WorldWideScience

Sample records for antimicrobial utilization program

  1. Entrez Programming Utilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Entrez Programming Utilities (E-utilities) are a set of eight server-side programs that provide a stable interface into the Entrez query and database system at...

  2. Measuring the impact of antimicrobial stewardship programs

    NARCIS (Netherlands)

    Dik, Jan-Willem H.; Hendrix, Ron; Poelman, Randy; Niesters, Hubert G.; Postma, Maarten J.; Sinha, Bhanu; Friedrich, Alexander W.

    Antimicrobial Stewardship Programs (ASPs) are being implemented worldwide to optimize antimicrobial therapy, and thereby improve patient safety and quality of care. Additionally, this should counteract resistance development. It is, however, vital that correct and timely diagnostics are performed in

  3. NASA's Technology Utilization Program.

    Science.gov (United States)

    Farley, C. F.

    1972-01-01

    NASA's Technology Utilization Program is described, illustrating how it can be useful in achieving improved productivity, providing more jobs, solving public sector challenges, and strengthening the international competitive situation. Underlying the program is the fact that research and development conducted in NASA's aeronautics and space programs have generated much technical information concerning processes, products, or techniques which may be useful to engineers, doctors, or to others. The program is based on acquisition and publication, working with the user, and applications engineering.

  4. Danish integrated antimicrobial in resistance monitoring and research program

    DEFF Research Database (Denmark)

    Hammerum, Anette Marie; Heuer, Ole Eske; Emborg, Hanne-Dorthe

    2007-01-01

    a systematic and continuous monitoring program of antimicrobial drug consumption and antimicrobial agent resistance in animals, food, and humans, the Danish Integrated Antimicrobial Resistance Monitoring and Research Program (DANMAP). Monitoring of antimicrobial drug resistance and a range of research......Resistance to antimicrobial agents is an emerging problem worldwide. Awareness of the undesirable consequences of its widespread occurrence has led to the initiation of antimicrobial agent resistance monitoring programs in several countries. In 1995, Denmark was the first country to establish...... activities related to DANMAP have contributed to restrictions or bans of use of several antimicrobial agents in food animals in Denmark and other European Union countries....

  5. Changes in antimicrobial prescribing behavior after the introduction of the antimicrobial stewardship program: A pre- and post-intervention survey

    Directory of Open Access Journals (Sweden)

    Ruchir Chavada

    2017-10-01

    Full Text Available The introduction of an antimicrobial stewardship (AMS program is associated with a change in antimicrobial prescribing behavior. A proposed mechanism for this change is by impacting the prescribing etiquette described in qualitative studies. This study sought to detect a change in prescribing attitudes 12 months after the introduction of AMS and gauge utility of various AMS interventions. Surveys were distributed to doctors in two regional Australian hospitals on a convenience basis 6 months before, and 12 months after, the introduction of AMS. Agreement with 20 statements describing attitudes (cultural, behavioral and knowledge towards antimicrobial prescribing was assessed on a 4-point Likert scale. Mean response scores were compared using the Wilcoxon Rank sum test. 155 responses were collected before the introduction of AMS, and 144 afterwards. After the introduction of AMS, an increase was observed in knowledge about available resources such as electronic decision support systems (EDSS and therapeutic guidelines, with raised awareness about the support available through AMS rounds and the process to be followed when prescribing restricted antimicrobials. Additionally, doctors were less likely to rely on pharmacy to ascertain when an antimicrobial was restricted, depend on infectious diseases consultant advice and use past experience to guide antimicrobial prescribing. Responses to this survey indicate that positive changes to the antimicrobial prescribing etiquette may be achieved with the introduction of an AMS program. Use of EDSS and other resources such as evidence-based guidelines are perceived to be important to drive rational antimicrobial prescribing within AMS programs.

  6. Ability of Latin America laboratories to detect antimicrobial resistance patterns: experience of the SENTRY antimicrobial surveillance program (1997-2000

    Directory of Open Access Journals (Sweden)

    Rodrigo E. Mendes

    Full Text Available The accuracy of antimicrobial susceptibility tests is a crucial step for the clinical management of patients with serious infections. They must be reliable and precise because they will guide antimicrobial therapy. Our main objective was to compare the results of susceptibility testing performed by the SENTRY coordinator laboratory with those reported by the participating Latin American medical centers. A total of 10,277 bacterial isolates were tested by the reference broth microdilution method at the coordinator laboratory in the United States. The tests were performed and interpreted following the National Committee for Clinical Laboratory Standards (NCCLS recommendations. Ten antimicrobial agent-organism combinations were analyzed. The susceptibility methods utilized in each of the medical centers were also evaluated. Total agreement of the results was obtained in nearly 88% of the antimicrobial agent-organism combinations. "Very major" (false-susceptible results and "major errors" (false-resistant results were observed in 12% and 6% of the cases, respectively. The highest disagreements were observed for coagulase-negative Staphylococcus - oxacillin (20% - very major error and Burkholderia cepacia - imipenem (21% - very major error. The susceptibility method with the highest agreement rate was Etest® (92% > PASCO® (91% > agar dilution (91% > MicroScan® (90% > Vitek® (87%. External quality assurance data obtained by surveillance programs such as the SENTRY Antimicrobial Surveillance Program are not only helpful for detecting the emergence of patterns of antimicrobial resistance, but also to monitor the performance of the participating microbiology laboratories.

  7. Ability of Latin America laboratories to detect antimicrobial resistance patterns: experience of the SENTRY antimicrobial surveillance program (1997-2000

    Directory of Open Access Journals (Sweden)

    Mendes Rodrigo E.

    2003-01-01

    Full Text Available The accuracy of antimicrobial susceptibility tests is a crucial step for the clinical management of patients with serious infections. They must be reliable and precise because they will guide antimicrobial therapy. Our main objective was to compare the results of susceptibility testing performed by the SENTRY coordinator laboratory with those reported by the participating Latin American medical centers. A total of 10,277 bacterial isolates were tested by the reference broth microdilution method at the coordinator laboratory in the United States. The tests were performed and interpreted following the National Committee for Clinical Laboratory Standards (NCCLS recommendations. Ten antimicrobial agent-organism combinations were analyzed. The susceptibility methods utilized in each of the medical centers were also evaluated. Total agreement of the results was obtained in nearly 88% of the antimicrobial agent-organism combinations. "Very major" (false-susceptible results and "major errors" (false-resistant results were observed in 12% and 6% of the cases, respectively. The highest disagreements were observed for coagulase-negative Staphylococcus - oxacillin (20% - very major error and Burkholderia cepacia - imipenem (21% - very major error. The susceptibility method with the highest agreement rate was Etest® (92% > PASCO® (91% > agar dilution (91% > MicroScan® (90% > Vitek® (87%. External quality assurance data obtained by surveillance programs such as the SENTRY Antimicrobial Surveillance Program are not only helpful for detecting the emergence of patterns of antimicrobial resistance, but also to monitor the performance of the participating microbiology laboratories.

  8. Trends in Utility Green Pricing Programs (2005)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Brown, E.

    2006-10-01

    This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

  9. A situational analysis of current antimicrobial governance, regulation, and utilization in South Africa

    Directory of Open Access Journals (Sweden)

    Natalie Schellack

    2017-11-01

    Full Text Available The Global Action Plan on antimicrobial resistance calls for the use of antimicrobial medicines in human and animal health to be optimized, in tandem with a strengthening of the knowledge and evidence base through surveillance and research. However, there is a paucity of consumption data for African countries such as South Africa. Determining antimicrobial consumption data in low-resource settings remains a challenge. This article describes alternative mechanisms of assessing antimicrobial consumption data, such as the use of Intercontinental Marketing Services (IMS data and contract data arising from tenders (an open Request for Proposal, RFP, as opposed to the international norms of daily defined doses per 100 patient-days or per 1000 population. Despite their limitations, these serve as indicators of antimicrobial exposure at the population level and represent an alternative method for ascertaining antimicrobial consumption in human health. Furthermore, South Africa has the largest antiretroviral treatment programme globally and carries a high burden of tuberculosis. This prompted the inclusion of antiretroviral and anti-tuberculosis antibiotic consumption data. Knowledge of antimicrobial utilization is imperative for meaningful future interventions. Baseline antimicrobial utilization data could guide future research initiatives that could provide a better understanding of the different measures of antibiotic use and the level of antibiotic resistance. Keywords: Antimicrobial governance, DOTS, Antibiotic consumption, Developing country, Antimicrobial exposure

  10. Equity implications of utility energy conservation programs

    Energy Technology Data Exchange (ETDEWEB)

    Sutherland, R.J.

    1994-03-15

    This paper uses the Residential Energy Consumption Survey undertaken by the Energy Information Administration in 1990 to estimate the statistical association between household income and participation in electric utility energy conservation programs and the association between participation and the electricity consumption. The results indicate that utility rebates, energy audits, load management programs and other conservation measures tend to be undertaken at greater frequency by high income households than by low income households. Participants in conservation programs tend to occupy relatively new and energy efficient residences and undertake conservation measures other than utility programs, which suggests that utility sponsored programs are substitutes for other conservation investments. Electricity consumption during 1990 is not significantly less for households participating in utility programs than for nonparticipants, which also implies that utility conservation programs are displacing other conservation investments. Apparently, utility programs are not avoiding costs of new construction and instead are transferring wealth, particularly to high income participating households.

  11. Phosphorus utilization response of pigs and broiler chickens to diets supplemented with antimicrobials and phytase

    Directory of Open Access Journals (Sweden)

    Katherine McCormick

    2017-03-01

    Full Text Available Three experiments were conducted to evaluate the phosphorus (P utilization responses of pigs and broiler chickens to dietary supplementation with antimicrobials and phytase and to determine if P digestibility response to phytase is affected by supplementation with antimicrobials. Experiment 1 used 4 diets (a basal negative control formulated to contain 0.41% total P and 0.71% calcium [Ca] without added antimicrobials, basal negative control with added carbadox, basal negative control with added tylosin, or basal negative control with added virginiamycin and six 18-kg barrows in individual metabolism crates per diet. There was no effect of antimicrobials on P and Ca digestibility or retention. Carbadox supplementation increased (P < 0.05 digestibility and retention of gross energy (GE and supplementation with tylosin increased (P < 0.05 N retention relative to the basal negative control diet. Experiment 2 used eight 19-kg barrows in individual metabolism crates per treatment and 9 dietary treatments arranged in a 3 × 3 factorial of antimicrobials (none, tylosin, or virginiamycin and phytase (0, 500, or 1,500 FTU/kg. Phytase addition to the diets linearly increased (P < 0.05 apparent total tract digestibility or retention of P, Ca, nitrogen (N and GE. Supplementation with antimicrobials did not affect apparent total tract digestibility or retention of P, Ca, N or GE. There were linear effects (P < 0.01 of phytase on Ca utilization in diets that were not supplemented with antimicrobials but only tendencies (P < 0.10 in diets supplemented with tylosin or virginiamycin. Phytase linearly improved (P < 0.05 N utilization in diets supplemented with tylosin or virginiamycin but not in diets without added antimicrobials. Experiment 3 was a broiler chicken experiment with the same experimental design as Exp. 2 but feeding 8 birds per cage and 10 replicate cages per diet. Antimicrobial supplementation improved (P < 0.05 feed efficiency and

  12. A situational analysis of current antimicrobial governance, regulation, and utilization in South Africa.

    Science.gov (United States)

    Schellack, Natalie; Benjamin, Deon; Brink, Adrian; Duse, Adriano; Faure, Kim; Goff, Debra; Mendelson, Marc; Meyer, Johanna; Miot, Jacqui; Perovic, Olga; Pople, Troy; Suleman, Fatima; van Vuuren, Moritz; Essack, Sabiha

    2017-11-01

    The Global Action Plan on antimicrobial resistance calls for the use of antimicrobial medicines in human and animal health to be optimized, in tandem with a strengthening of the knowledge and evidence base through surveillance and research. However, there is a paucity of consumption data for African countries such as South Africa. Determining antimicrobial consumption data in low-resource settings remains a challenge. This article describes alternative mechanisms of assessing antimicrobial consumption data, such as the use of Intercontinental Marketing Services (IMS) data and contract data arising from tenders (an open Request for Proposal, RFP), as opposed to the international norms of daily defined doses per 100 patient-days or per 1000 population. Despite their limitations, these serve as indicators of antimicrobial exposure at the population level and represent an alternative method for ascertaining antimicrobial consumption in human health. Furthermore, South Africa has the largest antiretroviral treatment programme globally and carries a high burden of tuberculosis. This prompted the inclusion of antiretroviral and anti-tuberculosis antibiotic consumption data. Knowledge of antimicrobial utilization is imperative for meaningful future interventions. Baseline antimicrobial utilization data could guide future research initiatives that could provide a better understanding of the different measures of antibiotic use and the level of antibiotic resistance. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  13. Trends in Utility Green Pricing Programs (2006)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Kaiser, M.

    2007-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities--or about 25% of all utilities nationally--provide their customers a "green power" option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

  14. Trends in Utility Green Pricing Programs (2006)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Kaiser, Marshall [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2007-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 750 utilities—or about 25% of all utilities nationally—provide their customers a “green power” option. Through these programs, more than 70 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2006 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

  15. Trends in Utility Green Pricing Programs (2004)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Brown, E.

    2005-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, nearly 600 utilities in regulated electricity markets--or almost 20% of all utilities nationally--provide their customers a "green power" option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals about 125. Through these programs, more than 40 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2004 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities as benchmarks by which to gauge the success of their green power programs.

  16. Trends in Utility Green Pricing Programs (2003)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Cardinal, K.

    2004-09-01

    Utilities first began offering consumers a choice of purchasing electricity generated from renewable energy sources in the early 1990s. Since then, the number of U.S. utilities offering green pricing programs has steadily grown. Today, more than 500 utilities in regulated electricity markets--or about 16% of all utilities nationally--offer their customers green power options. Because some of these utilities offer programs in conjunction with cooperative associations or other public power entities, the number of distinct programs is slightly more than 100. Through these programs, more than 33 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs, or make contributions to support the development of renewable energy resources. Typically, customers must pay a premium above standard electricity rates for this service. This report presents year-end 2003 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data provided in this report can be used by utilities as benchmarks by which to gauge the success of their green power programs.

  17. Trends in Utility Green Pricing Programs (2005)

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brown, Elizabeth [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2006-10-01

    In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, more than 600 utilities—or about 20% of all utilities nationally—provide their customers a “green power” option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals more than 130. Through these programs, more than 50 million customers have the ability to purchase renewable energy to meet some portion or all of their electricity needs—or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2005 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities to benchmark the success of their green power programs.

  18. Handbook of evaluation of utility DSM programs

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.; Reed, J. [eds.; Bronfman, B.; Fitzpatrick, G.; Hicks, E.; Hirst, E.; Hoffman, M.; Keating, K.; Michaels, H.; Nadel, S.; Peters, J.; Reed, J.; Saxonis, W.; Schoen, A.; Violette, D.

    1991-12-01

    Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility`s portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough to highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to ``triangulate`` an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.

  19. Beyond Widgets -- Systems Incentive Programs for Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mathew, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walter, Travis [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-08-15

    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 increasingly 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.

  20. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    OpenAIRE

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

    2016-01-01

    Abstract 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 s...

  1. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    OpenAIRE

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

    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 stewardshi...

  2. Utility green pricing programs: a statistical analysis of program effectiveness

    International Nuclear Information System (INIS)

    Ryan, W.; Scott, O.; Lori, B.; Blair, S.

    2005-01-01

    Utility green pricing programs represent one way in which consumers can voluntarily support the development of renewable energy. The design features and effectiveness of these programs varies considerably. Based on a survey of utility program managers in the United States, this article provides insight into which program features might help maximize both customer participation in green pricing programs and the amount of renewable energy purchased by customers in those programs. We find that program length has a substantial impact on customer participation and purchases; to achieve higher levels of success, utilities will need to remain committed to their product offering for some time. Our findings also suggest that utilities should consider higher renewable energy purchase thresholds for residential customers in order to maximize renewable energy sales. Smaller utilities are found to be more successful than larger utilities, and we find some evidence that providing private benefits to nonresidential participants can enhance success. Interestingly, we find little evidence that the cost of the green pricing product greatly impacts customer participation and renewable energy sales, at least over the narrow range of premiums embedded in our data set, and for the initial set of green power purchasers. (author)

  3. Technology to support integrated Antimicrobial Stewardship Programs : a user centered and stakeholder driven development approach

    NARCIS (Netherlands)

    Beerlage-de Jong, Nienke; van Gemert-Pijnen, Julia E.W.C.; Wentzel, M.J.; Hendrix, Ron; Tjin-Kam-Jet-Siemons, Liseth

    2017-01-01

    The rise of antimicrobial resistance (AMR) is a severe global health problem. Tackling this problem requires the prudent prescribing of antimicrobials. This is promoted through Antimicrobial Stewardship Programs (ASPs). In this position paper we describe i) how a socio-technical multidisciplinary

  4. A unique in vivo approach for investigating antimicrobial materials utilizing fistulated animals

    Science.gov (United States)

    Berean, Kyle J.; Adetutu, Eric M.; Zhen Ou, Jian; Nour, Majid; Nguyen, Emily P.; Paull, David; McLeod, Jess; Ramanathan, Rajesh; Bansal, Vipul; Latham, Kay; Bishop-Hurley, Greg J.; McSweeney, Chris; Ball, Andrew S.; Kalantar-Zadeh, Kourosh

    2015-06-01

    Unique in vivo tests were conducted through the use of a fistulated ruminant, providing an ideal environment with a diverse and vibrant microbial community. Utilizing such a procedure can be especially invaluable for investigating the performance of antimicrobial materials related to human and animal related infections. In this pilot study, it is shown that the rumen of a fistulated animal provides an excellent live laboratory for assessing the properties of antimicrobial materials. We investigate microbial colonization onto model nanocomposites based on silver (Ag) nanoparticles at different concentrations into polydimethylsiloxane (PDMS). With implantable devices posing a major risk for hospital-acquired infections, the present study provides a viable solution to understand microbial colonization with the potential to reduce the incidence of infection through the introduction of Ag nanoparticles at the optimum concentrations. In vitro measurements were also conducted to show the validity of the approach. An optimal loading of 0.25 wt% Ag is found to show the greatest antimicrobial activity and observed through the in vivo tests to reduce the microbial diversity colonizing the surface.

  5. OPTIMIZING ANTIMICROBIAL PHARMACODYNAMICS: A GUIDE FOR YOUR STEWARDSHIP PROGRAM

    Directory of Open Access Journals (Sweden)

    Joseph L. Kuti, PharmD

    2016-09-01

    Full Text Available Pharmacodynamic concepts should be applied to optimize antibiotic dosing regimens, particularly in the face of some multidrug resistant bacterial infections. Although the pharmacodynamics of most antibiotic classes used in the hospital setting are well described, guidance on how to select regimens and implement them into an antimicrobial stewardship program in one's institution are more limited. The role of the antibiotic MIC is paramount in understanding which regimens might benefit from implementation as a protocol or use in individual patients. This review article outlines the pharmacodynamics of aminoglycosides, beta-lactams, fluoroquinolones, tigecycline, vancomycin, and polymyxins with the goal of providing a basis for strategy to select an optimized antibiotic regimen in your hospital setting.

  6. Utilizing a Post-discharge Telephone Call in Outpatient Parenteral Antimicrobial Therapy (OPAT): Findings from a Quality Improvement Project

    Science.gov (United States)

    Felder, Kimberly; Vaz, Louise; Barnes, Penelope; Varley, Cara

    2017-01-01

    Abstract Background Transitions of care from hospitals to outpatient settings, especially for patients requiring outpatient parenteral antimicrobial therapy (OPAT) are complex. OPAT complications, such as adverse antimicrobial reactions, vascular access problems, and hospital readmissions are common. Data from transitions of care literature suggest that post-discharge telephone calls (TCs) may significantly decrease re-hospitalization but no studies have assessed the utility of post-discharge TCs as an OPAT program quality improvement process. Methods Adult OPAT patients discharged from our hospital between April 1, 2015 and May 31, 2016 were queried for post-discharge concerns. TCs to patients or their caregivers were administered by trained medical assistants within the Department of Infectious Diseases using a standardized script and documented in the electronic medical record (EMR). Feasibility was assessed using call completion rate. The type and frequency of reported issues were analyzed by retrospective chart review. Results 636 of 689 eligible adult OPAT patients or their caregivers received a TC with responses to scripted questions documented in the EMR (92% completion rate). 302 patients (47%) reported 319 issues, including 293 (92%) relevant to OPAT. Antimicrobial issues included diarrhea/stool changes (58; 9%); nausea/vomiting (27; 4%); and missed antimicrobial doses (22; 3%). Vascular access issues included line patency concerns (21; 3%); vascular access dressing problems (17; 2.6%) and arm pain/swelling (6; 1%). OPAT vendor issues included delays in lab or line care services (23; 4%) and OPAT orders reported as lost/not received (21; 3%). Other ID-related issues included fevers/chills/sweats (27; 4%), wound concerns (16; 2.5%), and pain (15; 2.5%). Conclusion Adding a post-discharge TC to an OPAT program was feasible and resulted in frequent and early identification of significant OPAT patient and caregiver concerns. Findings suggest potential high

  7. Spinoff 2002: Fortieth Anniversary Technology Utilization Program

    Science.gov (United States)

    2002-01-01

    Since its inception 40 years ago, NASA's Technology Transfer Program has led the way for our nation to benefit from cutting-edge aerospace technologies. In addition to contributing to U.S. economic growth, these technologies are improving the quality of life on Earth while finding new ways to protect and preserve it. NASA's research and development efforts have advanced areas in medicine, communications, manufacturing, computer technology, and homeland security. These breakthroughs, translated into commercial products, are enhancing the lives of Americans everywhere. When a congressional mandate led NASA to develop the Scientific and Technical Information (STI) Program, the Agency began a wide dissemination of its research and development results. In doing so, NASA recognized that many of its technologies were transferable to industry for the development of commercial products. As a result, the Technology Utilization Program was born in 1962. The successful program went through several changes over the years, as its philosophy, mission, and goals adapted into the Technology Transfer Program we know today. The program strives to make the latest technologies available to industry as soon as they are developed. Each year, NASA's Spinoff publication showcases new products and services resulting from commercial partnerships between NASA and private industry. In the 2002 issue, the NASA field centers reflect upon the growth that has made these innovations available to the public. The Research and Development section examines past achievements, current successes, and future goals for each of the ten NASA centers. The Commercial Benefits section proudly highlights 51 new spinoff products, including a heart pump for patients needing a heart transplant, as well as an air purifier that destroys anthrax spores. The Technology Transfer and Outreach section describes the outreach achievements and educational successes made possible through the NASA Commercial Technology Network

  8. Utilization of antimicrobial agents with and without prescription by out-patients in selected pharmacies in South-eastern Nigeria.

    Science.gov (United States)

    Esimone, Charles Okey; Nworu, Chukwuemeka Sylvester; Udeogaranya, Obinna Patrick

    2007-12-01

    We conducted a study in out-patient pharmacies in South-eastern Nigeria in order to determine the extent of self-medication of antimicrobial agents in this area, assess the dosing error associated with this practice and to ascertain the extent of involvement of community pharmacies. A survey was carried out daily in selected community pharmacies for a period of 90 days. Data were collected on the number of patients visiting these shops for antimicrobial agents, the number getting their medication with a prescription, the number getting their order without prescription and on the type and dose of antimicrobial agents received. MAIN OUT-COME MEASURE: The percentage of patients with prescription and without prescription was compared. The percentage under-dosages or over-dosages associated with how each antimicrobial agent was obtained were compared. The total DDDs of antimicrobial agents dispensed within this period with and without prescription were compared. A total of 4,128 outpatients visited the shops for antimicrobial agents within the period and were involved in the study. Of this number, 1,742 (42.2%) came with a prescription from qualified medical personnel and 2,386 (57.8%) came without a prescription. A total of 13,693.13 DDDs of antimicrobial agents was dispensed, of which 56.38% was dispensed with prescription and 43.62% was dispensed without prescription. The degrees of under-dosing were significantly (P better regulation of antimicrobial agents dispensing and utilization in the region.

  9. A Review of Quality Measures for Assessing the Impact of Antimicrobial Stewardship Programs in Hospitals.

    Science.gov (United States)

    Akpan, Mary Richard; Ahmad, Raheelah; Shebl, Nada Atef; Ashiru-Oredope, Diane

    2016-01-13

    The growing problem of antimicrobial resistance (AMR) has led to calls for antimicrobial stewardship programs (ASP) to control antibiotic use in healthcare settings. Key strategies include prospective audit with feedback and intervention, and formulary restriction and preauthorization. Education, guidelines, clinical pathways, de-escalation, and intravenous to oral conversion are also part of some programs. Impact and quality of ASP can be assessed using process or outcome measures. Outcome measures are categorized as microbiological, patient or financial outcomes. The objective of this review was to provide an overview of quality measures for assessing ASP and the reported impact of ASP in peer-reviewed studies, focusing particularly on patient outcomes. A literature search of papers published in English between 1990 and June 2015 was conducted in five databases using a combination of search terms. Primary studies of any design were included. A total of 63 studies were included in this review. Four studies defined quality metrics for evaluating ASP. Twenty-one studies assessed the impact of ASP on antimicrobial utilization and cost, 25 studies evaluated impact on resistance patterns and/or rate of Clostridium difficile infection (CDI). Thirteen studies assessed impact on patient outcomes including mortality, length of stay (LOS) and readmission rates. Six of these 13 studies reported non-significant difference in mortality between pre- and post-ASP intervention, and five reported reductions in mortality rate. On LOS, six studies reported shorter LOS post intervention; a significant reduction was reported in one of these studies. Of note, this latter study reported significantly (p evaluation. The choice of metrics is influenced by data and resource availability. Controlling for confounders must be considered in the design of evaluation studies to adequately capture the impact of ASP and it is important for unintended consequences to be considered. This review

  10. Point prevalence survey of antimicrobial utilization in a Canadian tertiary-care teaching hospital

    Directory of Open Access Journals (Sweden)

    Colin Lee

    2015-06-01

    Conclusion: This prospective point prevalence survey provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship initiatives. A multi-center point prevalence survey should be considered to identify patterns of antimicrobial use in Canada and to establish the first steps toward international antimicrobial surveillance.

  11. The role of antimicrobial management programs in optimizing antibiotic prescribing within hospitals.

    Science.gov (United States)

    Paterson, David L

    2006-01-15

    Managing serious infections is a balance between providing timely and appropriate broad-spectrum empirical therapy for individual patients, which has been consistently shown to improve outcomes, and reducing unnecessary use of antimicrobial agents, which may contribute to the development of antimicrobial resistance. To control the spread of antimicrobial resistance, hospitals commonly implement programs designed to optimize antimicrobial use, supported by infection-control measures. Hospital-based antimicrobial management programs--also called "antimicrobial stewardship programs"--are primarily based on education coupled with a "front-end" approach (i.e., restricting the availability of selected antimicrobial agents) or a "back-end" approach (i.e., reviewing broad-spectrum empirical therapy and then streamlining or discontinuing therapy, as indicated, on the basis of culture and susceptibility testing results and clinical response). Institutional efforts to optimize antimicrobial use should concentrate on patient outcomes, should have multidisciplinary support, and should use a combination of interventions customized to the needs, resources, and information technology infrastructure of the health care institution.

  12. Utility oversight of Cask System Development Program

    International Nuclear Information System (INIS)

    Vincent, J.A.; Jordan, J.M.; Schwartz, M.H.

    1993-01-01

    This paper will present the electric utility industry's perspective on the status and scope of the DOE's Office of Civilian Radioactive Waste Management's (DOE/OCRWM) transportation cask systems development activities, including the Cask Systems Development Program (CSDP) Initiative I transportation cask projects. This presentation is particularly timely because the CSDP Independent Management Review Group (IMRG), os which one of the authors is a member, completed an objective assessment of OCRWM's transportation cask system development activities and issued its first report in late August 1992. The perspective on these cask systems development activities that will be presented reflects conclusions based on (1) the industry's review of CSDP Preliminary and Draft Final Design Reports for the Initiative I cask projects, (2) the activities of one of the authors as a member of the IMRG, and (3) the positions that the industry has consistently taken on what it believes to be the appropriate scope and pace of the CSDP and its integration with other OCRWM activities. Background information on the OCRWM transportation cask systems development activities and the relevant industry activities will also be provided

  13. SENTRY antimicrobial surveillance program report: latin american and brazilian results for 1997 through 2001

    Directory of Open Access Journals (Sweden)

    Helio S. Sader

    Full Text Available The alarming emergence and spread of antimicrobial resistance among common bacteria threatens the effectiveness of therapy for many infections. Surveillance of antimicrobial resistance is essential to identify the major problems and guide adequate control measures. Several resistance surveillance programs have been implemented in North America and Europe in the last decade; however, very few programs have assessed antimicrobial resistance in Latin American countries. The SENTRY Antimicrobial Surveillance Program was initiated in 1997 and represents the most comprehensive surveillance program in place at the present time worldwide. The SENTRY Program collects consecutive isolates from clinically documented infections in more than 80 medical centers worldwide (10 in Latin America. The isolates are collected according to the type of infection (objectives and susceptibility tested in a central microbiology laboratory by reference broth microdilution methods according to NCCLS guidelines. The Program also incorporated molecular typing (ribotyping and PFGE and resistance mechanism analysis of selected isolates. In this report we present a very broad analysis of the data generated by testing almost 20,000 bacterial isolates against more than 30 antimicrobial agents. The susceptibility results (MIC50, MIC90 and % susceptible are presented in 11 tables according to the organism and site of infection. The data from Brazil, as well as the data from isolates collected in 2001, are analyzed separately. This report allows the evaluation of the activities numerous antimicrobial agents against clinical isolates collected in Latin American countries.

  14. Eight Habits of Highly Effective Antimicrobial Stewardship Programs to Meet the Joint Commission Standards for Hospitals.

    Science.gov (United States)

    Goff, Debra A; Kullar, Ravina; Bauer, Karri A; File, Thomas M

    2017-04-15

    In an effort to decrease antimicrobial resistance and inappropriate antibiotic use, The Joint Commission (TJC) recently issued new antimicrobial stewardship standards, consisting of 8 elements of performance, applicable to hospitals effective January 1, 2017. These standards coincide with those recommended by the Infectious Diseases Society of America (IDSA) and the Society of Healthcare Epidemiology (SHEA) guidelines. Little guidance exists on the "how" from these guidance documents. We review the 8 standards and provide real-world experience from established antimicrobial stewardship programs (ASPs) on how institutions can comply with these guidelines to reduce inappropriate antibiotic usage, decrease antimicrobial resistance, and optimize patient outcomes. TJC antimicrobial stewardship standards demonstrate actions being taken at the national level to make quality and patient safety a priority. © 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.

  15. Antimicrobial resistance programs in canada 1995-2010: a critical evaluation

    Directory of Open Access Journals (Sweden)

    Conly John M

    2012-02-01

    Full Text Available Abstract Background In Canada, systematic efforts for controlling antibiotic resistance began in 1997 following a national Consensus Conference. The Canadian strategy produced 27 recommendations, one of which was the formation of the Canadian Committee on Antibiotic Resistance (CCAR. In addition several other organizations began working on a national or provincial basis over the ensuing years on one or more of the 3 identified core areas of the strategy. Critical evaluation of the major programs within Canada which focused on antimicrobial resistance and the identified core components has not been previously conducted. Findings Data was collected from multiple sources to determine the components of four major AMR programs that were considered national based on their scope or in the delivery of their mandates. Assessment of program components was adapted from the report from the International Forum on Antibiotic Resistance colloquium. Most of the programs used similar tools but only the Do Bugs Need Drugs Program (DBND had components directed towards day cares and schools. Surveillance programs for antimicrobial resistant pathogens have limitations and/or significant sources of bias. Overall, there has been a 25.3% decrease in oral antimicrobial prescriptions in Canada since 1995, mainly due to decreases in β lactams, sulphonamides and tetracyclines in temporal association with multiple programs with the most comprehensive and sustained national programs being CCAR and DBND. Conclusions Although there has been a substantial decrease in oral antimicrobial prescriptions in Canada since 1995, there remains a lack of leadership and co-ordination of antimicrobial resistance activities.

  16. ONTOLOGY-DRIVEN TOOL FOR UTILIZING PROGRAMMING STYLES

    Directory of Open Access Journals (Sweden)

    Nikolay Sidorov

    2017-07-01

    Full Text Available Activities of a programmer will be more effective and the software will be more understandable when within the process of software development, programming styles (standards are used, providing clarity of software texts. Purpose: In this research, we present the tool for the realization of new ontology-based methodology automated reasoning techniques for utilizing programming styles. In particular, we focus on representing programming styles in the form of formal ontologies, and study how description logic reasoner can assist programmers in utilizing programming standards. Our research hypothesis is as follows: ontological representation of programming styles can provide additional benefits over existing approaches in utilizing programmer of programming standards. Our research goal is to develop a tool to support the ontology-based utilizing programming styles. Methods: ontological representation of programming styles; object-oriented programming; ontology-driven utilizing of programming styles. Results: the architecture was obtained and the tool was developed in the Java language, which provide tool support of ontology-driven programming styles application method. On the example of naming of the Java programming language standard, features of implementation and application of the tool are provided. Discussion: application of programming styles in coding of program; lack of automated tools for the processes of programming standards application; tool based on new method of ontology-driven application of programming styles; an example of the implementation of tool architecture for naming rules of the Java language standard.

  17. Antimicrobial Stewardship Programs: Appropriate Measures and Metrics to Study their Impact.

    Science.gov (United States)

    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

  18. Utility Battery Storage Systems Program plan: FY 1994--FY 1998

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The Utility Battery Storage Systems Program, sponsored by the US Department of Energy (DOE), is addressing needed improvements so that the full benefits of these systems can be realized. A key element of the Program is the quantification of the benefits of batteries used in utility applications. The analyses of the applications and benefits are ongoing, but preliminary results indicate that the widespread introduction of battery storage by utilities could benefit the US economy by more than $26 billion by 2010 and create thousands of new jobs. Other critical elements of the DOE Program focus on improving the batteries, power electronics, and control subsystems and reducing their costs. These subsystems are then integrated and the systems undergo field evaluation. Finally, the most important element of the Program is the communication of the capabilities and benefits of battery systems to utility companies. Justifiably conservative, utilities must have proven, reliable equipment that is economical before they can adopt new technologies. While several utilities are leading the industry by demonstrating battery systems, a key task of the DOE program is to inform the entire industry of the value, characteristics, and availability of utility battery systems so that knowledgeable decisions can be made regarding future investments. This program plan for the DOE Utility Battery Storage Systems Program describes the technical and programmatic activities needed to bring about the widespread use of batteries by utilities. By following this plan, the DOE anticipates that many of the significant national benefits from battery storage will be achieved in the near future.

  19. A Review of Quality Measures for Assessing the Impact of Antimicrobial Stewardship Programs in Hospitals

    Directory of Open Access Journals (Sweden)

    Mary Richard Akpan

    2016-01-01

    Full Text Available The growing problem of antimicrobial resistance (AMR has led to calls for antimicrobial stewardship programs (ASP to control antibiotic use in healthcare settings. Key strategies include prospective audit with feedback and intervention, and formulary restriction and preauthorization. Education, guidelines, clinical pathways, de-escalation, and intravenous to oral conversion are also part of some programs. Impact and quality of ASP can be assessed using process or outcome measures. Outcome measures are categorized as microbiological, patient or financial outcomes. The objective of this review was to provide an overview of quality measures for assessing ASP and the reported impact of ASP in peer-reviewed studies, focusing particularly on patient outcomes. A literature search of papers published in English between 1990 and June 2015 was conducted in five databases using a combination of search terms. Primary studies of any design were included. A total of 63 studies were included in this review. Four studies defined quality metrics for evaluating ASP. Twenty-one studies assessed the impact of ASP on antimicrobial utilization and cost, 25 studies evaluated impact on resistance patterns and/or rate of Clostridium difficile infection (CDI. Thirteen studies assessed impact on patient outcomes including mortality, length of stay (LOS and readmission rates. Six of these 13 studies reported non-significant difference in mortality between pre- and post-ASP intervention, and five reported reductions in mortality rate. On LOS, six studies reported shorter LOS post intervention; a significant reduction was reported in one of these studies. Of note, this latter study reported significantly (p < 0.001 higher unplanned readmissions related to infections post-ASP. Patient outcomes need to be a key component of ASP evaluation. The choice of metrics is influenced by data and resource availability. Controlling for confounders must be considered in the design of

  20. Utilities programs for the WIMSD4 code

    International Nuclear Information System (INIS)

    Leszczynski, F.

    1990-01-01

    The WIMSD4 code is widely known around the world. For its better use, it is convenient to count with auxiliary programs. Two of these programs, developed in FORTRAN 77, in the VAX computer of the Bariloche Atomic Center, are herein presented. WINTER (Wims INTERactive) to generate input data of WIMSD4 in an interactive way, and AMICO (Anisn MIx and COndense) to deal with cross sections data of a multigroup data library and of WIMS output to be used in other programs, such as: ANISN, DOT, CITATION, DIPOBAR, etc. (Author) [es

  1. The utilization and valuation of the program CONTIN

    International Nuclear Information System (INIS)

    Yu Weizhong; Sun Yizhan

    2000-01-01

    The updated analysis program CONTIN(PALS2) based on the Laplace inversion of positron annihilation spectra has been studied comprehensively. The principle and utilization of the program have been explained exhaustively. Three auxiliary programs have been made to help the transportation of data and adjustment of the data's pattern. Four experiments have been made, the results computed by program CONTIN(PALS2) have been analyzed, and compared with those by POSIREONFIT program

  2. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    Science.gov (United States)

    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.

  3. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    Directory of Open Access Journals (Sweden)

    Lucas Miyake Okumura

    2016-05-01

    Full Text Available 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.

  4. Enhanced human performance of utility maintenance programs

    International Nuclear Information System (INIS)

    Fresco, A.; Haber, S.; O'Brien, J.

    1993-01-01

    Assuring the safe operation of a nuclear power plant depends, to a large extent, on how effectively one understands and manages the aging-related degradation that occurs in structures, systems, and components (SSCs). Aging-related degradation is typically managed through a nuclear plant's maintenance program. A review of 44 Maintenance Team Inspection (MTI) Reports indicated that while some plant organizations appeared to assume a proactive mode in preventing aging-related failures of their SSCs important to safety, others seemed to be taking a passive or reactive mode. Across all plants, what is clearly needed, is a strong recognition of the importance of aging-related degradation and the use of existing organizational assets to effectively detect and mitigate those effects. Many of those assets can be enhanced by the consideration of organizational and management factors necessary for the implementation of an effective aging management program. This report provides a discussion of this program

  5. Nuclear Education and Training Programs of Potential Interest to Utilities.

    Science.gov (United States)

    Atomic Energy Commission, Washington, DC.

    This compilation of education and training programs related to nuclear applications in electric power generation covers programs conducted by nuclear reactor vendors, public utilities, universities, technical institutes, and community colleges, which were available in December 1968. Several training-program consultant services are also included.…

  6. Building Maintenance and Utilities Management. Florida Vocational Program Guide.

    Science.gov (United States)

    University of South Florida, Tampa. Dept. of Adult and Vocational Education.

    This program guide identifies primary concerns in the organization, operation, and evaluation of a building maintenance and utilities management program. It is designed for local school district and community college administrators, instructors, program advisory committees, and regional coordinating councils. The guide begins with the Dictionary…

  7. Utility battery storage systems. Program report for FY95

    Energy Technology Data Exchange (ETDEWEB)

    Butler, P.C.

    1996-03-01

    Sandia National Laboratories, New Mexico, conducts the Utility Battery Storage Systems Program, which is sponsored by the U.S. Department of Energy`s Office of Utility Technologies. The goal of this program is to assist industry in developing cost-effective battery systems as a utility resource option by 2000. Sandia is responsible for the engineering analyses, contracted development, and testing of rechargeable batteries and systems for utility energy storage applications. This report details the technical achievements realized during fiscal year 1995.

  8. Electric-utility DSM programs in a competitive market

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.

    1994-04-01

    During the past few years, the costs and effects of utility demand-side management (DSM) programs have grown sharply. In 1989, US electric utilities spent 0.5% of revenues on such programs and cut total electricity consumption by 0.6%. By 1992, these numbers had increased to 1.3% and 1.2%, respectively. Utility projections, as of early 1993, of DSM expenditures and energy savings for 1997 were 1.7% and 2.5%, respectively. Whether this projected growth comes to pass may depend on current debates about deregulation of, and increased competition in, the electric-utility industry. This report examines the factors likely to affect utility DSM programs in a more competitive environment. The electric-utility industry faces two forces that may conflict with each other. One is the pressure to open up both wholesale and retail markets for competition. The net effect of such competition, especially at the retail level, would have much greater emphasis on electricity prices and less emphasis on energy services. Such an outcome would force a sharp reduction in the scale of DSM programs that are funded by customers in general. The second force is increased concern about environmental quality and global warming. Because utilities are major contributors to US carbon dioxide emissions, the Administration`s Climate Change Action Plan calls on utilities to reduce such emissions. DSM programs are one key way to do that and, in the process, to cut customer electric bills and improve economic productivity. This report discusses the forms of competition and how they might affect DSM programs. It examines the important roles that state regulatory commissions could play to affect retail competition and utility DSM programs. The report also considers the effects of DSM programs on retail electricity prices.

  9. Review of US utility demand-side bidding programs

    International Nuclear Information System (INIS)

    Goldman, C.A.; Kito, M.S.

    1995-01-01

    In this study, we review utility experiences with demand-side management (DSM) bidding programs. Since 1987, about 35 US utilities have signed long-term contracts with developers of DSM resources (ie energy service companies and customers) to provide a quantity of demand and energy savings at specified prices. Total resource costs range between 5.4 and 8 cents/kWh for DSM bidding programs where complete information on program costs is available. Almost all DSM bidding programs have been cost-effective compared with the utility's own supply-side alternatives, although there is substantial disagreement regarding the value of these programs compared with the utility's own DSM programs. In most bidding programs, payments to bidders account for between 70 and 90% of total program costs. Variation in winning bid prices is influenced primarily by DSM bid ceiling prices, differences in the mix of measures and markets targeted by developers, and the degree of performance risk borne by the DSM developer. Bids targeting residential customers averaged 6.2 cents/kWh compared with about 5.0 cents/kWh for commercial/industrial bids. We also compared the costs of acquiring lighting savings in DSM bidding contracts with a sample of 20 utility sponsored commercial/industrial lighting programs. We found that, on average total resource costs were slightly higher in bidding programs (6.1 vs 5.6 cents/kWh), although ratepayers bear significantly less performance risk in bidding programs compared with traditional utility-sponsored DSM programs. (author)

  10. Utility Green Tariff Programs: Considerations for Federal Agencies

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, Jenny

    2017-05-08

    This FEMP First Thursday presentation will explain the concept of a utility green tariff, how it differs from a green pricing program, and what questions federal agencies should have about participating.

  11. Logistics Plans and Programs Utilization Field.

    Science.gov (United States)

    1985-04-01

    HQ USAF/LEXX 1 1 HQ USAF/ MPPT I1 HQ USAFE/DPAT 3 3 HQ USAFE/TTGT 1 1 HQ USMC (CODE TPI) 1 LM1DC/ AN 1 NODAC 1 3400 TCHTW/TTGX (LOWRY AFB CO) 5 1 5 1...clustering analysis program. The job inventory with the lowest case control number, 0001, was completed by an incumbent performing a mobility job...serve in Mobility Control Center (MCC) during exercises or deployments Analyze exercises or deployment after-action reports Request logistics inputs

  12. EPRI Guide to Managing Nuclear Utility Protective Clothing Programs

    International Nuclear Information System (INIS)

    Kelly, J.J.; Kelly, D.M.

    1993-10-01

    The Electric Power Research Institute (EPRI) commissioned a radioactive waste related project (RP2414-34) in 1989 to produce a guide for developing and managing nuclear plant protective clothing programs. Every nuclear facility must coordinate some type of protective clothing program for its radiation workers to ensure proper and safe protection for the wearer and to maintain control over the spread of contamination. Yet, every nuclear facility has developed its own unique program for managing such clothing. Accordingly, a need existed for a reference guide to assist with standardizing protective clothing programs and in controlling the potentially escalating economics of such programs. The initial Guide to Managing Nuclear Utility Protective Clothing Programs, NP-7309, was published in May 1991. Since that time, a number of utilities have reviewed and/or used the report to enhance their protective clothing programs. Some of these utilities requested that a computer program be developed to assist utilities in evaluating the economics of protective clothing programs consistent with the guidance in NP-7309. The PCEVAL computer code responds to that industry need. This report, the PCEVAL User's Manual, provides detailed instruction on use of the software

  13. Use of a structured panel process to define quality metrics for antimicrobial stewardship programs.

    Science.gov (United States)

    Morris, Andrew M; Brener, Stacey; Dresser, Linda; Daneman, Nick; Dellit, Timothy H; Avdic, Edina; Bell, Chaim M

    2012-05-01

    Antimicrobial stewardship programs are being implemented in health care to reduce inappropriate antimicrobial use, adverse events, Clostridium difficile infection, and antimicrobial resistance. There is no standardized approach to evaluate the impact of these programs. To use a structured panel process to define quality improvement metrics for evaluating antimicrobial stewardship programs in hospital settings that also have the potential to be used as part of public reporting efforts. A multiphase modified Delphi technique. Paper-based survey supplemented with a 1-day consensus meeting. A 10-member expert panel from Canada and the United States was assembled to evaluate indicators for relevance, effectiveness, and the potential to aid quality improvement efforts. There were a total of 5 final metrics selected by the panel: (1) days of therapy per 1000 patient-days; (2) number of patients with specific organisms that are drug resistant; (3) mortality related to antimicrobial-resistant organisms; (4) conservable days of therapy among patients with community-acquired pneumonia (CAP), skin and soft-tissue infections (SSTI), or sepsis and bloodstream infections (BSI); and (5) unplanned hospital readmission within 30 days after discharge from the hospital in which the most responsible diagnosis was one of CAP, SSTI, sepsis or BSI. The first and second indicators were also identified as useful for accountability purposes, such as public reporting. We have successfully identified 2 measures for public reporting purposes and 5 measures that can be used internally in healthcare settings as quality indicators. These indicators can be implemented across diverse healthcare systems to enable ongoing evaluation of antimicrobial stewardship programs and complement efforts for improved patient safety.

