionary calories (-64 kcal/d, SE 26.3); (3) reduced intake of sugar sweetened beverages, sweet baked goods, and candies (-0.6 servings/d, SE 0.2); (4) increased intake of solid fruit (0.2 servings/d, SE 0.1); and (5) improved Healthy Eating Index score (4.1 points, SE 1.4). Fewer improvements were observed in the incentive only and restriction only arms. A food benefit program that pairs incentives for purchasing more fruits and vegetables with restrictions on the purchase of less nutritious foods may reduce energy intake and improve the nutritional quality of the diet of participants compared with a program that does not include incentives or restrictions. clinicaltrials.gov Identifier: NCT02643576.

Using Financial Incentives to Motivate Staff: A Program that Works.

ERIC Educational Resources Information Center

Calhoun, A. Brian; Lestina, Ray

1986-01-01

Explains Triton College's incentive/bonus system used to promote the involvement and retention of Employee Development Institute staff. The six-step system involves determining departmental profit, establishing minimum profit figures and bonus base, calculating the bonus pool, determining individual bonus shares, adding special programing bonuses,…

Teacher Leadership Program Readiness Surveys. Toolkit/Guide

ERIC Educational Resources Information Center

Finster, Matthew

2016-01-01

Federal initiatives, such as the Teacher Incentive Fund (TIF), encourage school districts to develop teacher leadership (TL) roles and use funds to provide incentives for teachers to fill them. Before starting a teacher leader program, school districts should assess whether their current conditions are favorable to implementing teacher leader…

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) CMS requires a qualifying MA organization that registers MA EPs for the purpose of participating in the MA EHR Incentive Program to notify each of the MA EPs for which it is claiming an incentive...

42 CFR 495.208 - Avoiding duplicate payment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.208 Avoiding duplicate payment. (a) CMS requires a qualifying MA organization that registers MA EPs for the purpose of participating in the MA EHR Incentive Program to notify each of the MA EPs for which it is claiming an incentive...

Minnesota's Nursing Facility Performance-Based Incentive Payment Program: An Innovative Model for Promoting Care Quality

ERIC Educational Resources Information Center

Cooke, Valerie; Arling, Greg; Lewis, Teresa; Abrahamson, Kathleen A.; Mueller, Christine; Edstrom, Lisa

2010-01-01

Purpose: Minnesota's Nursing Facility Performance-Based Incentive Payment Program (PIPP) supports provider-initiated projects aimed at improving care quality and efficiency. PIPP moves beyond conventional pay for performance. It seeks to promote implementation of evidence-based practices, encourage innovation and risk taking, foster collaboration…

Employer Incentives to Participate in a Comprehensive School-to-Work Transition Program.

ERIC Educational Resources Information Center

Klein, Steven G.

This report evaluated economic incentives for employer participation in a comprehensive school-to-work (STW) initiative. In general, the business, economic, and educational literature emphasizes quantifying the fiscal benefits of employer-sponsored training, although only qualitative outcomes are available for some programs. The literature…

New Hampshire | Midmarket Solar Policies in the United States | Solar

Science.gov Websites

implemented. New Hampshire Public Utilities Commission's (NHPUC) administers a rebate program for commercial Administrator Incentive Commercial & Industrial Solar Incentive Program New Hampshire Public Utilities $0.25/W rebate for residential systems $0.25/W rebate for commercial/government systems Capped at $1,375

75 FR 3778 - Agency Information Collection Activities: Proposed Request and Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

..., or to evaluate a family bible or other family record when determining eligibility for benefits. The... per Response: 10 minutes. Estimated Annual Burden: 3,333 hours. 5. Work Incentives Planning and Assistance Program--0960-0629. The Work Incentives Planning and Assistance (WIPA) program collects...

78 FR 35936 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program Under the Paperwork Reduction Act... Collection: Evaluation of the Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program; Use: The Physician Quality Reporting System (PQRS) was first implemented in 2007 as an...

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...

Incentives for Tuition Savings.

ERIC Educational Resources Information Center

Miller, Scott E.

The role of the federal government in authorizing tuition savings plans and the relationship of these incentives to more traditional student aid programs are examined. Most of the recent proposals to provide incentives for families to save for their children's education would allow tax breaks. For example, the Reagan administration proposal would…

42 CFR § 414.1455 - Limitation on review.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) MEDICARE PROGRAM (CONTINUED) PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES Merit-Based Incentive Payment System and Alternative Payment Model Incentive § 414.1455 Limitation on review. There is... of the APM Incentive Payment under § 414.1450, including any estimation as part of such determination. ...

Agency Theory, Incentives, and Student Loans.

ERIC Educational Resources Information Center

Rudner, Lawrence M.

Using agency theory, this paper analyzes schools, particularly career schools, in the Stafford Loan Program for student incentive to graduate and pay off their loans. Agency theory focuses on the roles of information and incentives when a principal and an agent cooperate with respect to the utilization of resources. The analysis examines the…

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.

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.

Post-Closure Strategy for Use-Restricted Sites on the Nevada National Security Site, Nevada Test and Training Range, and Tonopah Test Range, Nevada

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

Effectiveness of financial incentive programs in promoting sustainable forestry in the west

Treesearch

John L. Greene; Steven E. Daniels; Michael A. Kilgore; Thomas J. Straka; Michael G. Jacobson

2011-01-01

Selected forestry officials in each of the 13 western states were surveyed in 2005 concerning their opinions on the public and private financial incentive programs available to nonindustrial private forest owners in their state. The officials were asked to name and describe the programs and to assess forest owners’ awareness of each one, its appeal among owners aware...