  14. Utility Green Pricing Programs: Design, Implementation, and Consumer Response

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L.; Swezey, B.; Aabakken, J.

    2004-02-01

    The term green pricing refers to programs offered by utilities in traditionally regulated electricity markets, which allow customers to support the development of renewable energy sources by paying a small premium on their electric bills. Since the introduction of the concept in the United States, the number of unique utility green pricing programs has expanded from just a few programs in 1993 to more than 90 in 2002. About 10% of U.S. utilities offered a green pricing option to about 26 million consumers by the end of 2002. This report provides: (1) aggregate industry data on consumer response to utility programs, which indicate the collective impact of green pricing on renewable energy development nationally; and (2) market data that can be used by utilities as a benchmark for gauging the relative success of their green pricing programs. Specifically, the paper presents current data and trends in consumer response to green pricing, as measured by renewable energy sales, participants, participation rates, and new renewable energy capacity supported. It presents data on various aspects of program design and implementation, such as product pricing, ownership of supplies, retention rates, marketing costs, the effectiveness of marketing techniques, and methods of enrolling and providing value to customers.

  15. Decreased antimicrobial resistance and defined daily doses after implementation of a clinical culture-guided antimicrobial stewardship program in a local hospital

    Directory of Open Access Journals (Sweden)

    Chang-Teng Wu

    2017-12-01

    Full Text Available Background: We aimed to report the implementation of an antimicrobial stewardship program (ASP guided by clinically significant cultures in a hospital to assess its pharmaceutical, microbiological, financial, and outcome effects. Methods: A 3-year cohort study of an antimicrobial restriction policy implementation was performed. The ASP with culture-guided de-escalation of antibiotics was instituted in a local hospital since January 1, 2012. The cost of antimicrobials, defined daily dose (DDD, susceptibility to antimicrobials, and outcome of all admitted patients were calculated and evaluated before and after the ASP implementation. Results: Average monthly length of stay of admitted patients decreased from 7.8 ± 0.5 days in 2011 to 6.9 ± 0.3 days in 2013 (p < 0.001. The average monthly cost of antimicrobials decreased 46.9% from US$30,146.8 in 2011 to US$16,021.3 in 2013 (p < 0.001. Total intravenous antimicrobial DDDs per 100 bed-days of the inpatients were 66.9, 54.1 and 48.4 in 2011, 2012 and 2013, respectively. A total of 18.6 DDDs per 100 bed-days of inpatients (27.7% decreased from 2011 to 2013. By comparing data in 2013 to those in 2011, the ASP reduced antimicrobial resistance of Gram-positive bacteria (p = 0.013, Gram-negative bacteria (p < 0.001, and predominant species (all p < 0.05. The yearly mortality also decreased from 1.3% in 2011 to 1.1% in 2012 and 1.0% in 2013. Conclusions: The ASP with a culture-guided de-escalation of antibiotics successfully reduced length of stay, mortality, the cost of antimicrobials, DDDs, and antimicrobial resistance rate, and that is highly recommended for local hospitals. Keywords: antimicrobial resistance, antimicrobial restriction policy, antimicrobial stewardship program, defined daily dose

  16. Prevalence of antimicrobial resistance among respiratory tract isolates in Latin America: results from SENTRY antimicrobial surveillance program (1997-98).

    Science.gov (United States)

    Sader, H S; Gales, A C; Granacher, T D; Pfaller, M A; Jones, R N

    2000-10-01

    One thousand seventy-three bacterial isolates were collected from patients with community acquired respiratory tract infections (CARTI) in 11 Latin American centers (7 countries) during 1997 and 1998. They were tested against numerous antimicrobial agents by the reference broth microdilution method as part of the ongoing multinational SENTRY Antimicrobial Surveillance Program. Among Streptococcus pneumoniae (553 isolates), approximately 61% were susceptible to penicillin. There was a great variation of the penicillin susceptibility rates among participating countries. The highest susceptibility rates were found in Argentina (76.7%) and Brazil (71.9%), while the lowest rate of penicillin susceptibility was detected in Mexico (33.3%). High level resistance to penicillin and resistance to cefotaxime were observed in nearly 10% of the isolates. The newer quinolones, levofloxacin (MIC(90) 2 microg/mL) and gatifloxacin (MIC90 0.5 microg/mL), were active against 100% of the isolates tested. Among the other non-beta-lactams drugs tested, the rank order of susceptibility against the pneumococci was: chloramphenicol (93.9%)>clindamycin (93.2%)> azithromycin (89.1%) > clarithromycin (88.7%)>tetracycline (78.5%)> trimethoprim/sulfamethoxazole (55.7%). The percentage of Haemophilus influenzae (361 isolates) isolates resistant to amoxicillin was 12. 7% (beta-lactamase positive). Among Moraxella catarrhalis (159 isolates) isolates, only 8.2% were susceptible. Clavulanic acid restored the activity of amoxicillin against both species. Trimethoprim/sulfamethoxazole was active against only 59.5% of H. influenzae, while susceptibility to this compound among M. catarrhalis was 96.1%. All other compounds tested were active against>95% of H. influenzae and M. catarrhalis isolates. These species were susceptible to levofloxacin (MIC90 resistance rates are particularly high among pneumococci in some countries. The newer fluoroquinolones show an excellent potency and spectrum against

  17. Implementation and first-year results of an antimicrobial stewardship program at a community hospital.

    Science.gov (United States)

    Bartlett, James M; Siola, Patricia L

    2014-06-01

    The implementation of an antimicrobial stewardship program (ASP) at a small community hospital affiliated with an accountable care organization (ACO) is described, including a report on first-year program outcomes. With no infectious diseases (ID)-trained pharmacists on staff, a 155-bed hospital formed an ASP by restructuring its clinical pharmacy services. One full-time pharmacist led the program; nine full- or part-time pharmacists-none of whom had residency training-shared ASP responsibilities on a weekly rotation. Under a contract with a private medical group, an ID physician reviewed cases with ASP pharmacists for up to two hours each weekday. ASP interventions and tracking and reporting of outcomes were done primarily by pharmacists. Monitoring of pharmacy purchases in the first year of the program indicated an annualized 26% decrease in overall antimicrobial expenditures from prior-year spending, with a nearly 18% decrease in defined daily doses per 1000 patient-days. Total first-year direct cost savings attributed to the ASP were estimated at $145,353. Pharmacist-initiated conversions of patients from i.v. to oral antimicrobial therapy increased by 688% (p acceptance of ASP-recommended interventions (mainly streamlining of therapy, limiting the duration of therapy to a specific stop date, and discontinuation of nonindicated drugs) was 74%. An ASP was implemented at a small ACO-affiliated community hospital by a team of pharmacists without specialized ID training. During the first year of the program, antimicrobial expenditures were reduced and there was a significant increase in pharmacist-initiated i.v.-to-oral conversions. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

    2016-01-01

    Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (C...

  19. SSL Pricing and Efficacy Trend Analysis for Utility Program Planning

    Energy Technology Data Exchange (ETDEWEB)

    Tuenge, J. R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-10-01

    Report to help utilities and energy efficiency organizations forecast the order in which important SSL applications will become cost-effective and estimate when each "tipping point" will be reached. Includes performance trend analysis from DOE's LED Lighting Facts® and CALiPER programs plus cost analysis from various sources.

  20. Effects of utility demand-side management programs on uncertainty

    International Nuclear Information System (INIS)

    Hirst, E.

    1994-01-01

    Electric utilities face a variety of uncertainties that complicate their long-term resource planning. These uncertainties include future economic and load growths, fuel prices, environmental and economic regulations, performance of existing power plants, cost and availability of purchased power, and the costs and performance of new demand and supply resources. As utilities increasingly turn to demand-side management (DSM) programs to provide resources, it becomes more important to analyze the interactions between these programs and the uncertainties facing utilities. This paper uses a dynamic planning model to quantify the uncertainty effects of supply-only vs DSM + supply resource portfolios. The analysis considers four sets of uncertainties: economic growth, fuel prices, the costs to build new power plants, and the costs to operate DSM programs. The two types of portfolios are tested against these four sets of uncertainties for the period 1990 to 2010. Sensitivity, scenario, and worst-case analysis methods are used. The sensitivity analyses show that the DSM + supply resource portfolio is less sensitive to unanticipated changes in economic growth, fuel prices, and power-plant construction costs than is the supply-only portfolio. The supply-only resource mix is better only with respect to uncertainties about the costs of DSM programs. The base-case analysis shows that including DSM programs in the utility's resource portfolio reduces the net present value of revenue requirements (NPV-RR) by 490 million dollars. The scenario-analysis results show an additional 30 million dollars (6%) in benefits associated with reduction in these uncertainties. In the worst-case analysis, the DSM + supply portfolio again reduces the cost penalty associated with guessing wrong for both cases, when the utility plans for high needs and learns it has low needs and vice versa. 20 refs

  1. Current activities handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-27

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the activities each of the thirteen state legislatures potentially affected by the Formerly Utilized Sites Remedial Action Program. It contains a description of the state legislative procedural rules and a schedule of each legislative session; a summary of pending relevant legislation; the name and telephone number of legislative and state agency contacts; and the full text of all bills identified.

  2. Current activities handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the activities each of the thirteen state legislatures potentially affected by the Formerly Utilized Sites Remedial Action Program. It contains a description of the state legislative procedural rules and a schedule of each legislative session; a summary of pending relevant legislation; the name and telephone number of legislative and state agency contacts; and the full text of all bills identified

  3. Utilization program of HANARO under IMF situation in Korea

    International Nuclear Information System (INIS)

    Choi, Chang Oong; Kuk, Il Hiun; Chae, Sung Ki; Sohn, Jae Min

    1999-01-01

    Some of utilization facilities in HANARO are still being installed and among them CNS and FTL are yet in the design stage. This kind of situation in HANARO was mainly caused by the shortage of total budget of the reactor project during the period of reactor construction (1985 ∼ 1994). Installation of remaining utilization facilities to be equipped after HANARO construction had to rely on the resources of the long-term nuclear R and D program. The program commenced in 1992 with the 10-year implementation plan. It stipulates to be revised every 5 years in order to reflect changing national and international nuclear circumstances. The original nuclear R and D program (1992 ∼ 2001) set up in 1992 was amended in 1997 to establish nuclear policy infrastructure and to strengthen technological self-reliance in nuclear power. In this amended long-term nuclear R and D program (1997 ∼ 2006), full scope of utilization facility in HANARO was accommodated. However, economical difficulty befell to Korea from the end of 1997 and every social structure in Korea had to be reshaped with top priority of productivity base. Every industrial sector was desperately striving to cope with the financial difficulty by utilizing maximum production efficiency and by minimizing other functions or activities, which are not directly related to production activity. Even though nationwide endeavor strenuously to get over the economical difficulty, the government had to be supported from IMF (International Monetary Fund). Under the IMF situation in Korea, the nuclear R and D program must be adjusted due to cut-down of research fund from the government. Consequently utilization facility of HANARO is to be evaluated based on the users' program and their requirements. According to the evaluation results from the users' conditions, among the HANARO utilization facilities the first priority is pointed to be RI production facility, the second is to be neutron scattering facility, the third to be fuel

  4. Healthcare utilization of patients accessing an African national treatment program

    Directory of Open Access Journals (Sweden)

    Wood Robin

    2007-06-01

    Full Text Available Abstract Background The roll-out of antiretroviral therapy (ART in Africa will have significant resource implications arising from its impact on demand for healthcare services. Existing studies of healthcare utilization on HAART have been conducted in the developed world, where HAART is commenced when HIV illness is less advanced. Methods This paper describes healthcare utilization from program entry by treatment-naïve patients in a peri-urban settlement in South Africa. Treatment criteria included a CD4 cell count Results 212 patients were followed for a median of 490 days. Outpatient visits per 100 patient years of observation (PYO, excluding scheduled primary-care follow-up, fell from 596 immediately prior to ART to 334 in the first 48 weeks on therapy and 245 thereafter. Total inpatient time fell from 2,549 days per 100 PYO pre-ART to 476 in the first 48 weeks on therapy and 73 thereafter. This fall in healthcare utilization occurred at every level of care. The greatest causes of utilization were tuberculosis, cryptococcal meningitis, HIV-related neoplasms and adverse reactions to stavudine. After 48 weeks on ART demand reverted to primarily non-HIV-related causes. Conclusion Utilization of both inpatient and outpatient hospital services fell significantly after commencement of ART for South African patients in the public sector, with inpatient demand falling fastest. Earlier initiation might reduce early on-ART utilization rates.

  5. An overview of antimicrobial susceptibility patterns for gram-negative bacteria from the National Antimicrobial Resistance Surveillance Thailand (NARST) program from 2000 to 2005.

    Science.gov (United States)

    Apisarnthanarak, Anucha; Buppunharun, Wanchai; Tiengrim, Surapee; Sawanpanyalert, Pathom; Aswapokee, Nalinee

    2009-08-01

    The National Antimicrobial Resistance Surveillance Thailand (NARST) has been initiated since 1998 to strengthen the surveillance program for antimicrobial-resistant pathogens as well as to standardize the laboratory practices in Thailand. This collaborative network was funded by the World Health Organization, and involved 33 hospitals throughout Thailand at the first phase. Nevertheless, no prior effort has been made to share the antimicrobial resistance data in the national level. In this overview, the authors provide an update on the status of antimicrobial resistance from 2000 to 2005 among important Gram-negative pathogens as well as the implication of these findings. The most striking finding appears to be the emergence of pandrug-resistant (PDR) Acinetobacter baumannii. Carbapenem-resistant A. baumannii has been dramatically increasing from 2.1% in 2000 to 46.7% in 2005. There is a trend towards the increasing incidence rates of ESBL-producing Escherichia coli from 2000 to 2005, but the incidence rates of ESBL-producing Klebseilla pneumoniae remain constant during the same period. The susceptibility of Burkholderia pseudomallei to various antibiotics, particularly ceftazidime and carbapenems, approached 100%. In conclusions, to help strengthen the future surveillance system, NARST needs to develop the data collection tools that include some important patient characteristics and the information that can help distinguish colonizations and infections as well as community-acquired infections and hospital-acquired infections. In addition, an appropriate test for antimicrobial susceptibility including the minimal inhibitory concentration determination should be implemented and carried out for all important pathogens. The NARST data emphasized a need to strengthen the antimicrobial stewardship as well as the infection control measures at the hospital level to help reduce the transmission of antimicrobial-resistant Gram-negative bacteria in Thailand.

  6. Prescription drug monitoring program utilization in Kentucky community pharmacies

    Directory of Open Access Journals (Sweden)

    Wixson SE

    2015-06-01

    Full Text Available Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists’ practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER. Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain and practice location (rural or urban. A multivariate Poisson regression model with robust error variance estimated risk ratios (RR of KASPER utilization by characteristics of pharmacists’ practice environment. Results: Responses were received from 563 pharmacists (response rate 27.9%. Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84% indicated they or someone in their pharmacy had requested a patient’s controlled substance history since KASPER’s inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94% than pharmacists in chain pharmacies (75%; p<0.001. Multivariate regression results found utilization of KASPER varied significantly among practice environments of community pharmacists with those who practiced in an urban location (RR: 1.11; [1.01–1.21] or at an independent pharmacy (RR: 1.27; [1.14–1.40] having an increased likelihood of KASPER utilization. Conclusion: Utilization of KASPER differs by community pharmacists’ practice environment, predominantly by practice type and location. Understanding characteristics of community pharmacists and community pharmacists’ practice environment associated with PDMP use is necessary to remove barriers to access and increase utilization thereby increasing PDMP effectiveness.

  7. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    International Nuclear Information System (INIS)

    Levine, M.B.; Sigmon, C.F.

    1989-01-01

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges

  8. Formerly Utilized Sites Remedial Action Program environmental compliance assessment checklists

    Energy Technology Data Exchange (ETDEWEB)

    Levine, M.B.; Sigmon, C.F.

    1989-09-29

    The purpose of the Environmental Compliance Assessment Program is to assess the compliance of Formerly Utilized Site Remedial Action Program (FUSRAP) sites with applicable environmental regulations and Department of Energy (DOE) Orders. The mission is to identify, assess, and decontaminate sites utilized during the 1940s, 1950s, and 1960s to process and store uranium and thorium ores in support of the Manhattan Engineer District and the Atomic Energy Commission. To conduct the FUSRAP environmental compliance assessment, checklists were developed that outline audit procedures to determine the compliance status of the site. The checklists are divided in four groups to correspond to these regulatory areas: Hazardous Waste Management, PCB Management, Air Emissions, and Water Discharges.

  9. Ground-source heat pump case studies and utility programs

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

    1995-04-01

    Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The case studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.

  10. Electric Utility Transmission and Distribution Line Engineering Program

    Energy Technology Data Exchange (ETDEWEB)

    Peter McKenny

    2010-08-31

    Economic development in the United States depends on a reliable and affordable power supply. The nation will need well educated engineers to design a modern, safe, secure, and reliable power grid for our future needs. An anticipated shortage of qualified engineers has caused considerable concern in many professional circles, and various steps are being taken nationwide to alleviate the potential shortage and ensure the North American power system's reliability, and our world-wide economic competitiveness. To help provide a well-educated and trained workforce which can sustain and modernize the nation's power grid, Gonzaga University's School of Engineering and Applied Science has established a five-course (15-credit hour) Certificate Program in Transmission and Distribution (T&D) Engineering. The program has been specifically designed to provide working utility engineering professionals with on-line access to advanced engineering courses which cover modern design practice with an industry-focused theoretical foundation. A total of twelve courses have been developed to-date and students may select any five in their area of interest for the T&D Certificate. As each course is developed and taught by a team of experienced engineers (from public and private utilities, consultants, and industry suppliers), students are provided a unique opportunity to interact directly with different industry experts over the eight weeks of each course. Course material incorporates advanced aspects of civil, electrical, and mechanical engineering disciplines that apply to power system design and are appropriate for graduate engineers. As such, target students for the certificate program include: (1) recent graduates with a Bachelor of Science Degree in an engineering field (civil, mechanical, electrical, etc.); (2) senior engineers moving from other fields to the utility industry (i.e. paper industry to utility engineering or project management positions); and (3) regular

  11. Utility of Small Animal Models of Developmental Programming.

    Science.gov (United States)

    Reynolds, Clare M; Vickers, Mark H

    2018-01-01

    Any effective strategy to tackle the global obesity and rising noncommunicable disease epidemic requires an in-depth understanding of the mechanisms that underlie these conditions that manifest as a consequence of complex gene-environment interactions. In this context, it is now well established that alterations in the early life environment, including suboptimal nutrition, can result in an increased risk for a range of metabolic, cardiovascular, and behavioral disorders in later life, a process preferentially termed developmental programming. To date, most of the mechanistic knowledge around the processes underpinning development programming has been derived from preclinical research performed mostly, but not exclusively, in laboratory mouse and rat strains. This review will cover the utility of small animal models in developmental programming, the limitations of such models, and potential future directions that are required to fully maximize information derived from preclinical models in order to effectively translate to clinical use.

  12. Hawaii alternative fuels utilization program. Phase 3, final report

    Energy Technology Data Exchange (ETDEWEB)

    Kinoshita, C.M.; Staackmann, M.

    1996-08-01

    The Hawaii Alternative Fuels Utilization Program originated as a five-year grant awarded by the US Department of Energy (USDOE) to the Hawaii Natural Energy Institute (HNEI) of the University of Hawaii at Manoa. The overall program included research and demonstration efforts aimed at encouraging and sustaining the use of alternative (i.e., substitutes for gasoline and diesel) ground transportation fuels in Hawaii. Originally, research aimed at overcoming technical impediments to the widespread adoption of alternative fuels was an important facet of this program. Demonstration activities centered on the use of methanol-based fuels in alternative fuel vehicles (AFVs). In the present phase, operations were expanded to include flexible fuel vehicles (FFVs) which can operate on M85 or regular unleaded gasoline or any combination of these two fuels. Additional demonstration work was accomplished in attempting to involve other elements of Hawaii in the promotion and use of alcohol fuels for ground transportation in Hawaii.

  13. Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever

    OpenAIRE

    Elfrida A. Rachmah; Maftuchah Rochmanti; Dwiyanti Puspitasari

    2016-01-01

    Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance. Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever. Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fe...

  14. Making It Count: Understanding the Value of Energy Efficiency Financing Programs Funded by Utility Customers

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fadrhonc, Emily Martin [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steve [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-12-01

    Utility customer-supported financing programs are receiving increased attention as a strategy for achieving energy saving goals. Rationales for using utility customer funds to support financing initiatives

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

    Science.gov (United States)

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

    2008-09-15

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

  16. Pennsylvania state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  17. Maryland State information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Handbook Series Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  18. Oregon state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  19. Oregon state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  20. Oregon state information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administater, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  1. Maryland state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  2. Massachusetts state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-09

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Massachusetts. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations.

  3. Illinois State information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Illinois. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  4. Ohio state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with the DOE, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Ohio. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations

  5. Oregon state information handbook formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administater, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Oregon. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  6. Iowa state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with the DOE, By Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Iowa. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations

  7. Massachusetts state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Massachusetts. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

  8. California state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-09

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of California. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations.

  9. Maryland State information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Handbook Series Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Maryland. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  10. Iowa state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-09

    This volume is one of a series produced under contract with the DOE, By Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Iowa. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations.

  11. Illinois state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Illinois. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

  12. Ohio state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    1981-02-09

    This volume is one of a series produced under contract with the DOE, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of Ohio. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full test of relevant statutes and regulations.

  13. Pennsylvania state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and State levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  14. Pennsylvania state information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Pennsylvania. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  15. California state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of California. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; the full text of relevant statutes and regulations

  16. An electric utility program to address global warming

    International Nuclear Information System (INIS)

    Smith, M.A.; Fair, T.R.

    1993-01-01

    Niagara Mohawk Power Corporation believes that despite the incomplete and uncertain state of scientific knowledge concerning global atmospheric change, the plausible negative effects of accelerated global warming, known as open-quotes the Greenhouse Effect,close quotes are so large that purdent actions can and should be taken now to reduce so-called greenhouse gas emissions. Thus, the corporation has adopted a Greenhouse Warming Action Program based on strategies recommended by the National Academy of Sciences and the corporation's Integrated Electric Resource Plan. The program is a logical outgrowth of the company's policy statement on protection of the environment and is designed to surpass the Rio Earth Summit's goal of stabilizing greenhouse gas emissions. Central to the Action Program are increased use of natural gas, aggressive expansion of energy efficiency programs, and maximized generation from hydroelectric and nuclear energy sources. Additional elements include preventing releases of CFC's through customer incentive recycling programs; a forest conservation program of managing lands on a sustainable yield basis, environmentally-conscious use of paper products, and waste paper and cardboard recycling; promoting commercialization of low emitting vehicles; and developing and demonstrating low-CO 2 technologies such as wind turbines and photo-voltaic cells. Niagara Mohawk believes that acting now to implement such a policy is a responsible step that makes sense from both scientific and business perspectives. Moreover, voluntary action now by utilities and other segments of the private sector is the best way to avoid the need for future regulation by government designed to achieve the same end. We intend to do our part to stabilize and reduce greenhouse gas emissions, while recognizing that our contribution is only a small fraction of total global greenhouse gas emissions

  17. Description of the Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1980-09-01

    The background and the results to date of the Department of Energy program to identify and evaluate the radiological conditions at sites formerly utilized by the Corps of Engineers' Manhattan Engineer District (MED) and the US Atomic Energy Commission (AEC) are summarized. The sites of concern were federally, privately, and institutionally owned and were used primarily for research, processing, and storage of uranium and thorium ores, concentrates, or residues. Some sites were subsequently released for other purposes without radiological restriction. Surveys have been conducted since 1974 to document radiological conditions at such sites. Based on radiological surveys, sites are identified in this document that require, or are projected to require, remedial action to remove potential restrictions on the use of the property due to the presence of residual low-level radioactive contamination. Specific recommendations for each site will result from more detailed environmental and engineering surveys to be conducted at those sites and, if necessary, an environmental impact assessment or environmental impact statement will be prepared. Section 3.0 describes the current standards and guidelines now being used to conduct remedial actions. Current authority of the US Department of Energy (DOE) to proceed with remedial actions and the new authority required are summarized. A plan to implement the Formerly Utilized Sites Remedial Action Program (FUSRAP) in accordance with the new authority is presented, including the objectives, scope, general approach, and a summary schedule. Key issues affecting schedule and cost are discussed

  18. Description of the Formerly Utilized Sites Remedial Action Program

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    The background and the results to date of the Department of Energy program to identify and evaluate the radiological conditions at sites formerly utilized by the Corps of Engineers' Manhattan Engineer District (MED) and the US Atomic Energy Commission (AEC) are summarized. The sites of concern were federally, privately, and institutionally owned and were used primarily for research, processing, and storage of uranium and thorium ores, concentrates, or residues. Some sites were subsequently released for other purposes without radiological restriction. Surveys have been conducted since 1974 to document radiological conditions at such sites. Based on radiological surveys, sites are identified in this document that require, or are projected to require, remedial action to remove potential restrictions on the use of the property due to the presence of residual low-level radioactive contamination. Specific recommendations for each site will result from more detailed environmental and engineering surveys to be conducted at those sites and, if necessary, an environmental impact assessment or environmental impact statement will be prepared. Section 3.0 describes the current standards and guidelines now being used to conduct remedial actions. Current authority of the US Department of Energy (DOE) to proceed with remedial actions and the new authority required are summarized. A plan to implement the Formerly Utilized Sites Remedial Action Program (FUSRAP) in accordance with the new authority is presented, including the objectives, scope, general approach, and a summary schedule. Key issues affecting schedule and cost are discussed.

  19. Progress and problems in the Formerly Utilized Sites Remedial Action Program and Surplus Facilities Management Program

    International Nuclear Information System (INIS)

    Fiore, J.J.; Turi, G.P.

    1988-01-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) was established in 1974 to identify, evaluate, and as appropriate, conduct remedial actions at sites used in the early years of nuclear energy development by the Manhattan Engineer District and the Atomic Energy Commission (AEC). This program currently has 29 sites and is evaluating 350 other sites for possible inclusion in the program. Another remedial action program in the Department of Energy's (DOE) Division of Facility and Site Decommissioning Projects is the Surplus Facilities Management Program (SFMP). The SFMP involves the safe management, decontamination and disposal of surplus DOE contaminated facilities which were not related to defense activities. There are currently 33 projects at 15 different sites in the program. These two programs have made steady progress over the last 10 or so years in cleaning up sites so that they can be reused or released for unrestricted use. Work has been completed at 8 of the FUSRAP sites and three of the SFMP sites

  20. Optimizing Antimicrobial Drug Use in Surgery: An Intervention ...

    African Journals Online (AJOL)

    Background: Antimicrobial control programs are widely used to decrease antibiotic utilization, but effects on antimicrobial resistance and outcomes for patients remain controversial. The purpose of this study was to determine the impact of rotation of antibiotic classes used as empirical surgical prophylaxis on the emergence ...

  1. Federal government information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant federal statutes and regulations

  2. Federal government information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant federal statutes and regulations.

  3. Federal government information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the Federal Government. It contains: a summary of the organization and responsibilities of agencies within the executive branch of the Federal government which may be relevant to FUSRAP activities; a brief summary of relevant Federal statutes and regulations; a description of the structure of the US Congress, identification of the officers, relevant committees and committee chairmen; a description of the Federal legislative process; a summary of legislation enacted and considered in the recently-adjourned 96th Congress; a description of the Federal budgetary process; a summary of the Carter Administration's comprehensive radioactive waste management program; and excerpts from the text of relevant Federal statutes and regulations

  4. Antimicrobial susceptibility patterns of unusual nonfermentative gram-negative bacilli isolated from Latin America: report from the SENTRY Antimicrobial Surveillance Program (1997-2002

    Directory of Open Access Journals (Sweden)

    Ana C Gales

    2005-10-01

    Full Text Available The antimicrobial susceptibility of 176 unusual non-fermentative gram-negative bacilli (NF-GNB collected from Latin America region through the SENTRY Program between 1997 and 2002 was evaluated by broth microdilution according to the National Committee for Clinical Laboratory Standards (NCCLS recommendations. Nearly 74% of the NF-BGN belonged to the following genera/species: Burkholderia spp. (83, Achromobacter spp. (25, Ralstonia pickettii (16, Alcaligenes spp. (12, and Cryseobacterium spp. (12. Generally, trimethoprim/sulfamethoxazole (MIC50, 16 µg/ml; 18.8% susceptible and meropenem (MIC50, 8 µg/ml; 50% susceptible against Ralstonia pickettii. Since selection of the most appropriate antimicrobial agents for testing and reporting has not been established by the NCCLS for many of NF-GNB species, results from large multicenter studies may help to guide the best empiric therapy.

  5. Renewable Energy Price-Stability Benefits in Utility Green Power Programs

    Energy Technology Data Exchange (ETDEWEB)

    Bird, L. A.; Cory, K. S.; Swezey, B. G.

    2008-08-01

    This paper examines utility experiences when offering the fixed-price benefits of renewable energy in green pricing programs, including the methods utilized and the impact on program participation. It focuses primarily on utility green pricing programs in states that have not undergone electric industry restructuring.

  6. Renewable Energy Price-Stability Benefits in Utility Green Power Programs. 36 pp

    Energy Technology Data Exchange (ETDEWEB)

    Bird, Lori A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Cory, Karlynn S. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Swezey, Blair G. [Applied Materials, Santa Clara, CA (United States)

    2008-08-01

    This paper examines utility experiences when offering the fixed-price benefits of renewable energy in green pricing programs, including the methods utilized and the impact on program participation. It focuses primarily on utility green pricing programs in states that have not undergone electric industry restructuring.

  7. The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

    Energy Technology Data Exchange (ETDEWEB)

    Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth; Schiller, Steven R.; Goldman, Charles A.; LaCommare, Kristina

    2014-03-19

    End-use energy efficiency is increasingly being relied upon as a resource for meeting electricity and natural gas utility system needs within the United States. There is a direct connection between the maturation of energy efficiency as a resource and the need for consistent, high-quality data and reporting of efficiency program costs and impacts. To support this effort, LBNL initiated the Cost of Saved Energy Project (CSE Project) and created a Demand-Side Management (DSM) Program Impacts Database to provide a resource for policy makers, regulators, and the efficiency industry as a whole. This study is the first technical report of the LBNL CSE Project and provides an overview of the project scope, approach, and initial findings, including: • Providing a proof of concept that the program-level cost and savings data can be collected, organized, and analyzed in a systematic fashion; • Presenting initial program, sector, and portfolio level results for the program administrator CSE for a recent time period (2009-2011); and • Encouraging state and regional entities to establish common reporting definitions and formats that would make the collection and comparison of CSE data more reliable. The LBNL DSM Program Impacts Database includes the program results reported to state regulators by more than 100 program administrators in 31 states, primarily for the years 2009–2011. In total, we have compiled cost and energy savings data on more than 1,700 programs over one or more program-years for a total of more than 4,000 program-years’ worth of data, providing a rich dataset for analyses. We use the information to report costs-per-unit of electricity and natural gas savings for utility customer-funded, end-use energy efficiency programs. The program administrator CSE values are presented at national, state, and regional levels by market sector (e.g., commercial, industrial, residential) and by program type (e.g., residential whole home programs, commercial new

  8. Missouri State information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Missouri. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature chairmen, and a summary of recent relevant legislative action; a description of the organization and structure of local governments affected by remedial action at the St. Louis area sites; a summary of relevant local ordinances and regulations; an identification of relevant public interest groups; a list of radio stations, television stations, and newspapers that provide public information to the St. Louis area or to Jefferson City; and the full text of relevant statutes and regulations.

  9. Missouri State information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Missouri. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature chairmen, and a summary of recent relevant legislative action; a description of the organization and structure of local governments affected by remedial action at the St. Louis area sites; a summary of relevant local ordinances and regulations; an identification of relevant public interest groups; a list of radio stations, television stations, and newspapers that provide public information to the St. Louis area or to Jefferson City; and the full text of relevant statutes and regulations

  10. Missouri state information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and rgulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Missouri. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; a description of the organization and structure of local governments affected by remedial action at the St. Louis area sites; a summary of relevant local ordinances and regulations; an identification of relevant public interest groups; a list of radio stations, television stations and newspapers that provide public information to the St. Louis area or to Jefferson City; and the full text of relevant statutes and regulations

  11. Advanced Utility Mercury-Sorbent Field-Testing Program

    Energy Technology Data Exchange (ETDEWEB)

    Ronald Landreth

    2007-12-31

    This report summarizes the work conducted from September 1, 2003 through December 31, 2007 on the project entitled Advanced Utility Mercury-Sorbent Field-Testing Program. The project covers the testing at the Detroit Edison St. Clair Plant and the Duke Power Cliffside and Buck Stations. The St. Clair Plant used a blend of subbituminous and bituminous coal and controlled the particulate emissions by means of a cold-side ESP. The Duke Power Stations used bituminous coals and controlled their particulate emissions by means of hot-side ESPs. The testing at the Detroit Edison St. Clair Plant demonstrated that mercury sorbents could be used to achieve high mercury removal rates with low injection rates at facilities that burn subbituminous coal. A mercury removal rate of 94% was achieved at an injection rate of 3 lb/MMacf over the thirty day long-term test. Prior to this test, it was believed that the mercury in flue gas of this type would be the most difficult to capture. This is not the case. The testing at the two Duke Power Stations proved that carbon- based mercury sorbents can be used to control the mercury emissions from boilers with hot-side ESPs. It was known that plain PACs did not have any mercury capacity at elevated temperatures but that brominated B-PAC did. The mercury removal rate varies with the operation but it appears that mercury removal rates equal to or greater than 50% are achievable in facilities equipped with hot-side ESPs. As part of the program, both sorbent injection equipment and sorbent production equipment was acquired and operated. This equipment performed very well during this program. In addition, mercury instruments were acquired for this program. These instruments worked well in the flue gas at the St. Clair Plant but not as well in the flue gas at the Duke Power Stations. It is believed that the difference in the amount of oxidized mercury, more at Duke Power, was the difference in instrument performance. Much of the equipment was

  12. Multiple utility constrained multi-objective programs using Bayesian theory

    Science.gov (United States)

    Abbasian, Pooneh; Mahdavi-Amiri, Nezam; Fazlollahtabar, Hamed

    2018-03-01

    A utility function is an important tool for representing a DM's preference. We adjoin utility functions to multi-objective optimization problems. In current studies, usually one utility function is used for each objective function. Situations may arise for a goal to have multiple utility functions. Here, we consider a constrained multi-objective problem with each objective having multiple utility functions. We induce the probability of the utilities for each objective function using Bayesian theory. Illustrative examples considering dependence and independence of variables are worked through to demonstrate the usefulness of the proposed model.

  13. Improvement in Quality Metrics by the UPMC Enhanced Care Program: A Novel Super-Utilizer Program.

    Science.gov (United States)

    Bryk, Jodie; Fischer, Gary S; Lyons, Anita; Shroff, Swati; Bui, Thuy; Simak, Deborah; Kapoor, Wishwa

    2017-09-25

    The aim was to evaluate pre-post quality of care measures among super-utilizer patients enrolled in the Enhanced Care Program (ECP), a primary care intensive care program. A pre-post analysis of metrics of quality of care for diabetes, hypertension, cancer screenings, and connection to mental health care for participants in the ECP was conducted for patients enrolled in ECP for 6 or more months. Patients enrolled in ECP showed statistically significant improvements in hemoglobin A1c, retinal exams, blood pressure measurements, and screenings for colon cancer, and trends toward improvement in diabetic foot exams and screenings for cervical and breast cancer. There was a significant increase in connecting patients to mental health care. This study shows that super-utilizer patients enrolled in the ECP had significant improvements in quality metrics from those prior to enrollment in ECP.

  14. Hazard Mitigation Assistance Programs Available to Water and Wastewater Utilities

    Science.gov (United States)

    You can prevent damage to your utility before it occurs. Utilities can implement mitigation projects to better withstand a natural disaster, minimize damage and rapidly recover from disruptions to service.

  15. ECUT (Energy Conversion and Utilization Technologies Program). Biocatalysis Project

    Science.gov (United States)

    1986-01-01

    Presented are the FY 1985 accomplishments, activities, and planned research efforts of the Biocatalysis Project of the U.S. Department of Energy, Energy Conversion and Utilization Technologies (ECUT) Program. The Project's technical activities were organized as follows: In the Molecular Modeling and Applied Genetics work element, research focused on (1) modeling and simulation studies to establish the physiological basis of high temperature tolerance in a selected enzyme and the catalytic mechanisms of three species of another enzyme, and (2) determining the degree of plasmid amplification and stability of several DNA bacterial strains. In the Bioprocess Engineering work element, research focused on (1) studies of plasmid propagation and the generation of models, (2) developing methods for preparing immobilized biocatalyst beads, and (3) developing an enzyme encapsulation method. In the Process Design and Analysis work element, research focused on (1) further refinement of a test case simulation of the economics and energy efficiency of alternative biocatalyzed production processes, (2) developing a candidate bioprocess to determine the potential for reduced energy consumption and facility/operating costs, and (3) a techno-economic assessment of potential advancements in microbial ammonia production.

  16. Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection.

    Science.gov (United States)

    Shea, Katherine M; Hobbs, Athena L V; Jaso, Theresa C; Bissett, Jack D; Cruz, Christopher M; Douglass, Elizabeth T; Garey, Kevin W

    2017-06-01

    Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41.0 (SD = 4.4) days of therapy (DOT) per 1,000 patient days (PD) preintervention to 21.5 (SD = 6.4) DOT/1,000 PD and 4.8 (SD = 3.6) DOT/1,000 PD posteducation and postrestriction, respectively. Using segmented regression analysis, both education (14.5 DOT/1,000 PD per month decrease; P = 0.023) and restriction (24.5 DOT/1,000 PD per month decrease; P respiratory fluoroquinolone use occurred postrestriction versus preintervention in patients administered at least one dose (74/130 [57%] versus 74/232 [32%]; P respiratory fluoroquinolone, was observed postrestriction compared to preintervention within the health care system ($123,882 versus $12,273; P = 0.002). Implementation of a stewardship-initiated respiratory fluoroquinolone restriction program can increase appropriate use while reducing overall utilization, acquisition cost, and CDI rates within a health care system. Copyright © 2017 American Society for Microbiology.

  17. The Clinical Utility of Methicillin Resistant Staphylococcus aureus (MRSA) Nasal Screening to Rule Out MRSA Pneumonia: A Diagnostic Meta-analysis with Antimicrobial Stewardship Implications.

    Science.gov (United States)

    Parente, Diane M; Cunha, Cheston B; Mylonakis, Eleftherios; Timbrook, Tristan T

    2018-01-11

    Recent literature has highlighted MRSA nasal screening as a possible antimicrobial stewardship program (ASP) tool for avoiding unnecessary empiric MRSA therapy for pneumonia, yet current guidelines recommend MRSA therapy based on risk factors. The objective of this meta-analysis was to evaluate the diagnostic value of MRSA nasal screening in MRSA pneumonia. Pubmed and EMBASE were searched from inception to November 2016 for English studies evaluating MRSA nasal screening and development of MRSA pneumonia. Data analysis was performed using a bivariate random-effects model to estimate pooled sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values. Twenty-two studies, comprising of 5,163 patients met our inclusion criteria. Pooled sensitivity and specificity of MRSA nares screen for all MRSA pneumonia types was 70.9% and 90.3%, respectively. With a 10% prevalence of potential MRSA pneumonia, the calculated PPV was 44.8% while the NPV was 96.5%. The pooled sensitivity and specificity for MRSA community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) were at 85% and 92.1%, respectively. For CAP and HCAP both the PPV and NPV increased to 56.8% and 98.1%, respectively. In comparison, for MRSA ventilated-associated pneumonia (VAP), the sensitivity, specificity, PPV, NPV was 40.3%, 93.7%, 35.7%, and 94.8%, respectively. Nares screening for MRSA had a high specificity and NPV for ruling out MRSA pneumonia, particularly in cases of CAP/HCAP. Based on the NPV, utilization of MRSA nares screening is a valuable tool for AMS to streamline empiric antibiotic therapy, especially among patients with pneu. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  18. Implementation of solar-reflective surfaces: Materials and utility programs

    Energy Technology Data Exchange (ETDEWEB)

    Bretz, S.; Akbari, H.; Rosenfeld, A.; Taha, H.

    1992-06-01

    This report focuses on implementation issues for using solar-reflective surfaces to cool urban heat islands, with specific examples for Sacramento, California. Advantages of solar-reflective surfaces for reducing energy use are: (1) they are cost-effective if albedo is increased during routine maintenance; (2) the energy savings coincide with peak demand for power; (3) there are positive effects on environmental quality; and (4) the white materials have a long service life. Important considerations when choosing materials for mitigating heat islands are identified as albedo, emissivity, durability, cost, pollution and appearance. There is a potential for increasing urban albedo in Sacramento by an additional 18%. Of residential roofs, we estimate that asphalt shingle and modified bitumen cover the largest area, and that built-up roofing and modified bitumen cover the largest area of commercial buildings. For all of these roof types, albedo may be increased at the time of re-roofing without any additional cost. When a roof is repaired, a solar-reflective roof coating may be applied to significantly increase albedo and extend the life of the root Although a coating may be cost-effective if applied to a new roof following installation or to an older roof following repair, it is not cost-effective if the coating is applied only to save energy. Solar-reflective pavement may be cost-effective if the albedo change is included in the routine resurfacing schedule. Cost-effective options for producing light-colored pavement may include: (1) asphalt concrete, if white aggregate is locally available; (2) concrete overlays; and (3) newly developed white binders and aggregate. Another option may be hot-rolled asphalt, with white chippings. Utilities could promote solar-reflective surfaces through advertisement, educational programs and cost-sharing of road resurfacing.

  19. Utilizing Web Technologies in a Master of Counselling Program

    Science.gov (United States)

    McBride, Dawn Lorraine; Davis, Lynn Ashley

    2009-01-01

    This article outlines Canada's first web based/residential Master of Counselling program. Since the program is open to students from around the world, the program is designed to be accessible, innovative and flexible. To meet these operational goals, the program is structured around interactive online discussion forums, video web-conferencing,…

  20. Salmonella spp. isolates causing bloodstream infections in Latin America: report of antimicrobial activity from the SENTRY Antimicrobial Surveillance Program (1997-2000).

    Science.gov (United States)

    Gales, Ana C; Sader, Helio S; Mendes, Rodrigo E; Jones, Ronald N

    2002-11-01

    Recent years have seen a dramatic rise in the incidence and severity of cases of human salmonellosis. In addition, multidrug resistant strains have arisen. The objective of this study was to characterize the antimicrobial susceptibility profile of Salmonella spp. clinical isolates collected from Latin American medical centers as part of the SENTRY Antimicrobial Surveillance System. A total of 144 bloodstream Salmonella spp. isolates were collected between 1997 and 2000. The susceptibility to diverse antimicrobial agents was tested by broth microdilution techniques according to the NCCLS recommendations. The Salmonella spp. strains were more frequently collected from adult patients (67.0%; 21-60 years) and isolated from Chile (28.5%) > Brazil (25.0%) > Mexico (18.8%) > Colombia (11.8%). Ampicillin (MIC(50), 1 microg/ml) showed good in vitro activity (92.4% susceptibility). Meropenem (MIC(50), 0.06 microg/ml) and gatifloxacin (MIC(50), 0.03 microg/ml) were the most potent compounds against the Salmonella spp. isolates (100.0% susceptible) followed by piperacillin/tazobactam (99.3%), ceftazidime (98.6%), ceftriaxone (98.6%), and amoxicillin/clavulanic acid (94.4%). The lowest susceptibility rates were observed for tetracycline (87.5%) and trimethoprim/sulfamethoxazole (91.7%). Four of 144 (2.8%) Salmonella spp. isolates demonstrated an ESBL phenotype; however, only two (1.4%) were confirmed as an inhibitable ESBL producer. The results of this study show that multidrug resistance, especially fluoroquinolone resistance, does not represent a serious problem among Salmonella isolates collected from the Latin American medical centers as monitored by the SENTRY Program.

  1. Utility residential new construction programs: Going beyond the code. A report from the Database on Energy Efficiency Programs (DEEP) Project

    Energy Technology Data Exchange (ETDEWEB)

    Vine, E.

    1995-08-01

    Based on an evaluation of 10 residential new construction programs, primarily sponsored by investor-owned utilities in the United States, we find that many of these programs are in dire straits and are in danger of being discontinued because current inclusion of only direct program effects leads to the conclusion that they are not cost-effective. We believe that the cost-effectiveness of residential new construction programs can be improved by: (1) promoting technologies and advanced building design practices that significantly exceed state and federal standards; (2) reducing program marketing costs and developing more effective marketing strategies; (3) recognizing the role of these programs in increasing compliance with existing state building codes; and (4) allowing utilities to obtain an ``energy-savings credit`` from utility regulators for program spillover (market transformation) impacts. Utilities can also leverage their resources in seizing these opportunities by forming strong and trusting partnerships with the building community and with local and state government.

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

    Science.gov (United States)

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

    2015-09-01

    To investigate the initiation and maintenance of participation in an employer-based wellness program that provides financial incentives for fitness center utilization. Using multivariate analysis, we investigated how employees' demographics, health status, exercise-related factors, and lifestyle change preferences affect program participation. Forty-two percent of eligible employees participated in the program, and 24% earned a $20 incentive at least once by utilizing a gym eight 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. 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.

  3. Maintenance program decision-making utilizing crash data.

    Science.gov (United States)

    2013-07-01

    This document describes methods that may be used by UDOT Maintenance personnel to improve highway safety. Four programs have been recommended using crash data to make more informed decisions concerning maintenance programs as follows: : Snow & Ic...

  4. Utilization of Advisory Councils in Pennsylvania Secondary Agricultural Education Programs

    Science.gov (United States)

    Foster, Daniel D.; Masser, Douglas T.; Falk, Jeremy M.; Sankey Rice, Laura L.

    2015-01-01

    Advisory councils are a vital component of the program-planning process in career and technical education programs, providing an important link from the community to the program. The purpose of this research study was to describe how Pennsylvania agricultural educators used and perceived agricultural education advisory councils. The results…

  5. Psychosocial Correlates of Clinicians' Prescription Drug Monitoring Program Utilization.

    Science.gov (United States)

    Pugliese, John A; Wintemute, Garen J; Henry, Stephen G

    2018-03-17

    The purpose of this study is to extend prior research on barriers to use of a prescription drug monitoring program by examining psychosocial correlates of intended use among physicians and pharmacists. Overall, 1,904 California physicians and pharmacists responded to a statewide survey (24.1% response rate) from August 2016 to January 2017. Participants completed an online survey examining attitudes toward prescription drug misuse and abuse, prescribing practices, prescription drug monitoring program design and ease of use, professional obligations, and normative beliefs regarding prescription drug monitoring program use. Data were analyzed in 2017. Perceived prescription drug monitoring program usefulness and normative beliefs fully mediated the relationship between concern about prescription drug abuse and intentions to use the prescription drug monitoring program. Clinicians' sense of professional and moral obligation to use the prescription drug monitoring program was unrelated to intention to use the prescription drug monitoring program despite a positive relationship with concern about misuse and abuse. Compared with physicians, pharmacists reported greater concern about prescription drug misuse, greater professional and moral obligation to use prescription drug monitoring program, and greater rating of prescription drug monitoring program usefulness. Interventions that target normative beliefs surrounding prescription drug monitoring program use and how to use prescription drug monitoring programs effectively are likely to be more effective than those that target professional obligations or moralize to the medical community. Published by Elsevier Inc.

  6. Net lost revenue adjustment (NLRA) mechanisms for utility DSM programs

    International Nuclear Information System (INIS)

    Baxter, L.W.

    1995-01-01

    We examine the experiences that states and utilities are having with the NLRA approach. Contrary to concerns raised by some industry analysts, our results indicate the NLRA is a feasible approach to the lost-revenue disincentive. Seven of the 10 states we studied report no substantial problems with their approach. We observe several conditions linked to effective NLRA implementation and, for those states reporting problems, conditions linked to implementation difficulties. Finally, observed changes in utility-investment behavior occur after implementation of DSM rate reforms, which include deployment of NLRA mechanisms. We find that utilities in states with lost revenue recovery invest more than twice as much in DSM as do utilities in other states. (Author)

  7. The instrumentation calibration reduction program (ICRP) at Northeast Utilities

    International Nuclear Information System (INIS)

    Wyckoff, R.; Blanch, P.

    1987-01-01

    Northeast Utilities (NU) funded a project to study the feasibility of determining the state of core exit thermocouple (CET) calibration without having to have direct access to the CETs. Although the CETs were the prime focus, other safety related sensors were investigated. This paper describes presumptions and methods employed in the first phase, the feasibility study. Additionally, it describes the cost/benefit analysis which can be used by any utility to determine ICRP payback

  8. 42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Drug utilization management, quality assurance, and... management, quality assurance, and medication therapy management programs (MTMPs). (a) General rule. Each... utilization management program, quality assurance measures and systems, and an MTMP as described in paragraphs...

  9. Monte Carlo programs and other utilities for high energy physics

    International Nuclear Information System (INIS)

    Palounek, A.P.T.; Youssef, S.

    1990-05-01

    The Software Standards and Documentation Group of the Workshop on Physics and Detector Simulation for SSC Experiments has compiled a list of physics generators, detector simulations, and related programs. This is not meant to be an exhaustive compilation, nor is any judgment made about program quality; it is a starting point or a more complete bibliography. Where possible we have included an author and source for the code. References for most programs are in the final section

  10. Antimicrobial resistance

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars

    2014-01-01

    Antimicrobial resistance is a global public health challenge, which has accelerated by the overuse of antibiotics worldwide. Increased antimicrobial resistance is the cause of severe infections, complications, longer hospital stays and increased mortality. Overprescribing of antibiotics......-the-counter sale of antibiotics, the use of antimicrobial stewardship programmes, the active participation of clinicians in audits, the utilization of valid rapid point-of-care tests, the promotion of delayed antibiotic prescribing strategies, the enhancement of communication skills with patients with the aid...... is associated with an increased risk of adverse effects, more frequent re-attendance and increased medicalization of self-limiting conditions. Antibiotic overprescribing is a particular problem in primary care, where viruses cause most infections. About 90% of all antibiotic prescriptions are issued by general...

  11. Impact of an Integrated Antibiotic Allergy Testing Program on Antimicrobial Stewardship: A Multicenter Evaluation.

    Science.gov (United States)

    Trubiano, Jason A; Thursky, Karin A; Stewardson, Andrew J; Urbancic, Karen; Worth, Leon J; Jackson, Cheryl; Stevenson, Wendy; Sutherland, Michael; Slavin, Monica A; Grayson, M Lindsay; Phillips, Elizabeth J

    2017-07-01

    Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015. Baseline demographics, AAL history, age-adjusted Charlson comorbidity index, infection history, and antibiotic usage for 12 months prior to testing (pre-AAT-AMS) and 3 months following testing (post-AAT-AMS) were recorded for each participant. Study outcomes included the proportion of patients who were "de-labeled" of their AAL, spectrum of antibiotic courses pre- and post-AAT-AMS, and antibiotic appropriateness (using standard definitions). From the 118 antibiotic allergy-tested patients, 226 AALs were reported (mean, 1.91/patient), with 53.6% involving 1 or more penicillin class drug. AAT-AMS allowed AAL de-labeling in 98 (83%) patients-56% (55/98) with all AALs removed. Post-AAT, prescribing of narrow-spectrum penicillins was more likely (adjusted odds ratio [aOR], 2.81, 95% confidence interval [CI], 1.45-5.42), as was narrow-spectrum β-lactams (aOR, 3.54; 95% CI, 1.98-6.33), and appropriate antibiotics (aOR, 12.27; 95% CI, 5.00-30.09); and less likely for restricted antibiotics (aOR, 0.16; 95% CI, .09-.29), after adjusting for indication, Charlson comorbidity index, and care setting. An integrated AAT-AMS program was effective in both de-labeling of AALs and promotion of improved antibiotic usage and appropriateness, supporting the routine incorporation of AAT into AMS programs. © 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.

  12. Expanding Antimicrobial Stewardship to Urgent Care Centers Through a Pharmacist-Led Culture Follow-up Program.

    Science.gov (United States)

    Dumkow, Lisa E; Beuschel, Thomas S; Brandt, Kasey L

    2017-09-01

    Urgent care centers represent a high-volume outpatient setting where antibiotics are prescribed frequently but resources for antimicrobial stewardship may be scarce. In 2015, our pharmacist-led Emergency Department (ED) culture follow-up program was expanded to include two urgent care (UC) sites within the same health system. The UC program is conducted by ED and infectious diseases clinical pharmacists as well as PGY1 pharmacy residents using a collaborative practice agreement (CPA). The purpose of this study was to describe the pharmacist-led UC culture follow-up program and its impact on pharmacist workload. This retrospective, descriptive study included all patients discharged to home from UC with a positive culture from any site resulting between 1 January and 31 December 2016. Data collected included the culture type, presence of intervention, and proportion of interventions made under the CPA. Additionally, pharmacist workload was reported as the number of call attempts made, new prescriptions written, and median time to complete follow-up per patient. Data were reported using descriptive statistics. A total of 1461 positive cultures were reviewed for antibiotic appropriateness as part of the UC culture follow-up program, with 320 (22%) requiring follow-up intervention. Culture types most commonly requiring intervention were urine cultures (25%) and sexually transmitted diseases (25%). A median of 15 min was spent per intervention, with a median of one call (range 1-6 calls) needed to reach each patient. Less than half of patients required a new antimicrobial prescription at follow-up. A pharmacist-led culture follow-up program conducted using a CPA was able to be expanded to UC sites within the same health system using existing clinical pharmacy staff along with PGY1 pharmacy residents. Service expansion resulted in minimal increase in pharmacist workload. Adding UC culture follow-up services to an existing ED program can allow health systems to expand

  13. The effects of utility DSM programs on electricity costs and prices

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.

    1991-11-01

    More and more US utilities are running more and larger demand-side management (DSM) programs. Assessing the cost-effectiveness of these programs raises difficult questions for utilities and their regulators. Should these programs aim to minimize the total cost of providing electric-energy services or should they minimize the price of electricity? This study offers quantitative estimates on the tradeoffs between total costs and electricity prices. This study uses a dynamic model to assess the effects of energy-efficiency programs on utility revenues, total resource costs, electricity prices, and electricity consumption for the period 1990 to 2010. These DSM programs are assessed under alternative scenarios. In these cases, fossil-fuel prices, load growth, the amount of excess capacity the utility has in 1990, planned retirements of power plants, the financial treatment of DSM programs, and the costs of energy- efficient programs vary. These analyses are conducted for three utilities: a ``base`` that is typical of US utilities; a ``surplus`` utility that has excess capacity, few planned retirements, and slow growth in fossil-fuel prices and incomes; and a ``deficit`` utility that has little excess capacity, many planned retirements, and rapid growth in fossil-fuel prices and incomes. 28 refs.

  14. The effects of utility DSM programs on electricity costs and prices

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.

    1991-11-01

    More and more US utilities are running more and larger demand-side management (DSM) programs. Assessing the cost-effectiveness of these programs raises difficult questions for utilities and their regulators. Should these programs aim to minimize the total cost of providing electric-energy services or should they minimize the price of electricity This study offers quantitative estimates on the tradeoffs between total costs and electricity prices. This study uses a dynamic model to assess the effects of energy-efficiency programs on utility revenues, total resource costs, electricity prices, and electricity consumption for the period 1990 to 2010. These DSM programs are assessed under alternative scenarios. In these cases, fossil-fuel prices, load growth, the amount of excess capacity the utility has in 1990, planned retirements of power plants, the financial treatment of DSM programs, and the costs of energy- efficient programs vary. These analyses are conducted for three utilities: a base'' that is typical of US utilities; a surplus'' utility that has excess capacity, few planned retirements, and slow growth in fossil-fuel prices and incomes; and a deficit'' utility that has little excess capacity, many planned retirements, and rapid growth in fossil-fuel prices and incomes. 28 refs.

  15. Utilizing Natural Cognitive Tendencies to Enhance Agricultural Education Programs

    Science.gov (United States)

    Lamm, Alexa J.; Rhodes, Emily B.; Irani, Tracy A.; Roberts, T. Grady; Snyder, Lori J. Unruh; Brendemuhl, Joel

    2011-01-01

    The influences of cognitive styles have been the focus of research on problems in education for quite some time (Witkin, Moore, Goodenough, & Cox, 1977). In fact, agricultural educators are rapidly increasing the amount of research and education focused on understanding and utilizing cognitive function in an attempt to improve educational…

  16. Line Program Environmental Management Audit: Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1992-05-01

    This report documents the results of the Line Program Environmental Management Audit completed for the Formerly Utilized Sites Remedial Action Program (FUSRAP). During this Audit, activities and records were reviewed and personnel interviewed at Oak Ridge, Tennessee. Additionally, since FUSRAP falls under the responsibility of the Office of the Assistant Secretary for Environmental Restoration and Waste Management, selected individuals from this office were interviewed in Washington, DC and Germantown, Maryland. The onsite portion of the FUSRAP Audit was conducted from March 16 through 27, 1992, by the US Department of Energy's Office of Environmental Audit (EH-24) located within the Office of the Assistant Secretary for Environment, Safety and Health (EH-1). The scope of the FUSRAP Line Program Environmental Management Audit was comprehensive and included all areas of environmental management with the exception of the National Environmental Policy Act (NEPA). Since the subject of compliance with and implementation of the requirements of NEPA is the responsibility of the DOE Headquarters Office of NEPA Oversight, management issues pertaining to NEPA were not investigated as part of this Audit

  17. Frequently Identified Gaps in Antimicrobial Stewardship Programs in Long-Term Care Facilities

    Science.gov (United States)

    Chung, Philip; Nailon, Regina; Tyner, Kate; Beach, Sue; Bergman, Scott; Drake, Margaret; Fitzgerald, Teresa; Lyden, Elizabeth; Rupp, Mark E; Schwedhelm, Michelle; Tierney, Maureen; Van Schooneveld, Trevor; Ashraf, Muhammad Salman

    2017-01-01

    Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in acute care, outpatient and long-term care facilities (LTCF). New Centers for Medicare and Medicaid Services (CMS) regulation requires LTCF to develop antimicrobial stewardship programs (ASP) by November 2017. Hence, we decided to study the current level of ASP activities and associated factors in LTCF. Methods NE ICAP conducted on-site surveys in 30 LTCF from 11/2015 to 3/2017. ASP activities related to 7 CDC recommended core elements (CE) including leadership support (LS), accountability, drug expertise, action, tracking, reporting, and education were assessed using the CDC Infection Control Assessment Tool for LTCF. Gap frequencies were calculated for CE. Fisher’s exact, Mann–Whitney and Kruskal–Wallis tests were used for statistical analyses examining the associations of LS, accountability, bed size (BS), hospital affiliation (HA), presence of trained infection preventionist (IP), and IP weekly hours (WH)/100-bed for IPCP with level of ASP activites. Results Of the 30 LTCF surveyed, 23% had HA and 60% had trained IP. Median BS, IP WH/100-bed for IPCP, and number of CE implemented were 60.5, 6.5, and 3, respectively. Only 1 (3%) LTCF had all 7 CE in place. LTCF with LS had a higher median number of the 6 remaining CE implemented compared with LTCF without LS (3 vs. 2; P = 0.03). Similarly, LTCF with accountability for ASP had a median of 3 remaining CE in place as opposed to 2 in LTCF without accountability (P < 0.05). LTCF with LS, accountability, and ≥20 IP WH/100-bed for IPCP were more likely to implement ≥2 of the last 4 CE, i.e., action, tracking, reporting and education (100% vs. 30%, P < 0.05). LTCF with ≥20 IP WH/100-bed dedicated towards IPCP were more likely to

  18. Frequently Identified Gaps in Antimicrobial Stewardship Programs in Critical Access Hospitals

    Science.gov (United States)

    Chung, Philip; Nailon, Regina; Tyner, Kate; Beach, Sue; Bergman, Scott; Drake, Margaret; Fitzgerald, Teresa; Lyden, Elizabeth; Rupp, Mark E; Schwedhelm, Michelle; Tierney, Maureen; Schooneveld, Trevor Van; Ashraf, Muhammad Salman

    2017-01-01

    Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a CDC funded project. ICAP team works in collaboration with NE Department of Health and Human Services (NEDHHS) to assess and improve infection prevention and control programs (IPCP) in various health care settings including resource limited settings like critical access hospitals (CAH). Little is known about the existing gaps in antimicrobial stewardship programs (ASP) of CAH. Hence, we decided to study the current level of ASP activities and factors associated with these activities in CAH. Methods NE ICAP conducted on-site surveys in 36 CAH from October 2015 to February 2017. ASP activities related to the 7 CDC recommended core elements (CE) including leadership support (LS), accountability, drug expertise (DE), action, tracking, reporting, and education were assessed using a CDC Infection Control Assessment Tool for acute care hospitals. Descriptive analyses evaluated CAH characteristics and frequency of CE implementation. Fisher’s exact, Mann–Whitney, and Kruskal–Wallis tests were used for statistical analyses examining the association of various factors with level of ASP activities. Results The 36 surveyed CAH had a median of 20 (range 10–25) beds and employed a median of 0.4 (range 0.1–1.6) infection preventionist (IP) full-time equivalent (FTE)/25-bed. Frequency of CE implementation varied among CAH with action and LS as the most (69%) and least (28%) frequently implemented elements, respectively. Close to half (47%) of surveyed CAH had implemented ≥4 CE but only 14% of facilities had all 7 CE. Median bed size and IP FTE/25-bed were similar among CAH with 0–2, 3-5, or ≥6 CE in place. CAH with LS or accountability for ASP implemented higher median numbers of the remaining CE compared with CAH without LS or accountability (5 vs. 2, P < 0.01 and 4 vs. 2, P < 0.01, respectively). Facilities with The presence of LS, accountability and drug expertise

  19. Utility Green-Pricing Programs: What Defines Success? (Topical Issues Brief); TOPICAL

    International Nuclear Information System (INIS)

    Swezey, B.; Bird, L.

    2001-01-01

    ''Green pricing'' is an optional service through which customers can support a greater level of investment by their electric utility in renewable energy technologies. Electric utilities in 29 states are now implementing green-pricing programs. This report examines important elements of green-pricing programs, including the different types of programs offered, the premiums charged, customer response, and additional factors that experience indicates are key to the development of successful programs. The best-performing programs tend to share a number of common attributes related to product design, value creation, product pricing, and program implementation. The report ends with a list of ''best practices'' for utilities to follow when developing and implementing programs

  20. Utility Green-Pricing Programs: What Defines Success? (Topical Issues Brief)

    Energy Technology Data Exchange (ETDEWEB)

    Swezey, B.; Bird, L.

    2001-09-13

    ''Green pricing'' is an optional service through which customers can support a greater level of investment by their electric utility in renewable energy technologies. Electric utilities in 29 states are now implementing green-pricing programs. This report examines important elements of green-pricing programs, including the different types of programs offered, the premiums charged, customer response, and additional factors that experience indicates are key to the development of successful programs. The best-performing programs tend to share a number of common attributes related to product design, value creation, product pricing, and program implementation. The report ends with a list of ''best practices'' for utilities to follow when developing and implementing programs.

  1. The Maryland nuclear science baccalaureate degree program: The utility perspective

    International Nuclear Information System (INIS)

    Mueller, J.R.

    1989-01-01

    In the early 1980s, Wisconsin Public Service Corporation (WPSC) made a firm commitment to pursue development and subsequent delivery of an appropriate, academically accredited program leading to a baccalaureate degree in nuclear science for its nuclear operations personnel. Recognizing the formidable tasks to be accomplished, WPSC worked closely with the University of Maryland University College (UMUC) in curriculum definition, specific courseware development for delivery by computer-aided instruction, individual student evaluation, and overall program implementation. Instruction began on our nuclear plant site in the fall of 1984. The university anticipates conferring the first degrees from this program at WPSC in the fall of 1989. There are several notable results that WPSC achieved from this degree program. First and most importantly, an increase in the level of education of our employees. It should be stated that this program has been well received by WPSC operator personnel. These employees, now armed with plant experience, a formal degree in nuclear science, and professional education in management are real candidates for advancement in our nuclear organization

  2. The cost and performance of utility commercial lighting programs. A report from the Database on Energy Efficiency Programs (DEEP) project

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J.; Vine, E.; Shown, L.; Sonnenblick, R.; Payne, C. [Lawrence Berkeley Lab., CA (United States). Energy and Environment Div.

    1994-05-01

    The objective of the Database on Energy Efficiency Programs (DEEP) is to document the measured cost and performance of utility-sponsored, energy-efficiency, demand-side management (DSM) programs. Consistent documentation of DSM programs is a challenging goal because of problems with data consistency, evaluation methodologies, and data reporting formats that continue to limit the usefulness and comparability of individual program results. This first DEEP report investigates the results of 20 recent commercial lighting DSM programs. The report, unlike previous reports of its kind, compares the DSM definitions and methodologies that each utility uses to compute costs and energy savings and then makes adjustments to standardize reported program results. All 20 programs were judged cost-effective when compared to avoided costs in their local areas. At an average cost of 3.9{cents}/kWh, however, utility-sponsored energy efficiency programs are not ``too cheap to meter.`` While it is generally agreed upon that utilities must take active measures to minimize the costs and rate impacts of DSM programs, the authors believe that these activities will be facilitated by industry adoption of standard definitions and reporting formats, so that the best program designs can be readily identified and adopted.

  3. JRR-3 maintenance program utilizing accumulated maintenance data

    International Nuclear Information System (INIS)

    Izumo, Hironobu; Kato, Tomoaki; Kinase, Masami; Torii, Yoshiya; Murayama, Yoji

    2007-07-01

    JRR-3(Japan Research Reactor No.3) has been operated for more than 15 years after the modification, without significant troubles by carrying out maintenance such as the preventive maintenance (mainly time-based maintenance) for the safety-grade equipments and the breakdown maintenance for the non-safety-grade equipments. Unscheduled shutdowns causes by aged non-safety-grade equipments have been increasing, and the resources such as budgets have been decreasing year by year. In this situation, JRR-3 maintenance program was reviewed about safety, reliability and economic efficiency. This report offers the policy of the maintenance review and the future direction of maintenance programs. (author)

  4. Utilizing a State Level Volunteer Recognition Program at the County Level

    Science.gov (United States)

    McCall, Fran Korthaus; Culp, Ken, III

    2013-01-01

    Volunteer recognition is an important component of Extension programs. Most land-grant universities have implemented a state volunteer recognition program. Extension professionals, however, are too overburdened with meetings, programs, and activities to effectively recognize volunteers locally. Utilizing a state model is an efficient means of…

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

    Science.gov (United States)

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

    2015-01-01

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

  6. College Student Utilization of a Comprehensive Psychiatric Emergency Program

    Science.gov (United States)

    Mitchell, Sharon L.; Kader, Mahrin; Haggerty, Melinda Z.; Bakhai, Yogesh D.; Warren, Calvert G.

    2013-01-01

    The authors sought to identify college students at risk for experiencing a mental health crisis that warranted a psychiatric evaluation at a hospital and/or a psychiatric hospitalization. A retrospective chart review of college students evaluated at a comprehensive psychiatric emergency program during a 1-year period was conducted. Demographic…

  7. The Integrated Safety Program: A Northeast Utilities perspective

    International Nuclear Information System (INIS)

    Bonaca, M.V.; Kacich, R.M.

    1993-01-01

    Northeast Utilities (NU) operates four nuclear units in Connecticut and one in New Hampshire. We provide electricity to ∼1.66 million customers covering 11,335 miles from the Canadian border down into southern New England. More than 50% of the company's assets are directly associated with our nuclear facilities. Approximately 18% of our electricity generated in 1992 was from our nuclear units, and we anticipate that this percentage will be considerably higher in 1993. As with other utilities, we are responsible to a variety of stakeholders (customers, stockholders, employees, federal and state agencies, etc.). Successfully balancing the competing interests of all of these stakeholders in today's business environment challenges our ingenuity. The competitive challenge facing our industry requires that we become more adept at allocating resources where they are most needed in order to improve our cost-effectiveness. We need to be able to rank by importance and prioritize the many activities that support our plants and individual tasks within those activities so that we can allocate our limited resources accordingly

  8. The Establishment of the Colombian Integrated Program for Antimicrobial Resistance Surveillance (COIPARS): A Pilot Project on Poultry Farms, Slaughterhouses and Retail Market.

    Science.gov (United States)

    Donado-Godoy, P; Castellanos, R; León, M; Arevalo, A; Clavijo, V; Bernal, J; León, D; Tafur, M A; Byrne, B A; Smith, W A; Perez-Gutierrez, E

    2015-04-01

    The development of antimicrobial resistance among bacteria (AMR) is currently one of the world's most pressing public health problems. The use of antimicrobial agents in humans and animals has resulted in AMR which has narrowed the potential use of antibiotics for the treatment of infections in humans. To monitor AMR and to develop control measures, some countries, such as the USA, Canada and Denmark, have established national integrated surveillance systems (FDA, , CIPARS, 2007, DANMAP,2002). The components of these programs monitor changes in susceptibility/resistance to antimicrobial agents of selected zoonotic pathogens and commensal organisms recovered from animals, retail meats and humans. The rapid development of Colombia's animal production industry has raised food safety issues including the emergence of antibiotic resistance. The Colombian Integrated Surveillance Program for Antimicrobial Resistance (COIPARS) was established as a pilot project to monitor AMR on poultry farms, slaughter houses and retail markets. © 2015 Blackwell Verlag GmbH.

  9. Florida state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1981-01-01

    This volume is one of a series produced under contract with DOE, Office of Nuclear Waste Management, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the federal and state levels, the pertinent programs they administer, each affected state legislature, and current federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Florida. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  10. Florida state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-27

    This volume is one of a series produced under contract with DOE, Office of Nuclear Waste Management, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the federal and state levels, the pertinent programs they administer, each affected state legislature, and current federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of Florida. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  11. Targeting utility customers to improve energy savings from conservation and efficiency programs

    International Nuclear Information System (INIS)

    Taylor, Nicholas W.; Jones, Pierce H.; Kipp, M. Jennison

    2014-01-01

    Highlights: • Improving DSM program impacts by targeting high energy users. • DSM energy savings potential hinges on pre-participation performance. • Targeting can benefit different utilities and energy efficiency programs. • Overall performance can be improved by up to 250% via targeting strategies. - Abstract: Electric utilities, government agencies, and private interests in the US have committed and continue to invest substantial resources – including billions of dollars of financial capital – in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. While most of these programs are deemed to be cost effective, and therefore in the public interest, opportunities exist to improve cost effectiveness by targeting programs to those customers with the greatest potential for energy savings. This article details an analysis of three DSM programs offered by three Florida municipal electric utilities to explore such opportunities. First, we estimate programs’ energy savings impacts; second, we measure and compare energy savings across subgroups of program participants as determined by their pre-intervention energy performance, and third, we explore potential changes in program impacts that might be realized by targeting specific customers for participation in the DSM programs. All three programs resulted in statistically significant average (per-participant) energy savings, yet average savings varied widely, with the customers who performed best (i.e., most efficient) before the intervention saving the least energy and those who performed worst (i.e., least efficient) before the intervention saving the most. Assessment of alternative program participation scenarios with varying levels of customer targeting suggests that program impacts could be increased by as much as 80% for a professional energy audit program, just over 100% for a high-efficiency heat pump upgrade program, and nearly 250% for an attic insulation

  12. Acceptance of PACS utilizing a PACS QI Program.

    Science.gov (United States)

    Stockman, Troy; Krishnan, Santha

    2006-01-01

    This article describes the quality improvement program that Mercy Hospital (Alegent Health System) initiated after it implemented a picture archiving and communication system (PACS) in November 2003. The radiology department encountered numerous PACS-related issues that directly affected the quality and workflow of patient care. In order to get a better understanding of the situation, the department developed a quality improvement plan for its PACS program. The first step was to dedicate a resource--in this case, a radiology information technology (RIT) support specialist--who would serve as a PACS subject matter expert while dealing with day-to-day PACS-related issues--specifically, errors. The error data were collected and categorized for consistency using statistical process control (SPC) tools. The information gathered was then traced back to the team members responsible for the errors and used as a training tool to further educate them. As a result of this program, the average error rate was reduced from 12% to 4% because the radiology team developed a better understanding of the errors by identifying the root causes and being accountable for eliminating errors within their control. In addition, the radiology staff learned to accept and trust the PACS, resulting in a positive culture change that benefited teamwork and staff morale as well as improve the workflow and the quality of patient care.

  13. Interactions between Energy Efficiency Programs funded under the Recovery Act and Utility Customer-Funded Energy Efficiency Programs

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, Charles A.; Stuart, Elizabeth; Hoffman, Ian; Fuller, Merrian C.; Billingsley, Megan A.

    2011-02-25

    Since the spring of 2009, billions of federal dollars have been allocated to state and local governments as grants for energy efficiency and renewable energy projects and programs. The scale of this American Reinvestment and Recovery Act (ARRA) funding, focused on 'shovel-ready' projects to create and retain jobs, is unprecedented. Thousands of newly funded players - cities, counties, states, and tribes - and thousands of programs and projects are entering the existing landscape of energy efficiency programs for the first time or expanding their reach. The nation's experience base with energy efficiency is growing enormously, fed by federal dollars and driven by broader objectives than saving energy alone. State and local officials made countless choices in developing portfolios of ARRA-funded energy efficiency programs and deciding how their programs would relate to existing efficiency programs funded by utility customers. Those choices are worth examining as bellwethers of a future world where there may be multiple program administrators and funding sources in many states. What are the opportunities and challenges of this new environment? What short- and long-term impacts will this large, infusion of funds have on utility customer-funded programs; for example, on infrastructure for delivering energy efficiency services or on customer willingness to invest in energy efficiency? To what extent has the attribution of energy savings been a critical issue, especially where administrators of utility customer-funded energy efficiency programs have performance or shareholder incentives? Do the new ARRA-funded energy efficiency programs provide insights on roles or activities that are particularly well-suited to state and local program administrators vs. administrators or implementers of utility customer-funded programs? The answers could have important implications for the future of U.S. energy efficiency. This report focuses on a selected set of ARRA

  14. [Selection of indicators for continuous monitoring of the impact of programs optimizing antimicrobial use in Primary Care].

    Science.gov (United States)

    Fernández-Urrusuno, Rocío; Flores-Dorado, Macarena; Moreno-Campoy, Eva; Montero-Balosa, M Carmen

    2015-05-01

    To determine core indicators for monitoring quality prescribing in Primary Care based on the evidence, and to assess the feasibility of these indicators for monitoring the use of antibiotics. A literature review was carried out on quality indicators for antimicrobial prescribing through an electronic search limited to the period 2001-2012. It was completed with an "ad hoc" search on the websites of public national and international health services. Finally, indicators were chosen by consensus by a multidisciplinary group of professionals dedicated to managing infections from several areas. The feasibility and applicability of these indicators was verified through the reporting and use of data in the prescription database. Twenty two indicators were found. The consensus group selected 16 indicators. Eleven of them measure the specific antimicrobial selection, and 5 are consumption rates. The indicators were successfully applied to the prescription database, being able to make comparisons between different geographical areas and to observe trends in prescriptions. The definition of a basic set of indicators to monitor antibiotic use adapted to local conditions is required. The results of these indicators can be used for feedback to professionals and for evaluating the impact of programs aimed at improving antimicrobial use. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  15. Participatory eHealth development to support nurses in antimicrobial stewardship

    NARCIS (Netherlands)

    Wentzel, Jobke; van Velsen, Lex; van Limburg, Maarten; de Jong, Nienke; Karreman, Joyce; Hendrix, Ron; van Gemert-Pi, Julia Elisabeth Wilhelmina Cornelia

    2014-01-01

    Background: Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put

  16. Participatory eHealth development to support nurses in antimicrobial stewardship

    NARCIS (Netherlands)

    Wentzel, M.J.; van Velsen, Lex Stefan; van Limburg, A.H.M.; Beerlage-de Jong, Nienke; Karreman, Joyce; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

    2014-01-01

    Background Antimicrobial resistance poses a threat to patient safety worldwide. To stop antimicrobial resistance, Antimicrobial Stewardship Programs (ASPs; programs for optimizing antimicrobial use), need to be implemented. Within these programs, nurses are important actors, as they put

  17. Investigating the Utilization of Research Evidence in the 4-H Youth Development Program

    Directory of Open Access Journals (Sweden)

    Lynette H. Bikos

    2011-06-01

    Full Text Available This study investigated the acquisition, interpretation, and utilization of research evidence in the 4-H Youth Development Program from the frame of Social Cognitive Theory. Utilizing Consensual Qualitative Research, we interviewed twenty 4-H faculty, staff, and volunteers from seven states. Results indicated four domains, which covered participants’ definitions of research utilization, their experiences utilizing research, the process of acquiring and distributing research, and barriers and facilitators to research utilization. Participants described research use primarily in terms of improving 4-H programs. They discussed their level of confidence (i.e. self-efficacy in finding and applying research evidence and their beliefs about the outcomes of research utilization (i.e. outcomes expectancy. Participants mentioned such barriers as not knowing where to look for research, lack of time, lack of funding, and difficulty applying research findings to their work. The facilitators included support from other 4-H colleagues and availability of 4-H specific conferences, publications, and curriculum databases.

  18. Behavioral approach to appropriate antimicrobial prescribing in hospitals: the Dutch Unique Method for Antimicrobial Stewardship (DUMAS) participatory intervention study.

    NARCIS (Netherlands)

    Sikkens, J.J.; Agtmael, M.A. van; Peters, E.J.G.; Lettinga, K.D.; Kuip, M. van der; Vandenbroucke-Grauls, C.M.J.E.; Wagner, C.; Kramer, M.H.H.

    2017-01-01

    Importance: Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. Objective: To examine whether an

  19. Utilizing the computer for a hospital bid program.

    Science.gov (United States)

    Caufman, M

    1984-01-01

    The goals of a computerized bid program include acquisition of pharmaceuticals at lowest possible cost, guaranteeing prices for a fixed period of time, having the ability to provide budget and patient charge information, decreased payroll hours and expenses vs. a manual system, and having the ability to retrieve data for accounting and purchasing procedures. These goals can be obtained by separating the bid procedure into five operations, which are identifying the pharmaceuticals to bid, preparing a vendor bid list, tabulating the bids received, selection of awarded bids, and vendor notification of awarded bids.

  20. Evaluation of an antimicrobial resistance monitoring program for campylobacter in poultry by simulation

    DEFF Research Database (Denmark)

    Regula, G.; Wong, Danilo Lo Fo; Ledergerber, U.

    2005-01-01

    sampling points. Existing methods of sample size calculation can not be used to solve this problem, because sampling decisions do not only depend on the prevalence of resistance and sensitivity and specificity of resistance testing, but also on the prevalence of the bacteria, and test characteristics...... of isolation of these bacteria. Our aim was to develop a stochastic simulation model that optimized a national resistance monitoring program, taking multi-stage sampling, imperfect sensitivity and specificity of diagnostic tests, and cost-effectiveness considerations into account. The process of resistance...... testing were evaluated regarding the precision of the resulting prevalence estimate. Precision of the prevalence estimate was defined as the absolute difference between apparent and true prevalence of resistance. A partial budget approach was utilized to find the most cost-effective combination of samples...

  1. The demand-side management program development process: A utility perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, A.K. [Oak Ridge National Lab., TN (United States); Yourstone, N.E. [Yourstone (Evelin), Albuquerque, NM (United States)

    1992-03-01

    This report describes an aspect of DSM that has received little attention, namely, how utilities develop DSM programs. The selection of utilities to study purposely was biased in favor of those with reputations for being experienced DSM program developers so as to optimize the chances to obtain detailed information. The DSM planning process is affected by organizational factors and external influences: (1) the location of the demand-side planning department within the utility; (2) the demand-side planning group`s functional responsibilities; (3) upper management participation in the DSM program development process; and (4) the organizational relationship between (or, separation of) supply-side and demand-side planning. Organizational factors reflect utilities` views of DSM programs and thus can affect the adoption of a technology- or customer-oriented approach. Despite repeated claims of the uniqueness of the demand- side planning process and its resistance to standardization, two general approaches to program development were discerned, namely technology- or customer-orientation. Although utilities consider customer related and technological factors in their DSM program development process, utilities can be differentiated by their emphasis on one or the other approach. 25 refs.

  2. The demand-side management program development process: A utility perspective

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, A.K. (Oak Ridge National Lab., TN (United States)); Yourstone, N.E. (Yourstone (Evelin), Albuquerque, NM (United States))

    1992-03-01

    This report describes an aspect of DSM that has received little attention, namely, how utilities develop DSM programs. The selection of utilities to study purposely was biased in favor of those with reputations for being experienced DSM program developers so as to optimize the chances to obtain detailed information. The DSM planning process is affected by organizational factors and external influences: (1) the location of the demand-side planning department within the utility; (2) the demand-side planning group's functional responsibilities; (3) upper management participation in the DSM program development process; and (4) the organizational relationship between (or, separation of) supply-side and demand-side planning. Organizational factors reflect utilities' views of DSM programs and thus can affect the adoption of a technology- or customer-oriented approach. Despite repeated claims of the uniqueness of the demand- side planning process and its resistance to standardization, two general approaches to program development were discerned, namely technology- or customer-orientation. Although utilities consider customer related and technological factors in their DSM program development process, utilities can be differentiated by their emphasis on one or the other approach. 25 refs.

  3. Utilization of aging program results in plant inspections

    International Nuclear Information System (INIS)

    Gunther, W.; Fullwood, R.

    1988-01-01

    Research conducted under the auspices of the US Nuclear Regulatory Commission Nuclear Plant Aging Research (NPAR) Program has resulted in a large data base of component and system operating experience. This data base has been used to determine equipment aging susceptibility and the potential for equipment aging to impact plant safety and reliability. Methods of detecting and mitigating component and system aging have also been identified. This paper discusses how the NPAR results could be used to focus inspection activities on age-sensitive components and systems and on the specific modes and mechanisms of age degradation. These activities range from the regular inspections conducted by resident inspectors to extensive special inspections such as the Safety System Functional Inspection typically conducted by a team of inspectors. 5 refs., 3 figs., 1 tab

  4. Utilization of aging program results in plant inspections

    International Nuclear Information System (INIS)

    Gunther, W.; Fullwood, R.

    1989-01-01

    Research conducted under the auspices of the US Nuclear Regulatory Commission Nuclear Plant Aging Research (NPAR) Program has resulted in a large data base of component and system operating experience. This data base has been used to determine equipment aging susceptibility and the potential for equipment aging to impact plant safety and reliability. Methods of detecting and mitigating component and system aging have also been identified. This paper discusses how the NPAR results could be used to focus inspection activities on age-sensitive components and systems and on the specific modes and mechanisms of age degradation. These activities range from the regular inspections conducted by resident inspectors to extensive special inspections such as the Safety System Functional Inspection typically conducted by a team of inspectors. 5 refs., 3 figs., 1 tab

  5. SSL Pricing and Efficacy Trend Analysis for Utility Program Planning

    Energy Technology Data Exchange (ETDEWEB)

    Tuenge, Jason R.

    2013-10-01

    An LED lamp or luminaire can generally be found that matches or exceeds the efficacy of benchmark technologies in a given product category, and LED products continue to expand into ever-higher lumen output niches. However, the price premium for LED continues to pose a barrier to adoption in many applications, in spite of expected savings from reduced energy use and maintenance. Other factors—such as dimmability and quality of light—can also present challenges. The appropriate type, timing, and magnitude of energy efficiency activities will vary from organization to organization based on local variables and the method of evaluation. A number of factors merit consideration when prioritizing activities for development. Category-specific projections for pricing and efficacy are provided herein to assist in efficiency program planning efforts.

  6. ECUT (Energy Conversion and Utilization Technologies) program: Biocatalysis project

    Science.gov (United States)

    Baresi, Larry

    1989-01-01

    The Annual Report presents the fiscal year (FY) 1988 research activities and accomplishments, for the Biocatalysis Project of the U.S. Department of Energy, Energy Conversion and Utilization Technologies (ECUT) Division. The ECUT Biocatalysis Project is managed by the Jet Propulsion Laboratory, California Institute of Technology. The Biocatalysis Project is a mission-oriented, applied research and exploratory development activity directed toward resolution of the major generic technical barriers that impede the development of biologically catalyzed commercial chemical production. The approach toward achieving project objectives involves an integrated participation of universities, industrial companies and government research laboratories. The Project's technical activities were organized into three work elements: (1) The Molecular Modeling and Applied Genetics work element includes research on modeling of biological systems, developing rigorous methods for the prediction of three-dimensional (tertiary) protein structure from the amino acid sequence (primary structure) for designing new biocatalysis, defining kinetic models of biocatalyst reactivity, and developing genetically engineered solutions to the generic technical barriers that preclude widespread application of biocatalysis. (2) The Bioprocess Engineering work element supports efforts in novel bioreactor concepts that are likely to lead to substantially higher levels of reactor productivity, product yields and lower separation energetics. Results of work within this work element will be used to establish the technical feasibility of critical bioprocess monitoring and control subsystems. (3) The Bioprocess Design and Assessment work element attempts to develop procedures (via user-friendly computer software) for assessing the energy-economics of biocatalyzed chemical production processes, and initiation of technology transfer for advanced bioprocesses.

  7. Issues associated with energy efficiency programs implementation at the housing and utility enterprises

    Directory of Open Access Journals (Sweden)

    Borisova Natalia

    2017-01-01

    Full Text Available Energy saving potential is quite huge in the most sectors of the national economy, particularly in housing and utilities and industry. Due to this, energy efficiency increase at the enterprises of housing and utilities and industry through the energy efficiency programs implementation, is one of the priorities in the modern economy of Russia and its regions, and requires radical measures to improve the effectiveness of its implementation. The purpose of the authors is the scientific and practical study of the main problems of energy efficiency programs implementation at the enterprises of housing and utilities services and industry in modern conditions. To achieve this purpose the authors solved the following problems: the current state of the housing and utilities sector and industry, the relevance and the need for energy saving policy at the enterprises of housing and utilities services and industry are studied; the main problems impeding to implement the energy-saving program effectively at the enterprises of housing and utilities services and industry are determined; the possible ways of solving the problems identified in the energy efficiency programs implementation at the enterprises of housing and industry are offered. The team of authors focuses in this study on the problems of the energy audit using in practice as a basic tool for the energy saving programs development at the enterprises of housing and utilities services, industry and their subsequent implementation. The subject of author's researches is the factors that determine the energy efficiency programs implementation at the enterprises of housing and utilities services and industry at the level of individual region and the whole country, and the object is the enterprises of housing and utilities services and industry. Methodologically the scientific and practical research is based on the complex approach using the methods of comparative, statistical and logical analysis.

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

    Science.gov (United States)

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

    2014-02-01

    The Johns Hopkins Children's Medical and Surgery Center developed a Web-based Antimicrobial Stewardship Program (ASP) in 2005. The present study aimed to assess longitudinal antimicrobial request and approval patterns for this ASP. We analyzed a total of 16,229 antimicrobial requests for 3,542 patients between June 1, 2005, and June 30, 2009. Antimicrobial approval was the outcome of interest. We assessed gaming by studying trends in automatically approved requests. Nonparametric tests for trend were performed to detect changes in approval patterns. Multiple logistic regression was used to identify factors associated with approval. The vast majority (91.3%) of antimicrobial requests were approved, with an increase of 6.1% over time (P Web-based ASP allows management of a large number of antimicrobial requests, without apparent gaming. Observed differences in approval patterns based on patient, requestor, and antimicrobial factors may inform the development of ASPs and evaluation of provider education and training. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Monitoring Resource Utilization in a Health Care Coordination Program.

    Science.gov (United States)

    Popejoy, Lori L; Jaddoo, Julie; Sherman, Jan; Howk, Christopher; Nguyen, Raymond; Parker, Jerry C

    2015-01-01

    This initial article describes the development of a health care coordination intervention and documentation system designed using the Agency for Healthcare Research and Quality (AHRQ) Care Coordination Atlas framework for Centers for Medicare & Medicaid-funded innovation project, Leveraging Information Technology to Guide High-Tech, High-Touch Care (LIGHT). The study occurred at an academic medical center that serves 114 counties. Twenty-five registered nurse care managers (NCMs) were hired to work with 137 providers in 10 family community and internal medicine clinics. Patients were allocated into one of the four tiers on the basis of their chronic medical conditions and health care utilization. Using a documentation system on the basis of the AHRQ domains developed for this study, time and touch data were calculated for 8,593 Medicare, Medicaid, or dual-eligible patients. We discovered through the touch and time analysis that the majority of health care coordination activity occurred in the AHRQ domains of communication, assess needs and goals, and facilitate transitions, accounting for 79% of the NCM time and 61% of the touches. As expected, increasing tier levels resulted in increased use of NCM resources. Tier 3 accounted for roughly 16% of the patients and received 159 minutes/member (33% of total minutes), and Tier 4 accounted for 4% of patients and received 316 minutes/member (17% of all minutes). In contrast Tier 2, which did not require routine touches per protocol, had 5,507 patients (64%), and those patients received 5,246 hours of health care coordination, or 57 minutes/member, and took 48% of NCM time. 1. The AHRQ Care Coordination Atlas offered a systematic way to build a documentation system that allowed for the extraction of data that was used to calculate the amount of time and the number of touches that NCMs delivered per member. 2. Using a framework to systematically guide the work of health care coordination helped NCMs to think strategically

  10. Development and application of an objective staffing calculator for antimicrobial stewardship programs in the Veterans Health Administration.

    Science.gov (United States)

    Echevarria, Kelly; Groppi, Julie; Kelly, Allison A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A

    2017-11-01

    The development and validation of a staffing calculator and its use in creating staffing guidance for antimicrobial stewardship programs (ASPs) in Veterans Health Administration (VHA) facilities are described. The Tools and Resources Work Group of the Antimicrobial Stewardship Task Force and PBM Clinical Pharmacy Practice Office of the Department of Veterans Affairs developed, tested, and validated a staffing calculator to track patient care and ASP management activities needed to maintain a comprehensive ASP. Time spent on activities was based on time-in-motion tracking studies and input from experienced antimicrobial stewards. The staffing calculator was validated across VHA facilities of varying sizes and complexities to determine the number of needed clinical pharmacist full-time equivalents (FTEs) to implement and maintain ASPs per 100 occupied beds. A total of 12 facilities completed the staffing calculator for 1 calendar week. The median number of occupied beds was 226. Most facilities had at least 100 occupied beds, and 6 of the 12 were considered high complexity facilities. The median calculated FTE personnel requirement was 2.62, or 1.01 per 100 occupied beds. The majority of FTE time (70%) was spent on patient care activities and 30% on program management activities, including infectious diseases or ASP rounds. The final recommendations indicated that in order to implement and manage a robust ASP, a pharmacist FTE investment of 1.0 per 100 occupied beds would be needed. A staffing calculator to account for the time needed to implement ASP activities and provide staffing guidance across a large health-care system was validated. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  11. TRAX (Disk Sector Utility Program). Technical Memorandum 84-1. Focus on the Trained Person.

    Science.gov (United States)

    Johnson, Charles C.; Hodak, Gary W.

    A disk sector utility program (called TRAX) was designed and developed since a computer aid capable of inspecting and modifying the byte data on a disk platter, independent of any other program or system, was not commercially available. This report: (1) provides an overview of the TRAX system; (2) briefly describes the major system options; and…

  12. 32 CFR 199.15 - Quality and utilization review peer review organization program.

    Science.gov (United States)

    2010-07-01

    ... relating to the administration and management of CHAMPUS in that the Peer Review Organization program is... model. The CHAMPUS Quality and Utilization Review Peer Review Organization program, based on specific.... Application of these objectives in the context of hospital services covered by the DRG-based payment system...

  13. Perceptions of and preferences for fee program dollar utilization among wilderness visitors

    Science.gov (United States)

    Ingrid Schneider; Christopher LaPointe; Sharon Stievater

    2000-01-01

    The purpose of this study was to ascertain visitor perceptions of a fee program and preferences for management utilization of the fee dollars. Differences in program perceptions were examined both by activity and activity style. Wilderness visitors in the American Southwest were surveyed on-site during the 1997–1998 season. Overall, respondents moderately agreed that...

  14. The past, present, and future of U.S. utility demand-side management programs

    International Nuclear Information System (INIS)

    Eto, J.

    1996-12-01

    Demand-side management or DSM refers to active efforts by electric and gas utilities to modify customers' energy use patterns. The experience in the US shows that utilities, when provided with appropriate incentives, can provide a powerful stimulus to energy efficiency in the private sector. This paper describes the range and history of DSM programs offered by US electric utilities, with a focus on the political, economic, and regulatory events that have shaped their evolution. It also describes the changes these programs are undergoing as a result of US electricity industry restructuring. DSM programs began modestly in the 1970s in response to growing concerns about dependence on foreign sources of oil and environmental consequences of electricity generation, especially nuclear power. The foundation for the unique US partnership between government and utility interests can be traced first to the private-ownership structure of the vertically integrated electricity industry and second to the monopoly franchise granted by state regulators. Electricity industry restructuring calls into question both of these basic conditions, and thus the future of utility DSM programs for the public interest. Future policies guiding ratepayer-funded energy-efficiency DSM programs will need to pay close attention to the specific market objectives of the programs and to the balance between public and private interests

  15. Impact of Large Scale Energy Efficiency Programs On Consumer Tariffs and Utility Finances in India

    Energy Technology Data Exchange (ETDEWEB)

    Abhyankar, Nikit; Phadke, Amol

    2011-01-20

    Large-scale EE programs would modestly increase tariffs but reduce consumers' electricity bills significantly. However, the primary benefit of EE programs is a significant reduction in power shortages, which might make these programs politically acceptable even if tariffs increase. To increase political support, utilities could pursue programs that would result in minimal tariff increases. This can be achieved in four ways: (a) focus only on low-cost programs (such as replacing electric water heaters with gas water heaters); (b) sell power conserved through the EE program to the market at a price higher than the cost of peak power purchase; (c) focus on programs where a partial utility subsidy of incremental capital cost might work and (d) increase the number of participant consumers by offering a basket of EE programs to fit all consumer subcategories and tariff tiers. Large scale EE programs can result in consistently negative cash flows and significantly erode the utility's overall profitability. In case the utility is facing shortages, the cash flow is very sensitive to the marginal tariff of the unmet demand. This will have an important bearing on the choice of EE programs in Indian states where low-paying rural and agricultural consumers form the majority of the unmet demand. These findings clearly call for a flexible, sustainable solution to the cash-flow management issue. One option is to include a mechanism like FAC in the utility incentive mechanism. Another sustainable solution might be to have the net program cost and revenue loss built into utility's revenue requirement and thus into consumer tariffs up front. However, the latter approach requires institutionalization of EE as a resource. The utility incentive mechanisms would be able to address the utility disincentive of forgone long-run return but have a minor impact on consumer benefits. Fundamentally, providing incentives for EE programs to make them comparable to supply

  16. Utilization of the Arkansas Prescription Monitoring Program to combat prescription drug abuse

    OpenAIRE

    Rittenhouse, Rebecca; Wei, Feifei; Robertson, Denise; Ryan, Kevin

    2015-01-01

    Objective: The Arkansas Prescription Monitoring Program (AR PMP) was implemented in 2013 to combat prescription drug abuse. All enrollees were invited to participate in a user survey available in February 2014, to identify makeup of users, utilization of the program, and changes made to health care practices after implementation of the program. Methods: Of the 3694 individual enrollees invited to participate, 1541 (41.7%) completed the survey. Data collected were analyzed to identify chang...

  17. Measuring the benefits and costs of utility conservation and load-management programs

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.

    1984-06-01

    Much less has been learned than could have been from utility operation of conservation and load management programs. This general ignorance concerning the performance (i.e., benefits and costs) of these programs exists because the authors have not devoted sufficient resources to careful evaluations of past and present programs. The authors need to build evaluation into the program planning and implementation process, and the authors should use actual electricity and gas bills to measure program performance. Finally, the authors should conduct well designed experiments to learn what does and does not work.

  18. A scoping study on energy-efficiency market transformation by California Utility DSM Programs

    Energy Technology Data Exchange (ETDEWEB)

    Eto, J.; Prahl, R.; Schlegel, J.

    1996-07-01

    Market transformation has emerged as a central policy objective for future publicly-funded energy-efficiency programs in California. California Public Utilities Commission (CPUC) Decision 95-12-063 calls for public funding to shift to activities designed to transform the energy-efficiency market. The CPUC envisions that funding {open_quotes}would only be needed for specific and limited periods of time to cause the market to be transformed{close_quotes}. At the same time, the CPUC also acknowledges that {open_quotes}there are many definitions of market transformation{close_quotes} ... and does {open_quotes}not attempt to refine those definitions today{close_quotes}. We argue that a definition of market transformation is essential. The literature is now replete with definitions, and an operational definition is needed for the CPUC to decide on which programs should be supported with public funds. The CPUC decision initially indicated a preference for programs that do not provide financial assistance 4-efficiency programs that rely on financial assistance to customers. However, energy customers have traditionally accounted for a substantial portion of California utility`s DSM programs, so the CPUC`s direction to use ratepayer funds to support programs that will transform the market raises critical questions about how to analyze what has happened in order to plan effectively for the future: Which utility energy-efficiency programs, including those that provide financial assistance to customers, have had market transforming effects? To what extent do current regulatory rules and practices encourage or discourage utilities from running programs that are designed to transform the market? Should the rules and programs be modified, and, if so, how, to promote market transformation?

  19. Prediction of Antimicrobial Peptides Based on Sequence Alignment and Support Vector Machine-Pairwise Algorithm Utilizing LZ-Complexity

    Directory of Open Access Journals (Sweden)

    Xin Yi Ng

    2015-01-01

    Full Text Available This study concerns an attempt to establish a new method for predicting antimicrobial peptides (AMPs which are important to the immune system. Recently, researchers are interested in designing alternative drugs based on AMPs because they have found that a large number of bacterial strains have become resistant to available antibiotics. However, researchers have encountered obstacles in the AMPs designing process as experiments to extract AMPs from protein sequences are costly and require a long set-up time. Therefore, a computational tool for AMPs prediction is needed to resolve this problem. In this study, an integrated algorithm is newly introduced to predict AMPs by integrating sequence alignment and support vector machine- (SVM- LZ complexity pairwise algorithm. It was observed that, when all sequences in the training set are used, the sensitivity of the proposed algorithm is 95.28% in jackknife test and 87.59% in independent test, while the sensitivity obtained for jackknife test and independent test is 88.74% and 78.70%, respectively, when only the sequences that has less than 70% similarity are used. Applying the proposed algorithm may allow researchers to effectively predict AMPs from unknown protein peptide sequences with higher sensitivity.

  20. Handbook of evaluation of utility DSM programs. [Demand-Side Management (DSM)

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.; Reed, J. (eds.); Bronfman, B.; Fitzpatrick, G.; Hicks, E.; Hirst, E.; Hoffman, M.; Keating, K.; Michaels, H.; Nadel, S.; Peters, J.; Reed, J.; Saxonis, W.; Schoen, A.; Violette, D.

    1991-12-01

    Program evaluation has become a central issue in the world of utility integrated resource planning. The DSM programs that utilities were operating to meet federal requirements or to improve customer relations are now becoming big business. DSM is being considered an important resource in a utility's portfolio of options. In the last five years, the amount of money that utilities have invested in DSM has grown exponentially in most regulatory jurisdictions. Market analysts are now talking about DSM being a $30 billion industry by the end of the decade. If the large volume of DSM-program investments was not enough to highlight the importance of evaluation, then the introduction of regulatory incentives has really focused the spotlight. This handbook was developed through a process that involved many of those people who represent the diverse constituencies of DSM-program evaluation. We have come to recognize the many technical disciplines that must be employed to evaluate DSM programs. An analysis might start out based on the principles of utility load research to find out what happened, but a combination of engineering and statistical methods must be used to triangulate'' an estimate of what would have happened without the program. The difference, of course, is that elusive but prized result of evaluation: what happened as the direct result of the DSM program. Technical performance of DSM measures is not the sole determinant of the answer, either. We also recognize the importance of such behavioral attributes of DSM as persistence and free ridership. Finally, DSM evaluation is meaningless without attention to planning an approach, communicating results to relevant decision-makers, and focusing as much on the process as the impacts of the program. These topics are all covered in this handbook.

  1. Sustained pediatric antimicrobial stewardship program with consultation to infectious diseases reduced carbapenem resistance and infection-related mortality.

    Science.gov (United States)

    Horikoshi, Yuho; Suwa, Junichi; Higuchi, Hiroshi; Kaneko, Tetsuji; Furuichi, Mihoko; Aizawa, Yuta; Fukuoka, Kahoru; Okazaki, Kaoru; Ito, Kenta; Shoji, Takayo

    2017-11-01

    The impact of pediatric antimicrobial stewardship programs (ASP) on antimicrobial resistance (AMR) remains largely unknown. This study aimed to evaluate the AMR for carbapenem of Gram-negative bacilli (GNB) and carbapenem use with infectious diseases consultation after the implementation of an ASP. This quasi-experimental study was conducted at Tokyo Metropolitan Children's Medical Center in Japan. The pre- and post-intervention periods were April 2010 to September 2011 and October 2011 to March 2017, respectively. The pre-intervention phase consisted of consultations with the infectious diseases service alone. The ASP was implemented during the post-intervention phase. The carbapenem resistance rates of GNB were calculated. The correlation between carbapenem resistance rates and carbapenem day of therapy (DOT) was examined. The outcome metrics were compared by average length of hospitalization, all-cause mortality, and infection-related mortality. A positive correlation was observed between the carbapenem resistance rate in Pseudomonas aeruginosa and DOT (0.76, p=0.04). The carbapenem resistance rate in P. aeruginosa (pcarbapenem use and resistance in P. aeruginosa, leading to favorable outcomes in terms of length of hospitalization and infection-related mortality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  2. Outcomes and Utilization of a Low Intensity Workplace Weight Loss Program

    OpenAIRE

    Kelly M. Carpenter; Jennifer C. Lovejoy; Jane M. Lange; Jenny E. Hapgood; Susan M. Zbikowski

    2014-01-01

    Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensi...

  3. Using program impact pathways to understand and improve program delivery, utilization, and potential for impact of Helen Keller International's homestead food production program in Cambodia.

    Science.gov (United States)

    Olney, Deanna K; Vicheka, Sao; Kro, Meng; Chakriya, Chhom; Kroeun, Hou; Hoing, Ly Sok; Talukder, Aminzzaman; Quinn, Victoria; Iannotti, Lora; Becker, Elisabeth; Roopnaraine, Terry

    2013-06-01

    Evidence of the impact of homestead food production programs on nutrition outcomes such as anemia and growth is scant. In the absence of information on program impact pathways, it is difficult to understand why these programs, which have been successful in increasing intake of micronutrient-rich foods, have had such limited documented impact on nutrition outcomes. To conduct a process evaluation of Helen Keller International's (HKI's) homestead food production program in Cambodia to assess whether the program was operating as planned (in terms of design, delivery, and utilization) and to identify ways in which the program might need to be strengthened in order to increase its potential for impact. A program theory framework, which laid out the primary components along the hypothesized program impact pathways, was developed in collaboration with HKI and used to design the research. Semistructured interviews and focus group discussions with program beneficiaries (n = 36 and 12, respectively), nonbeneficiaries (n = 12), and program implementers (n = 17 and 2, respectively) and observations of key program delivery points, including health and nutrition training sessions (n = 6), village model farms (n = 6), and household gardens of beneficiaries (n = 36) and nonbeneficiaries (n = 12), were conducted to assess the delivery and utilization of the primary program components along the impact pathways. The majority of program components were being delivered and utilized as planned. However, challenges with some of the key components posited to improve outcomes such as anemia and growth were noted. Among these were a gap in the expected pathway from poultry production to increased intake of eggs and poultry meat, and some weaknesses in the delivery of the health and nutrition training sessions and related improvements in knowledge among the village health volunteers and beneficiaries. Although the program has been successful in delivering the majority of the program

  4. Pathogen frequency and resistance patterns in Brazilian hospitals: summary of results from three years of the SENTRY antimicrobial surveillance program

    Directory of Open Access Journals (Sweden)

    Helio S. Sader

    Full Text Available BACKGROUND: Pathogen frequency and resistance patterns may vary significantly from country to country and also in different hospitals within a country. Thus, regional surveillance programs are essential to guide empirical therapy and infection control measures. METHODS: Rank order of occurrence and antimicrobial susceptibility of pathogenic species causing bloodstream infections (BSI, lower respiratory tract infections (LRTI, wound or skin and soft tissue infections (WSSTI, and urinary tract infections (UTI in hospitalized patients were determined by collecting consecutive isolates over a specified period of time, as part of the SENTRY Antimicrobial Resistance Surveillance Program (SENTRY. All isolates were tested by reference broth microdilution. RESULTS AND CONCLUSIONS: A total of 3,728 bacterial strains were obtained from January, 1997, to December, 1999, from 12 Brazilian hospitals located in 4 states. The largest number of isolates were obtained from patients with BSI (2,008, followed by LRTI (822 cases, UTI (468 cases, and WSSTI (430 cases. Staphylococcus aureus was the most frequently isolated pathogen in general (22.8% - 852 isolates, followed by E. coli (13.8% - 516 cases and Pseudomonas aeruginosa (13.3% - 496 cases. Staphylococcus aureus was also the most common species isolated from BSI (23.6% and WSSTI (45.8%, and P. aeruginosa was the most frequent species isolated from patients with LRTI (29.4%. The main bacterial resistance problems found in this study were: imipenem resistance among P. aeruginosa (69.8% susceptibility and Acinetobacter spp. (88.1% susceptibility; ESBL production among K. pneumoniae (48.4% and E. coli (8.9%; resistance to third generation cephalosporins among Enterobacter spp. (68.1% susceptible to ceftazidime and oxacillin resistance among S. aureus (34.0% and coagulase negative staphylococci (80.1%. Only the carbapenems (88.1% to 89.3% susceptibility showed reasonable activity against the Acinetobacter spp

  5. Pathogen frequency and resistance patterns in Brazilian hospitals: summary of results from three years of the SENTRY antimicrobial surveillance program

    Directory of Open Access Journals (Sweden)

    Sader Helio S.

    2001-01-01

    Full Text Available BACKGROUND: Pathogen frequency and resistance patterns may vary significantly from country to country and also in different hospitals within a country. Thus, regional surveillance programs are essential to guide empirical therapy and infection control measures. METHODS: Rank order of occurrence and antimicrobial susceptibility of pathogenic species causing bloodstream infections (BSI, lower respiratory tract infections (LRTI, wound or skin and soft tissue infections (WSSTI, and urinary tract infections (UTI in hospitalized patients were determined by collecting consecutive isolates over a specified period of time, as part of the SENTRY Antimicrobial Resistance Surveillance Program (SENTRY. All isolates were tested by reference broth microdilution. RESULTS AND CONCLUSIONS: A total of 3,728 bacterial strains were obtained from January, 1997, to December, 1999, from 12 Brazilian hospitals located in 4 states. The largest number of isolates were obtained from patients with BSI (2,008, followed by LRTI (822 cases, UTI (468 cases, and WSSTI (430 cases. Staphylococcus aureus was the most frequently isolated pathogen in general (22.8% - 852 isolates, followed by E. coli (13.8% - 516 cases and Pseudomonas aeruginosa (13.3% - 496 cases. Staphylococcus aureus was also the most common species isolated from BSI (23.6% and WSSTI (45.8%, and P. aeruginosa was the most frequent species isolated from patients with LRTI (29.4%. The main bacterial resistance problems found in this study were: imipenem resistance among P. aeruginosa (69.8% susceptibility and Acinetobacter spp. (88.1% susceptibility; ESBL production among K. pneumoniae (48.4% and E. coli (8.9%; resistance to third generation cephalosporins among Enterobacter spp. (68.1% susceptible to ceftazidime and oxacillin resistance among S. aureus (34.0% and coagulase negative staphylococci (80.1%. Only the carbapenems (88.1% to 89.3% susceptibility showed reasonable activity against the Acinetobacter spp

  6. [Design and implementation of an outpatient parenteral antimicrobial therapy program in primary care: the experience at a second level hospital].

    Science.gov (United States)

    Ruiz-Campuzano, M; García-Vázquez, E; Hernández-Roca, J J; Gómez-Gómez, J; Canteras-Jordana, M; Mené-Fenor, E; Hernández-Torres, A; Peláez-Ballesta, A

    2017-02-01

    Outpatient parenteral antimicrobial therapy (OPAT) programs are a good assistance option in a wide variety of infectious diseases. Our aim was to design and implement an OPAT program in the area of influence of a second-level hospital, with no Home Hospitalization Service available, being necessary close collaboration between hospitalization and Primary Care teams, describe our cohort, analyse the antimicrobial treatment indicated and evaluate the prognostic and risk factors associated with readmission and mortality. Prospective study cohorts of patients admitted to the OPAT programme, from 1 January 2012 to 31 May 2015. During the period of study a total of 98 episodes were recorded. The average age of the cohort was 66 years. The most frequent comorbidity was immunosuppression (33.67 %), with an overall average of Charlson index of 5.21 ± 3.09. The most common source of infection was respiratory (33.67 %). Microbiological isolation was achieved in fifty-eight patients (59.18 %) being Escherichia coli the most frequently isolated (25%). The average number of days of antibiotics administration at home was 10.42 ± 6.02 (SD), being carbapenems (43.48%) the more administered. Eighty-six patients (87.75%) completed the treatment successfully. Thirty-two patients (32.65%) were readmitted within 30 days after being discharged and seven patients (7.14%) died. A statistically significant association was only found in the readmission with variables: elderly patients (p=0.03), being carriers of Porth-a-Cath (p=0.04) and treatment termination related with infection (pService in Spain, which could allow to optimize the hospital and primary care resources available. Nevertheless this pilot study results are poor in terms of optimization of antibiotics choice, transition to oral administration, de-escalation and duration.

  7. Utilization of Adult and Non-Formal Education Programs in Combating Rural Poverty in Nigeria

    Science.gov (United States)

    Ihejirika, John Chinedu

    2012-01-01

    The purpose of this paper was to examine the concept of poverty and its causes in Nigeria and to analyze how adult and non-formal education programs can be utilized to reduce rural poverty in Nigeria. In spite of Nigeria's affluence in human and material resources, it is classified among countries with high level of poverty. Incidentally, the…

  8. Demonstrating a small utility approach to demand-side program implementation

    Energy Technology Data Exchange (ETDEWEB)

    1991-10-01

    The US DOE awarded a grant to the Burlington Electric Department (B.E.D.) to test a demand-side management (DSM) demonstration program designed to quickly save a significant amount of power with little disruption to the utility's customers or its normal operations. B.E.D. is a small municipal utility located in northern Vermont, with a lengthy history of successful DSM involvement. In our grant application, we proposed to develop a replicable program and approach to DSM that might be useful to other small utilities and to write a report to enable such replication. We believe that this DSM program and/or individual program components are replicable. This report is designed to allow other utilities interested in DSM to replicate this program or specific program design features to meet their DSM goals. We also wanted to use the opportunity of this grant to test the waters of residential heating fuel-switching. We hoped to test the application of one fuel-switching technology, and to benefit from the lessons learned in developing a full-scale DSM program for this end- use. To this end the pilot effort has been very successful. In the pilot pressure we installed direct-vent gas fired space heaters sized as supplemental heating units in 44 residences heated solely by electric resistance heat. We installed the gas space heating units at no cost to the owners or residents. We surveyed participating customers. The results of those surveys are included in this report and preliminary estimates of winter peak capacity load reductions are also noted in this report.

  9. Demonstrating a small utility approach to demand-side program implementation

    International Nuclear Information System (INIS)

    1991-01-01

    The US DOE awarded a grant to the Burlington Electric Department (B.E.D.) to test a demand-side management (DSM) demonstration program designed to quickly save a significant amount of power with little disruption to the utility's customers or its normal operations. B.E.D. is a small municipal utility located in northern Vermont, with a lengthy history of successful DSM involvement. In our grant application, we proposed to develop a replicable program and approach to DSM that might be useful to other small utilities and to write a report to enable such replication. We believe that this DSM program and/or individual program components are replicable. This report is designed to allow other utilities interested in DSM to replicate this program or specific program design features to meet their DSM goals. We also wanted to use the opportunity of this grant to test the waters of residential heating fuel-switching. We hoped to test the application of one fuel-switching technology, and to benefit from the lessons learned in developing a full-scale DSM program for this end- use. To this end the pilot effort has been very successful. In the pilot pressure we installed direct-vent gas fired space heaters sized as supplemental heating units in 44 residences heated solely by electric resistance heat. We installed the gas space heating units at no cost to the owners or residents. We surveyed participating customers. The results of those surveys are included in this report and preliminary estimates of winter peak capacity load reductions are also noted in this report

  10. The current utilization and perceptions of prescription drug monitoring programs among emergency medicine providers in Florida.

    Science.gov (United States)

    Young, Henry W; Tyndall, Joseph A; Cottler, Linda B

    2017-12-01

    Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida. A survey assessing the utilization and perception of Florida's prescription drug monitoring program was distributed to emergency medicine providers in Florida over a 5 week period. Attending physicians, physicians in training, and extenders from a variety of practice types were assessed. A total of 88 surveys were completed. Over two thirds (67%) of the respondents were male. The majority of respondents were attending physicians (62%), 13 (14%) were residents, and 21 (23%) were extenders. Nearly all (99%) were aware of Electronic-Florida Online Reporting of Controlled Substance Evaluation Program (EFORCSE) and 84% had registered accounts. More than 2/3 (73%) reported feeling pressured to prescribe opioids, and 70% reported receiving no formal education on identifying individuals at increased risk of opioid misuse. Approximately half (51%) reported that they used EFORCSE only when they suspect the patient may misuse the medication, 21% reported that they rarely used EFORCSE, and only 3% reported using PDMP every time that they prescribed opioids. Residents used PDMP less frequently than extenders and attending physicians. The most common barriers associated with PDMP use were related to access. Although most providers reported that they were aware of their states' PDMP, utilization of the PDMP among emergency medicine providers in Florida remains low

  11. Regulatory and policy implications of Federal legislation on utility DSM programs

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, M.E.F. [Pacific Northwest Lab., Richland, WA (United States); Griffiths, D. [Pennsylvania Public Utility Commission, Harrisburg, PA (United States)

    1994-03-01

    This paper reviews some potential consequences of recent Federal legislation to demand-side management (DSM) at utilities. The legislation discussed are the 1992 Energy Policy Act (EPAct), the 1990 Amendments to the Clean Air Act, and FERC Order No. 636. Examples of specific activities regarding DSM in Pennsylvania are included for illustration. Each of the Federal laws under discussion is unique in terms of origin, goals, and focus. Nevertheless, they all focus on the regulated energy industries such that their effects tend to combine to force massive changes. In die regulated electric and natural gas industries, this synergy is compounding the complexity of management and, at least in the short term, contributing to increases in the cost of doing business. In the long term, these Federal initiatives are likely to lead to a massive reassessment of state-regulated energy sources in production and end use, and their environmental consequences. The overall effect of all three pieces of legislation is to increase competition among the state-regulated utilities. The differences between competitive and regulated industries are noted in a effort to explain the effect of inducing competition among energy utilities. This has particular relevance to utility-sponsored energy-efficiency programs such as DSM and other customer assistance activities. This paper has three objectives. First, it outlines the contents of the Federal legislation regarding utility DSM programs. Second, it explains some of the impacts of these laws and regulations on utility programs, particularly the likely effects of the emerging competitive utility market. Third, it seeks to understand where and how action will be needed to carry out many of the provisions of these laws in the most cost-effective manner.

  12. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Center for Veterinary Medicine is cited as the corporate author. Animation Animation of Antimicrobial Resistance (video) Animation ... Information Safety Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials ...

  13. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  14. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinician's efforts ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  15. Advances in rapid identification and susceptibility testing of bacteria in the clinical microbiology laboratory: implications for patient care and antimicrobial stewardship programs

    Directory of Open Access Journals (Sweden)

    Florian P. Maurer

    2017-03-01

    Full Text Available Early availability of information on bacterial pathogens and their antimicrobial susceptibility is of key importance for the management of infectious diseases patients. Currently, using traditional approaches, it usually takes at least 48 hours for identification and susceptibility testing of bacterial pathogens. Therefore, the slowness of diagnostic procedures drives prolongation of empiric, potentially inappropriate, antibacterial therapies. Over the last couple of years, the improvement of available techniques (e.g. for susceptibility testing, DNA amplification assays, and introduction of novel technologies (e.g. MALDI-TOF has fundamentally changed approaches towards pathogen identification and characterization. Importantly, these techniques offer increased diagnostic resolution while at the same time shorten the time-to-result, and are thus of obvious importance for antimicrobial stewardship. In this review, we will discuss recent advances in medical microbiology with special emphasis on the impact of novel techniques on antimicrobial stewardship programs.

  16. Utility DSM Programs from 1989 Through 1998: Continuation or Cross-Roads?

    Energy Technology Data Exchange (ETDEWEB)

    Hadley, S.

    1995-01-01

    Over the past five years, the Energy Information Administration (EIA) has been collecting data annually from US electric utilities on their demand-side management (DSM) programs, both current and projected. The latest data cover activities for 1993 and projections for 1994 and 1998. In 1993, 991 utilities operated DSM programs. That year, they spent $2.8 billion, a 13% increase over 1992 expenditures. These and earlier DSM programs saved 44,000 GWh of energy and reduced potential peak demand by 40,000 MW, 30% and 22% increases over the 1992 values, respectively. While some people predict the demise of electric-utility DSM programs, the data do not paint so bleak a picture. In most parts of the country, DSM programs grew in 1993 and utilities (as of Spring 1994) projected continued growth through 1998. Expenditures grew from 1.3% of revenues in 1992 to 1.5% in 1993, and are expected to grow 2.5% per year faster than inflation, which is equivalent to revenue growth. Thus, DSM spending is expected to stay constant at 1.5% of revenues through 1998. Because of the cumulative effect of DSM programs, energy savings are expected to grow from 1.2% of sales in 1992 to 1.6% in 1993 and 3.0% in 1998. Potential-peak reductions are expected to increase from 5.9% of peak demand in 1992 to 6.8% in 1993 and 8.9% in 1998. However, the growth in spending is not as rapid as the 8% annual real growth projected a year earlier. Actual expenditures in 1993 were 6.5% lower than projected early that year. Energy savings, on the other hand, were the same as projected earlier. Potential peak reductions were actually 9% higher than previously projected.

  17. Integration of Digital Dentistry into a Predoctoral Implant Program: Program Description, Rationale, and Utilization Trends.

    Science.gov (United States)

    Afshari, Fatemeh S; Sukotjo, Cortino; Alfaro, Maria F; McCombs, Jeri; Campbell, Stephen D; Knoernschild, Kent L; Yuan, Judy Chia-Chun

    2017-08-01

    A recently revised predoctoral implant curriculum at the University of Illinois at Chicago College of Dentistry integrated digital dentistry into both the preclinical dental implant course and clinical activities. Traditionally, competence in the didactic and clinical parts of predoctoral education in single tooth implant restorations has emphasized the analog impression technique and subsequent mounting of soft tissue working casts. However, computer-aided design/computer-aided manufacturing (CAD/CAM) implant restorations can play a significant role in predoctoral dental education utilizing digital technologies. The goal of the curriculum expansion is to transition from analog to partially digital and, finally, complete digital workflow. The aim of this article is to describe the specific components, implementation, and rationale for the new digitally integrated implant curriculum and present short-term clinical utilization trends.

  18. State Clean Energy Policies Analysis: State, Utility, and Municipal Loan Programs

    Energy Technology Data Exchange (ETDEWEB)

    Lantz, E.

    2010-05-01

    High initial costs can impede the deployment of clean energy technologies. Financing can reduce these costs. And, state, municipal, and utility-sponsored loan programs have emerged to fill the gap between clean energy technology financing needs and private sector lending. In general, public loan programs are more favorable to clean energy technologies than are those offered by traditional lending institutions; however, public loan programs address only the high up-front costs of clean energy systems, and the technology installed under these loan programs rarely supports clean energy production at levels that have a notable impact on the broader energy sector. This report discusses ways to increase the impact of these loan programs and suggests related policy design considerations.

  19. Clinical utility of the Hospital Anxiety and Depression Scale (HADS) for an outpatient fibromyalgia education program.

    Science.gov (United States)

    Nam, Seungree; Tin, Diane; Bain, Lorna; Thorne, J Carter; Ginsburg, Liane

    2014-05-01

    This paper examines the clinical utility of the Hospital Anxiety and Depression Scale (HADS) in the context of evaluating the Fibromyalgia Outpatient Education Program at Southlake Regional Health Centre (Newmarket, Canada). A pre-test/post-test design was implemented for data analysis. A total of 232 patients' data were obtained through retrospective patient chart review. Complete pre-post data were available for 70 patients and qualitative analysis was done for 12 patients. Main outcome measures included HADS and Arthritis Self-Efficacy (ASE) scores. At the end of the education program, subgroups of patients (high attendance, high exercise habit, low medication) experienced significant improvement on HADS-depression and ASE scores. Linear regression analysis found that HADS pre-program scores explain far more variance in HADS post-test scores than ASE pre-program scores explain in ASE post-program scores; more variance in ASE post-program scores was explained by other variables. In contrast to the quantitative analysis of the Anxiety subscale of HADS, patients in the focus group indicated that their anxiety level decreased through attending the education program. These findings suggest that HADS is an appropriate tool for evaluating fibromyalgia and related patient education programs. Moreover, patient education programs have positive effects on enhancing patients' psychological well-being and self-confidence in controlling fibromyalgia-related symptoms.

  20. Results of a utilization-focused evaluation of a Right To Play program for Indigenous youth.

    Science.gov (United States)

    Arellano, Alexandra; Halsall, Tanya; Forneris, Tanya; Gaudet, Cindy

    2018-02-01

    This paper presents an evaluation of the Promoting Life Skills for Aboriginal Youth (PLAY) program that is operated by Right to Play (RTP). The focus of the program is to help youth develop a variety of life skills and become leaders within their communities. Piloted in 2010 with 2 communities, the program is now implemented in 88 communities in Ontario, Manitoba, British Columbia, and Alberta. This study applies a utilization-focused evaluation to examine staff perceptions related to program implementation. Data were collected using semi-structured interviews and a thematic analysis was performed. Themes emerged related to: 1) Integrating program flexibility to help facilitate community ownership, 2) Building capacity through skills training for Community Mentors (CMs), 3) Having a motivated staff and organizational learning, 4) Balancing the integration of culture and 5) Challenges related to adapting to multiple stakeholders and program pace. Findings are discussed in relation to relevant literature and recommendations for program improvements are provided. We also describe program improvements that were made as a result of applying the findings. This research contributes to the expanding literature related to programming for youth and evaluation practice within Indigenous communities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Descriptors for antimicrobial peptides

    DEFF Research Database (Denmark)

    Jenssen, Håvard

    2011-01-01

    Introduction: A frightening increase in the number of isolated multidrug resistant bacterial strains linked to the decline in novel antimicrobial drugs entering the market is a great cause for concern. Cationic antimicrobial peptides (AMPs) have lately been introduced as a potential new class...... of antimicrobial drugs, and computational methods utilizing molecular descriptors can significantly accelerate the development of new peptide drug candidates. Areas covered: This paper gives a broad overview of peptide and amino-acid scale descriptors available for AMP modeling and highlights which...

  2. Transitional Home Care program utilizing the Integrated Practice Unit concept (THC-IPU: Effectiveness in improving acute hospital utilization

    Directory of Open Access Journals (Sweden)

    Lian Leng Low

    2017-08-01

    Full Text Available Background: Organizing care into integrated practice units (IPUs around conditions and patient segments has been proposed to increase value. We organized transitional care into an IPU (THC-IPU for a patient segment of functionally dependent patients with limited community ambulation. Methods: 1,166 eligible patients were approached for enrolment into THC-IPU. THC-IPU patients received a comprehensive assessment within two weeks of discharge; medication reconciliation; education using standardized action plans and a dedicated nurse case manager for up to 90 days after discharge. Patients who rejected enrolment into THC-IPU received usual post-discharge care planned by their attending hospital physician, and formed the control group. The primary outcome was the proportion of patients with at least one unscheduled readmission within 30 days after discharge. Results: We found a statistically significant reduction in 30-day readmissions and emergency department visits in patients on THC-IPU care compared to usual care, even after adjusting for confounders. Conclusion: Delivering transitional care to patients with functional dependence in the form of home visits and organized into an IPU reduced acute hospital utilization in this patient segment. Extending the program into the pre-hospital discharge phase to include discharge planning can have incremental effectiveness in reducing avoidable hospital readmissions.

  3. Thorium utilization program. Quarterly progress report for the period ending May 31, 1977

    Energy Technology Data Exchange (ETDEWEB)

    1977-06-01

    Results of work performed under the National HTGR Fuel Recycle Program (also known as the Thorium Utilization Program) at General Atomic Company are presented. Results of work on this program prior to June 1974 were included in a quarterly series on the HTGR Base Program. The work reported includes the development of unit processes and equipment for reprocessing of High-Temperature Gas-Cooled Reactor (HTGR) fuel, the design and development of an integrated pilot line to demonstrate the head end of HTGR reprocessing using unirradiated fuel materials, and design work in support of Hot Engineering Tests (HET). Work is also described on trade-off studies concerning the required design of facilities and equipment for the large-scale recycle of HTGR fuels in order to guide the development activities for HTGR fuel recycle.

  4. PASS (PIXE analysis shell software). A computer utility program for the evaluation of PIXE spectra

    International Nuclear Information System (INIS)

    Tahat, Amani N.; Salah, Wa'el; Hallak, Awni B.

    2010-01-01

    This paper describes a shell which facilitates the use of the existing PIXE analysis software package PIXAN. In this work, we designed, wrote and examined several PIXE spectra in a utility program that is called WPASS. The WPASS program merely links PIXAN modules and makes their use more convenient than before. The WPASS program handles automatically PEAKFIT (BATTY) and THICK programs. It outputs the results into several files belonging to the same data file. These include converting data files from one-column-format OCF to PIXANPC format; control, graphics, and result files from PEAKFIT; control and result files from THICK; options for graphical plotting the results on the PC and converting the graphics files for their components for publications of the results. WPASS has new features that consider the secondary interelement fluorescence. WPASS has been used successfully for the analysis of PIXE spectra and inner-shell ionization studies. (author)

  5. Utilization of the Arkansas Prescription Monitoring Program to Combat Prescription Drug Abuse.

    Science.gov (United States)

    Rittenhouse, Rebecca; Wei, Feifei; Robertson, Denise; Ryan, Kevin

    The Arkansas Prescription Monitoring Program (AR PMP) was implemented in 2013 to combat prescription drug abuse. All enrollees were invited to participate in a user survey available in February 2014, to identify makeup of users, utilization of the program, and changes made to health care practices after implementation of the program. Of the 3,694 individual enrollees invited to participate, 1,541(41.7%) completed the survey. Data collected were analyzed to identify changes in health care practices by program frequency of use and user profession. Medical doctors, advanced practice nurses, and pharmacists are the professions who use the program most frequently. Daily AR PMP users are considerably more likely than infrequent users to be prompted to access the program by the involvement of a controlled substance (CS) prescription or by office/facility policy requirements. Increased frequency of use of the AR PMP results in positive impacts on CS prescribing and dispensing practices. Compelling more users of the AR PMP to be prompted to access the program by the involvement of a CS prescription or by requirements per office/facility policy may increase frequency of use of the program and thereby changes in health care practices to combat prescription drug abuse.

  6. Utilization of Concept Mapping Program at the Root Cause Analysis of Events

    International Nuclear Information System (INIS)

    Kim, Bae-Joo; Kim, Gwang-Bong

    2008-01-01

    KHNP introduced the Corrective Action Program (CAP) as a part of the nuclear operation innovation. The Key program of the CAP is the Root Cause Analysis (RCA) program. The RCA is a technique to extract root causes and take actions to prevent a recurrence in the event that management doesn't want it to happen again. KHNP establishes a temporary team for RCA of some event. KHNP should assign some human resources to the temporary team. KNPEI introduced a RCA training program from Comanche Peak Steam Electric Station in 2005 and began training the engineers from 2006. But the RCA Program doesn't operate well at the stations because of two reasons. KNPEI performed a research project from March 2006 to September 2007 to capture experience knowledge from seniors and transfer it to juniors. As part of the research activity KNPEI introduced a Concept Mapping Program and set up a Concept Mapping server to capture experience knowledge. Originally, the Concept Mapping Program was to teach conceptual knowledge by remote. But this Concept Mapping Program has some characteristics that can be used in root causes analysis. The purpose of this report is to suggest the utilization method in root causes analysis in the Concept Mapping

  7. Citizens Utilities Company's successful residential new construction market transformation program

    Energy Technology Data Exchange (ETDEWEB)

    Caulfield, T.O.; Shepherd, M.A.

    1998-07-01

    Citizens Utilities Company, Arizona Electric Division (CUC/AED) fielded a Residential New Construction Program (RNC) in the forth quarter of 1994 that had been designed from conception as a market transformation program. The CUC RNC Program encouraged builders to adopt energy efficient building practices for new homes by supplying builders estimates of energy savings, supplying inspections services to assist builders in applying energy efficient building practices while verifying compliance, and posting and promoting the home as energy efficient during the sales period. Measures generally required to qualify for the program were R-38 ceiling insulation, R-21 wall insulation, polysealing of all infiltration gaps during construction, well sealed air-conditioning ducts, and an air conditioner Seasonal Energy Efficiency Rating (SEER) of 11.0 or greater. In less than two years the program achieved over 17% market penetration without offering rebates to builders. This paper reviews the design of the program, including a discussion of the features felt to be primarily responsible for its success. It reviews the levels of penetration achieved, free-ridership, spillover, and market barriers encountered. Finally it proposes improvements to the program designed to carry it the next step toward a self-sustaining market transformation program.

  8. Commercialization of PV-powered pumping systems for use in utility PV service programs. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    The project described in this report was a commercialization effort focused on cost-effective remote water pumping systems for use in utility-based photovoltaic (PV) service programs. The project combined a commercialization strategy tailored specifically for electric utilities with the development of a PV-powered pumping system that operates conventional ac pumps rather than relying on the more expensive and less reliable PV pumps on the market. By combining these two attributes, a project goal was established of creating sustained utility purchases of 250 PV-powered water pumping systems per year. The results of each of these tasks are presented in two parts contained in this Final Summary Report. The first part summarizes the results of the Photovoltaic Services Network (PSN) as a new business venture, while the second part summarizes the results of the Golden Photon system installations. Specifically, results and photographs from each of the system installations are presented in this latter part.

  9. Progress report Waste Resources Utilization Program period ending March 31, 1976

    International Nuclear Information System (INIS)

    1976-06-01

    This report describes the work on the Waste Resources Utilization Program for the quarter ending March 31, 1976. The purpose of this program is to develop technologies to utilize a 137 Cs γ source to modify sewage sludge for safe application as a fertilizer or an animal feed supplement. Results are reported from studies in microbiology, virology, and physical-chemical studies. Determinations were made of inactivation rates for Salmonella species, coliforms, and fecal strep in sewage sludge when radiation and thermoradiation were applied while bubbling oxygen through the sludge. Virology studies were continued investigating virucidal characteristics of anaerobically digested sludge. Another area of study was the dewatering of sewage sludge to reduce the drying time of the sewage sludge in the drying beds. A centrifuge was also installed to dewater treated sludge to approximately 30 percent solids

  10. Free-electron laser research-and-development and utilization program at Tokai, JAERI

    International Nuclear Information System (INIS)

    Kawarasaki, Yuuki

    1992-01-01

    The free-electron laser (FEL) research and development (R and D) and utilization program now underway at the Linac Laboratory, Tokai Research Establishment, JAERI, is presented together with the current status of the R and D. Specific feature of this program is at the points that the R and D period will range over a long time, around a decade, tentatively divided into three developmental phases, aiming at the final utilization in a field of nuclear energy industry and the FEL here under R and D is based on a superconducting (SC) linear accelerator (linac) which will in later phases be incorporated with addition of more SC-cavity modules for beam energy increase and with adoption of rather novel accelerator technique: beam recirculation both for further energy increase and for power economy by beam energy recovery. Application scheme is additionally discussed. (author)

  11. Drug and alcohol abuse: the bases for employee assistance programs in the nuclear-utility industry

    Energy Technology Data Exchange (ETDEWEB)

    Radford, L.R.; Rankin, W.L.; Barnes, V.; McGuire, M.V.; Hope, A.M.

    1983-07-01

    This report describes the nature, prevalence, and trends of drug and alcohol abuse among members of the US adult population and among personnel in non-nuclear industries. Analogous data specific to the nuclear utility industry are not available, so these data were gathered in order to provide a basis for regulatory planning. The nature, prevalence, and trend inforamtion was gathered using a computerized literature, telephone discussions with experts, and interviews with employee assistance program representatives from the Seattle area. This report also evaluates the possible impacts that drugs and alcohol might have on nuclear-related job performance, based on currently available nuclear utility job descriptions and on the scientific literature regarding the impairing effects of drugs and alcohol on human performance. Employee assistance programs, which can be used to minimize or eliminate job performance decrements resulting from drug or alcohol abuse, are also discussed.

  12. Thermal insulation research plan for the Energy Conversion and Utilization Technologies (ECUT) materials program

    Energy Technology Data Exchange (ETDEWEB)

    Fine, H.A.

    1986-08-01

    This report documents both the process and the output of the process of establishing a peer review panel primarily from the private sector to suggest research and development activities appropriate for government sponsorship through the US Department of Energy (DOE) Energy Conversion and Utilization Technologies (ECUT) Program on the subject of thermal insulation. We expect to use information and guidance from the document during the federal budgetary process to allow more informed decision making. All related results of that budgetary decision making will affect what the DOE or Oak Ridge National Laboratory (ORNL) can and will sponsor during this or subsequent years through detailed decisions of DOE and ORNL program managers.

  13. Can a chronic disease management pulmonary rehabilitation program for COPD reduce acute rural hospital utilization?

    Science.gov (United States)

    Rasekaba, T M; Williams, E; Hsu-Hage, B

    2009-01-01

    Chronic obstructive pulmonary disease (COPD) imposes a costly burden on healthcare. Pulmonary rehabilitation (PR) is the best practice to better manage COPD to improve patient outcomes and reduce acute hospital care utilization. To evaluate the impact of a once-weekly, eight-week multidisciplinary PR program as an integral part of the COPD chronic disease management (CDM) Program at Kyabram District Health Services. The study compared two cohorts of COPD patients: CDM-PR Cohort (4-8 weeks) and Opt-out Cohort (0-3 weeks) between February 2006 and March 2007. The CDM-PR Program involved multidisciplinary patient education and group exercise training. Nonparametric statistical tests were used to compare acute hospital care utilization 12 months before and after the introduction of CDM-PR. The number of patients involved in the CDM-PR Cohort was 29 (n = 29), and that in the Opt-out Cohort was 24 (n = 24). The CDM-PR Cohort showed significant reductions in cumulative acute hospital care utilization indicators (95% emergency department presentations, 95% inpatient admissions, 99% length of stay; effect sizes = 0.62-0.66, P 0.05). Total costs associated with the hospital care utilization decreased from $130,000 to $7,500 for the CDM-PR Cohort and increased from $77,700 to $101,200 for the Opt-out Cohort. Participation in the CDM-PR for COPD patients can significantly reduce acute hospital care utilization and associated costs in a small rural health service.

  14. Impact of a drug utilization review program on high-risk use of prescription controlled substances.

    Science.gov (United States)

    Daubresse, Matthew; Gleason, Patrick P; Peng, Yi; Shah, Nilay D; Ritter, Stephen T; Alexander, G Caleb

    2014-04-01

    Prescription drug abuse has prompted considerable concern. We evaluated a retrospective drug utilization review program to reduce controlled substance use among individuals with high-risk utilization. We analyzed pharmacy claims from a large pharmaceutical benefits manager. For each eligible member, we calculated a controlled substance score based on the number and type of claims, prescribers and pharmacies, and utilization patterns over three months. Two state health plans sent controlled substance letters to prescribers of members meeting or exceeding a plan- and pre-specified controlled substance score. Two different state health plans did not send such letters. We used a difference-in-difference design and generalized estimating equations to quantify the impact of the program on the mean difference in reduction of the controlled substance score over six months. Eligible members in the intervention and comparison states had similar baseline mean controlled substance scores (19.0 vs. 18.6, p = 0.36). Adjusting for individuals' age, sex and pharmacy risk group score, reductions in the mean controlled substance score were greater in the intervention than comparison cohort (5.67 vs. 4.31, p = 0.01), corresponding with a 34.0% reduction in the intervention cohort compared to a 25.5% reduction in the comparison cohort. Changes were driven primarily by reductions in the number of controlled substance claims filled (30.5% vs. 23.1%, p = 0.01), as well as by a non-statistically significant trend towards reductions in the number of prescribers and pharmacies used (26.9% vs. 20.1%, p = 0.07). Retrospective drug utilization review programs may reduce controlled substance scores and claims among individuals with patterns suggesting high-risk utilization. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Utilization Patterns and User Characteristics of an Ad Libitum Internet Weight Loss Program

    OpenAIRE

    Binks, Martin; van Mierlo, Trevor

    2010-01-01

    Background The Internet holds promise for the delivery of evidence-based weight loss treatment to underserved populations. However, most studies do not reflect the more naturalistic and common ad libitum, or freely at will, use of the Internet. Randomized clinical trials, for example, typically include at least some direct contact with participants and often have restrictive selection criteria. There is a paucity of research examining utilization patterns of online weight loss programs, parti...

  16. Utilization of oral health care services among adults attending community outreach programs.

    Science.gov (United States)

    Kadaluru, Umashankar Gangadhariah; Kempraj, Vanishree Mysore; Muddaiah, Pramila

    2012-01-01

    Good oral health is a mirror of overall health and well-being. Oral health is determined by diet, oral hygiene practices, and the pattern of dental visits. Poor oral health has significant social and economic consequences. Outreach programs conducted by dental schools offer an opportunity for early diagnosis and treatment, dental health education, and institution of preventive measures. To assess the utilization of oral healthcare services among adults attending outreach programs. This study included 246 adults aged 18-55 years attending community outreach programs in and around Bangalore. Using a questionnaire we collected data on dental visits, perceived oral health status, reasons for seeking care, and barriers in seeking care. Statistical significance was assessed using the Chi-square test. In this sample, 28% had visited the dentist in the last 12 months. Males visited dentist more frequently than females. The main reason for a dental visit was for tooth extraction (11%), followed by restorative and endodontic treatment 6%. The main barriers to utilization of dental services were high cost (22%), inability to take time off from child care duties (19.5%), and fear of the dentist or dental tools (8.5%). The utilization of dental services in this population was poor. The majority of the dental visits were for treatment of acute symptoms rather than for preventive care. High cost was the main barrier to the utilization of dental services. Policies and programs should focus on these factors to decrease the burden of oral diseases and to improve quality of life among the socioeconomically disadvantaged.

  17. Building Energy Asset Score for Utilities and Energy Efficiency Program Administrators

    Energy Technology Data Exchange (ETDEWEB)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for utilities and energy efficiency program administrators.

  18. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations

    Directory of Open Access Journals (Sweden)

    Jenine R. Leal

    2017-06-01

    Full Text Available Abstract Background The rates of antimicrobial-resistant organisms (ARO continue to increase for both hospitalized and community patients. Few resources have been allocated to reduce the spread of resistance on global, national and local levels, in part because the broader economic impact of antimicrobial resistance (i.e. the externality is not fully considered when determining how much to invest to prevent AROs, including strategies to contain antimicrobial resistance, such as antimicrobial stewardship programs. To determine how best to measure and incorporate the impact of externalities associated with the antimicrobial resistance when making resource allocation decisions aimed to reduce antimicrobial resistance within healthcare facilities, we reviewed the literature to identify publications which 1 described the externalities of antimicrobial resistance, 2 described approaches to quantifying the externalities associated with antimicrobial resistance or 3 described macro-level policy options to consider the impact of externalities. Medline was reviewed to identify published studies up to September 2016. Main body An externality is a cost or a benefit associated with one person’s activity that impacts others who did not choose to incur that cost or benefit. We did not identify a well-accepted method of accurately quantifying the externality associated with antimicrobial resistance. We did identify three main methods that have gained popularity to try to take into account the externalities of antimicrobial resistance, including regulation, charges or taxes on the use of antimicrobials, and the right to trade permits or licenses for antimicrobial use. To our knowledge, regulating use of antimicrobials is the only strategy currently being used by health care systems to reduce antimicrobial use, and thereby reduce AROs. To justify expenditures on programs that reduce AROs (i.e. to formally incorporate the impact of the negative externality of

  19. Radiological guidelines for application to DOE's Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1983-03-01

    The US Department of Energy has implemented a program to evaluate and, where necessary, take action to protect the public from contamination at sites that were used in the past to process and/or store radioactive materials for the former US Army Corps of Engineers Manhattan Engineer District or the US Atomic Energy Commission. The program is identified as the Formerly Utilized Sites Remedial Action Program (FUSRAP). This document describes methods considered appropriate for the evaluation of health effects that might possible be caused by radioactive contamination at FUSRAP sites. This assessment methodology is applied to a typical site for the purposeof deriving guidelines for the cleanup of contaminated soil. Additional guidance is provided for planning site-specific remedial action that is consistent with the overall objectives of FUSRAP

  20. Dissemination of a bla(VIM-2)-carrying integron among Enterobacteriaceae species in Mexico: report from the SENTRY Antimicrobial Surveillance Program.

    Science.gov (United States)

    Morfin-Otero, Rayo; Rodriguez-Noriega, Eduardo; Deshpande, Lalitagauri M; Sader, Helio S; Castanheira, Mariana

    2009-03-01

    Three VIM-2-producing Enterobacteriaceae (two Enterobacter cloacae and one Klebsiella oxytoca) isolates recovered from patients in a Mexican hospital were characterized during the SENTRY Antimicrobial Surveillance Program (2005-2007). These strains carried identical bla(VIM-2) integrons in a 450-kb plasmid. The interspecies dissemination of this bla(VIM-2)-harboring element emphasizes the potential for spread of genetic structures carrying metallo-beta-lactamases that could limit therapeutic options in this geographic region.

  1. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  2. Residential energy-consumption analysis utilizing the DOE-1 computer program

    Energy Technology Data Exchange (ETDEWEB)

    Arentsen, S K

    1979-04-01

    The DOE-1 computer program is used to examine energy consumption in a typical middle-class household in Cincinnati, Ohio. The program is used to compare energy consumption under different structural and environmental conditions, including various levels of insulation in the walls and ceiling, double and single glazing of windows, and thermostat setback schedules. In addition, the DOE-1 program is used to model the house under three energy distribution systems: a unit heater, a single-zone fan system with optional subzone reheat; and a unitary heat pump. A plant equipment simulation is performed to model the heating and cooling plant currently installed in the house. A simple economic analysis of life-cycle costs for the house is done utilizing the economic simulation portion of DOE-1. Utility bills over the past six years are analyzed to gain an actual energy-use profile for the house to compare with computer results. Results indicate that a 35% savings in heating load may be obtained with addition of proper amounts of insulation as compared with the house with no insulation. The installation of double glazing on windows may save close to 6% on heating load. Thermostat setbacks may result in savings of around 25% on energy consumed for heating. Similar results are achieved with regard to cooling load. Comparison of actual energy consumed by the household (from utility bills) with the computer results shows a 4.25% difference in values between the two. This small percent difference certainly strengthens the case for future use of computer programs in comparing construction alternatives and predicting building energy consumption.

  3. Antimicrobial Resistance

    Science.gov (United States)

    ... least 10 countries (Australia, Austria, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom ... plan Global report on surveillance Country situation analysis Policy to combat antimicrobial resistance More on antimicrobial resistance ...

  4. A LINEAR PROGRAMMING METHOD TO ENHANCE RESOURCE UTILIZATION CASE OF ETHIOPIAN APPAREL SECTOR

    Directory of Open Access Journals (Sweden)

    Gezahegn Tesfaye

    2016-06-01

    Full Text Available The Ethiopian industrial development strategy is characterized by export-led and labor intensive industrialization. The country is emerging as the most important investment destination in its apparel sector. Thought this sector is expected to generate more income from the export market, its export earnings remain trivial mainly due to the inefficient organizational resource utilization. One of the competent techniques that help companies to efficiently improve the use of their resources to increase their profit is linear programming. In apparel manufacturing firms, efficient use of materials such as fabrics and sewing threads and processing time at different stages of production as well as minimization of labor and materials cost are necessary to enhance their profitability. Cutting, sewing, and finishing operations deserve more attention for apparel process optimization. However, the issue of proper resource allocation remains an unsolved problem within the Ethiopian apparel industry. The aim of this research is to devise efficient resource utilization mechanism for Ethiopian apparel sector to improve their resource utilization and profitability, taking one of the garment factories engaged in the export market as a case study. Five types of products the company is currently producing, the amount of resources employed to produce each unit of the products, and the value of profit per unit from the sale of each products have been collected from the case company. The monthly availability of resources utilized and the monthly production volume of the five products have also been collected from the company. The data gathered was mathematically modeled using a linear programming technique, and solved using MS-Excel solver. The findings of the study depicts that all of the organizational resources are severely underutilized. This research proved that the resource utilization of the case company can be improved from 46.41% of the current resource

  5. Outside the operating room: How a robotics program changed resource utilization on the inpatient Ward.

    Science.gov (United States)

    Leung, Annie; Abitbol, Jeremie; Ramana-Kumar, Agnihotram V; Fadlallah, Bassam; Kessous, Roy; Cohen, Sabine; Lau, Susie; Salvador, Shannon; Gotlieb, Walter H

    2017-04-01

    To analyze the changes in the composition of the gynecologic oncology inpatient ward following the implementation of a robotic surgery program and its impact on inpatient resource utilization and costs. Retrospective review of the medical charts of patients admitted onto the gynecologic oncology ward the year prior to and five years after the implementation of robotics. The following variables were collected: patient characteristics, hospitalization details (reason for admission and length of hospital stay), and resource utilization (number of hospitalization days, consultations, and imaging). Following the introduction of robotic surgery, there were more admissions for elective surgery yet these accounted for only 21% of the inpatient ward in terms of number of hospital days, compared to 36% prior to the robotic program. This coincided with a sharp increase in the overall number of patients operated on by a minimally invasive approach (15% to 76%, probotics era. The robotics program contributed to a ward with higher proportion of patients with complex comorbidities (Charlson≥5: RR 1.06), Stage IV disease (RR 1.30), and recurrent disease (RR 1.99). Introduction of robotic surgery allowed for more patients to be treated surgically while simultaneously decreasing inpatient resource use. With more patients with non-surgical oncological issues and greater medical complexity, the gynecologic oncology ward functions more like a medical rather than surgical ward after the introduction of robotics, which has implications for hospital-wide resource planning. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. The effect of different training programs on eccentric energy utilization in college-aged males.

    Science.gov (United States)

    Hawkins, Sheldon B; Doyle, Tim L A; McGuigan, Michael R

    2009-10-01

    The Eccentric Utilization Ratio (EUR), which is the ratio of countermovement jump (CMJ) to squat jump (SJ) performance measures, is a useful indicator of training status in elite athletes and their utilization of the stretch-shortening cycle. This investigation sought to determine if EUR was sensitive to different types of resistance training in untrained college-aged males. Twenty-nine college-aged males completed 8 weeks of training and were randomly allocated to 1 of 3 training programs: weight training (n = 10), plyometrics (n = 10), or weightlifting (n = 9). Testing occurred 3 times (pre, mid, post) with a CMJ and SJ conducted on a force plate integrated with a position transducer. Height, weight, and a 1RM (repetition maximum) squat also were measured. Weightlifting significantly (p training program might not be a long enough time period to see changes in this group of participants. Results did indicate that high-velocity and high-force training programs, consisting of weightlifting and plyometrics, improved lower-body performance, especially in the areas of jump height and power.

  7. Basic research program for innovated coal utilization in Japan. BRAIN-C program; Sekitan riyo kiban gijutsu kaihatsu. BRAIN-C program

    Energy Technology Data Exchange (ETDEWEB)

    Harada, M. [Center for Coal Utilization, Japan, Tokyo (Japan)

    1996-09-01

    This paper introduces the circumstances and purpose of establishing the Basic Research Associate for Innovated Coal Utilization (BRAIN-C) Program started in October 1995, and the summary of the results therefrom in fiscal 1995. Although development of coal utilization technologies has been implemented over a number of years, there are many problems still requiring solutions. Early realization has been urged on diversification of coal utilization, acceleration of technological development and diversification of coal types. In order to achieve these goals, the necessity was recognized afresh on not only the hardwares, but also on basic technologies in terms of software which can identify properties of coals, systematize different reactions, and estimate reactions, fluidity and heat transmission of coals. Therefore, receiving a subsidy from the Agency of Natural Resources and Energy of the Ministry of International Trade and Industry, a research and development program to be implemented jointly by industries, administrative agencies and academic societies had been started with a five-year plan for the time being. With the activities for the program such as collecting 50 to 100 types of coals and supplying them to researchers, the program had been accelerated in fiscal 1995 on a large number of themes and results therefrom, including fundamental properties and thermo-chemical reactions. 2 figs., 4 tabs.

  8. Utilization of logistic computer programs in the power plant piping industry

    International Nuclear Information System (INIS)

    Motzel, E.

    1982-01-01

    Starting from the general situation of the power plant piping industry, the utilization of computer programs as well as the specific magnitude of complexity connected with the project realisation, the necessity for using logistic computer programs especially in case of nuclear power plants is explained. The logistic term as well as the logistic data are described. At the example of the nuclear power plant KRB II, Gundremmingen, Block B/C the practical use of such programs is shown. The planning, scheduling and supervision is carried out computer-aided by means of network-technique. The material management, prefabrication, installation including management of certificates for welding and testing activities is planned and controlled by computer programs as well. With the piping systems installed a complete erection work documentation is available which also serves as base for the billing versus the client. The budgeted costs are continuously controlled by means of a cost control program. Summing-up the further development in controlling piping contracts computer-supported is described with regard to software, hardware and the organisation structure. Furthermore the concept of a self-supporting field computer is introduced for the first time. (orig.) [de

  9. Status of disposal sites for the Department of Energy's Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    Kannard, J.R.

    1988-01-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) is a US Department of Energy (DOE) program to evaluate and remedy radiological and chemical contamination conditions at sites across the nation where contamination exceeding current guidelines remains from the early years of the nation's atomic energy program or from commercial operations that resulted in conditions which Congress has mandated DOE to remedy. The need for permanent disposal facilities for the low-level radioactive wastes and mixed wastes resulting from the FUSRAP program was recognized early. The selection and development of disposal sites was known to require significant time. Because of the complexities of developing a disposal site, a plan was developed to proceed with remedial action prior to availability of permanent disposal sites. To accomplish this, the waste from remedial action activities would be placed in temporary storage at interim storage sites. The paper provides a description of the wastes involved, and issues requiring attention including public relations, regulations, government agency interaction, mixed waste requirements. Current status of the program along with evolving strategies are discussed

  10. Alternative dispute resolution programs in health care: a study of organizational utilization.

    Science.gov (United States)

    Rotarius, T M; Liberman, A; Osterman, K C; Putnam, P

    1999-03-01

    The hyperturbulence in today's health care environment acts as a primer that escalates the frequency and severity of business conflicts. Several alternative dispute resolution (ADR) programs are described, with ADR suggested as a viable approach in assisting organizations in resolving conflicts. The data indicate that all of the health care organizations surveyed utilize some form of ADR to resolve conflict. The most common conflict resolution objective found is win/win, and respondents felt that ADR effectively met intended objectives. While the data gathered for this study are from a limited geographic region in Central Florida, the results can likely be generalized to many socially and ethnically diverse regions of the country.

  11. The Ontario Program To Improve AntiMIcrobial USE (OPTIMISE): A Descriptive Analysis of Dispensed Antibiotics

    OpenAIRE

    Schwartz, Kevin; Achonu, Camille; Brown, Kevin; Garber, Gary; Johnstone, Jennie; Langford, Bradley; Leung, Valerie; Daneman, Nick

    2017-01-01

    Abstract Background Antimicrobial resistant infections are an emerging global public health crisis. Antibiotic use is the largest modifiable risk factor for antimicrobial resistance. Greater than 90% of antibiotic use in Canada occurs outside of the hospital setting; however, there is a lack of data describing the patterns of community antibiotic use. Our objective was to describe outpatient antibiotic prescriptions for all of Ontario, Canada and to examine variability in antibiotic prescribi...

  12. New York state information handbook formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying our the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New York. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  13. Waste resources utilization program. Progress report, period ending 30 June 1975

    International Nuclear Information System (INIS)

    1975-08-01

    Initial progress on the Waste Resources Utilization Program, a joint effort sponsored by ERDA and EPA under the terms of Interagency Agreement E(29-2)-3536/EPA-IAG-D5-0675 is reported. This program has as its objective the use of 134 Cs/ 137 Cs (a potential nuclear reactor ''waste resource'') as a gamma radiation source, coupled with modest heating, to treat sewage sludge (another ''waste resource'') to rid it of pathogenic organisms so that it may be safely used as a fertilizer or a feed supplement for ruminant animals. The potential exists for using at least 50 percent of the by-product cesium from future reactor fuel-rod reprocessing in this one application alone. Activities dealing with research on many aspects of the problem such as pathogen reduction, physical and chemical effects, cost benefit analysis, safety and security, and systems engineering are reported. (U.S.)

  14. Environmental auditing: Capabilities and management utility of recreation impact monitoring programs

    Science.gov (United States)

    Marion, J.L.

    1995-01-01

    A recreation impact monitoring system was developed and applied in 1984?1986 and in 1991 to all backcountry river-accessed campsites within Delaware Water Gap National Recreation Area, Pennsylvania and New Jersey. Results suggest that actions implemented by park managers in response to problems identified by the initial survey were highly effective in reducing resource degradation caused by camping. In particular, the elimination of some designated campsites and installation of anchored firegrates reduced the total area of disturbance by 50%. Firegrate installation provided a focal point that increased the concentration of camping activities, allowing peripheral areas to recover. As suggested by predictive models, additional resource degradation caused by increased camping intensities is more than offset by improvements in the condition of areas where use is eliminated. The capabilities and management utility of recreation impact monitoring programs, illustrated by the Delaware Water Gap monitoring program, are also presented and discussed.

  15. New Mexico state information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Informaion Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New Mexico. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  16. The ERDA thermionic program. [for nuclear propulsion and utility power plants

    Science.gov (United States)

    Newby, G. A.

    1975-01-01

    A rationale for increased Federal support of thermionic research is considered and the objectives and milestones of the thermionic program of the U.S. Energy Research and Development Administration (ERDA) are examined. The ERDA program is to provide very high specific power systems needed for planned future NASA nuclear electric propulsion missions. Another objective is the enhancement of the overall thermal conversion efficiency of the present utility power plants from approximately 35% to 50% or more. Attention is given to key problem areas, taking into account inadequate analytical tools, the reduction of the plasma arc-drop losses, aspects of hot shell materials development, and the coordination of the participating groups programmatic activities.

  17. New York state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New York. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  18. New Mexico state information handbook: formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New Mexico. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  19. New York state information handbook formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying our the Formerly Utilized Sites Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New York. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  20. New Mexico state information handbook formerly utilized sites remedial action program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-12-31

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This Informaion Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New Mexico. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations.

  1. New Mexico state information handbook: formerly utilized sites remedial action program

    International Nuclear Information System (INIS)

    1980-01-01

    This volume is one of a series produced under contract with the DOE, by Politech Corporation to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Formerly Utilized Sites Remedial Action Program. This information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the State of New Mexico. It contains a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations

  2. Construction and clinical application of complex utility programs in the SEGAMS-80 system

    International Nuclear Information System (INIS)

    Mate, E.; Csirik, J.; Csernay, L.; Makay, A.

    1981-01-01

    SEGAMS-80 is a system for processing isotope-diagnostic pictures easily and safely for physicians. The functions built into the system form a tree-structure. In certain stages of processing, tables completed according to the medical point of view show identification and a short description of the actual performable functions. The functions available allow an interactive performance of diagnostic processes for different purposes. Interactivity is undesirable while processing routine examinations, since the functions to be performed, their sequence and parameters could be identical in all cases. SEGAMS-80 makes it possible to construct complex programs, to put them into the system and execute them. During the complex program the desired functions are automatically executed. The operator's interference is needed only where the author of the complex program has stated that it is necessary from the medical aspects. Experience gained with several SEGAMS-80 systems has shown that they can be successfully used in isotope diagnostics, without requiring any training in computing techniques from the physicians. A schematic description is given of the structure of SEGAMS-80 together with a detailed account of how to construct complex utility programs. (author)

  3. A python-based docking program utilizing a receptor bound ligand shape: PythDock.

    Science.gov (United States)

    Chung, Jae Yoon; Cho, Seung Joo; Hah, Jung-Mi

    2011-09-01

    PythDock is a heuristic docking program that uses Python programming language with a simple scoring function and a population based search engine. The scoring function considers electrostatic and dispersion/repulsion terms. The search engine utilizes a particle swarm optimization algorithm. A grid potential map is generated using the shape information of a bound ligand within the active site. Therefore, the searching area is more relevant to the ligand binding. To evaluate the docking performance of PythDock, two well-known docking programs (AutoDock and DOCK) were also used with the same data. The accuracy of docked results were measured by the difference of the ligand structure between x-ray structure, and docked pose, i.e., average root mean squared deviation values of the bound ligand were compared for fourteen protein-ligand complexes. Since the number of ligands' rotational flexibility is an important factor affecting the accuracy of a docking, the data set was chosen to have various degrees of flexibility. Although PythDock has a scoring function simpler than those of other programs (AutoDock and DOCK), our results showed that PythDock predicted more accurate poses than both AutoDock4.2 and DOCK6.2. This indicates that PythDock could be a useful tool to study ligand-receptor interactions and could also be beneficial in structure based drug design.

  4. Utilization of services rendered in dental outreach programs in rural areas of Haryana

    Directory of Open Access Journals (Sweden)

    Shelja Vashisth

    2012-01-01

    Full Text Available Background: The availability of oral health services are very scarce in rural India; therefore the unmet treatment needs of rural population are very high. Hence, a retrospective study was conducted to evaluate the types of patients, disease pattern, and services rendered in outreach programs in rural areas of Haryana. Materials and Methods: A The data were obtained from records of outreach programs conducted, in last 3 months, by Swami Devi Dyal Hospital and Dental College. The data from were analyzed using descriptive statistics. Results: A total of 1371 individuals in the age group of 4--70 years (56.8% males and 43.2% females attended the outreach program seeking the treatment. Dental caries (43.7%, gingivitis (27.2%, and periodontitis (22.9% were commonly observed dental diseases. The services provided were oral prophylaxis (51.2%, restoration (22.9%, referral (20%, and extractions (8.8%. Conclusion: The attendance and utilization of dental services in the out reach programs seem to be influenced by sociodemographic characteristics of the population.

  5. Alternatives for management of wastes generated by the formerly utilized sites remedial action program and supplement

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Peterson, J.M.; Vocke, R.W.; Alexander, J.K.

    1983-03-01

    Alternatives for disposal or stabilization of the wastes generated by the US Department of Energy's Formerly Utilized Sites Remedial Action Program (FUSRAP) are identified and compared, with emphasis on the long-term aspects. These wastes consist of soil material and rubble containing trace amounts of radionuclides. A detailed pathway analysis for the dose to the maximally exposed individual is carried out using an adaptation of the natural analogue method. Comparisons of the different alternatives, based on the results of the pathway analysis and qualitative cost considerations, indicate that, if the hazard is such that the wastes must be removed and disposed of rather than stabilized in place, disposal by immediate dispersal is preferable to containment, and containment followed by slow planned dispersal is preferable to containment without dispersal. The Supplement presents refinements of work that was reported at the 1982 International Decommissioning Symposium. The new material consists of revisions of the estimates of the predicted potential dose to the maximally exposed individual and a more detailed comparative assessment of the radiological impacts of alternatives for management of wastes generated by the US Department of Energy's Formerly Utilized Sites Remedial Action Program (FUSRAP)

  6. Trends in Drug Resistance of Acinetobacter baumannii over a 10-year Period: Nationwide Data from the China Surveillance of Antimicrobial Resistance Program.

    Science.gov (United States)

    Gao, Lei; Lyu, Yuan; Li, Yun

    2017-03-20

    Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China. Minimum inhibitory concentrations (MICs) were determined by a 2-fold agar dilution method, and antimicrobial susceptibility was established using the 2014 Clinical Laboratory Standards Institute-approved breakpoints. Isolates not susceptible to all the tested aminoglycosides, fluoroquinolones, β-lactams, β-lactam/β-lactam inhibitors and carbapenems were defined as extensively drug resistant. The rates of nonsusceptibility to common antimicrobial agents remained high (>65%) over the years with some fluctuations to certain agents. The prevalence of imipenem-resistant A. baumannii (IRAB) increased from 13.3% in 2004 to 70.5% in 2014 and that of extensively drug-resistant A. baumannii (XDRAB) increased from 11.1% in 2004 to 60.4% in 2014. The activity of tigecycline was stable with MIC90 ≤4 mg/L against A. baumannii from 2009 to 2014. Susceptibility to colistin remained high (97.0%) from 2009 to 2014. The prevalence of XDRAB increased in all the three surveillance regions over the years and was significantly higher in Intensive Care Unit (ICU) wards than non-ICU wards. This longitudinal multicenter surveillance program revealed the nationwide emergence of A. baumannii in China and showed a significant increase in prevalence from 2004 to 2014. High levels of bacterial resistance were detected among samples collected from clinical settings in China, with IRAB and XDRAB being especially prevalent. This study will help to guide empirical therapy and identify at-risk groups requiring more intense interventional infection control

  7. Use and utility of Web-based residency program information: a survey of residency applicants.

    Science.gov (United States)

    Embi, Peter J; Desai, Sima; Cooney, Thomas G

    2003-01-01

    The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty

  8. What’s Next? Sustaining Hospital-Initiated Nursing Home Antimicrobial Stewardship Programs

    Science.gov (United States)

    Felsen, Christina B; Barney, Grant; Ashley, Elizabeth Dodds; Dumyati, Ghinwa

    2017-01-01

    Abstract Background The core elements provide a framework for nursing homes (NH) to establish antibiotic stewardship programs (ASP). We report on implementation and sustainability of ASP through a hospital-NH partnership. Methods Since 2014, a hospital-based team (HBT) assisted 9 NH in Monroe County, NY in implementing ASP. Enrollment was staggered; data are currently available from 2 NH: Facility X (470 beds, full-time medical director and Infection Preventionist (IP)) and Facility Y (288 beds, part-time medical director and IP). The HBT analyzed antibiotic data to develop initial interventions focusing on reducing urinary tract infection (UTI) treatment and quinolone use. Activities included (1) regular presentation of antibiotic days of therapy (DOT), urine culture rates and treatment appropriateness; (2) coaching on interpretation and use of data to expand interventions; (3) creation of citywide guideline for diagnosis and treatment of common infections; and (4) education of nurses, providers, and families. Results The HBT provided drug expertise and support throughout the project; however, involvement of NH staff varied. The Facility X IP assumed responsibility for the review and feedback of urine culture data and education and the medical director educated clinicians and families on treatment guidelines. Facility Y’s ASP was led by the medical director and focused mainly on education of clinicians. Facility X saw significant reductions in all metrics in 2016. Facility Y significantly reduced their quinolone use and urine culture rate; however, this did not translate into a reduction in DOT for UTI (Table 1). Table 1. Rates per 1,000 resident days Facility X Y 2014 2016 Rate Ratio (RR) (95% Confidence Interval [CI]) 2014 2016 RR 
(95% CI) UTI DOT 11.6 8.8 0.77 (0.71–0.82) 13.6 12.7 0.94 (0.87-1.01) Quinolone DOT 17.6 9.8 0.56 (0.52-0.59) 21.8 12.0 0.55 (0.51–0.59) Urine Cultures 5.7 2.7 0.48 (0.43-0.54) 5.1 3.0 0.59 (0.51–0.68) Conclusion Hospital

  9. Assessing the role of federal community assistance programs to develop biomass utilization capacity in the Western United States

    Science.gov (United States)

    Dennis R. Becker; Mark Nechodom; Adam Barnett; Tad Mason; Eini C. Lowell; John Shelly; Dean Graham

    2008-01-01

    As forest biomass utilization becomes cost effective to harvest, more areas at risk of catastrophic wildfire can be thinned of dense brush and small-diameter trees. In an effort to increase biomass utilization, the USDA Forest Service granted more than $36 million in National Fire Plan-Economic Action Program funds in the Western United States during fiscal years 2001...

  10. Utilization, spending, and price trends for benzodiazepines in the US Medicaid program: 1991-2009.

    Science.gov (United States)

    Gorevski, Elizabeth; Bian, Boyang; Kelton, Christina M L; Martin Boone, Jill E; Guo, Jeff J

    2012-04-01

    Although it is well-known that drug costs in the US have risen precipitously over the last 25 years, what is much less appreciated is how this rise in cost has occurred across so many seemingly distinct drug markets. To describe trends in the utilization, spending, and average per-prescription cost of benzodiazepines individually, in subgroups, and overall, in the Medicaid program. Medicaid has been the primary public payer for benzodiazepines over the past 2 decades. A retrospective, descriptive analysis was performed for the years 1991-2009 using the publicly available national Summary Files from the Medicaid State Drug Utilization Data maintained by the Centers for Medicare & Medicaid Services. Quarterly prescription counts and reimbursement amounts were calculated for all benzodiazepines reimbursed by Medicaid. Average per-prescription spending as a proxy for drug price was found by dividing reimbursement by the number of prescriptions. Prescriptions for benzodiazepines among Medicaid beneficiaries increased from 8.0 million in 1991 to 17.1 million in 2009. Expenditures rose from $131.6 million to $171.1 million over the same time period. The average per-prescription price was a little over $10 in 2009. Whereas utilization of intermediate- and long-acting agents increased over time, prescriptions for short-acting drugs fell from 1.1 million to 0.3 million (1991-2009). The percentage rise in Medicaid spending on benzodiazepines since 1991 (30.0%) was less than the general rate of inflation (57.5%), as measured by the percentage change in the consumer price index over the same time period. Relative to the rise in the number of Medicaid beneficiaries (more than doubled over the study period), there is no evidence of an extraordinary rise in the utilization of benzodiazepines. Moreover, both nominal and real average prices of benzodiazepines have fallen, primarily because of generic entry over the last 2 decades.

  11. A Method of Determination of an Acquisition Program in Order to Maximize the Total Utility Using Linear Programming in Integer Numbers

    Directory of Open Access Journals (Sweden)

    Alin Cristian Ioan

    2010-03-01

    Full Text Available This paper solves in a different way the problem of maximization of the total utility using the linear programming in integer numbers. The author uses the diofantic equations (equations in integers numbers and after a decomposing in different cases, he obtains the maximal utility.

  12. Lessons Learned: A review of utility experience with conservation and load management programs for commercial and industrial customers

    Energy Technology Data Exchange (ETDEWEB)

    Nadel, S.

    1990-10-01

    This report examines utility experience with conservation and load management (C LM) programs of commercial and industrial (C I) customers in order to summarize the lessons learned from program experiences to date and what these teach us about how to operate successful programs in the future. This analysis was motivated by a desire to learn about programs which achieve high participation rates and high electricity savings while remaining cost effective. Also, we wanted to review the very latest experiences with innovative program approaches -- approaches that might prove useful to utilities as they scale up their C LM activities. Specific objectives of this phase of the study are threefold: (1) To disseminate information on utility C LM experience to a nationwide audience. (2) To review current New York State utility programs and make suggestions on how these programs can be improved. (3) To collect data for the final phase of the American Council for an Energy-Efficient Economy/New York State Energy Research and Development Authority project, which will examine the savings that are achievable if C LM programs are pushed to the limit'' of current knowledge on how to structure and run cost-effective C LM programs. 19 tabs.

  13. Outcomes and Utilization of a Low Intensity Workplace Weight Loss Program

    Directory of Open Access Journals (Sweden)

    Kelly M. Carpenter

    2014-01-01

    Full Text Available Obesity is related to high health care costs and lost productivity in the workplace. Employers are increasingly sponsoring weight loss and wellness programs to ameliorate these costs. We evaluated weight loss outcomes, treatment utilization, and health behavior change in a low intensity phone- and web-based, employer-sponsored weight loss program. The intervention included three proactive counseling phone calls with a registered dietician and a behavioral health coach as well as a comprehensive website. At six months, one third of those who responded to the follow-up survey had lost a clinically significant amount of weight (≥5% of body weight. Clinically significant weight loss was predicted by the use of both the counseling calls and the website. When examining specific features of the web site, the weight tracking tool was the most predictive of weight loss. Health behavior changes such as eating more fruits and vegetables, increasing physical activity, and reducing stress were all predictive of clinically significant weight loss. Although limited by the low follow-up rate, this evaluation suggests that even low intensity weight loss programs can lead to clinical weight loss for a significant number of participants.

  14. Manual for Getdata Version 3.1: a FORTRAN Utility Program for Time History Data

    Science.gov (United States)

    Maine, Richard E.

    1987-01-01

    This report documents version 3.1 of the GetData computer program. GetData is a utility program for manipulating files of time history data, i.e., data giving the values of parameters as functions of time. The most fundamental capability of GetData is extracting selected signals and time segments from an input file and writing the selected data to an output file. Other capabilities include converting file formats, merging data from several input files, time skewing, interpolating to common output times, and generating calculated output signals as functions of the input signals. This report also documents the interface standards for the subroutines used by GetData to read and write the time history files. All interface to the data files is through these subroutines, keeping the main body of GetData independent of the precise details of the file formats. Different file formats can be supported by changes restricted to these subroutines. Other computer programs conforming to the interface standards can call the same subroutines to read and write files in compatible formats.

  15. The North Wind and the Sun: Pediatric Antimicrobial Stewardship Program Combining Restrictive and Persuasive Approaches in Hematology-Oncology Ward and Hematopoietic Stem Cell Transplant Unit.

    Science.gov (United States)

    Horikoshi, Yuho; Kaneko, Tetsuji; Morikawa, Yoshihiko; Isogai, Mihoko; Suwa, Junichi; Higuchi, Hiroshi; Yuza, Yuki; Shoji, Takayo; Ito, Kenta

    2018-02-01

    The Japanese government's goal for the reduction of antimicrobial consumption is two-thirds of the 2013 rate by 2020. While the antimicrobial stewardship programs (ASPs) are essential in health care facilities, ASP data on pediatric hematology-oncology and hematopoietic stem cell transplant (HSCT) patients are limited. Our aim was to evaluate the impact of restrictive and persuasive ASP on immunocompromised children. The ASP for hematology-oncology and HSCT patients at Tokyo Metropolitan Children's Medical Center was assessed. Phase 1 was a postprescriptive review of carbapenem conducted between April 2010 and September 2011. Phase 2 consisted of the preauthorization of carbapenem, prospective audit with feedback, a weekly luncheon meeting among physicians, consensus on febrile neutropenia management, and implementation of viral molecular diagnostics between October 2011 and September 2015. Both phases were compared for day-of-therapy per 1,000 patient-days, cost of intravenous antimicrobial agents, average hospitalization duration, all-cause mortality, infection-related mortality at 30 days, and appropriateness of empirical treatment of bacteremia. The ASP did not differ from phase 1 to phase 2 in terms of average hospitalization length, mortality rate, or appropriateness of empirical treatment for bacteremia. Day-of-therapies of cefepime, piperacillin/tazobactam, meropenem, vancomycin, liposomal amphotericin B, and fosfluconazole decreased by 20%, 45%, 57%, 38%, 85% and 44%, respectively (P persuasive ASP in the hematology-oncology ward and the HSCT unit safely decreased the use of antibacterial and antifungal agents.

  16. Variables Influencing the Return on Investment in Management Training Programs: A Utility Analysis of 10 Swiss Cases

    Science.gov (United States)

    Chochard, Yves; Davoine, Eric

    2011-01-01

    In this article, we present the utility analysis approach as an alternative and promising approach to measure the return on investment in managerial training programs. This approach, linking economic value with competencies developed by trainees, enables researchers and decision-makers to compare the return on investment from different programs in…

  17. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Cuadros JA

    2015-06-01

    Full Text Available Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future. Keywords: telemedicine, diabetes, retinopathy, retinal imaging

  18. Background report for the formerly utilized Manhattan Engineer District/Atomic Energy Commission sites program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-09-01

    The Department of Energy is conducting a program to determine radiological conditions at sites formerly used by the Army Corps of Engineers' Manhattan Engineer District and the Atomic Energy Commission in the early years of nuclear energy development. Also included in the program are sites used in the Los Alamos plutonium development program and the Trinity atomic bomb test site. Materials, equipment, buildings, and land became contaminated, primarily with naturally occurring radioactive nuclides. They were later decontaminated in accordance with the standards and survey methods in use at that time. Since then, however, radiological criteria, and proposed guidelines for release of such sites for unrestricted use have become more stringent as research on the effects of low-level radiation has progressed. In addition, records documenting some of these decontamination efforts cannot be found, and the final radiological conditions of the sites could not be adequately determined from the records. As a result, the Formerly Utilized Sites Program was initiated in 1974 to identify these formerly used sites and to reevaluate their radiological status. This report covers efforts through June 1980 to determine the radiological status of sites for which the existing conditions could not be clearly defined. Principal contractor facilities and associated properties have already been identified and activities are continuing to identify additional sites. Any new sites located will probably be subcontractor facilities and areas used for disposal of contractor waste or equipment; however, only limited information regarding this equipment and material has been collected to date. As additional information becomes available, supplemental reports will be published.

  19. Pharmacy-based medication reconciliation program utilizing pharmacists and technicians: a process improvement initiative.

    Science.gov (United States)

    Smith, Stephanie B; Mango, Michael D

    2013-02-01

    Pharmacists and pharmacy technicians have an opportunity to impact the quality of the medication histories and improve patient safety by ensuring accurate medication lists are obtained and complete reconciliation has occurred with the admission medication orders by owning the admission medication reconciliation process. To compare the quality of a pharmacy-based medication reconciliation program on admission utilizing pharmacists and technicians to the usual multidisciplinary process. This was a retrospective chart review process improvement study at a 186-bed tertiary care inpatient facility. Primary outcomes included both the accuracy of pre-admission medications listed and the reconciliation of those medications with admission inpatient orders. Technicians obtained patient medication histories. Pharmacists checked the technician-obtained medication histories and ensured reconciliation of those medications with admission orders. Medication accuracy increased from 45.8% to 95% per patient (P process improvement data collection.

  20. Incorporating Reading in an Elementary Physical Education Program with the Utilization of the Physio-Cat Program to Improve Fifth-Grade Reading-Comprehension Skills

    Science.gov (United States)

    Polite', Cheryl Powell

    2012-01-01

    This was a quantitative study utilized to determine the effect of the Physio-Cat Program on improving reading-comprehension scores in reading for students in kindergarten through Grade 5 at an elementary school in Dade County Florida. The Physio-Cat Program, designed by this researcher, was developed to provide an innovative approach to improve…

  1. Utility QA viewpoint: Quality assurance program conforming to 10CFR50, Appendix B and 10CFR71, subpart H

    International Nuclear Information System (INIS)

    Grodi, D.L.

    1987-01-01

    The Nuclear Regulatory Commission issued IE Information Notice No. 84-50: ''Clarification of Scope of Quality Assurance Programs for Transport Packages Pursuant to 10CFR50, Appendix B, in June, 1984. The reason for this notice was to eliminate confusion applicable to the quality assurance provisions of Appendix B, 10CFR50 to certain transport packages for which a quality assurance program is required by 10 CFR 71. The purpose of this paper is to provide methodology for establishing, implementing and verifying that all 10CFR71, Subpart H requirements are met with the utility's NRC approved 10CFR50, Appendix B Quality Assurance Program when utilizing a contractor (with a NRC approved Quality Assurance Program for Radioactive Waste Packaging and Transport) providing the radioactive waste solidification, packaging and transport for the utility. Collectively (utility and contractor) the quality assurance programs will meet the applicable regulatory requirements without the necessity of the utility establishing a separate and specific quality assurance program for Packaging and Transport of Radioactive Waste

  2. Trends in Florida's Prescription Drug Monitoring Program registration and utilization: Implications for increasing voluntary use.

    Science.gov (United States)

    Delcher, Chris; Wang, Yanning; Young, Henry W; Goldberger, Bruce A; Schmidt, Siegfried; Reisfield, Gary M

    Effective use of state prescription drug monitoring programs (PDMPs) to track controlled substance prescribing and dispensing may help mitigate the current opioid crisis. Our objective was to examine trends in registration for and use of Florida's PDMP by physicians and pharmacists, from 2013 to 2016. We discuss implications for PDMP uptake and policy. Key measures, such as cumulative number of registrants per license type and monthly utilization intensity, are presented. A time series forecasting approach was used to (1) model the monthly count of new PDMP registrants and users from January 2013 to December 2016 and (2) estimate cumulative registration totals after 1 year. Florida. As of November 2016, there were 16,498 physicians (representing 31 percent of Drug Enforcement Administration licensees) and 17,241 pharmacists registered with the PDMP, representing 21 and 57 percent of professional licensees, respectively. Of note, the PDMP's designation as a "specialized registry" for electronic medical record "meaningful use" criteria led to a nearly sevenfold increase in physician registrations in a single month. In November 2016, pharmacists displayed a higher past-month PDMP utilization rate (52.2 percent vs 30.1 percent), while physicians displayed a higher past-month PDMP utilization intensity (58.1 vs. 36.1 queries per user). Approximately 25,000 physicians and 31,000 pharmacists must register by the end of 2017 to meet national policy goals. PDMP registration among physicians and pharmacists is limited, and the use of the PDMP among registrants is more limited still. Our findings suggest that Florida will not meet national policy goals for registrants by the end of 2017, although new initiatives may alter this trend. Allowing the PDMP to help prescribers meet other professional needs, such as "meaningful use" or similar efforts, may be effective in increasing PDMP use.

  3. Progress Made in Lunar In-Situ Resource Utilization Under NASA's Exploration Technology and Development Program

    Science.gov (United States)

    Sanders, Gerald B.; Larson, William E.

    2012-01-01

    Incorporation of In-Situ Resource Utilization (ISRU) and the production of mission critical consumables for 9 propulsion, power, and life support into mission architectures can greatly reduce the mass, cost, and risk of missions 10 leading to a sustainable and affordable approach to human exploration beyond Earth. ISRU and its products can 11 also greatly affect how other exploration systems are developed, including determining which technologies are 12 important or enabling. While the concept of lunar ISRU has existed for over 40 years, the technologies and systems 13 had not progressed much past simple laboratory proof-of-concept tests. With the release of the Vision for Space 14 Exploration in 2004 with the goal of harnessing the Moon.s resources, NASA initiated the ISRU Project in the 15 Exploration Technology Development Program (ETDP) to develop the technologies and systems needed to meet 16 this goal. In the five years of work in the ISRU Project, significant advancements and accomplishments occurred in 17 several important areas of lunar ISRU. Also, two analog field tests held in Hawaii in 2008 and 2010 demonstrated 18 all the steps in ISRU capabilities required along with the integration of ISRU products and hardware with 19 propulsion, power, and cryogenic storage systems. This paper will review the scope of the ISRU Project in the 20 ETDP, ISRU incorporation and development strategies utilized by the ISRU Project, and ISRU development and 21 test accomplishments over the five years of funded project activity.

  4. A.G.A. program gives utilities a leg up on benchmarking

    International Nuclear Information System (INIS)

    Share, J.

    1997-01-01

    In this era of downsizing, distribution companies are banding together under the aegis of the American Gas Association to improve their performance, ultimately saving money and jobs. The Best Practice Benchmarking program began in 1990 when New Orleans Public Service coordinated an effort by several utilities wanting to compare practices and data. It is not benchmarking in the traditional sense. Best Practices stresses functional rather than competitive or numerical benchmarking by focusing on what utilities have done to improve their operations. In a report on Best Practices, John Bayko, Director of System Operations for Consumers Gas in Toronto, noted these success stories: Building odorant storage and transport facilities were found to save one company $17,500 annually because it could buy odorant in bulk as opposed to 55-gallon drums. Upgrading its cathodic protection system helped a company realize a 40 percent reduction in corrosion leaks over a two-year period, saving $200,000 a year. Another company began studying partnering with contractors which would eliminate the need of a pipeline inspector in each crew. Those potential savings are over $2 million. This paper describes three other Best Practices related to worker safety, system mapping, and activity-based accounting. A.G.A.'s role is briefly discussed

  5. U.S. Department of Energy Program of International Technical Cooperation for Research Reactor Utilization

    Energy Technology Data Exchange (ETDEWEB)

    Chong, D.; Manning, M.; Ellis, R.; Apt, K.; Flaim, S.; Sylvester, K.

    2004-10-03

    The U.S. Department of Energy, National Nuclear Security Administration (DOE/NNSA) has initiated collaborations with the national nuclear authorities of Egypt, Peru, and Romania for the purpose of advancing the commercial potential and utilization of their respective research reactors. Under its Office of International Safeguards ''Sister Laboratory'' program, DOE/NNSA has undertaken numerous technical collaborations over the past decade intended to promote peaceful applications of nuclear technology. Among these has been technical assistance in research reactor applications, such as neutron activation analysis, nuclear analysis, reactor physics, and medical radioisotope production. The current collaborations are intended to provide the subject countries with a methodology for greater commercialization of research reactor products and services. Our primary goal is the transfer of knowledge, both in administrative and technical issues, needed for the establishment of an effective business plan and utilization strategy for the continued operation of the countries' research reactors. Technical consultation, cooperation, and the information transfer provided are related to: identification, evaluation, and assessment of current research reactor capabilities for products and services; identification of opportunities for technical upgrades for new or expanded products and services; advice and consultation on research reactor upgrades and technical modifications; characterization of markets for reactor products and services; identification of competition and estimation of potential for market penetration; integration of technical constraints; estimation of cash flow streams; and case studies.

  6. U.S. Department of Energy Program of International Technical Cooperation for Research Reactor Utilization

    International Nuclear Information System (INIS)

    Chong, D.; Manning, M.; Ellis, R.; Apt, K.; Flaim, S.; Sylvester, K.

    2004-01-01

    The U.S. Department of Energy, National Nuclear Security Administration (DOE/NNSA) has initiated collaborations with the national nuclear authorities of Egypt, Peru, and Romania for the purpose of advancing the commercial potential and utilization of their respective research reactors. Under its Office of International Safeguards ''Sister Laboratory'' program, DOE/NNSA has undertaken numerous technical collaborations over the past decade intended to promote peaceful applications of nuclear technology. Among these has been technical assistance in research reactor applications, such as neutron activation analysis, nuclear analysis, reactor physics, and medical radioisotope production. The current collaborations are intended to provide the subject countries with a methodology for greater commercialization of research reactor products and services. Our primary goal is the transfer of knowledge, both in administrative and technical issues, needed for the establishment of an effective business plan and utilization strategy for the continued operation of the countries' research reactors. Technical consultation, cooperation, and the information transfer provided are related to: identification, evaluation, and assessment of current research reactor capabilities for products and services; identification of opportunities for technical upgrades for new or expanded products and services; advice and consultation on research reactor upgrades and technical modifications; characterization of markets for reactor products and services; identification of competition and estimation of potential for market penetration; integration of technical constraints; estimation of cash flow streams; and case studies

  7. Dynamic Power Management for Portable Hybrid Power-Supply Systems Utilizing Approximate Dynamic Programming

    Directory of Open Access Journals (Sweden)

    Jooyoung Park

    2015-05-01

    Full Text Available Recently, the optimization of power flows in portable hybrid power-supply systems (HPSSs has become an important issue with the advent of a variety of mobile systems and hybrid energy technologies. In this paper, a control strategy is considered for dynamically managing power flows in portable HPSSs employing batteries and supercapacitors. Our dynamic power management strategy utilizes the concept of approximate dynamic programming (ADP. ADP methods are important tools in the fields of stochastic control and machine learning, and the utilization of these tools for practical engineering problems is now an active and promising research field. We propose an ADP-based procedure based on optimization under constraints including the iterated Bellman inequalities, which can be solved by convex optimization carried out offline, to find the optimal power management rules for portable HPSSs. The effectiveness of the proposed procedure is tested through dynamic simulations for smartphone workload scenarios, and simulation results show that the proposed strategy can successfully cope with uncertain workload demands.

  8. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... of Animation of Antimicrobial Resistance More in Antimicrobial ... Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated ...

  9. Animation of Antimicrobial Resistance

    Science.gov (United States)

    ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... of Animation of Antimicrobial Resistance More in Antimicrobial ... Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated ...

  10. Antimicrobial stewardship in small animal veterinary practice

    DEFF Research Database (Denmark)

    Guardabassi, Luca; Prescott, John F

    2015-01-01

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

  11. The handwriting on the wall: program transformations utilizing effective change management strategies.

    Science.gov (United States)

    Amos, Anita; Johns, Colleen; Hines, Nordia; Skov, Tracey; Kloosterman, Linda

    2012-01-01

    Historically, there have been indications that we need to change the way we work and think about our health care processes. Yet, with the urgency to keep abreast of the changing needs of our patients, have we seen these signs? Moreover, how do we respond to the inevitable change processes that must occur? In 2010, St. Michael's entered into a five-year partnership with Baxter Canada. The overall goal is to improve the quality of care and life for people living with chronic kidney disease. This initiative was undertaken in response to concerns identified internally related to existing health care delivery processes within the renal program. As in any work environment, the depth and breadth of inevitable changes evoke a variety of responses that are based on the individual's attitudes regarding change. As we embarked on this journey, the nursing leadership team and staff within the program were encouraged to review their usual responses toward change utilizing the book, Who Moved My Cheese? (Johnson, 1998). It is imperative to identify the attitudes of those people involved in change processes. This awareness facilitates the use of specific strategies to enhance the effectiveness of their engagement in the process and the outcome of the initiative. Reading the writing on the wall prepares people to participate in and embrace changes that promise to benefit those for whom we provide professional care.

  12. The Nautilus Exploration Program: Utilizing Live Ocean Exploration as a Platform for STEM Education and Outreach

    Science.gov (United States)

    Fundis, A.; Cook, M.; Sutton, K.; Garson, S.; Poulton, S.; Munro, S.

    2016-02-01

    By sparking interest in scientific inquiry and engineering design at a young age through exposure to ocean exploration and innovative technologies, and building on that interest throughout students' educational careers, the Ocean Exploration Trust (OET) aims to motivate more students to be lifelong learners and pursue careers in STEM fields. Utilizing research conducted aboard Exploration Vessel Nautilus, the ship's associated technologies, and shore-based facilities at the University of Rhode Island — including the Graduate School of Oceanography and the Inner Space Center — we guide students to early career professionals through a series of educational programs focused on STEM disciplines and vocational skills. OET also raises public awareness of ocean exploration and research through a growing online presence, live streaming video, and interactions with the team aboard the ship 24 hours a day via the Nautilus Live website (www.nautiluslive.org). Annually, our outreach efforts bring research launched from Nautilus to tens of millions worldwide and allow the public, students, and scientists to participate in expeditions virtually from shore. We share the Nautilus Exploration Program's strategies, successes, and lessons learned for a variety of our education and outreach efforts including: 1) enabling global audiences access to live ocean exploration online and via social media; 2) engaging onshore audiences in live and interactive conversations with scientists and engineers on board; 3) engaging young K-12 learners in current oceanographic research via newly developed lessons and curricula; 4) onshore and offshore professional development opportunities for formal and informal educators; 5) programs and authentic research opportunities for high school, undergraduate, and graduate students onshore and aboard Nautilus; and 6) collaborative opportunities for early career and seasoned researchers to participate virtually in telepresence-enabled, interdisciplinary

  13. Evaluation of Orange and Rockland Utilities, Inc.`s competitive bidding program for demand-side resources. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Peters, J.S.; Stucky, L.; Seratt, P.; Darden-Butler, D. [Barakat and Chamberlin, Inc., Portland, OR (United States)

    1993-02-01

    The process evaluation reports on the implementation of Orange and Rockland Utilities demand-side bidding program in New York State during 1991 and 1992. The program is implemented by two energy service companies in Orange and rockland`s New York State service territory. The process evaluation methodology included interviews with utility staff (3), energy service company staff (2), and participating (6) and nonparticipating (7) utility customers. The two energy service companies had enrolled 14 customers in the program by summer 1992. One company had achieved 90% of their 2.75 MW bid and the other had achieved less than 90% of their 6.9 MW bid. Critical factors in success were determination of a reasonable bid amount for the market and marketing to the appropriate customers. Customers most interested in the program included those with limited access to capital and medium-sized firms with poor cash flows, particularly schools and hospitals. The findings also show that due to the incentive structure and associated need for substantial customer contributions, lighting measures dominate all installations. Customers, however, were interested in the potential savings and six of the nonparticipants chose to either install measures on their own or enroll in the utility`s rebate program.

  14. Effects of Reducing Antimicrobial Use and Applying a Cleaning and Disinfection Program in Veal Calf Farming: Experiences from an Intervention Study to Control Livestock-Associated MRSA.

    Science.gov (United States)

    Dorado-García, Alejandro; Graveland, Haitske; Bos, Marian E H; Verstappen, Koen M; Van Cleef, Brigitte A G L; Kluytmans, Jan A J W; Wagenaar, Jaap A; Heederik, Dick J J

    2015-01-01

    With the ultimate aim of containing the emergence of resistant bacteria, a Dutch policy was set in place in 2010 promoting a reduction of antimicrobial use (AMU) in food-producing animals. In this context, a study evaluated strategies to curb livestock-associated methicillin resistant Staphylococcus aureus (LA-MRSA). Fifty-one veal calf farms were assigned to one of 3 study arms: RAB farms reducing antimicrobials by protocol; RAB-CD farms reducing antimicrobials by protocol and applying a cleaning and disinfection program; and Control farms without interventions. MRSA carriage was tested in week 0 and week 12 of 2 consecutive production cycles in farmers, family members and veal calves. Interventions were validated and a cyclic rise in MRSA-prevalence in animals was shown with a more moderate increase in RAB farms. Prevalence in humans declined parallel over time in the study arms but RAB farms were at the lowest MRSA levels from the beginning of the study. In RAB-CD farms, human and animal prevalence did not differ from Control farms and MRSA air loads were significantly higher than in the other study arms. Mimicking the national trend, an overall AMU decrease (daily dosages per animal per cycle (DDDA/C)) was observed over 4 pre-study and the 2 study cycles; this trend did not have a significant effect on a set of evaluated farm technical parameters. AMU was positively associated with MRSA across study arms (ORs per 10 DDDA/C increase = 1.26 for both humans (p = 0.07) and animals (p = 0.12 in first cycle)). These results suggest that AMU reduction might be a good strategy for curbing MRSA in veal calf farming, however the specific cleaning and disinfecting program in RAB-CD farms was not effective. The drop in MRSA prevalence in people during the study could be attributed to the observed long-term AMU decreasing trend.

  15. Antimicrobial ceramics. Kokinsei ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinari, T.; Uchida, M. (Shinagawa Fuel Co. Ltd., Nagoya (Japan))

    1993-07-01

    In recent years, the occurrence of infection by methicillin resistant staphylococcus aureus (MRSA), for which almost all antibiotics do not affect, in facilities such as hospitals is causing trouble. The antimicrobial property of silver has been known empirically since the ancient times. However, since 1985, so called silver zeolite in which zeolite carries silver ions has become utilized as an inorganic antimicrobial agent with silver as its constituent. In this article, the effect of inhibiting MRSA propagation of antimicrobial fibers containing silver zeolite is explained centering around the physical properties of silver zeolite. MRSA has resistance against antibiotics, methicillin which is mainly used at present. When the antimicrobial power of silver zeolite is compared with those of copper zeolite and zinc zeolite, the antimicrobial power of silver zeolite is the strongest and further increases as the silver ion concentration in the zeolite increases. Silver zeolite is safe to use and used for tools and clothes to be used in the fields of food and medical care. 12 refs., 3 figs., 8 tabs.

  16. Lessons learned from new construction utility demand side management programs and their implications for implementing building energy codes

    Energy Technology Data Exchange (ETDEWEB)

    Wise, B.K.; Hughes, K.R.; Danko, S.L.; Gilbride, T.L.

    1994-07-01

    This report was prepared for the US Department of Energy (DOE) Office of Codes and Standards by the Pacific Northwest Laboratory (PNL) through its Building Energy Standards Program (BESP). The purpose of this task was to identify demand-side management (DSM) strategies for new construction that utilities have adopted or developed to promote energy-efficient design and construction. PNL conducted a survey of utilities and used the information gathered to extrapolate lessons learned and to identify evolving trends in utility new-construction DSM programs. The ultimate goal of the task is to identify opportunities where states might work collaboratively with utilities to promote the adoption, implementation, and enforcement of energy-efficient building energy codes.

  17. Thrombolytic utilization for ischemic stroke in US hospitals with neurology residency program.

    Science.gov (United States)

    Moradiya, Yogesh; Crystal, Howard; Valsamis, Helen; Levine, Steven R

    2013-12-03

    We aimed to compare the rates of thrombolysis utilization for acute ischemic stroke in hospitals with neurology residency (NR) to those of other teaching (OT) and nonteaching (NT) hospitals. A retrospective serial cross-sectional cohort study of a nationally representative sample of stroke patients was conducted. Accreditation Council for Graduate Medical Education-accredited NR program-affiliated hospitals in the United States were cross-matched to the hospitals in the Nationwide Inpatient Sample from 2000 to 2010. ICD-9-CM codes were used for case ascertainment. A total of 712,433 adult ischemic stroke patients from 6,839 hospital samples were included, of whom 10.1%, 29.1%, and 60.8% were treated in NR, OT, and NT hospitals, respectively. Stroke patients in NR received thrombolysis more frequently (3.74% ± 0.24% [standard error]) than in OT (2.28% ± 0.11%, p < 0.001) and NT hospitals (1.44% ± 0.06%, p < 0.001). The adjusted odds ratios (ORs) of thrombolysis rates in NR vs OT and NR vs NT increased with each decade increment in age. In multivariate analysis, NR was independently predictive of higher thrombolysis rate (adjusted OR 1.51; 95% confidence interval [CI] 1.44-1.59 [NR vs OT], and adjusted OR 1.82; 95% CI 1.73-1.91 [NR vs NT]). Acute stroke care in NR hospitals is associated with an increased thrombolytic utilization. The disparities between the thrombolysis rate in NR and that in OT and NT hospitals are greater among elderly patients.

  18. User's guide to SERICPAC: A computer program for calculating electric-utility avoided costs rates

    Energy Technology Data Exchange (ETDEWEB)

    Wirtshafter, R.; Abrash, M.; Koved, M.; Feldman, S.

    1982-05-01

    SERICPAC is a computer program developed to calculate average avoided cost rates for decentralized power producers and cogenerators that sell electricity to electric utilities. SERICPAC works in tandem with SERICOST, a program to calculate avoided costs, and determines the appropriate rates for buying and selling of electricity from electric utilities to qualifying facilities (QF) as stipulated under Section 210 of PURA. SERICPAC contains simulation models for eight technologies including wind, hydro, biogas, and cogeneration. The simulations are converted in a diversified utility production which can be either gross production or net production, which accounts for an internal electricity usage by the QF. The program allows for adjustments to the production to be made for scheduled and forced outages. The final output of the model is a technology-specific average annual rate. The report contains a description of the technologies and the simulations as well as complete user's guide to SERICPAC.

  19. LFTR: in search of the ideal pathway to thorium utilization-development program and current status

    International Nuclear Information System (INIS)

    Soon, Benjamin

    2015-01-01

    Thorium has gained substantial attention as a potential energy source that could rival and eventually replace fossil fuels as humanity's primary energy source. This could not have come at a more opportune time as concerns about global climate change from CO 2 emissions and the approaching spectre of finite fossil fuel resources create serious challenges for the continuation of our advanced industrial societies, which are reliant on readily available and affordable energy. Thorium also potentially represents the catalyst with which the nuclear industry could reinvent itself and finally gain widespread public acceptance. There are many opinions on how to utilize thorium as a fuel, but the question of what constitutes an 'ideal' pathway has mostly been under-emphasized. Many specific characteristics of the thorium fuel cycle can differ significantly depending on the conditions and methodologies of utilization; characteristics such as safety, efficiency, waste profile and volume, and fissile protection can vary greatly according to reactor design and utilization philosophy. With thorium, we have been given an opportunity to start over, a blank slate. Therefore, in imagining the 'Thorium Economy' to come, it behoves the scientific and engineering communities to consider the most 'elegant' solution physically possible-what constitutes the 'ideal' and is it possible to reconcile it with what is both economically and technically practical? The characteristics desired of an 'ideal' nuclear reactor, in the areas of safety, efficiency, economy, and sustainability, and the 5 key design choices that could enable such a reactor will be discussed. This will be followed by an overview of the Liquid Fluoride Thorium Reactor, a 2-fluid Molten Salt Reactor currently under development by Flibe Energy in the United States. LFTR is a direct descendant of the MSRE, which was developed at Oak Ridge National Laboratory (ORNL) in the

  20. Estimating the cost of saving electricity through U.S. utility customer-funded energy efficiency programs

    International Nuclear Information System (INIS)

    Hoffman, Ian M.; Goldman, Charles A.; Rybka, Gregory; Leventis, Greg; Schwartz, Lisa; Sanstad, Alan H.; Schiller, Steven

    2017-01-01

    The program administrator and total cost of saved energy allow comparison of the cost of efficiency across utilities, states, and program types, and can identify potential performance improvements. Comparing program administrator cost with the total cost of saved energy can indicate the degree to which programs leverage investment by participants. Based on reported total costs and savings information for U.S. utility efficiency programs from 2009 to 2013, we estimate the savings-weighted average total cost of saved electricity across 20 states at $0.046 per kilowatt-hour (kW h), comparing favorably with energy supply costs and retail rates. Programs targeted on the residential market averaged $0.030 per kW h compared to $0.053 per kW h for non-residential programs. Lighting programs, with an average total cost of $0.018 per kW h, drove lower savings costs in the residential market. We provide estimates for the most common program types and find that program administrators and participants on average are splitting the costs of efficiency in half. More consistent, standardized and complete reporting on efficiency programs is needed. Differing definitions and quantification of costs, savings and savings lifetimes pose challenges for comparing program results. Reducing these uncertainties could increase confidence in efficiency as a resource among planners and policymakers. - Highlights: • The cost of saved energy allows comparisons among energy resource investments. • Findings from the most expansive collection yet of total energy efficiency program costs. • The weighted average total cost of saved electricity was $0.046 for 20 states in 2009–2013. • Averages in the residential and non-residential sectors were $0.030 and $0.053 per kW h, respectively. • Results strongly indicate need for more consistent, reliable and complete reporting on efficiency programs.

  1. 76 FR 30904 - Rural Utilities Service Telecommunications Loan and Loan Guarantee Program

    Science.gov (United States)

    2011-05-27

    ... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Utilities Service Telecommunications Loan... access to advanced telecommunications systems, equipment and services. The List of Materials historically... taking a fundamentally new approach to advancing state-of-the-art telecommunications technologies...

  2. E-FUSRAP: AUTOMATING THE CASE FILE FOR THE FORMERLY UTILIZED SITES REMEDIAL ACTION PROGRAM

    Energy Technology Data Exchange (ETDEWEB)

    Mackenzie, D.; Marshall, K.

    2003-02-27

    The Department of Energy's (DOE) Office of Site Closure, EM-30, houses the document library pertaining to sites that are related to the Formerly Utilized Sites Remedial Action Program (FUSRAP) and regularly addresses ongoing information demands, primarily from Freedom of Information Act (FOIA) requests, interested members of the public, the DOE, and other Federal Agencies. To address these demands more efficiently, DOE has begun to implement a new multi-phase, information management process known as e-FUSRAP. The first phase of e-FUSRAP, the development of the Considered Sites Database, summarizes and allows public access to complex information on over 600 sites considered as candidates for FUSRAP. The second phase of e-FUSRAP, the development of the Document Indexing Database, will create an internal index of more than 10,000 documents in the FUSRAP library's case file, allowing more effective management and retrieval of case file documents. Together, the phases of e-FUSRAP will allow EM-30 to become an innovative leader in enhancing public information sources.

  3. Program of solar wind data analysis utilizing data from Pioneer 6, Mariner 5 and explorer 35

    Science.gov (United States)

    Siscoe, G. L.

    1972-01-01

    A combined data analysis and theoretical program aimed at interpreting and utilizing solar wind data obtained from Pioneer 6, Mariner 5, and Explorer 35 has been completed. A theoretical model of the radial dependence of large scale solar wind inhomogeneities was developed and used to map solar wind variations measured by Explorer 35 to various heliocentric distances and to the orbits of Mercury, Venus, and Mars. The model was also used to determine power spectra velocity, density and temperature variations of 20 R sub s from spectra obtained from the Mariner 5 data at an average heliocentric distance of 180 R sub s. Five stream-stream interaction events in the Pioneer 6 data were analyzed which confirmed the picture of a spiral compression ridge interfacing the two streams and the associated east-west deflections of the solar wind flow. Magnetopause crossings observed in Explorer 35 plasma data were used to develop statics on boundary motions at lunar distance. A study of the geomagnetic disturbance field asymmetry was performed and a model of disturbance field from a partial ring current was developed.

  4. Design program to increase the EDG rated load at Gulf States Utilities - River Bend Station

    International Nuclear Information System (INIS)

    Pischinger, F.; Rogers, G.; Last, R.

    1987-01-01

    This paper presents the results of a program to develop system design improvements which, if incorporated, would increase the EDG rated loads at Gulf States Utilities (GSU) River Bend Station (RBS) - unit 1. The Transamerica Delaval Inc. (TDI) DSR-48 diesel generators are currently restricted to 3130 kW while the name plate rating is 3500 kW, continuous, and 3850 kW for intermittent overload conditions. The project focused on the design margin of the diesel engine crankshaft and evaluated alternative modifications including: reduction of the EDG system excitation; reduction of crankshaft stresses through geometrical changes; and increased material strength. Upon completing an assessment of the engine operational characteristics and evaluating the existing crankshaft design, improved crankshaft design, material and fabrication specifications were developed. These changes include modifications to the crank web fillet geometries and oil hole radii. However, no changes are necessary for the existing block, connecting rods, bearings or generator. The design calculated safety factor is 1.269 at 3500 kW, when using the conservative criteria described by Kritzer and Stahl which is commonly used by German engine manufacturers. A factor of 1.25 is considered adequate when applying these conservative design criteria. All of these proposed changes, in combination, provide an adequate operational safety factor at 3500 kW, 450 rpm, with intermittent overload to 3850 kW. (orig.)

  5. Impacts of Workplace Health Promotion and Wellness Programs on Health Care Utilization and Costs: Results From an Academic Workplace.

    Science.gov (United States)

    Dement, John M; Epling, Carol; Joyner, Julie; Cavanaugh, Kyle

    2015-11-01

    This study evaluated the impacts of a long-standing workplace health promotion (HP) program on health care utilization and costs and estimated return on investment (ROI). Analyses used a retrospective, observational cohort design based on 7 years (2005 to 2011) of health claims and HP program participation data for 3829 HP participants and 6617 controls. Inverse propensity score-weighted mixed-model regression methods were used to balance employee demographics and comorbidities by study arm. Mean monthly health care costs were $35 less for HP participants compared with controls, and results were robust based on sensitivity analyses. ROI was estimated to be $2.53 for every dollar spent on the HP program. Results support a positive impact of HP program participation with regard to reduced health care utilization and costs and a positive ROI.

  6. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... video) Animation of Antimicrobial Resistance (text version) Arabic Translation of Animation of Antimicrobial Resistance Chinese Translation of Animation of Antimicrobial Resistance French Translation of ...

  7. Antimicrobial textiles.

    Science.gov (United States)

    McArthur, J Vaun; Tuckfield, R C; Baker-Austin, C

    2012-01-01

    Bacteria have evolved unique mechanisms that allow them survive in the presence of strong selection pressures. Included in these mechanisms is the ability to share genetic determinants among and between species of bacteria thus spreading metal or antibiotic resistance traits quickly. The textile industry in response to demand has developed antimicrobial fabrics by the addition of bactericidal compounds during production. Some of these antimicrobials include metal nanoparticles, quaternary ammonia compounds, and broad spectrum compounds like triclosan. Bacteria have already expressed resistance to each of these bactericides. Here we discuss the evolutionary and ecological consequences of antimicrobial textiles in terms of co-selection. We predict that continued use of such materials could result in increased and widespread resistance to specific antimicrobials, especially metals, with an increased resistance to antibiotics. Such increases have the potential to find their way into other bacterial populations of human pathogens leading to serious and unintended public health consequences.

  8. Antimicrobial Pesticides

    Science.gov (United States)

    ... may be harboring disease organisms. Determining human and ecological risks from exposure to antimicrobial pesticides requires different ... Open Government Regulations.gov Subscribe USA.gov White House Ask. Contact Us Hotlines FOIA Requests Frequent Questions ...

  9. Effects of a pain education program in Complementary and Alternative Medicine treatment utilization at a VA medical center.

    Science.gov (United States)

    Cosio, David; Lin, Erica H

    2015-06-01

    Past studies have shown that U.S. Veterans are consumers of CAM. However, more than 75% of Veteran non-users report they would utilize these treatment options if made available. Thus, Veterans may not be fully aware of the CAM options currently available to them in the current U.S. VA health care system. The current study tested the hypothesis that Veterans would report an increase in CAM utilization after completing a formal pain education program in a VA medical center. The study used a quasi-experimental, one-group, pre/post-test design. Midwestern, U.S. VA Medical Center. The responses from 103 Veterans who elected to participate in the program and the assessment measures were included in the outcome analyses. "Pain Education School" is a 12-week, educational program that is open to all Veterans and their families. It is a comprehensive program that introduces patients to 23 different disciplines at the VA Medical Center that deal with chronic, non-cancer pain. An adaptation of the Complementary and Alternative Medicine Questionnaire(©), SECTION A: Use of Alternative Health Care Providers. There was a significant difference found in overall utilization of CAM after completing the pain education program. The most utilized CAM modality was the chiropractor; the least utilized were hypnosis and aromatherapy. Not all health care systems or providers may have access to an education-focused, professionally driven program as an amenity. However, lessons can be learned from this study in terms of what pain providers may be able to accomplish in their practice. Published by Elsevier Ltd.

  10. Academic Support Programs Utilized for Nursing Students at Risk of Academic Failure: A Review of the Literature.

    Science.gov (United States)

    Freeman, Julie C; All, Anita

    The purpose of the literature review is to evaluate and discuss the various types of academic support programs used for at-risk nursing students to identify those that are most effective. Nurse educators are concerned about students admitted to nursing programs who are unable to successfully complete the program. To determine the format and efficacy of academic support programs, the literature review addressed the identification of at-risk students and academic support programs applicable to all student groups. Nurse educators need to develop and implement plans to support and retain students in order to address the impending nursing shortage. Replacing a student lost to academic failure is difficult. Although utilized in different manners, academic support programs are an effective retention strategy.

  11. The efficacy of the direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in the pediatric ward of a tertiary medical facility without a pediatric antimicrobial stewardship program.

    Science.gov (United States)

    Hoshina, T; Yamamoto, N; Ogawa, M; Nakamoto, T; Kusuhara, K

    2017-08-01

    Antimicrobial stewardship programs (ASPs) have been introduced in most hospital complexes; however, they are not always useful for pediatric patients. The aim of this study is to investigate the efficacy of direct clinical intervention for infectious diseases by a pediatric infectious disease specialist in a tertiary medical facility without pediatric ASP. This retrospective study included 1,821 patients who were hospitalized in the pediatric ward of a large metropolitan hospital from 2010 to 2015. The clinical course, the use of intravenous antimicrobial agents and the results of a microbiological analysis were compared between the period after the beginning of direct intervention by the specialist (post-intervention period) and the previous period (pre-intervention period). In the post-intervention period, the proportion of the patients who received intravenous antimicrobial agents, the number of antimicrobial agents used for each episode, and the proportion of episodes in which an antimicrobial agent was re-administrated were significantly lower (P = 0.006, P = 0.004, P = 0.036, respectively), and the duration of antimicrobial treatment was significantly shorter (P infectious diseases specialist is useful for the treatment of infectious diseases in the pediatric ward of a tertiary medical facility without a pediatric ASP. The creation of a pediatric ASP is recommended in hospital complexes.

  12. Description of a cost-effective integrated nuclear plant life extension (PLEX) program and its benefits to utilities

    International Nuclear Information System (INIS)

    Massie, H.W.

    1985-01-01

    Significant benefits can be obtained by a utility in extending the life of its operating nuclear power plants by utilizing a systematic approach to nuclear plant life extension. As nuclear power plants age, it is expected that the plant availability/reliability will decline. This has been observed in fossil power plants and a similar trend is to be expected for nuclear plants. A systematic and well planned life extension program can be utilized to maintain and/or improve plant availability resulting in substantial continued cost savings to utilities and their customers. A planned and integrated approach for extending the license and lifetime of nuclear power plants has been developed. The following three areas must be addressed: Licensing; Technology; Economics. The result of a plant life extension study is a 10- to 20-year plan for monitoring, inspecting, upgrading, maintaining, and extending the real operating life of a utility's nuclear plant(s) at high reliability and high availability levels. This long term strategic plan for a total plant life extension program allows the utility to better plan and optimize its financial and human resources

  13. Utilization of an Accelerated Queso Fresco Recipe to Teach Concepts of Food Science in a Didactic Program in Dietetics

    Science.gov (United States)

    Therrien, Mona; Calder, Beth L.; Castonguay, Zakkary J.

    2018-01-01

    Students in the Didactic Program in Dietetics (DPD) at the University of Maine were exposed to the cheese-making process, within a lab setting of two hours, utilizing an accelerated recipe for a Queso Fresco-style cheese. The purpose of this project was to provide students with a novel, hands-on learning experience, which covered concepts of…

  14. With better connection between utility and its customers and with more quality database toward more efficiently DSM program

    International Nuclear Information System (INIS)

    Tomasic-Skevin, S.

    1996-01-01

    In this paper new demand-side technologies and their influence on power system are described. Better connection between utility and its customers is the most important thing for build up good data-base and that data-base is base for efficient usage of DSM program. (author)

  15. Assessing the Utility of and Improving USGS Earthquake Hazards Program Products

    Science.gov (United States)

    Gomberg, J. S.; Scott, M.; Weaver, C. S.; Sherrod, B. L.; Bailey, D.; Gibbons, D.

    2010-12-01

    A major focus of the USGS Earthquake Hazards Program (EHP) has been the development and implementation of products and information meant to improve earthquake hazard assessment, mitigation and response for a myriad of users. Many of these products rely on the data and efforts of the EHP and its partner scientists who are building the Advanced National Seismic System (ANSS). We report on a project meant to assess the utility of many of these products and information, conducted collaboratively by EHP scientists and Pierce County Department of Emergency Management staff. We have conducted focus group listening sessions with members of the engineering, business, medical, media, risk management, and emergency response communities as well as participated in the planning and implementation of earthquake exercises in the Pacific Northwest. Thus far we have learned that EHP and ANSS products satisfy many of the needs of engineers and some planners, and information is widely used by media and the general public. However, some important communities do not use these products despite their intended application for their purposes, particularly county and local emergency management and business communities. We have learned that products need to convey more clearly the impact of earthquakes, in everyday terms. Users also want products (e.g. maps, forecasts, etc.) that can be incorporated into tools and systems they use regularly. Rather than simply building products and posting them on websites, products need to be actively marketed and training provided. We suggest that engaging users prior to and during product development will enhance their usage and effectiveness.

  16. Cost and utilization impacts of oral antihistamines in the California Medi-Cal program.

    Science.gov (United States)

    Hay, Joel W; Leahy, Michael

    2005-01-01

    Newer oral allergic rhinitis (AR) medications, the second-generation antihistamines (SGAs) have gained widespread acceptance because of their efficacy and reduced side effects relative to first-generation antihistamines (FGAs). There are no empirical studies comparing the costs of treatment of SGAs relative to FGAs. We analyzed data from a 20% beneficiary sample (approximately 120,000 continuously enrolled beneficiaries per year) for the Medi-Cal Fee-for-Service program during 1999 to 2000. AR medications available under Medi-Cal included three SGA medications (loratadine, fexofenadine, and cetirizine) and over 200 FGA products containing either diphenhydramine or chlorpheniramine or both. Because multiple medications were evaluated, a sample selection model was estimated using a two-stage multinomial logistic--variance components regression framework. SGA medications have significantly lower total direct health-care treatment costs per patient than FGA medications with costs ranging from US 347 dollars to US 448 dollars less (P < 0.001), despite higher AR medication costs. Total drug expenditures were also not significantly different for patients using SGA or FGA medications despite SGA prescriptions averaging US 47 dollars higher than FGAs. Emergency department visits, inpatient admissions and physician office visits were also significantly lower for patients using SGA medications. Significant cost and utilization reductions were associated with all of the SGA medications relative to FGA drugs, despite their higher acquisition costs. If facing higher copayments for prescription AR drugs, many patients, particularly lower income patients, may choose cheaper over-the-counter (OTC) FGAs rather than SGAs. Our analysis finds this might lead to increased overall health-care treatment costs, unless Medicaid and health insurance plans subsidize OTC AR medications.

  17. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it ... Veterinary Medicine is cited as the corporate author. Animation Animation of Antimicrobial Resistance (video) Animation of Antimicrobial ...

  18. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Antimicrobial Resistance More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated Report Data Meetings and Publications Resources Judicious Use of Antimicrobials Page Last Updated: ...

  19. A program for calculating load coefficient matrices utilizing the force summation method, L218 (LOADS). Volume 1: Engineering and usage

    Science.gov (United States)

    Miller, R. D.; Anderson, L. R.

    1979-01-01

    The LOADS program L218, a digital computer program that calculates dynamic load coefficient matrices utilizing the force summation method, is described. The load equations are derived for a flight vehicle in straight and level flight and excited by gusts and/or control motions. In addition, sensor equations are calculated for use with an active control system. The load coefficient matrices are calculated for the following types of loads: translational and rotational accelerations, velocities, and displacements; panel aerodynamic forces; net panel forces; shears and moments. Program usage and a brief description of the analysis used are presented. A description of the design and structure of the program to aid those who will maintain and/or modify the program in the future is included.

  20. Transportable educational programs for scientific and technical professionals: More effective utilization of automated scientific and technical data base systems

    Science.gov (United States)

    Dominick, Wayne D.

    1987-01-01

    This grant final report executive summary documents a major, long-term program addressing innovative educational issues associated with the development, administration, evaluation, and widespread distribution of transportable educational programs for scientists and engineers to increase their knowledge of, and facilitate their utilization of automated scientific and technical information storage and retrieval systems. This educational program is of very broad scope, being targeted at Colleges of Engineering and Colleges of Physical sciences at a large number of colleges and universities throughout the United States. The educational program is designed to incorporate extensive hands-on, interactive usage of the NASA RECON system and is supported by a number of microcomputer-based software systems to facilitate the delivery and usage of the educational course materials developed as part of the program.

  1. Technical procedures for utilities and solid waste: Environmental Field Program, Deaf Smith County site, Texas: Final draft

    International Nuclear Information System (INIS)

    1987-08-01

    The evaluation of environmental issues and concerns and the addressing of statutory requirements are fundamental parts in the characterization of the site in Deaf Smith County, Texas for the US Department of Energy's Salt Repository Project (SRP). To ensure that the environmental field program comprehensively addresses the issues and requirements of the project, a site study plan (SSP) has been prepared for Utilities and Solid Waste considerations. This technical procedure (TP) has been developed to implement the field program described in the Utilities and Solid Waste Site Study Plan. The purpose and scope of the Utilities and Solid Waste Technical Procedure is to develop and implement a data collection procedure to fulfill the data base needs of the Utilities and Solid Waste SSP. The procedure describes a method of obtaining, assessing and verifying the capabilities of the regional service utilities and disposal contractors. This data base can be used to identify a preferred service source for the engineering contractor. The technical procedure was produced under the guidelines established in Technical Administrative Procedure No. 1.0, Preparation, Review and Approval of Technical Procedures

  2. Associations between eating disorder related symptoms and participants' utilization of an individualized Internet-based prevention and early intervention program.

    Science.gov (United States)

    Kindermann, Sally; Moessner, Markus; Ozer, Fikret; Bauer, Stephanie

    2017-10-01

    Flexible, individualized interventions allow participants to adjust the intensity of support to their current needs. Between-persons, participants with greater needs can receive more intense support, within-persons, participants can adjust utilization to their current level of symptoms. The purpose of the present study was to analyze associations between ED-related symptoms and utilization of the individualized program ProYouth both between- and within-persons, aiming to investigate whether participants adapt utilization intensity to their current needs. Generalized estimated equations (GEEs) were used to analyze log data on program utilization (monthly page visits, monthly use of chats and forum) assessed via server logs and self-reported data on ED-related symptoms from N = 394 ProYouth participants who provided longitudinal data for at least two months. Between-persons, page visits per month were significantly associated with compensatory behavior, body dissatisfaction, and binge eating. Monthly use of the more intense modules with personal support chat and forum was associated with the frequency of compensatory behavior. Within-persons, unbalanced nutrition and dieting showed the strongest associations with monthly page visits. Monthly use of chats and forum was significantly associated with compensatory behavior and unbalanced nutrition and dieting. Results indicate that program utilization is associated with ED-related symptoms between- as well as within-persons. The individualized, flexible approach of ProYouth thus seems to be a promising way for Internet-based provision of combined prevention and early intervention programs addressing ED. © 2017 Wiley Periodicals, Inc.

  3. The impact of a conditional cash transfer program on the utilization of non-targeted services: Evidence from Afghanistan.

    Science.gov (United States)

    Witvorapong, Nopphol; Foshanji, Abo Ismael

    2016-03-01

    While existing research suggests that health-related conditional cash transfer (CCT) programs have positive impacts on the utilization of CCT-targeted health services, little is known as to whether they also influence the utilization of non-targeted health services-defined as general health services for which program participants are not financially motivated. Based on a sample of 6649 households in a CCT program that took place in May 2009-June 2011 in Afghanistan, we evaluate the impact of the receipt of CCTs on the utilization of non-targeted health services both by women, who were direct beneficiaries of the program, and by members of their households. We estimate the outcomes of interest through four probit models, accounting for potential endogeneity of the CCT receipt and dealing with lack of credible exclusion restrictions in different ways. In comparison with the control group, the receipt of CCTs is found to be associated with an increase in the probability of utilizing non-targeted services among household members across regression models. The results are mixed, with regard to the utilization by women, suggesting that there exist non-economic barriers to health care, unique to women, that are not captured by the data. The results confirm the importance of accounting for direct as well as indirect effects in policy evaluation and suggest that future studies investigate more deeply the role of community health workers in removing non-economic barriers for Afghan women and the possibility of introducing an incentive structure to motivate them to contribute more actively to population health in Afghanistan. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. NRC review of Electric Power Research Institute's Advanced Light Reactor Utility Requirements Document - Program summary, Project No. 669

    International Nuclear Information System (INIS)

    1992-08-01

    The staff of the US Nuclear Regulatory Commission has prepared Volume 1 of a safety evaluation report (SER), ''NRC Review of Electric Power Research Institute's Advanced Light Water Reactor Utility Requirements Document -- Program Summary,'' to document the results of its review of the Electric Power Research Institute's ''Advanced Light Water Reactor Utility Requirements Document.'' This SER provides a discussion of the overall purpose and scope of the Requirements Document, the background of the staff's review, the review approach used by the staff, and a summary of the policy and technical issues raised by the staff during its review

  5. Psychosocial and nonclinical factors predicting hospital utilization in patients of a chronic disease management program: a prospective observational study.

    Science.gov (United States)

    Tran, Mark W; Weiland, Tracey J; Phillips, Georgina A

    2015-01-01

    Psychosocial factors such as marital status (odds ratio, 3.52; 95% confidence interval, 1.43-8.69; P = .006) and nonclinical factors such as outpatient nonattendances (odds ratio, 2.52; 95% confidence interval, 1.22-5.23; P = .013) and referrals made (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = .003) predict hospital utilization for patients in a chronic disease management program. Along with optimizing patients' clinical condition by prescribed medical guidelines and supporting patient self-management, addressing psychosocial and nonclinical issues are important in attempting to avoid hospital utilization for people with chronic illnesses.

  6. The Future of Utility Customer-Funded Energy Efficiency Programs in the United States: Projected Spending and Savings to 2025

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-09-11

    We develop projections of future spending on, and savings from, energy efficiency programs funded by electric and gas utility customers in the United States, under three scenarios through 2025. Our analysis, which updates a previous LBNL study, relies on detailed bottom-up modeling of current state energy efficiency policies, regulatory decisions, and demand-side management and utility resource plans. The three scenarios are intended to represent a range of potential outcomes under the current policy environment (i.e., without considering possible major new policy developments). By 2025, spending on electric and gas efficiency programs (excluding load management programs) is projected to double from 2010 levels to $9.5 billion in the medium case, compared to $15.6 billion in the high case and $6.5 billion in the low case. Compliance with statewide legislative or regulatory savings or spending targets is the primary driver for the increase in electric program spending through 2025, though a significant share of the increase is also driven by utility DSM planning activity and integrated resource planning. Our analysis suggests that electric efficiency program spending may approach a more even geographic distribution over time in terms of absolute dollars spent, with the Northeastern and Western states declining from over 70% of total U.S. spending in 2010 to slightly more than 50% in 2025, with the South and Midwest splitting the remainder roughly evenly. Under our medium case scenario, annual incremental savings from customer-funded electric energy efficiency programs increase from 18.4 TWh in 2010 in the U.S. (which is about 0.5% of electric utility retail sales) to 28.8 TWh in 2025 (0.8% of retail sales). These savings would offset the majority of load growth in the Energy Information Administration’s most recent reference case forecast, given specific assumptions about the extent to which future energy efficiency program savings are captured in that forecast

  7. Utilization of Leucaena Leucocephala in Traditional Fattening Program of Bali Cattle in Amarasi

    OpenAIRE

    Lani, Mona Lastri; Abdullah, Luki; Priyanto, Rudi

    2015-01-01

    This field study was aimed to evaluate the availability and the utility of forage on Bali cattle in Amarasi system in dry land area such as Kupang. Amarasi system is a fattening production system (paronisasi), which traditionally utilizes Leucaena leucocephala forage in dry season of Amarasi region. This field study was conducted during the period of July to December 2013 in Oesena and Merbaun Villages. The method used in this research was field survey. This type of survey was used to identif...

  8. Daptomycin: the first approved lipopeptide antimicrobial.

    Science.gov (United States)

    Guay, David R P

    2004-07-01

    such pathogens. To preserve its utility, it should not be used indiscriminately for infections resulting from pathogens sensitive to other antimicrobials. It is probably best used with restricted access and used only for multiresistant gram-positive pathogens where alternative agents cannot be employed. If used, careful monitoring for the signs and symptoms of myotoxicity, including obtaining weekly serum CPK levels, is mandatory. In addition, bacterial sensitivities to this agent should be prospectively monitored by national antimicrobial surveillance programs like SENTRY, TRUST, and LIBRA.

  9. Materials project of the Energy Conversion and Utilization Technologies (ECUT) program for Fiscal Year 1983: Annual progress report

    Energy Technology Data Exchange (ETDEWEB)

    Morris, L.E.; Jordan, A.; Carpenter, J.A. Jr.

    1987-02-01

    This is the annual technical progress report for fiscal year 1983 of the Materials Project of the US Department of Energy (DOE) Energy Conversion and Utilization Technologies (ECUT) Program. In fiscal year 1983, the ECUT Materials Project conducted research in four technical areas, or ''work elements,'' entitled High Temperature Materials, Lightweight Materials, Materials by Design, and New Assessments and Initiatives. The progress of the various tasks of the work elements is discussed in this report.

  10. Data gathering in support of phase O program for waste heat utilization from nuclear enrichment facilities, Ohio

    International Nuclear Information System (INIS)

    1978-01-01

    The gathering of demographic, community development, and economic data for the region impacted by the Pikeville (Ohio) Nuclear Enrichment Facility is described. These data are to be used for establishing possible community uses, e.g., space heating, domestic water heating, and industrial uses, of waste heat from the facility. It was concluded that although the economic feasibility of such waste heat utilization remains to be proven, the community would cooperate in a feasibility demonstration program

  11. Transforming EQ-5D utilities for use in cost–value analysis of health programs.

    Science.gov (United States)

    Nord, Erik; Johansen, Rune

    2015-04-01

    In a number of jurisdictions there is increasing interest in incorporating concerns for fairness in models for economic evaluation of health interventions. Cost–value analysis is a name for evaluations with such a broader aim. The most widely held concern for fairness is a concern for the worse off, i.e. the idea that severity of illness should count in determining priorities. In economic evaluations of improvements in health-related quality of life this concern may be taken into account by replacing conventional health state utilities with societal values for health states that are characterised by strong upper end compression and decreasing marginal value of utility gains. We review evidence on the strength of concerns for the worse off--measured at the cardinal level--in 15 articles published in peer-reviewed journals in the time period 1978–2010, with reports from altogether 20 individual studies in nine different countries. We report 116 individual observations of paired comparisons of utility improvements with different start levels. Concerns for severity show up quite strongly across countries, sample types and question framings. By means of regression analyses we fit a societal value function to the data that has the property of decreasing marginal value of utility gains. Using the central tendency in the data we present two plausible transformations of EQ-5D utilities into societal values that reflect concerns for the worse off.

  12. Emergence of extensively drug-resistant Acinetobacter baumannii complex over 10 years: Nationwide data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR program

    Directory of Open Access Journals (Sweden)

    Kuo Shu-Chen

    2012-08-01

    Full Text Available Abstract Background Acinetobacter baumannii complex (ABC has emerged as an important pathogen causing a variety of infections. Longitudinal multicenter surveillance data on ABC from different sources in Taiwan have not been published. Using data from the Taiwan Surveillance of Antimicrobial Resistance (TSAR conducted biennially, we investigated the secular change in resistance of 1640 ABC from 2002 to 2010 (TSAR period III to VII to different antimicrobial agents and identified factors associated with imipenem-resistant and extensively drug-resistant ABC (IRABC and XDRABC. Methods Isolates were collected by TSAR from the same 26 hospitals located in all 4 regions of Taiwan. Minimum inhibitory concentrations (MIC were determined by reference broth microdilution method. Isolates nonsusceptible to all tested aminoglycosides, fluoroquinolones, β-lactam, β-lactam/β-lactam inhibitors, and carbapenems were defined as extensively drug-resistant (XDR. Multivariate logistic regression analysis was performed to assess the relationship between predictor variables among patients with resistant ABC and patients with non-resistant ABC. Results The prevalence of IRABC increased from 3.4% in 2002 to 58.7% in 2010 (P P 55% over the years with some fluctuations before and after TSAR V (2006 on some agents. Multivariate analysis revealed that recovery from elderly patients, origins other than blood, from ICU settings, or geographic regions are independent factors associated with IRABC and XDRABC. Although the prevalence of XDRABC increased in all four regions of Taiwan over the years, central Taiwan had higher prevalence of XDRABC starting in 2008. Susceptibility to polymyxin remained high (99.8%. Conclusions This longitudinal multicenter surveillance program revealed significant increase and nationwide emergence of IRABC and XDRABC in Taiwan over the years. This study also identified factors associated with IRABC and XDRABC to help guide empirical therapy

  13. Utilization of the Arkansas Prescription Monitoring Program to combat prescription drug abuse

    Directory of Open Access Journals (Sweden)

    Rebecca Rittenhouse

    2015-01-01

    Conclusion: Compelling more users of the AR PMP to be prompted to access the program by the involvement of a CS prescription or by requirements per office/facility policy may increase frequency of use of the program and thereby changes in health care practices to combat prescription drug abuse.

  14. Utilizing the Theoretical Framework of Collective Identity to Understand Processes in Youth Programs

    Science.gov (United States)

    Futch, Valerie A.

    2016-01-01

    This article explores collective identity as a useful theoretical framework for understanding social and developmental processes that occur in youth programs. Through narrative analysis of past participant interviews (n = 21) from an after-school theater program, known as "The SOURCE", it was found that participants very clearly describe…

  15. Nuclear R+D+I in Spanish utilities. Programs and strategies

    International Nuclear Information System (INIS)

    Farmacia, L.; Casero, M.

    2003-01-01

    The Spanish Utilities have traditionally devoted important resources to Research. Development and Innovation in the nuclear field in order to improve the technology and the tools needed for its proper management, as well as to increase the knowledge on the phenomena associated to a safe and reliable operation of the Spanish NPPs. The purpose of this article is to show the continuous effort of the Spanish Utilities to get that the research results better meet the NPPs needs, to improve the coordination with other national and international agents with the aim of ensuring an optimum use of the resources and capabilities, and, most of all, to permanently incorporate the lessons learned. (Author)

  16. Multidisciplinary research program directed toward utilization of solar energy through bioconversion of renewable resources

    Energy Technology Data Exchange (ETDEWEB)

    1980-07-01

    Progress is reported in this multidisciplinary research program. Genetic selection of superior trees, physiological basis of vigor, tissue culture systems leading to cloning of diploid and haploid cell lines are discussed in the Program A report. The physiological basis of enhanced oleoresin formation in southern pines when treated with sublethal concentrations of the herbicide paraquat was investigated in Program B. In Program C, metabolic changes in the stems of slash pine, in vivo, after application with paraquat were determined. The use of phdoem and xylem tissue slices as a laboratory model for studying paraquat associated- and normal-terpene synthesis in pines is discussed. The biochemistry and physiology of methane formation from cellulose during anaerobic fermentation are discussed in the Program D report. (DMC)

  17. The undergraduate physics tutorial program at CSU Los Angeles assessment of utility and areas of interest

    Science.gov (United States)

    Avetyan, Smbat

    The Physics Education Research (PER) group at the University of Washington have researched traditional teaching methods and found that students in introductory physics are lacking a conceptual understanding of the physics material. The solution they put forth is an interactive tutorial program designed to meet the lack of conceptual understanding. Since the tutorial programs inception at CSU Los Angeles in Fall 2006 no evaluation has been successfully undertaken therefore the effect of the tutorial program in the physics 200 series is deeply obscure to the department. The research has shed light on the tutorial program and brought into context its effectiveness on the overall physics 200 series courses at CSU Los Angeles. The researcher has addressed the following research questions, what overall effect does the tutorial program have on the Physics 200 series curriculum? What is the size and significance of gains attributable to the undergraduate calculus based Physics 200 series tutorial program at CSU Los Angeles? What can we learn from gains about individual weekly lessons from the Physics 200 series tutorial courses? What is the correlation of tutorial gains with student final course grades? Are the gains from the tutorial program different for genders? Is there a difference in gains based on the different students' colleges?

  18. Northeast Utilities' participation in the Kaman/NASA wind power program

    Science.gov (United States)

    Lotker, M.

    1975-01-01

    The role of Northeast Utilities in the Kaman/NASA large wind generator study is reviewed. The participation falls into four principal areas: (1) technical assistance; (2) economic analysis; (3) applications; and (4) institutional and legal. A model for the economic viability of wind power is presented.

  19. Can energy utilities play a role in local political energy savings programs?

    DEFF Research Database (Denmark)

    Dirckinck-Holmfeld, Kasper

    2012-01-01

    companies. The Carbon 20 project has entered agreements with different energy consultants to provide these screenings for little or no cost - utilising a national scheme obligating the Danish energy utilities to reduce energy use among customers. However, the energy consultants are rather reluctant to offer...

  20. Radiological guidelines for application to DOE's Formerly Utilized Sites Remedial Action Program. [FUSRAP sites

    Energy Technology Data Exchange (ETDEWEB)

    1983-03-01

    The US Department of Energy has implemented a program to evaluate and, where necessary, take action to protect the public from contamination at sites that were used in the past to process and/or store radioactive materials for the former US Army Corps of Engineers Manhattan Engineer District or the US Atomic Energy Commission. The program is identified as the Formerly Utilized Sites Remedial Action Program (FUSRAP). This document describes methods considered appropriate for the evaluation of health effects that might possible be caused by radioactive contamination at FUSRAP sites. This assessment methodology is applied to a typical site for the purposeof deriving guidelines for the cleanup of contaminated soil. Additional guidance is provided for planning site-specific remedial action that is consistent with the overall objectives of FUSRAP.

  1. Thorium utilization program progress report, July 1, 1975--September 30, 1976

    Energy Technology Data Exchange (ETDEWEB)

    Lotts, A.L.; Kasten, P.R.

    1977-07-01

    Status of the following tasks is reported: program management and analysis; reprocessing development; refabrication development; waste treatment; fuels irradiation and examination; HTGR fuel recycle demonstration facility; hot engineering test project; and cold prototype refabrication development. (LK)

  2. Strategic Plan Outline for the Army Utilities Modernization Program: Fiscal Years 2008-2013

    National Research Council Canada - National Science Library

    Brown, William; Vavrin, John; Potts, Noel; Marsh, Charles; Hock, Vincent; Zhivov, Alexander; Holcomb, Franklin; Sohn, Chang; Scholze, Richard; Gignilliat, Henry; Zeigler, Carl; Volkman, Paul; Jones, Cecil; Phetteplace, Gary

    2006-01-01

    .../ refrigeration systems, but also on electric, natural gas, potable water, and wastewater systems. This program is supported by initiatives/actions under the Army Energy and Water Campaign Plan for Installations...

  3. Thorium utilization program progress report, July 1, 1975--September 30, 1976

    International Nuclear Information System (INIS)

    Lotts, A.L.; Kasten, P.R.

    1977-07-01

    Status of the following tasks is reported: program management and analysis; reprocessing development; refabrication development; waste treatment; fuels irradiation and examination; HTGR fuel recycle demonstration facility; hot engineering test project; and cold prototype refabrication development

  4. Multidisciplinary research program directed toward utilization of solar energy through bioconversion of renewable resources. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Finnerty, W. R.

    1976-07-01

    Progress is reported in four research areas of solar bioconversion. The first program deals with the genetic selection of superior trees, physiological basis of vigor, tissue culture, haploid cell lines, and somatic hybridization. The second deals with the physiology of paraquat-induced oleoresin biogenesis. Separate abstracts were prepared for the other two program areas: biochemical basis of paraquat-induced oleoresin production in pines and biochemistry of methanogenesis. (JSR)

  5. Antimicrobial Peptides

    Directory of Open Access Journals (Sweden)

    Ali Adem Bahar

    2013-11-01

    Full Text Available The rapid increase in drug-resistant infections has presented a serious challenge to antimicrobial therapies. The failure of the most potent antibiotics to kill “superbugs” emphasizes the urgent need to develop other control agents. Here we review the history and new development of antimicrobial peptides (AMPs, a growing class of natural and synthetic peptides with a wide spectrum of targets including viruses, bacteria, fungi, and parasites. We summarize the major types of AMPs, their modes of action, and the common mechanisms of AMP resistance. In addition, we discuss the principles for designing effective AMPs and the potential of using AMPs to control biofilms (multicellular structures of bacteria embedded in extracellular matrixes and persister cells (dormant phenotypic variants of bacterial cells that are highly tolerant to antibiotics.

  6. NASA's Management and Utilization of the Small Business Innovative Research (SBIR) Program

    Science.gov (United States)

    Mexcur, Winfield Paul

    2003-01-01

    The United Space Congress established the SBIR program in 1982 for the following purposes: ( 1) Stimulate technological innovation (2) Increase private-sector commercialization derived from federal R&D (3) Use small business to meet federal R&D needs (4) Foster and encourage participation by disadvantaged persons and women in technological innovation The STTR program was established in 1992 with the additional requirement of having a small business partner with a research institution (usually a university) for the purpose of transferring intellectual property from the research institution to the small business concern for enabling a government technical need and furthering the technological development for the purpose of developing commercial products. The government of Japan has established a program that models portions of the U.S. SBIR and STTR programs. They are very interested in how NASA has been so successful in fulfilling the Congressional objectives of these programs. In particular, they want to understand the management practices and incentives that are provided to enable partnerships between business enterprises, academia and government. The speech will also focus on some of the many successful technologies (on a conceptual level) that have been developed through NASA s SBIR and STTR programs and mechanisms used to promote cooperation between small businesses, large businesses, academia and government agencies within the United States. The speech is on a conceptual level, focusing on U.S. and NASA policies and management implementation practices. No enabling technical discussion will be held.

  7. Changes In Hospital Utilization Three Years Into Maryland's Global Budget Program For Rural Hospitals.

    Science.gov (United States)

    Roberts, Eric T; Hatfield, Laura A; McWilliams, J Michael; Chernew, Michael E; Done, Nicolae; Gerovich, Sule; Gilstrap, Lauren; Mehrotra, Ateev

    2018-04-01

    In a substantial shift in payment policy, the State of Maryland implemented a global budget program for acute care hospitals in 2010. Goals of the program include controlling hospital use and spending. Eight rural hospitals entered the program in 2010, while urban and suburban hospitals joined in 2014. Prior analyses, which focused on urban and suburban hospitals, did not find consistent evidence that Maryland's program had contributed to changes in hospital use after two years. However, these studies were limited by short follow-up periods, may have failed to isolate impacts of Maryland's payment change from other state trends, and had limited generalizability to rural settings. To understand the effects of Maryland's global budget program on rural hospitals, we compared changes in hospital use among Medicare beneficiaries served by affected rural hospitals versus an in-state control population from before to after 2010. By 2013-three years after the rural program began-there were no differential changes in acute hospital use or price-standardized hospital spending among beneficiaries served by the affected hospitals, versus the within-state control group. Our results suggest that among Medicare beneficiaries, global budgets in rural Maryland hospitals did not reduce hospital use or price-standardized spending as policy makers had anticipated.

  8. Status report of the program on neutron beam utilization at the Dalat Nuclear Research Reactor

    International Nuclear Information System (INIS)

    Vuong Huu Tan

    1996-08-01

    The thermal reactor is an intense source not only of thermal neutron, but also intermediate as well as fast neutrons. Using the filtered neutron beam technique at steady state atomic reactor allows receiving the neutrons in the intermediate energy region with the most available intense flux at present. In the near time at the Dalat reactor the filtered neutron beam technique has been applied. Utilization of the filtered neutron beams in basic and applied researches has been a important activity of the Dalat Nuclear Research Institute (DNRI). This report presents some relevant characteristics of the filtered neutron beams and their utilization in nuclear data measurements, neutron capture gamma ray spectroscopy, neutron radiography, neutron dose calibration and other applications. (author). 3 refs, 2 figs

  9. The German R&D Program for CO2 Utilization-Innovations for a Green Economy.

    Science.gov (United States)

    Mennicken, Lothar; Janz, Alexander; Roth, Stefanie

    2016-06-01

    Carbon capture and utilization (CCU) is a field of key emerging technologies. CCU can support the economy to decrease the dependency on fossil carbon raw materials, to stabilize electricity grids and markets with respect to a growing share of fluctuating renewable energy. Furthermore, it can contribute to mitigate anthropogenic CO2 emissions. The German Federal Ministry of Education and Research has provided substantial financial support for research and development projects, stimulating research, development, and innovations in the field of CO2 utilization. This review provides an overview over the most relevant funding measures in this field. Examples of successful projects demonstrate that CCU technologies are already economically viable or technologically ready for industrial application. CCU technologies as elements of a future "green economy" can contribute to reach the ambitious German sustainability targets with regard to climate protection as well as raw material productivity.

  10. Impact of a new reimbursement program on hepatitis B antiviral medication cost and utilization in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Qian Qiu

    Full Text Available BACKGROUND: Hepatitis B virus (HBV infection is a significant clinical and financial burden for chronic hepatitis B (CHB patients. In Beijing, China, partial reimbursement on antiviral agents was first implemented for the treatment of CHB patients in July 1, 2011. AIMS: In this study, we describe the medical cost and utilization rates of antiviral therapy for CHB patients to explore the impact of the new partial reimbursement policy on the medical care cost, the composition, and antivirals utilization. METHODS: Clinical and claims data of a retrospective cohort of 92,776 outpatients and 2,774 inpatients with non-cirrhotic CHB were retrieved and analyzed from You'an Hospital, Beijing between February 14, 2008 and December 31, 2012. The propensity score matching was used to adjust factors associated with the annual total cost, including age, gender, medical insurance type and treatment indicator. RESULTS: Compared to patients who paid out-of-pocket, medical cost, especially antiviral costs increased greater among patients with medical insurance after July 1, 2011, the start date of reimbursement policy. Outpatients with medical insurance had 16% more antiviral utilization; usage increased 3% among those who paid out-of-pocket after the new partial reimbursement policy was implemented. CONCLUSIONS: Direct medical costs and antiviral utilization rates of CHB patients with medical insurance were higher than those from paid out-of-pocket payments, even after adjusting for inflation and other factors. Thus, a new partial reimbursement program may positively optimize the cost and standardization of antiviral treatment.

  11. Utilization of Pharmaceutical Patient and Prescription Assistance Programs via a Pharmacy Department Patient Assistance Program for Indigent Cancer Patients.

    Science.gov (United States)

    Gao, Limin; Joseph, Jivin; Santoro-Levy, Marcelle; Multz, Alan S; Gotlieb, Vladimir K

    2016-07-01

    With the advances in cancer treatments, mortality rates in the United States have been consistently falling but they are accompanied by substantial increases in the cost of cancer care. Patient and prescription assistance programs (PPAPs) are offered by pharmaceutical manufacturers to provide free medications to medically indigent patients. To assist the Cancer Care Center (CCC) at Nassau University Medical Center (NUMC) with drug costs for chemotherapies, the pharmacy department uses a patient assistance program (PAP) to obtain medications from the drug companies at no cost. This study evaluates the impact of the PAP at a public hospital from which indigent cancer patients obtain assistance for chemotherapy. We followed all patients requiring assistance with chemotherapy who enrolled in the PAP from January 1, 2011 through December 31, 2012. Medications included both oral and parenteral chemotherapy drugs and antiemetics used in the outpatient clinic setting. The program served 347 patients in 2011 and 579 patients in 2012. The total number of visits in the clinic over 24 months was 9,405. The total cost savings of the medications was $1,066,000 in 2011 and $1,715,538 in 2012. A pharmacy-based PAP to procure free medications from PPAPs for cancer patients has helped to defray the expense of providing care at NUMC, increased patients' compliance with chemo protocols, and allowed many patients to receive the treatment they otherwise would not be able to afford. The combination of PPAPs and PAP provides a safety net to ensure that indigent cancer patients receive needed prescription medications in the outpatient clinic setting.

  12. An Analysis of the Geothermal Energy Extraction and Utilization Technology R&D Program

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Van Thanh; Dhillon, Harpal S.

    1979-05-01

    The Division of Geothermal Energy (DGE) in the Department of Energy is currently reviewing its RD&D programs to evaluate their relevance to the national goals for the development of geothermal energy during the next 22 years. This report presents the results of an analysis of the RD&D program for geothermal energy extraction and conversion technology. A review of the state-of-the-art was conducted to identify opportunities for improvement. The current RDBD program was checked against the opportunities for improvement to determine if any potential improvements are being ignored, Finally, a benefit/cost analysis was conducted by estimating the benefits expected to result from successful completion of various projects.

  13. Application of linear programming and perturbation theory in optimization of fuel utilization in a nuclear reactor

    International Nuclear Information System (INIS)

    Zavaljevski, N.

    1985-01-01

    Proposed optimization procedure is fast due to application of linear programming. Non-linear constraints which demand iterative application of linear programming are slowing down the calculation. Linearization can be done by different procedures starting from simple empirical rules for fuel in-core management to complicated general perturbation theory with higher order of corrections. A mathematical model was formulated for optimization of improved fuel cycle. A detailed algorithm for determining minimum of fresh fuel at the beginning of each fuel cycle is shown and the problem is linearized by first order perturbation theory and it is optimized by linear programming. Numerical illustration of the proposed method was done for the experimental reactor mostly for saving computer time

  14. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, ...

  15. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... how antimicrobial resistance both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinician's efforts to select the appropriate antimicrobial ...

  16. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet Linkedin Pin it More sharing options ... CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. Over time, ...

  17. Practice in development and utilization of program-technical complex (PTK) in in-reactor control systems

    International Nuclear Information System (INIS)

    Gribov, A.A.; Kuzil, A.C.; Padun, S.P.; Surnachov, S.I.; Jakovlev, G.V.

    2001-01-01

    Experience with the development and utilization of the program-technical complex PTK 'KRUIZ' is analyzed in the paper. A peculiarity of PTK is the orientation on acquisition, processing and diagnostics of signals from in-reactor sensors (thermocouples and SPD). The PTK 'KRUIZ' represents a new generation of tools open for further development, oriented specifically on the use in in-reactor control systems in modernized and built power units of the WWER type. In the PTK 'KRUIZ', methods, models and algorithms proved in nuclear power plants are used accounting for the utilization of up to date technical tools and systematic technical solutions. Experience with the use of basic elements of the PTK 'KRUIZ' at existing WWER reactors including peculiarities of temperature control in nuclear power plants are also dealt within the paper. (Authors)

  18. Implementation of the utilization program for the fuel elements of the Atucha I nuclear power plant

    International Nuclear Information System (INIS)

    Martin, H.R.; Serra, O.H.; Parker, Alejandro

    1981-01-01

    The programming operation for the use of the fuel elements in the Atucha-1 nuclear power plant was initially under the responsibility of the KWU Company, as part of the services rendered due for the manufacturing of said elements. This job was done with the help of the TRISIC program, developed in the early seventies by CNEA and SIEMENS staff. From april 21, 1979 on, CNEA took over the responsibility and strategy of the interchange of fuel elements. The several stages carried out for the implementation of this service are detailed. (M.E.L.) [es

  19. Improving institutional memory on challenges and methods for estimation of pig herd antimicrobial exposure based on data from the Danish Veterinary Medicines Statistics Program (VetStat)

    DEFF Research Database (Denmark)

    Dupont, Nana Hee; Fertner, Mette; Birkegård, Anna Camilla

    2017-01-01

    With the increasing occurrence of antimicrobial resistance, more attention has been directed towards surveillance of both human and veterinary antimicrobial use. Since the early 2000s, several research papers on Danish pig antimicrobial usage have been published, based on data from the Danish...... was based on a consensus by a cross-institutional group of researchers working in projects using VetStat data. No quantitative data quality evaluations were performed, as the frequency of errors and inconsistencies in a dataset will vary, depending on the period covered in the data. Instead, this paper...... focuses on clarifying how VetStat data may be translated to an estimation of the antimicrobial exposure at herd level, by suggesting uniform methods of extracting and editing data, in order to obtain reliable and comparable estimates on pig antimicrobial consumption for research purposes....

  20. Utilization of Leucaena leucocephala in Traditional Fattening Program of Bali Cattle in Amarasi

    Directory of Open Access Journals (Sweden)

    M. L. Lani

    2015-04-01

    Full Text Available This field study was aimed to evaluate the availability and the utility of forage on Bali cattle in Amarasi system in dry land area such as Kupang. Amarasi system is a fattening production system (paronisasi, which traditionally utilizes Leucaena leucocephala forage in dry season of Amarasi region. This field study was conducted during the period of July to December 2013 in Oesena and Merbaun Villages. The method used in this research was field survey. This type of survey was used to identify the forage availability and utility for Bali cattle; including determining the level of feed intake, measuring carrying capacity of both observe villages, and recording body weight of cattle. Cluster random sampling was applied in this study to determine sample used in the research, those were two villages with different altitudes, namely Oesena Village and Merbaun Village. Data were analyzed descriptively to describe the related existing conditions in the field. T-test was conducted to determine leucaena consumption and Bali cattle body weight in both villages. The results showed that during observation period, availability of leucaena forage for cattle was low based on dry matter intake 3.60 and 3.58 kg/head/day, which led to low consumption of cattle. Nevertheless, the use of leucaena in this system increased average body weight gain of Bali cattle up to 0.77 kg/day, due to high crude protein consumption. The conclusion of this study was the availability of leucaena as Bali cattle feed did not meet the cattle needs, but the use of leucaena increased the average of Bali cattle body weight gain.

  1. The Danish large wind turbine program. [feasibility of wind power in a utility grid

    Science.gov (United States)

    Pederson, B. M.

    1979-01-01

    A brief description of the Danish wind energy program and its present status is given. Results and experiences from tests on the Gedser windmill (200 kW) are presented. The key results are presented from the preliminary design study and detailed design of two new WECS (630 kW each) is described.

  2. Utility of the CIPP Model for Evaluating an Established Career Program in a Community College.

    Science.gov (United States)

    Hecht, Alfred R.

    How useful is Stufflebeam's Context, Input, Process, Product (CIPP) model for evaluating an established career program in a community college? On the basis of a case study, advantages of using CIPP include: comprehensiveness, flexibility, integration and decision-orientation. Implementation problems include: establishing procedures for delineating…

  3. Assessing Performance Outcomes of New Graduates Utilizing Simulation in a Military Transition Program

    Science.gov (United States)

    2013-01-01

    emergency manage - ment skills, and team- leadership skills over a 3-month period. A military nurse educator provides oversight to the program at both...RWKHUSURYLVLRQRIODZ QR SHUVRQVKDOOEH VXEMHFWWRDQ\\SHQDOW\\IRUIDLOLQJWRFRPSO\\ZLWKDFROOHFWLRQRILQIRUPDWLRQLILWGRHVQRWGLVSOD\\D...Foster, R. R. (2011). The impact of nursing transitions programme on retention and cost savings. Journal of Nursing Management , 19, 50Y56. doi

  4. Nursing Student Retention in Associate Degree Nursing Programs Utilizing a Retention Specialist

    Science.gov (United States)

    Schrum, Ronna A.

    2014-01-01

    The purpose of this study was to examine specific variables associated with nursing student retention in Associate Degree Nursing (ADN) Programs. Jeffreys (2004) Nursing Undergraduate Retention and Success (NURS) conceptual model provided the framework for this descriptive correlational study. One hundred sixty eight pre-licensure associate degree…

  5. 77 FR 5755 - Request for Proposals: 2012 Hazardous Fuels Woody Biomass Utilization Grant Program

    Science.gov (United States)

    2012-02-06

    ... program are to: Promote projects that target and help remove economic and market barriers to using woody... target market(s), extent of competition for supply and delivered costs and general characterization of... of biomass fuel available and realistic pricing information based on fuel specifications required by...

  6. 78 FR 11622 - Request for Proposals: 2013 Hazardous Fuels Woody Biomass Utilization Grant Program

    Science.gov (United States)

    2013-02-19

    ... infrastructure from wildfires. Goals of the grant program are to: Promote projects that target and help remove... target market(s), extent of competition for supply and delivered costs and general characterization of... project site; Types of biomass fuel available and realistic pricing information based on fuel...

  7. Strategic plan for the utilization of remote sensing technologies in the environmental restoration program

    International Nuclear Information System (INIS)

    King, A.D.; Doll, W.E.; Durfee, R.C.; Luxmoore, R.J.; Conder, S.R.; Nyquist, J.E.

    1993-12-01

    The objectives of the Environmental Restoration (ER) Remote Sensing and Special Surveys Program are to apply state-of-the-art remote sensing and geophysical technologies and to manage routine and remotely-sensed examinations of the Oak Ridge Reservation (ORR), the Paducah Gaseous Diffusion Plant (PGDP), the Portsmouth Gaseous Diffusion Plant (PORTS), and their adjacent off-site areas. Repeated multispectral scanner (MSS) imagery, gamma, and photographic surveys will allow monitoring of the degradation that might occur in waste containment vessels and monitoring (at a later stage in the remediation life cycle) of improvements from restoration efforts and cleanup. These technologies, in combination with geophysical surveys, will provide an effective means for identifying unknown waste sites and contaminant transport pathways. All of the data will be maintained in a data base that will be accessible to site managers in the ER Program. The complete analysis of collected data will provide site-specific data to the ER Program for characterizing and monitoring ER Program hazardous waste sites

  8. Strategic plan for the utilization of remote sensing technologies in the Environmental Restoration Program

    International Nuclear Information System (INIS)

    King, A.D.; Doll, W.E.; Durfee, R.C.; Luxmoore, R.J.; Conder, S.R.; Nyquist, J.E.

    1994-03-01

    The objectives of the Environmental Restoration (ER) Remote Sensing and Special Surveys Program are to apply state-of-the-art remote sensing and geophysical technologies and to manage routine and remotely-sensed examinations of the Oak Ridge Reservation (ORR), the Paducah Gaseous Diffusion Plant (PGDP), the Portsmouth Gaseous Diffusion Plant (PORTS), and their adjacent off-site areas. Repeated multispectral scanner (MSS) imagery, gamma, and photographic surveys will allow monitoring of the degradation that might occur in waste containment vessels and monitoring (at a later stage in the remediation life cycle) of improvements from restoration efforts and cleanup. These technologies, in combination with geophysical surveys, will provide an effective means for identifying unknown waste sites and contaminant transport pathways. All of the data will be maintained in a data base that will be accessible to site managers in the ER Program. The complete analysis of collected data will provide site-specific data to the ER Program for characterizing and monitoring ER Program hazardous waste sites

  9. Antimicrobial use surveillance in broiler chicken flocks in Canada, 2013-2015.

    Science.gov (United States)

    Agunos, Agnes; Léger, David F; Carson, Carolee A; Gow, Sheryl P; Bosman, Angelina; Irwin, Rebecca J; Reid-Smith, Richard J

    2017-01-01

    There is a paucity of data on the reason for and the quantity of antimicrobials used in broiler chickens in Canada. To address this, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) implemented surveillance of antimicrobial use (AMU) and antimicrobial resistance (AMR) in broiler chicken flocks in 2013. Shortly after this (2014), the poultry industry banned the preventive use of ceftiofur in broiler chickens. The objectives of this analysis were to describe antimicrobial use (AMU) in Canadian broiler chickens between 2013 and 2015 (n = 378 flocks), compare these results to other animal species in Canada, to highlight the utility of farm surveillance data to evaluate the impact of a policy change, and to explore how different antimicrobial use metrics might affect data interpretation and communication. The surveillance data indicated that the poultry industry policy resulted in lower antimicrobial use and resistance, and they successfully captured information on when, where, why, and how much antimicrobials were being used. The majority of antimicrobials were administered via the feed (95%). The relative frequency of antimicrobial classes used in broiler chickens differed from those used in swine or in food animal production in general. Coccidiostats were the most frequently used antimicrobial classes (53% of total kg). Excluding coccidiostats, the top three most frequently used antimicrobial classes were bacitracin (53% of flocks), virginiamycin (25%) and avilamycin (21%), mainly used for the prevention of necrotic enteritis. Depending on the AMU metric utilized, the relative rankings of the top antimicrobials changed; hence the choice of the AMU metric is an important consideration for any AMU reporting. When using milligrams/Population Correction Unit (mg/PCU) the top three antimicrobial classes used were bacitracins (76 mg/PCU), trimethoprim-sulfonamides (24 mg/PCU), and penicillins (15 mg/PCU), whereas when using a number of

  10. Antimicrobial use surveillance in broiler chicken flocks in Canada, 2013-2015.

    Directory of Open Access Journals (Sweden)

    Agnes Agunos

    Full Text Available There is a paucity of data on the reason for and the quantity of antimicrobials used in broiler chickens in Canada. To address this, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS implemented surveillance of antimicrobial use (AMU and antimicrobial resistance (AMR in broiler chicken flocks in 2013. Shortly after this (2014, the poultry industry banned the preventive use of ceftiofur in broiler chickens. The objectives of this analysis were to describe antimicrobial use (AMU in Canadian broiler chickens between 2013 and 2015 (n = 378 flocks, compare these results to other animal species in Canada, to highlight the utility of farm surveillance data to evaluate the impact of a policy change, and to explore how different antimicrobial use metrics might affect data interpretation and communication. The surveillance data indicated that the poultry industry policy resulted in lower antimicrobial use and resistance, and they successfully captured information on when, where, why, and how much antimicrobials were being used. The majority of antimicrobials were administered via the feed (95%. The relative frequency of antimicrobial classes used in broiler chickens differed from those used in swine or in food animal production in general. Coccidiostats were the most frequently used antimicrobial classes (53% of total kg. Excluding coccidiostats, the top three most frequently used antimicrobial classes were bacitracin (53% of flocks, virginiamycin (25% and avilamycin (21%, mainly used for the prevention of necrotic enteritis. Depending on the AMU metric utilized, the relative rankings of the top antimicrobials changed; hence the choice of the AMU metric is an important consideration for any AMU reporting. When using milligrams/Population Correction Unit (mg/PCU the top three antimicrobial classes used were bacitracins (76 mg/PCU, trimethoprim-sulfonamides (24 mg/PCU, and penicillins (15 mg/PCU, whereas when using a number

  11. Green power programs in Canada : 2002 : Overview of Government green power policies, utility green power development programs, green power and certificate marketing initiatives, and their benefits

    International Nuclear Information System (INIS)

    Bramley, M.; Boustie, S.; Vadgama, J.; Wieler, C.; Pape-Salmon, A.; Holmes, R.

    2003-11-01

    Green power is generally defined as electricity produced from renewable sources, and whose production has low adverse impacts on the environment, human health and communities. Green power has near-zero greenhouse gas (GHG) emissions and includes sources such as wind, hydro, and solar power. Green power offers several environmental benefits, as well as the enhancement of energy security, regional development, economic diversification and the creation of skilled jobs. There are four categories of programs related to green power development in Canada: government green power policies, utility green power development programs, green power marketing initiatives, and green power certificate marketing initiatives. Most of the activities associated with these four categories in 2002 were discussed in this report. However, difficulties with quantification prevented the inclusion of some green power activities in the report, such as (1) the generation of green power not certified or identified by the generator as green power, (2) industry or residential self-generation, (3) net metering, and (4) small government programs. Each category was presented in detail. The information included in the report was based on surveys sent to each program proponent. Follow-up communications and other publicly available information was also included. New programs operating in 2003 or currently under development were listed. refs., 8 tabs

  12. Pilot study investigating the utility of a specialized online symptom management program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome as compared to an online meditation program

    Directory of Open Access Journals (Sweden)

    Arroll MA

    2014-09-01

    Full Text Available Megan A Arroll, Elizabeth A Attree, Claire L Marshall, Christine P DanceyChronic Illness Research Team, School of Psychology, University of East London, London, UKBackground: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is a long-term, debilitating condition that impacts numerous areas of individuals' lives. The two predominant treatment options for ME/CFS are cognitive behavioral therapy and graded exercise therapy; however, many people have found these techniques unacceptable or even damaging. This pilot study aimed to evaluate the utility of a specialized online symptom management program for ME/CFS in comparison to an online meditation program in an effort to ascertain whether this tool could be a further option for those with ME/CFS.Methods: This experimental design consisted of two interventions: a specialized online symptoms management program (N=19 and a control intervention based on an online meditation website (N=9. A battery of questionnaires, including measures of multidimensional fatigue, illness-specific symptoms, perceived control, and mindful awareness, were completed before the participants commenced use of the programs and following 8 weeks' use.Results: Significant differences were found in the areas of chance and powerful others' locus of control, and sleeping difficulties, but not in ME/CFS symptomatology overall.Conclusion: The specialized online program described in this study warrants further investigation, as it appears to influence perceived control and key ME/CFS symptoms over time.Keywords: ME/CFS, perceived control, sleep, outcomes, online intervention

  13. A case study in technology utilization: Industrial products and practices. [summary of benefits to national economy resulting from space programs

    Science.gov (United States)

    1973-01-01

    In pursuit of such missions as Apollo, the National Aeronautics and Space Administration has called into being unique equipment that obviously has little direct application beyond the achievement of mission objectives. Yet, to assume that further direct application of space program hardware is somehow a measure of the industrial benefits accruing to the nation is to misunderstand how the creation of new technology affects modern industrial capability. This document presents a profile of the significant ways in which technological developments in response to aerospace mission requirements have been coupled into industrial practice, with the result being that improved products and processes are now being utilized to benefit the nation.

  14. Research and services partnerships: a partnership to develop a utilization-focused evaluation plan for a criminal justice diversion program.

    Science.gov (United States)

    Rubin, Maureen; Alarid, Leanne Fiftal; Rodriguez, Mary Jo

    2014-01-01

    More than 100,000 offenders in the Texas correctional system have a mental illness, which represents about 19% of the state's correctional population, including offenders in prison and under community correctional supervision. To reduce these numbers, a leading mental health service provider established the Community Reintegration Program (CRP) to divert misdemeanor offenders with mental illness to community-based treatment. This column describes a collaborative process between the University of Texas at San Antonio and community partners to develop a utilization-focused evaluation plan for the CRP that would benefit all stakeholders. The evaluation used data collected as part of routine clinical work.

  15. Utilizing Secondary Agricultural Education Programs to Deliver Evidence-Based Grain Safety Training for Young and Beginning Workers.

    Science.gov (United States)

    Cheng, Yuan-Hsin; Field, William E; Tormoehlen, Roger L; French, Brian F

    2017-01-01

    Purdue University's Agricultural Safety and Health Program (PUASHP) has collaborated with secondary agricultural education programs, including FFA Chapters, for over 70 years to deliver and promote agricultural safety and health programming. With support from a U.S. Department of Labor Susan Harwood Program grant, PUASHP utilized a Developing a Curriculum (DACUM) process to develop, implement, and evaluate an evidence-based curriculum for use with young and beginning workers, ages 16-20, exposed to hazards associated with grain storage and handling. The primary audience was students enrolled in secondary agricultural education programs. A review of the literature identified a gap in educational resources that specifically addresses this target population. The curriculum developed was based on fatality and injury incident data mined from Purdue's Agricultural Confined Space Incident Database and input from a panel of experts. The process identified 27 learning outcomes and finalized a pool of test questions, supported by empirical evidence and confirmed by a panel of experts. An alignment process was then completed with the current national standards for secondary agricultural education programs. Seventy-two youth, ages 16-20, enrolled in secondary-school agricultural education programs, and a smaller group of post-secondary students under the age of 21 interested in working in the grain industry pilot tested the curriculum. Based on student and instructor feedback, the curriculum was refined and submitted to OSHA for approval as part of OSHA's online training resources. The curriculum was delivered to 3,665 students, ages 16-20. A total of 346 pre- and post-tests were analyzed, and the results used to confirm content validity and assess knowledge gain. Findings led to additional modifications to curriculum content, affirmed knowledge gain, and confirmed appropriateness for use with secondary agricultural education programs. The curriculum has been promoted

  16. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System About NARMS 2015 NARMS Integrated Report Data Meetings and Publications Resources Judicious Use of ...

  17. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System ... If you need help accessing information in different file formats, see Instructions for Downloading ...

  18. EntrezAJAX: direct web browser access to the Entrez Programming Utilities.

    Science.gov (United States)

    Loman, Nicholas J; Pallen, Mark J

    2010-06-21

    Web applications for biology and medicine often need to integrate data from Entrez services provided by the National Center for Biotechnology Information. However, direct access to Entrez from a web browser is not possible due to 'same-origin' security restrictions. The use of "Asynchronous JavaScript and XML" (AJAX) to create rich, interactive web applications is now commonplace. The ability to access Entrez via AJAX would be advantageous in the creation of integrated biomedical web resources. We describe EntrezAJAX, which provides access to Entrez eUtils and is able to circumvent same-origin browser restrictions. EntrezAJAX is easily implemented by JavaScript developers and provides identical functionality as Entrez eUtils as well as enhanced functionality to ease development. We provide easy-to-understand developer examples written in JavaScript to illustrate potential uses of this service. For the purposes of speed, reliability and scalability, EntrezAJAX has been deployed on Google App Engine, a freely available cloud service. The EntrezAJAX webpage is located at http://entrezajax.appspot.com/

  19. Cyclodextrins: A Weapon in the Fight Against Antimicrobial Resistance

    Science.gov (United States)

    Wong, Chew Ee; Dolzhenko, Anton V.; Lee, Sui Mae; Young, David James

    Antimicrobial resistance poses one of the most serious global challenges of our age. Cyclodextrins (CDs) are widely utilized excipients in formulations because of their solubilizing properties, low toxicity, and low inflammatory response. This review summarizes recent investigations of antimicrobial agents involving CDs and CD-based antimicrobial materials. CDs have been employed for antimicrobial applications either through formation of inclusion complexes or by chemical modification of their hydroxyl groups to tailor pharmaceutically active compounds. Applications of these CD inclusion complexes include drug delivery, antimicrobial coatings on materials (e.g., biomedical devices and implants) and antimicrobial dressings that help to prevent wound infections. There are relatively limited studies of chemically modified CDs with antimicrobial activity. The mechanism of action of antimicrobial CD inclusion complexes and derivatives needs further elucidation, but activity of CDs and their derivatives is often associated with their interaction with bacterial cell membranes.

  20. Antimicrobial stewardship: Strategies for a global response

    Directory of Open Access Journals (Sweden)

    Jenny Grunwald

    2014-01-01

    Full Text Available The increasing antimicrobial resistance worldwide, combined with dwindling antimicrobial armamentarium, has resulted in a critical threat to the public health and safety of patients. To combat this hazard, antimicrobial stewardship programs (ASPs have emerged. Antimicrobial stewardship programs prevent or slow the emergence of antimicrobial resistance by coordinated interventions designed to optimize antimicrobial use to achieve the best clinical outcomes and limiting selective pressures that drive the emergence of resistance. This also reduces excessive costs attributable to suboptimal antimicrobial use. Even though an ideal effective ASP should incorporate more than one element simultaneously, it also requires a multidisciplinary team, which should include an infectious diseases physician, a clinical pharmacist with infectious diseases training, infection control professionals, hospital epidemiologist, a clinical microbiologist and an information specialist. However, for antimicrobial stewardship (AMS programs to be successful, they must address the specific needs of individual institutions, must be built on available resources, the limitations and advantages of each institution, and the available staffing and technological infrastructure.

  1. Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness

    OpenAIRE

    Cuadros, Jorge

    2015-01-01

    Jorge A Cuadros Optometry/Vision Science, University of California, Berkeley, CA, USA Abstract: Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS) programs have been developed to identify patients with sight-threatening diabetic eye disease becaus...

  2. New Jersey state information handbook: Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1980-01-01

    Under the implied authority of the Atomic Energy Act of 1954, as amended, radiological surveys and research work has been conducted to determine radiological conditions at former MED/AEC sites. As of this time, 31 sites in 13 states have been identified that require or may require remedial action. This volume is one of a series produced under contract with DOE, Office of Nuclear Waste Management, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of New Jersey. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations. The loose-leaf format used in these volumes will allow the material to be updated periodically as the Remedial Action Program progresses

  3. New Jersey state information handbook: Formerly Utilized Sites Remedial Action Program

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-10-31

    Under the implied authority of the Atomic Energy Act of 1954, as amended, radiological surveys and research work has been conducted to determine radiological conditions at former MED/AEC sites. As of this time, 31 sites in 13 states have been identified that require or may require remedial action. This volume is one of a series produced under contract with DOE, Office of Nuclear Waste Management, by POLITECH CORPORATION to develop a legislative and regulatory data base to assist the FUSRAP management in addressing the institutional and socioeconomic issues involved in carrying out the Remedial Action Program. This Information Handbook series contains information about all relevant government agencies at the Federal and state levels, the pertinent programs they administer, each affected state legislature, and current Federal and state legislative and regulatory initiatives. This volume is a compilation of information about the state of New Jersey. It contains: a description of the state executive branch structure; a summary of relevant state statutes and regulations; a description of the structure of the state legislature, identification of the officers and committee chairmen, and a summary of recent relevant legislative action; and the full text of relevant statutes and regulations. The loose-leaf format used in these volumes will allow the material to be updated periodically as the Remedial Action Program progresses.

  4. Pre-implementation Assessment of An Antimicrobial Stewardship Program for Acute Respiratory Infections within Emergency and Urgent Care Settings

    OpenAIRE

    May, Larissa; Shigyo, Kristina; Stahmer, Aubyn; Yadav, Kabir

    2017-01-01

    Abstract Background Inappropriate antibiotic use in emergency department (ED) and urgent care center (UCC) settings is a major public health concern, yet few antibiotic stewardship programs have been designed for these settings. We report a qualitative pre-implementation workflow analysis of five ED and UCC settings investigating the facilitators and barriers to incorporating an adapted CDC Get Smart antibiotic stewardship intervention for antibiotic-nonresponsive acute respiratory infections...

  5. Radiological protection guidelines for the Formerly Utilized Sites Remedial Action Program and Remote Surplus Facilities Management Program

    International Nuclear Information System (INIS)

    Gilbert, T.L.

    1984-01-01

    The need for a definitive basis for radiological guidelines and criteria for FUSRAP became apparent by 1981 and led ORO to sponsor a joint ANL/BNI/LANL/ORO effort under the chairmanship of Wayne Hansen (LANL) that resulted in a final FUSRAP radiological guidelines document in March 1983. A separate effort to develop guidelines for remedial action criteria for SFMP was in progress at PNL. The need to coordinate both efforts with impending revisions of DOE Radiological Protection Standards and impending new developments in EPA and NRC Radiological Protection Standards led to convening of the first DOE Workshop on Remedial Action Criteria in Gaithersburg, Maryland, in February 1984, followed by a second workshop in June 1984 at ANL. The major decisions were to base the criteria on dosimetry models and basic limits currently recommended by the International Commission on Radiological Protection, to emphasize the development and use of site-specific rather than generic guidelines and criteria for residual radionuclide concentrations in the ground, and to prepare a manual to accompany the guidelines that would present procedures and tables for deriving site-specific soil guidelines and criteria for the remedial action programs. A joint ANL/LANL/ORNL/PNL effort to prepare a definitive set of guidelines and a manual has been initiated. The scope, status, and current plans for this effort, and some of the key issues, are presented. 10 references, 1 table

  6. Assessing the effectiveness of a place-based conservation education program by applying utilization-focused evaluation

    Science.gov (United States)

    Flowers, Alice Blood

    Lack of personal connection to the natural world by most American youth builds reason for assessing effectiveness of conservation education programs. Place-based learning is important in helping youth understand how their personal and societal well-being are linked and dependent upon their local habitats. Across Montana 2277 students in grades 3--10 participate in an interactive year long fishing education program with their teachers called Hooked on Fishing (HOF). The purpose of my study was to assess the effectiveness of HOF, a place-based conservation education program established in 1996, and modeled after the national Hooked on Fishing, Not on Drugs program. Using a quasi-experimental nonequivalent group study design, students received a pre-survey during the beginning of the program, a post-survey after the program, and an extended post-survey 12 to 14 weeks later. Teachers voluntarily participated in an Internet survey during May 2006, and program instructors voluntarily participated in a structured open-ended telephone interview in June 2006. A key component of my study was the decision to conduct the evaluation process using an approach which included stakeholders in the development of the instruments to measure student outcomes. This approach is called utilization-focused evaluation and was developed by Michael Q. Patton. The motive of this approach is to promote the usability of the evaluation results. The results are considered to have a better chance to be applied by the program stakeholders to not only gauge program effectiveness, but to be used to improve the program. Two research questions were: (1) does the frequency of outdoor experiences have significant affects on students' knowledge, skills, attitudes, and intended stewardship behaviors; and (2) does improved knowledge of local natural resources have significant affects on students' skills, attitudes and intended stewardship behavior. Nonparametric statistical analyses calculated statistical

  7. Formerly Utilized Sites Remedial Action Program: Wayne Interim Storage Site: Annual site environmental report, Wayne, New Jersey, Calendar year 1986

    International Nuclear Information System (INIS)

    1987-05-01

    During 1986, the environmental monitoring program was continued at the Wayne Interim Storage Site (WISS), a US Department of Energy (DOE) facility located in the Township of Wayne, New Jersey. The WISS is part of the Formerly Utilized Sites Remedial Action Program (FUSRAP), a DOE program to decontaminate or otherwise control sites where residual radioactive material remains from the early years of the nation's atomic energy program or from commercial operations causing conditions that Congress has mandated DOE to remedy. As part of the decontamination research and development decontamination program authorized by Congress under the 1984 Energy and Water Appropriations Act, remedial action is being conducted at the site and at vicinity properties by Bechtel National, Inc., Project Management Contractor for FUSRAP. The monitoring program at the WISS measures radon and thoron gas concentrations in air; external gamma radiation levels; and uranium, radium, and thorium concentrations in surface water, groundwater, and sediment. To verify that the site is in compliance with the DOE radiation protection standard (100 mrem/y) and to assess its potential effect on public health, the radiation dose was calculated for the maximally exposed individual. Based on the conservative scenario described in the report, this individual would receive an annual external exposure approximately equivalent to 1% of the DOE radiation protection standard. By comparison, the average American receives a dose of 1 mrem/y from watching color television. The cumulative dose to the population within an 80-km radius of the WISS that would result from radioactive materials present at the site would be indistinguishable from the dose that the same population would receive from naturally occurring radioactive sources. Results of the 1986 monitoring show that the WISS is in compliance with the DOE radiation protection standard. 22 refs., 8 figs., 17 tabs

  8. Utilizing the Scientist as Teacher Through the Initiating New Science Partnerships in Rural Education (INSPIRE) Program

    Science.gov (United States)

    Pierce, D.; McNeal, K. S.; Radencic, S.

    2011-12-01

    The presence of a scientist or other STEM expert in secondary school science classroom can provide fresh new ideas for student learning. Through the Initiating New Science Partnerships in Rural Education (INSPIRE) program sponsored by NSF Graduate STEM Fellows in K-12 Education (GK-12), scientists and engineers at Mississippi State University work together with graduate students and area teachers to provide hands-on inquiry-based learning to middle school and high school students. Competitively selected graduate fellows from geosciences, physics, chemistry, and engineering spend ten hours per week in participating classrooms for an entire school year, working as a team with their assigned teacher to provide outstanding instruction in science and mathematics and to serve as positive role models for the students. We are currently in the second year of our five-year program, and we have already made significant achievements in science and mathematics instruction. We successfully hosted GIS Day on the Mississippi State University campus, allowing participating students to design an emergency response to a simulated flooding of the Mississippi Delta. We have also developed new laboratory exercises for high school physics classrooms, including a 3-D electric field mapping exercise, and the complete development of a robotics design course. Many of the activities developed by the fellows and teachers are written into formal lesson plans that are made publicly available as free downloads through our project website. All participants in this program channel aspects of their research interests and methods into classroom learning, thus providing students with the real-world applications of STEM principles. In return, participants enhance their own communication and scientific inquiry skills by employing lesson design techniques that are similar to defining their own research questions.

  9. Raw material utilization in slaughterhouses – optimizing expected profit using mixed-integer programming

    DEFF Research Database (Denmark)

    Jensen, Toke Koldborg; Kjærsgaard, Niels Christian

    Slaughterhouses are major players in the pork supply chain, and supply and demand must be matched in order to generate the highest profit. In particular, carcasses must be sorted in order to produce the “right” final products from the “right” carcasses. We develop a mixed-integer programming (MIP) ...... at slaughterhouses. Finally, we comment on the expected effect of variations in the raw material supply and the demand as well as future research concerning joint modelling of supply chain aspects....

  10. Contributing to a green energy economy? A macroeconomic analysis of an energy efficiency program operated by a Swiss utility

    International Nuclear Information System (INIS)

    Yushchenko, Alisa; Patel, Martin Kumar

    2016-01-01

    Highlights: • Our input–output model allows estimating impacts of energy efficiency programs on GDP and employment in Switzerland. • We provide with a deeper insight into modeling of income impacts of energy savings with regard to input–output method. • Geneva case study demonstrates that energy efficiency programs can have positive macroeconomic impacts in Switzerland. • Our results help to understand how to enhance positive macroeconomic impacts of energy efficiency programs. • We provide policy recommendations for further development of energy efficiency programs. - Abstract: In order to enhance energy efficiency as a pillar of transition to a green energy economy it is important to understand whether and under which conditions energy efficiency programs could have positive economic and social impacts. There are a growing number of studies on macroeconomic impacts of energy efficiency programs for various countries and regions. However, in Switzerland only few evaluations have been performed. The present study evaluates the impacts on GDP and employment of Geneva’s energy efficiency program portfolio éco21 which is operated by the local utility. Two programs aiming for electricity savings in the residential sector are analyzed: Eco-sociales targets social housing and Communs d’immeubles focuses on common spaces in buildings. An input–output model is developed, based on the Swiss input–output table, program administrator data, Swiss, and European statistics. Both impacts of initial expenditure and energy cost savings are evaluated. We estimate and compare the impacts of the two programs and discuss factors that cause differences. Our results show that energy efficiency programs can have positive impacts on GDP and employment. According to our estimates, each Swiss Franc (CHF) spent within the energy efficiency program creates approximately 0.2 CHF of additional GDP compared to the reference case scenario. Net impacts on employment are

  11. Online support and education for dementia caregivers: overview, utilization, and initial program evaluation.

    Science.gov (United States)

    Glueckauf, Robert L; Ketterson, Timothy U; Loomis, Jeffrey S; Dages, Pat

    2004-01-01

    Family caregivers of older adults with progressive dementia (e.g., Alzheimer's disease) are confronted with a variety of challenges in providing assistance to their loved ones, such as dealing with persistent, repetitive questions, managing episodes of agitation and aggressive responding, as well as monitoring hygiene and self-care activities. Although professional and governmental organizations have called for the creation of community-based education and support programs, a significant proportion of dementia caregivers in the United States continue to receive little or no formal instruction in responding effectively to these anxiety-provoking situations. This paper describes the development and implementation of Alzheimer's Caregiver Support Online (also known as AlzOnline), an Internet- and telephone-based education and support network for caregivers of individuals with progressive dementia. An outcome analysis of a Robert Wood Johnson Foundation-funded strategic marketing initiative to promote the use of AlzOnline is reviewed, followed by a presentation of the findings of an initial program evaluation. Finally, future directions for online caregiver evaluation research are proposed.

  12. PRR1 rehabilitation and the current and future neutron beam utilization program

    International Nuclear Information System (INIS)

    Calix, Virginia S.

    2003-01-01

    The PRR1 research reactor is the center for nuclear science R and D in the Philippines. It is located in Metro Manila inside the campus of the University of the Philippines. It is a General Electric designed reactor and was commissioned in 1963 with a rated thermal power of 1 MW. It was operated for 20 years enabling the Institute to pursue activities in radioisotope production, neutron scattering, activation analyses and other R and D activities requiring neutron beams. In 1984 it was converted to a 3 MW TRIGA Type reactor. Conversion was completed and test run was successfully accomplished in 1988. In the same year the reactor was shut down due to a leak in the aluminum linear of the reactor pool. During the repair deterioration of the other parts of the reactor was discovered that could affect the safety of its operation. A rehabilitation program is made that include the reactor core box and all the other peripherals that could affect its safety operation and to address present regulatory concerns. Modification of the core box and its position in the pool opens opportunities and possibilities to suit specific neutron beam application for the users. Plans for this will be presented as well as the strategy of the Institute to satisfy the current need for reactor based facilities to enhanced implementation of the Country's S and T Program. (author)

  13. Using the theory of planned behavior to examine pharmacists' intention to utilize a prescription drug monitoring program database.

    Science.gov (United States)

    Fleming, Marc L; Barner, Jamie C; Brown, Carolyn M; Shepherd, Marvin D; Strassels, Scott; Novak, Suzanne

    2014-01-01

    Prescription drug monitoring programs (PDMPs) are state-operated electronic databases that contain patients' controlled drug histories. Most states provide these data to pharmacists via online web portals to combat prescription drug abuse and diversion. The objectives of this study were to: 1) explore the theory of planned behavior's (TPB) utility in predicting Texas pharmacists' intention to utilize an online accessible PDMP; 2) to determine the contribution of each construct, attitude (A), subjective norm (SN) and perceived behavioral control (PBC) in predicting pharmacists' intention; and 3) test whether the addition of perceived obligation (PO) is significantly related to pharmacists' intention. A cross-sectional, 36-item questionnaire was developed from focus groups and literature of pharmacists' views regarding prescription drug abuse. A total of 998 practicing Texas community pharmacists were surveyed to collect data on their intention to utilize a PDMP database. Descriptive statistics, multivariate and hierarchical logistic regression analyses were used to address the study objectives. The response rate was 26.2% (261/998). TPB constructs were significant predictors of pharmacists' high intention to utilize the PDMP. Pharmacists with positive attitudes were almost twice as likely to have high intention (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.2-2.8). SN was the strongest predictor of pharmacists' high intention (OR = 2.2, 95% CI = 1.4-3.3). Pharmacists with high PBC were also twice as likely to have high intention (OR = 1.9, 95% CI = 1.2-3.0). Additionally, pharmacists' PO contributed to the prediction of high intention (OR = 1.8, 95% CI = 1.0-3.1) above that explained by the TPB model constructs (X(2) = 4.14, P prescription drug abuse. Future studies that assess whether intention to use PDMPs translates to actual usage are needed to strengthen these findings. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Effects of atmospheric variability on energy utilization and conservation. [Space heating energy demand modeling; Program HEATLOAD

    Energy Technology Data Exchange (ETDEWEB)

    Reiter, E.R.; Johnson, G.R.; Somervell, W.L. Jr.; Sparling, E.W.; Dreiseitly, E.; Macdonald, B.C.; McGuirk, J.P.; Starr, A.M.

    1976-11-01

    Research conducted between 1 July 1975 and 31 October 1976 is reported. A ''physical-adaptive'' model of the space-conditioning demand for energy and its response to changes in weather regimes was developed. This model includes parameters pertaining to engineering factors of building construction, to weather-related factors, and to socio-economic factors. Preliminary testing of several components of the model on the city of Greeley, Colorado, yielded most encouraging results. Other components, especially those pertaining to socio-economic factors, are still under development. Expansion of model applications to different types of structures and larger regions is presently underway. A CRT-display model for energy demand within the conterminous United States also has passed preliminary tests. A major effort was expended to obtain disaggregated data on energy use from utility companies throughout the United States. The study of atmospheric variability revealed that the 22- to 26-day vacillation in the potential and kinetic energy modes of the Northern Hemisphere is related to the behavior of the planetary long-waves, and that the midwinter dip in zonal available potential energy is reflected in the development of blocking highs. Attempts to classify weather patterns over the eastern and central United States have proceeded satisfactorily to the point where testing of our method for longer time periods appears desirable.

  15. Program of research and development on the thorium utilization in PWRS

    International Nuclear Information System (INIS)

    1988-01-01

    Detailed investigations performed for a standard 1,300 MW e PWR show that (Th,U)O 2 and (Th,Pu)O 2 fuels can be inserted in 3 and 4 cycle operating schemes without modifications in the fuel assembly or core design. The most important aspects of the fuel cycle have been covered. Ex-gel pelletizing of (Th,U)O 2 fuel making use of available LWR and HTR fuel manufacturing technology was demonstrated. The most promising application for Th-based fuels at present was proved to be the use of recycle plutonium in extended burnup once-through fuel cycle. The program was performed in a cooperative way between Brazilian and German partners. (orig.)

  16. Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

    Science.gov (United States)

    Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

    2015-03-01

    The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

  17. Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.; Gallagher, K.C.; Hejna, D.; Rielley, K.J.

    1980-03-01

    This report is a summary of a series of preliminary reports describing the laws and regulatory programs of the United States and each of the 50 states affecting the siting and operation of energy generating facilities likley to be used in Integrated Community Energy Systems (ICES). A brief summary of public utility regulatory programs, energy facility siting programs, and municipal franchising authority is presented in this report to identify how such programs and authority may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES. Subsequent reports will (1) describe public utility rate regulatory procedures and practices as they might affect an ICES, (2) analyze each of the aforementioned regulatory programs to identify impediments to the development of ICES, and (3) recommend potential changes in legislation and regulatory practices and procedures to overcome such impediments.

  18. The interaction of fiber, supplied by distillers dried grains with solubles, with an antimicrobial and a nutrient partitioning agent on nitrogen balance, water utilization, and energy digestibility in finishing pigs.

    Science.gov (United States)

    Pilcher, C M; Arentson, R; Patience, J F

    2015-03-01

    The objective of this study was to determine if a higher-fiber diet alters the response of finishing pigs to an antimicrobial (tylosin phosphate [TP]) and a nutrient partitioning agent (ractopamine HCl [RAC]) in terms of N and water utilization and energy digestibility. Seventy-two gilts (initial BW = 107.4 ± 4.2 kg) were blocked by weight and allotted to 1 of 8 dietary treatments. Treatments were arranged as a 2 × 2 × 2 factorial: distillers dried grains with solubles (DDGS; 0 vs. 30%), RAC (0 mg of RAC/kg and 0.70% standardized ileal digestible [SID] Lys vs. 5 mg of RAC/kg and 0.95% SID Lys) and TP (0 vs. 44 mg of TP/kg). Pig was the experimental unit, with 9 replications per treatment. Pigs were housed in individual metabolism crates and fed treatment diets for 17 d. Feed was provided twice daily, as much as the pigs could consume within 1 h per meal, and water was provided to the pigs between feeding periods, ad libitum. Fecal and urine collection occurred on d 7 and 8 and on d 15 and 16, for sampling periods 1 and 2, respectively. Pigs fed the DDGS diets had reduced ADG ( interaction ( 0.10). Pigs fed DDGS diets had higher N intake ( < 0.01) and higher fecal ( < 0.0001) and urinary ( < 0.01) N excretion with no difference in N retention (g/d). Overall, RAC increased N retention by 33% ( < 0.0001) and the response to RAC was similar in both corn-soybean meal-based and corn-soybean meal-DDGS-based diets. Tylosin phosphate tended to improve growth performance in pigs fed corn-soybean meal-based diets but not in diets containing 30% DDGS; however, this response was not explained by changes in N balance or in energy digestibility.

  19. Case studies of community relations on DOE's Formerly Utilized Sites Remedial Action Program as models for Superfund sites

    International Nuclear Information System (INIS)

    Plant, S.W.; Adler, D.G.

    1995-01-01

    Ever since the US Department of Energy (DOE) created its Formerly Utilized Sites Remedial Action Program (FUSRAP) in 1974, there has been a community relations program. The community relations effort has grown as FUSRAP has grown. With 20 of 46 sites now cleaned up, considerable experience in working with FUSRAP stakeholders has been gained. Why not share that experience with others who labor on the Superfund sites? Many similarities exist between the Superfund sites and FUSRAP. FUSRAP is a large, multiple-site environmental restoration program. The challenges range from small sites requiring remedial actions measurable in weeks to major sites requiring the full remedial investigation/feasibility study process. The numerous Superfund sites throughout the United States offer the same diversity, both geographically and technically. But before DOE offers FUSRAP's community relations experience as a model, it needs to make clear that this will be a realistic model. As experiences are shared, DOE will certainly speak of the efforts that achieved its goals. But many of the problems that DOE encountered along the way will also be related. FUSRAP relies on a variety of one- and two-way communication techniques for involving stakeholders in the DOE decision-making process. Some of the techniques and experiences from the case studies are presented

  20. Blazing an evaluation pathway: lessons learned from applying utilization-focused evaluation to a conservation education program.

    Science.gov (United States)

    Flowers, Alice B

    2010-05-01

    In 2005, state fish and wildlife agency wanted to examine how one of its conservation education programs was providing science-based understanding and outdoor experiences by evaluating students' knowledge, skills, attitudes and intended behavioral outcomes related to fish, fishing and aquatic habitats in Montana. A key factor in this study was the acceptance by program stakeholders to conduct the evaluation using a utilization-focused evaluation approach to promote usability and accuracy of evaluation results. Using a quasi-experimental non-equivalent group design, more than 2000 students in participating classrooms throughout Montana received a pre-survey, post-survey and an extended post-survey; 114 teachers participated in an Internet survey and 16 program instructors took part in a structured open-ended telephone interview. The participatory approach and mixed methods enhanced abilities to interpret results of student surveys in particular. The user-focused approach was discovered to be personal and situational, allowed the facilitation of the evaluation process with consideration for increased application of evaluation findings and implementation of recommendations from beginning to end. Further development of evaluation pathways is needed to more effectively evaluate outcomes and implement practical and transferable measures to determine if environmental education activities produce desired participant outcomes. Copyright 2009 Elsevier Ltd. All rights reserved.

  1. Environmental compliance at U.S. Department of Energy FUSRAP (Formerly Utilized Sites Remedial Action Program) sites

    International Nuclear Information System (INIS)

    Liedle, S.D.; Clemens, B.W.

    1988-01-01

    With the promulgation of the Superfund Amendments and Reauthorization Act (SARA), federal facilities were required to comply with the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) in the same manner as any non-government entity. This presented challenges for the Department of Energy (DOE) and other federal agencies involved in remedial action work because there are many requirements under SARA that overlap other laws requiring DOE compliance, e.g., the National Environmental Policy Act (NEPA). This paper outlines the options developed to comply with CERCLA and NEPA as part of active, multi-site remedial action program. The program, the Formerly Utilized Sites Remedial Action Program (FUSRAP), was developed to identify, clean up, or control sites containing residual radioactive or chemical contamination as a result of the nation's early development of nuclear power. During the Manhattan Project, uranium was extracted from ores and resulted in mill concentrates, purified metals, and waste products that were transported for use or disposal at other locations. Figure 1 shows the steps for producing uranium metal during the Manhattan Project. As a result of these activities materials, equipment, buildings, and land became contaminated, primarily with naturally occurring radionuclides. Currently, FUSRAP includes 29 sites; three are on the Environmental Protection Agency's (EPA's) National Priorities List (NPL) of hazardous waste sites

  2. Using Logarithmic Fuzzy Preference Programming To Prioritization Social Media Utilization Based On Tourists’ Perspective

    Directory of Open Access Journals (Sweden)

    Balouchi Mina

    2015-06-01

    Full Text Available The advent of Web 2.0 or social media technologies gives travelers a chance to access quickly and conveniently to a mass of travel-related information. This study investigates the importance of social media in travel process in three different phases (pre-visit, on site, post-visit from the perspective of Iranian travelers. It is worthwhile to know the level of influence of social media on respondents’ travel behavior. Logarithmic fuzzy preference programming methodology is used in this article to determine the importance of social media usage in each phase of travel process and its subcategories. Fuzzy analytic hierarchy process methodology, based on Chang’s Fuzzy Extent Analysis is also used for the data analysis, then the results of these two methods are presented for comparison and better understanding. The results of this study suggest that the most usage of social media is on pre-visit phase while post-visit has the least usage. This study shows that Iranian travelers use social media mainly to share experiences (post-visit phase, get help in different circumstances and gain travel advice.

  3. Defense by-products production and utilization program: noble metal recovery screening experiments

    International Nuclear Information System (INIS)

    Hazelton, R.F.; Jensen, G.A.; Raney, P.J.

    1986-03-01

    Isotopes of the platinum metals (rutheium, rhodium, and palladium) are produced during uranium fuel fission in nuclear reactors. The strategic values of these noble metals warrant considering their recovery from spent fuel should the spent fuel be processed after reactor discharge. A program to evaluate methods for ruthenium, rhodium, and palladium recovery from spent fuel reprocessing liquids was conducted at Pacific Northwest Laboratory (PNL). The purpose of the work reported in this docuent was to evaluate several recovery processes revealed in the patent and technical literature. Beaker-scale screening tests were initiated for three potential recovery processes: precipitation during sugar denitration of nitric acid reprocessing solutions after plutonium-uranium solvent extraction, adsorption using nobe metal selective chelates on active carbon, and reduction forming solid noble metal deposits on an amine-borane reductive resin. Simulated reprocessing plant solutions representing typical nitric acid liquids from defense (PUREX) or commercial fuel reprocessing facilities were formulated and used for evaluation of the three processes. 9 refs., 3 figs., 9 tabs

  4. Utility of Walk Tests in Evaluating Functional Status Among Participants in an Outpatient Cardiac Rehabilitation Program.

    Science.gov (United States)

    Harris, Kristie M; Anderson, Derek R; Landers, Jacob D; Emery, Charles F

    2017-09-01

    Although walk tests are frequently used in cardiac rehabilitation (CR), no prior study has evaluated the capacity of these measures to predict peak oxygen uptake during exercise testing ((Equation is included in full-text article.)O2peak). This study evaluated the interrelationship of objective measures of exercise performance (walk and exercise testing) among patients entering CR as well as a novel measure of functional status assessment for use in CR. Forty-nine patients (33 males) referred to an outpatient CR program were evaluated with objective measures of ambulatory functional status (peak oxygen uptake [(Equation is included in full-text article.)O2peak], 6-minute walk test [6MWT], and 60-ft walk test [60ftWT]). All measures of functional status were moderately to highly intercorrelated (r values from 0.50 to 0.88; P values text article.)O2peak and other measures. Measures of functional status, including (Equation is included in full-text article.)O2peak, 6MWT, and 60ftWT, were highly correlated among CR patients, suggesting the plausibility of using them interchangeably to fit the needs of the patient and testing environment. Among women, walk tests may not be appropriate substitutes for (Equation is included in full-text article.)O2peak. Because of the brevity of the 60ftWT, it may be particularly useful for measuring functional status in patients with greater symptoms and those with comorbidities limiting walking.

  5. Utilizing job/task analysis to establish content validity in the design of training programs

    Energy Technology Data Exchange (ETDEWEB)

    Nay, W.E.

    1988-01-01

    The decade of the 1980's has been a turbulent time for the Department of Energy. With concern mounting about the terrorist threat, a wave of congressional inquiries and internal inspections crossed the nation and engulfed many of the nuclear laboratories and facilities operated by DOE contractors. A typical finding was the need to improve, and increase, the training of the protective force. The immediate reaction resulted in a wide variety of responses, with most contractors feeling safer with too much, rather than not enough training. As soon as the initial pressures to upgrade subsided, a task force was established to evaluate the overall training needs. Representatives from the contractor facilities worked together to conduct a job analysis of the protective force. A generic task inventory was established, and validated at the different sites. This list has been invaluable for determining the tasks, conditions, and standards needed to develop well stated learning objectives. The enhanced training programs are being refined to ensure job content validity based on the data collected.

  6. Farmers' Market Utilization among Supplemental Nutrition Assistance Program Recipients in New Orleans, Louisiana: Preliminary Findings.

    Science.gov (United States)

    Nuss, Henry; Skizim, Meg; Afaneh, Hasheemah; Miele, Lucio; Sothern, Melinda

    2017-01-01

    Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor and underserved communities. However, farmers' market (FM) use remains low among low-income patrons. The purpose of our study was to examine FM awareness and use, grocery shopping behaviors, and internet use among Supplemental Nutrition Assistance Program (SNAP) recipients. A descriptive analysis of preliminary data was performed to evaluate quantitative baseline data among SNAP recipients between June and August 2016 in New Orleans, Louisiana (N=51). Data were collected via a 42-item online survey that included demographics, internet use, FM awareness and use, health information seeking behaviors and fruit and vegetable purchasing behaviors. Less than half of the survey respondents (n=24) had ever been to a FM. Local grocery stores and Wal-Mart were most used for purchasing fruits and vegetables (88% and 84%, respectively). The most common sources of healthy eating information were Women, Infants and Children (WIC) and the internet, frequently accessed via smartphones. More than 80% of participants were not aware that local FMs accepted electronic benefit transfer payments as a form of payment. These results support the incorporation of promotional methodology that combines internet-based mobile technology and existing services (eg, WIC) as a viable strategy to improve farmers' market use among low-income populations. As most participants were not aware that participating FMs accept electronic benefit transfer payments, this fact should be emphasized in promotional material.

  7. Optimizing antimicrobial therapy in critically ill patients

    Directory of Open Access Journals (Sweden)

    Vitrat V

    2014-10-01

    Full Text Available Virginie Vitrat,1 Serge Hautefeuille,2 Cécile Janssen,1 David Bougon,2 Michel Sirodot,2 Leonardo Pagani1,3 1Antimicrobial Stewardship Program, Infectious Diseases Unit, 2Intensive Care Unit, Annecy-Genevois Hospital Center (CHANGE, Annecy, France; 3Infectious Diseases Unit, Bolzano Central Hospital, Bolzano, Italy Abstract: Critically ill patients with infection in the intensive care unit (ICU would certainly benefit from timely bacterial identification and effective antimicrobial treatment. Diagnostic techniques have clearly improved in the last years and allow earlier identification of bacterial strains in some cases, but these techniques are still quite expensive and not readily available in all institutions. Moreover, the ever increasing rates of resistance to antimicrobials, especially in Gram-negative pathogens, are threatening the outcome for such patients because of the lack of effective medical treatment; ICU physicians are therefore resorting to combination therapies to overcome resistance, with the direct consequence of promoting further resistance. A more appropriate use of available antimicrobials in the ICU should be pursued, and adjustments in doses and dosing through pharmacokinetics and pharmacodynamics have recently shown promising results in improving outcomes and reducing antimicrobial resistance. The aim of multidisciplinary antimicrobial stewardship programs is to improve antimicrobial prescription, and in this review we analyze the available experiences of such programs carried out in ICUs, with emphasis on results, challenges, and pitfalls. Any effective intervention aimed at improving antibiotic usage in ICUs must be brought about at the present time; otherwise, we will face the challenge of intractable infections in critically ill patients in the near future. Keywords: ICU, antimicrobial therapies, antimicrobial stewardship, pharmacokinetics, pharmacodynamics, antimicrobial resistance, early diagnosis

  8. Frequent major errors in antimicrobial susceptibility testing of bacterial strains distributed under the Deutsches Krebsforschungszentrum Quality Assurance Program.

    Science.gov (United States)

    Boot, R

    2012-07-01

    The Quality Assurance Program (QAP) of the Deutsches Krebsforschungszentrum (DKFZ) was a proficiency testing system developed to service the laboratory animal discipline. The QAP comprised the distribution of bacterial strains from various species of animals for identification to species level and antibiotic susceptibility testing (AST). Identification capabilities were below acceptable standards. This study evaluated AST results using the DKFZ compilations of test results for all bacterial strains showing the number of participants reporting the strain as resistant (R), sensitive (S) or intermediate susceptible (I) to each antibiotic substance used. Due to lack of information about methods used, it was assumed that what the majority of the participants reported (R or S) was the correct test result and that an opposite result was a major error (ME). MEs occurred in 1375 of 14,258 (9.7%) of test results and ME% ranged from 0% to 23.2% per bacterial group-agent group combination. Considerable variation in MEs was found within groups of bacteria and within groups of agents. In addition to poor performance in proper species classification, the quality of AST in laboratory animal diagnostic laboratories seems far below standards considered acceptable in human diagnostic microbiology.

  9. Green power programs in Canada : 2003 : overview of Government green power policies, utility green power implementation initiatives, green power and certificate marketing programs, and their benefits

    International Nuclear Information System (INIS)

    Whitmore, J.; Bramley, M.; Holmes, R.

    2004-09-01

    Green power is defined as electricity produced from renewable sources, and whose production has low adverse impacts on the environment, human health and communities. Green power has near-zero greenhouse gas (GHG) emissions and includes sources such as wind, hydro, and solar power. It offers several environmental benefits, as well as the enhancement of energy security, regional development, economic diversification and the creation of skilled jobs. There are four categories of programs related to green power development in Canada: government green power policies, utility green power development programs, green power marketing initiatives, and green power certificate marketing initiatives. Most of the activities in Canada associated with these four categories in 2003 were discussed in this report. However, difficulties with quantification prevented the inclusion of some green power activities such as (1) the generation of green power not certified or identified by the generator as green power, (2) industry or residential self-generation, (3) net metering, and (4) small government programs. Green power generation facilities in 2003 totaled 775 MW of capacity compared to 539 MW in 2002. Hydro capacity represented 41 per cent, followed by wind capacity at 40 per cent and wood waste at 17 per cent. Most of the green power generation facilities in 2003 were located in Alberta, followed by British Columbia, Ontario and Quebec. 230 refs., 8 tabs., 1 fig

  10. Thorium utilization program. Quarterly progress report for the period ending November 30, 1975

    International Nuclear Information System (INIS)

    1975-01-01

    The development program for HTGR fuel reprocessing continues to emphasize the design and construction of a prototype head-end line. Design work on the multistage crushing system, the primary and secondary fluidized bed burners, the pneumatic transfer systems, and the ancillary fixtures for semiremote assembly and disassembly is essentially complete. Fabrication and receipt of all major components is under way, and auxiliary instrumentation and support systems are being installed. Studies of flow characteristics of granular solids in pneumatic transfer systems are continuing and data are being collected for use in design of systems for solids handling. Experimental work on the 20-cm primary fluidized bed burner verified the fines recycle operating mode in runs of greater than 24 hr. Twelve leaching runs were performed during the quarter using crushed, burned-back TRISO coated ThC 2 particles and burned-back BISO coated sol gel ThO 2 particles to examine the effect of varying the Thorex-to-thoria ratio to give product solutions ranging from 0.25M to 1M in thorium. Only minor effects were observed and reference values for facility operations were specified. Two-stage leaching runs with burned-back ThC 2 indicate there are no measurable differences in total dissolution time as compared to single-stage leaching. Bench-scale tests on oxidation of HTGR fuel boron carbide at 900 0 C indicates that most if not all of the carbide will be converted to boron oxide in the fluidized bed burner. Eight solvent extraction runs were completed during the quarter. These runs represented the first cycle and second uranium cycle of the acid-Thorex flowsheet. A detailed calculation of spent fuel compositions by fuel block and particle type is being performed for better definition of process streams in a fuel reprocessing facility

  11. Vigilancia de la resistencia a los antibacterianos en Argentina. Programa WHONET, 1995-1996 Monitoring antimicrobial resistance in Argentina: the WHONET program, 1995-1996

    Directory of Open Access Journals (Sweden)

    Alicia Rossi

    1999-10-01

    %, respectivamente. Se detectó resistencia a las cefalosporinas de tercera generación en 40% de los aislados de Salmonella spp. recuperados en hospitales pediátricos. En casos de meningitis bacteriana, las tasas de resistencia de Streptococcus pneumoniae a la penicilina (18% y de Haemophilus influenzae a la ampicilina (19% se situaron en el rango intermedio de las descritas en países americanos y europeos.The World Health Organization has implemented a surveillance program for antimicrobial resistance that is known as WHONET. In Argentina the program was developed through a network of 23 public and private hospitals that participate in national and international quality-control programs. Between January 1995 and December 1996, the antimicrobial susceptibility of 16 073 consecutive clinical isolates was determined, using the recommended standards of the National Committee for Clinical Laboratory Standards of the United States of America. More than half of the Escherichia coli urinary isolates were resistant to ampicillin and more than 30% to trimethoprim/sulfamethoxazole (SXT. When the percentage of resistant isolates from outpatients (OPs was compared to that observed in hospitalized patients (HPs, a marked difference in antimicrobial activity was noted in the case of gentamicin (2% from OPs resistant vs. 8% from HPs resistant, norfloxacin (2% vs. 6%, and third-generation cephalosporins (7% vs. 15%. Of the Klebsiella pneumoniae isolates recovered from blood cultures, 71% and 60% showed resistance to third-generation cephalosporins and to gentamicin, respectively. The overall rate of oxacillin resistance in Staphylococcus aureus was 39%. Around half of the Enterococcus spp. isolates showed high resistance to aminoglycosides, but resistance to glycopeptides was not found. In Argentina, ampicillin and SXT were not suitable for treating diarrhea. Shigella flexneri had a higher number of isolates resistant to both of those drugs (87% and 74%, respectively than Sh. sonnei did (47% and

  12. A prior authorization program of a radiology benefits management company and how it has affected utilization of advanced diagnostic imaging.

    Science.gov (United States)

    Levin, David C; Bree, Robert L; Rao, Vijay M; Johnson, Jean

    2010-01-01

    Radiology benefits management companies have evolved in recent years to meet the need to control the rapid growth in advanced diagnostic imaging. The Obama administration and other key policymakers have proposed using them as a cost-control mechanism, but little is known about how they operate or what results they have produced. The main tool they use is prior authorization. The authors describe the inner workings of the call center of one radiology benefits management company and how its prior authorization program seems to have slowed the growth in the utilization of MRI, CT, and PET in the large markets of one commercial payer. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Establishment and utilization of radiological protection programs for the transport of radioactive material

    International Nuclear Information System (INIS)

    Lopez V, J.; Capadona, N.

    2006-01-01

    The present work has by objective to indicate rules for the establishment and the use of the Radiological Protection Programs (PPR) that are of application to the transport of radioactive materials according to that required by the Transport Regulation of the International Atomic Energy Agency (IAEA). The PPR are established and applied in systematic form for remittent, transport and addressees, to consider the measures of radiological protection and its appropriately control during the transport stages of radioactive material. In particular, in the work it is analyzed the PPR applied to the operative stage, in the one that can be considered as one of the more important documents to use since it summarizes the evaluations and the necessary controls of radiological protection. Also it is analyzed the importance that this document gets ready on the base that it converges in the the analyses, evaluations and data that have been kept in mind during the previous stages of design of bundles and production of packings, the types and quantities of involved bundles, as well as of considering the quantities of expeditions and its frequencies, the ways of transport, etc. It is included a brief description of the parts that the PPR conforms on the base of that suggested in the advanced draft of the TS-G-1.5 Guide 'Radiation Protection Programmes for Transport of Radioactive Material', of October, 2005, of the IAEA: objectives. necessity, scope, basic elements of a PPR in function of the occupational dose. assignment of functions and responsibilities for the establishment of a PPR, evaluation and dose optimization, surface contamination, segregation and other protection measures, responses in emergencies. training and administration systems for baled and transport of radioactive material. Next an example of PPR for the transport of bundles of the A Type by lorry with content of radiopharmaceuticals that are the bundles more used worldwide in the expeditions of radioactive

  14. Extension of the hybrid linear programming method to optimize simultaneously the design and operation of groundwater utilization systems

    Science.gov (United States)

    Bostan, Mohamad; Hadi Afshar, Mohamad; Khadem, Majed

    2015-04-01

    This article proposes a hybrid linear programming (LP-LP) methodology for the simultaneous optimal design and operation of groundwater utilization systems. The proposed model is an extension of an earlier LP-LP model proposed by the authors for the optimal operation of a set of existing wells. The proposed model can be used to optimally determine the number, configuration and pumping rates of the operational wells out of potential wells with fixed locations to minimize the total cost of utilizing a two-dimensional confined aquifer under steady-state flow conditions. The model is able to take into account the well installation, piping and pump installation costs in addition to the operational costs, including the cost of energy and maintenance. The solution to the problem is defined by well locations and their pumping rates, minimizing the total cost while satisfying a downstream demand, lower/upper bound on the pumping rates, and lower/upper bound on the water level drawdown at the wells. A discretized version of the differential equation governing the flow is first embedded into the model formulation as a set of additional constraints. The resulting mixed-integer highly constrained nonlinear optimization problem is then decomposed into two subproblems with different sets of decision variables, one with a piezometric head and the other with the operational well locations and the corresponding pumping rates. The binary variables representing the well locations are approximated by a continuous variable leading to two LP subproblems. Having started with a random value for all decision variables, the two subproblems are solved iteratively until convergence is achieved. The performance and ability of the proposed method are tested against a hypothetical problem from the literature and the results are presented and compared with those obtained using a mixed-integer nonlinear programming method. The results show the efficiency and effectiveness of the proposed method for

  15. Antimicrobial commodities. 3. Antimicrobial treatment for plastics; Kokin seikatsu yohin. 3. Kokin plastic

    Energy Technology Data Exchange (ETDEWEB)

    Tomioka, T. [Matsushita Electric Industrial Co. Ltd., Osaka (Japan)

    1998-06-01

    This paper describes antimicrobial plastics. Antimicrobial agents may sometimes be used to maintain cleanliness on surface of plastics. The antimicrobial agents can be divided into organic agents including natural substance systems and inorganic materials. The organic agents are volatile, can retain their effects even if dust is deposited on the surface, and are utilized as anti-fungus agents. The inorganic systems, which are heat resistant, can withstand plastics molding temperatures, and are used kneaded with plastic materials. The inorganic systems use silver or silver complex, copper and zinc carried or displaced in inorganic oxides. Properties of the carriers produce different features. The action mechanism of a silver antimicrobial agent uses active oxidization of plastic surface by means of catalytic action of silver, and enzymatic inhibition of silver ions. Antimicrobial treatment methods include mixing and kneading with resins, and surface coating. Antimicrobial agents can include those having high reactivity against resins, whereas the antimicrobial treatment and the mold processing must be conceived independently and cooperatively. What is important is not simply the initial antimicrobial characteristics, but their sustainability. Their using environment and required antimicrobial performance require adequate evaluation and verification. 4 refs., 12 figs., 8 tabs.

  16. Prevalence and antimicrobial resistance among Escherichia coli and Salmonella in Ontario smallholder chicken flocks.

    Science.gov (United States)

    Lebert, L; Martz, S-L; Janecko, N; Deckert, A E; Agunos, A; Reid, A; Rubin, J E; Reid-Smith, R J; McEwen, S A

    2018-02-01

    Surveillance is an important component of an overall strategy to address antimicrobial resistant bacteria in food animals and the food chain. The poultry market has many points of entry into the Canadian food chain, and some production practices are underrepresented in terms of surveillance. For example, pathogen carriage and antimicrobial resistance surveillance data are limited in smallholder chicken flocks raised for slaughter at provincially inspected abattoirs. In Canada, antimicrobial resistance in Escherichia coli and Salmonella isolated from commercial broiler chicken flocks, slaughtered at federally inspected abattoirs, is monitored by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The objective of this study was to establish baseline information of antimicrobial resistance presence in E. coli and Salmonella isolated from smallholder flocks in Ontario, utilizing CIPARS collection and isolation methodologies, and to compare findings with CIPARS federally inspected abattoir data from Ontario, Canada. Five chickens per flock were sampled from 205 smallholder flocks. Of 1,025 samples, the E. coli prevalence was 99% (1,022/1,025), and 47% (483/1,022) of positive E. coli isolates were resistant to one or more of the 14 antimicrobials. Furthermore, as compared to results reported for the CIPARS commercial flocks, E. coli isolates from smallholder flocks had significantly lower resistance prevalence to six of 14 individual antimicrobials. Recovery of E. coli did not differ between federally inspected and provincially inspected flocks. Salmonella prevalence at the bird level in smallholder flocks was 0.3% (3/1,025), significantly lower (p ≪ 0.0001, 95% CI 0.080%-0.86%) than federally inspected commercial flocks. The overall differences found between the commercial and smallholder flocks may be explained by differences in poultry husbandry practices and hatchery sources. © 2017 Her Majesty the Queen in Right of Canada

  17. Integron, Plasmid and Host Strain Characteristics of Escherichia coli from Humans and Food Included in the Norwegian Antimicrobial Resistance Monitoring Programs.

    Directory of Open Access Journals (Sweden)

    Marianne Sunde

    Full Text Available Antimicrobial resistant Escherichia coli (n=331 isolates from humans with bloodstream infections were investigated for the presence of class 1 and class 2 integrons. The integron cassettes arrays were characterized and the findings were compared with data from similar investigations on resistant E. coli from meat and meat products (n=241 produced during the same time period. All isolates were obtained from the Norwegian monitoring programs for antimicrobial resistance in human pathogens and in the veterinary sector. Methods used included PCR, sequencing, conjugation experiments, plasmid replicon typing and subtyping, pulsed-field-gel-electrophoresis and serotyping. Integrons of class 1 and 2 occurred significantly more frequently among human isolates; 45.4% (95% CI: 39.9-50.9 than among isolates from meat; 18% (95% CI: 13.2 -23.3, (p<0.01, Chi-square test. Identical cassette arrays including dfrA1-aadA1, aadA1, dfrA12-orfF-aadA2, oxa-30-aadA1 (class 1 integrons and dfrA1-sat1-aadA1 (class 2 integrons were detected from both humans and meat. However, the most prevalent cassette array in human isolates, dfrA17-aadA5, did not occur in isolates from meat, suggesting a possible linkage between this class 1 integron and a subpopulation of E. coli adapted to a human host. The drfA1-aadA1 and aadA1 class 1 integrons were found frequently in both human and meat isolates. These isolates were subjected to further studies to investigate similarities with regard to transferability, plasmid and host strain characteristics. We detected incF plasmids with pMLST profile F24:A-:B1 carrying drfA1-aadA1 integrons in isolates from pork and in a more distantly related E. coli strain from a human with septicaemia. Furthermore, we showed that most of the class 1 integrons with aadA1 were located on incF plasmids with pMLST profile F51:A-:B10 in human isolates. The plasmid was present in unrelated as well as closely related host strains, demonstrating that dissemination

  18. Environmental audit of the Maywood Site: Formerly Utilized Sites Remedial Action Program, Maywood Interim Storage Site vicinity properties

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-01

    This report presents the results of the Environmental Audit of the Maywood Site managed by the Formerly Utilized Sites Remedial Action Program (FUSRAP). The Audit was carried out from November 7 through 16, 1990. The Audit Team found overall technical competence and knowledge of management and staff to be excellent. This applies to DOE as well as to Bechtel National, Incorporated (BNI). In particular, there was excellent knowledge of federal, state, and local environmental regulations, as well as analysis for applicability of these regulations to FUSRAP. Project management of the Maywood Site is also excellent. BNI and DOE project staff have made frequent contact with members of the community, and all removal actions and remedial investigation activities have been planned, scheduled, and accomplished with competence and attention to total quality principles. To date, all actions taken for the Maywood Site cleanup have been completed ahead of schedule and on or under budget. Weakness noted include self-assessment efforts by DOE, failure to fully implement DOE Order requirements throughout the program, and some discrepancies in formally documenting and reviewing procedures. 7 figs., 10 tabs.

  19. Vicinity Property Assessments at Formerly Utilized Sites Remedial Action Program Project Sites in the New York District - 13420

    International Nuclear Information System (INIS)

    Ewy, Ann; Hays, David

    2013-01-01

    The Formerly Utilized Sites Remedial Action Program (FUSRAP) has addressed sites across the nation for almost 4 decades. Multiple stake holder pressures, multiple regulations, and process changes occur over such long time periods. These result in many challenges to the FUSRAP project teams. Initial FUSRAP work was not performed under Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Records of Decision (ROD). The ROD identifies the remedy decision and ultimately the criteria to be used to release a site. Early FUSRAP projects used DOE Orders or the Uranium Mill Tailings Radiation Control Act (UMTRCA) standards. Under current RODs, regulations may differ, resulting in different cleanup criteria than that used in prior Vicinity Property (VP) remediation. The USACE, in preparation for closeout of Sites, conducts reviews to evaluate whether prior actions were sufficient to meet the cleanup criteria specified in the current ROD. On the basis of these reviews, USACE has conducted additional sampling, determined that prior actions were sufficient, or conducted additional remediation consistent with the selected remedy in the ROD. As the public pressures, regulations, and processes that the FUSRAP encounters continue to change, the program itself continues to evolve. Assessment of VPs at FUSRAP sites is a necessary step in the life cycle of our site management. (authors)

  20. Antimicrobial Stewardship in Acute Care Centres: A Survey of 68 Hospitals in Quebec

    Directory of Open Access Journals (Sweden)

    Vincent Nault

    2008-01-01

    Full Text Available BACKGROUND: Antimicrobial stewardship programs (ASPs and quantitative monitoring of antimicrobial use are required to ensure that antimicrobials are used appropriately in the acute care setting, and have the potential to reduce costs and limit the spread of antimicrobial-resistant organisms and Clostridium difficile. Currently, it is not known what proportion of Quebec hospitals have an ASP and/or monitor antimicrobial use.

  1. An Assessment Model for Energy Efficiency Program Planning in Electric Utilities: Case of the Pacific of Northwest U.S.A

    Science.gov (United States)

    Iskin, Ibrahim

    Energy efficiency stands out with its potential to address a number of challenges that today's electric utilities face, including increasing and changing electricity demand, shrinking operating capacity, and decreasing system reliability and flexibility. Being the least cost and least risky alternative, the share of energy efficiency programs in utilities' energy portfolios has been on the rise since the 1980s, and their increasing importance is expected to continue in the future. Despite holding great promise, the ability to determine and invest in only the most promising program alternatives plays a key role in the successful use of energy efficiency as a utility-wide resource. This issue becomes even more significant considering the availability of a vast number of potential energy efficiency programs, the rapidly changing business environment, and the existence of multiple stakeholders. This dissertation introduces hierarchical decision modeling as the framework for energy efficiency program planning in electric utilities. The model focuses on the assessment of emerging energy efficiency programs and proposes to bridge the gap between technology screening and cost/benefit evaluation practices. This approach is expected to identify emerging technology alternatives which have the highest potential to pass cost/benefit ratio testing procedures and contribute to the effectiveness of decision practices in energy efficiency program planning. The model also incorporates rank order analysis and sensitivity analysis for testing the robustness of results from different stakeholder perspectives and future uncertainties in an attempt to enable more informed decision-making practices. The model was applied to the case of 13 high priority emerging energy efficiency program alternatives identified in the Pacific Northwest, U.S.A. The results of this study reveal that energy savings potential is the most important program management consideration in selecting emerging energy

  2. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  3. Evaluation of the pilot program on the real-time drug utilization review system in South Korea.

    Science.gov (United States)

    Heo, Ji Haeng; Suh, Dong Churl; Kim, Sukil; Lee, Eui-Kyung

    2013-10-01

    A pilot drug utilization review (DUR) program was initiated by the Korean government, which provided safety information in real-time at the stage of prescribing and dispensing. This study aimed to compare the "physician/pharmacist Co-DUR" system and the traditional "pharmacist-only DUR" system. Data collected during a DUR pilot program from July 1 to October 31 of 2009 were obtained from the Health Insurance Review & Assessment Service. Descriptive analyses were conducted to investigate DUR-pop up alert rates, categories of alerts, the reasons for dispensing without prescription change after an alert, and changes in drug expenditures associated with the DUR. DUR pop-up alert rates were 8.55% at clinics and 1.90% at pharmacies in the physician/pharmacist Co-DUR, whereas the rate was 2.22% in the pharmacist-only DUR. Rates of pop-up alerts were high for between-prescription ingredient duplication at pharmacies, whereas for clinics, the rate for drug-pregnancy contraindications was high. A greater reduction in drug expenditure was estimated in the physician/pharmacist Co-DUR compared to the pharmacist-only DUR. The physician/pharmacist Co-DUR has better sensitivity at detecting potential adverse drug events than the pharmacist-only DUR. Pharmacists also have opportunities to double-check prescribed drugs when doctors do not voluntarily modify pop-up alerts. Further comprehensive study will be needed to confirm the results of pilot program that favored the physician/pharmacist Co-DUR. Copyright © 2013. Published by Elsevier Ireland Ltd.

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

    Science.gov (United States)

    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

  5. Waste Resources Utilization program

    International Nuclear Information System (INIS)

    Anon.

    1975-01-01

    The effectiveness of thermoradiation (simultaneous use of heat and ionizing radiation) as a treatment for ridding sewage sludge of pathogenic organisms is being studied. The feasibiity of treating sewage sludge with thermoradiation to the ultimate benefit of society depends on a number of factors. For any proposed use of the sludge, the degree of thermoradiation treatment needed must be determined. This involves biological studies of major classes of organisms in sewage sludge. The cost of such a treatment versus the value of the benefits from sludge usage must be assessed. To do this realistically optimal treatment facilities must be designed, and actual sludge use assessment must be made. (LK)

  6. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... version) Arabic Translation of Animation of Antimicrobial Resistance Chinese Translation of Animation of Antimicrobial Resistance French Translation ... FEAR Act Site Map Nondiscrimination Website Policies U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver ...

  7. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Medicine (CVM) produced a nine-minute animation explaining how antimicrobial resistance both emerges and proliferates among bacteria. ... concept more understandable to non-scientists by showing how bacterial antimicrobial resistance can develop and spread. All ...

  8. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share ...

  9. Antimicrobial stewardship: attempting to preserve a strategic resource

    Directory of Open Access Journals (Sweden)

    Trevor Van Schooneveld, Md

    2011-07-01

    Full Text Available Antimicrobials hold a unique place in our drug armamentarium. Unfortunately the increase in resistance among both gram-positive and gram-negative pathogens coupled with a lack of new antimicrobial agents is threatening our ability to treat infections. Antimicrobial use is the driving force behind this rise in resistance and much of this use is suboptimal. Antimicrobial stewardship programs (ASP have been advocated as a strategy to improve antimicrobial use. The goals of ASP are to improve patient outcomes while minimizing toxicity and selection for resistant strains by assisting in the selection of the correct agent, right dose, and best duration. Two major strategies for ASP exist: restriction/pre-authorization that controls use at the time of ordering and audit and feedback that reviews ordered antimicrobials and makes suggestions for improvement. Both strategies have some limitations, but have been effective at achieving stewardship goals. Other supplemental strategies such as education, clinical prediction rules, biomarkers, clinical decision support software, and institutional guidelines have been effective at improving antimicrobial use. The most effective antimicrobial stewardship programs have employed multiple strategies to impact antimicrobial use. Using these strategies stewardship programs have been able to decrease antimicrobial use, the spread of resistant pathogens, the incidence of C. difficile infection, pharmacy costs, and improved patient outcomes.

  10. Occurrence of antimicrobial resistance among bacterial pathogens

    OpenAIRE

    Hendriksen, Rene S.; Mevius, Dik J.; Schroeter, Andreas; Teale, Christopher; Jouy, Eric; Butaye, Patrick; Franco, Alessia; Utinane, Andra; Amado, Alice; Moreno, Miguel; Greko, Christina; Stärk, Katharina D.C.; Berghold, Christian; Myllyniemi, Anna-Liisa; Hoszowski, Andrzej

    2008-01-01

    Background: The project "Antibiotic resistance in bacteria of animal origin – II" (ARBAO-II) was funded by the European Union (FAIR5-QLK2-2002-01146) for the period 2003–05. The aim of this project was to establish a program for the continuous monitoring of antimicrobial susceptibility of pathogenic and indicator bacteria from food animals using validated and harmonised methodologies. In this report the first data on the occurrence of antimicrobial resistance among bacteria cau...

  11. Polymeric Systems of Antimicrobial Peptides—Strategies and Potential Applications

    Directory of Open Access Journals (Sweden)

    Ewa Olędzka

    2013-11-01

    Full Text Available The past decade has seen growing interest in the investigation of peptides with antimicrobial activity (AMPs. One approach utilized in infection control is incorporation of antimicrobial agents conjugated with the polymers. This review presents the recent developments on polymeric AMP carriers and their potential applications in the biomedical and pharmaceutical fields.

  12. Retrospective Evaluation of Pharmacist Interventions on Use of Antimicrobials Using a Clinical Surveillance Software in a Small Community Hospital

    Directory of Open Access Journals (Sweden)

    Samuel R. Huber

    2016-10-01

    Full Text Available The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America “Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship” recommend the use of computer-based surveillance programs for efficient and thorough identification of potential interventions as part of an antimicrobial stewardship program (ASP. This retrospective study examined the benefit of utilizing a clinical surveillance software program to help guide antimicrobial therapy in an inpatient setting, in a small community hospital, without a formal ASP. The electronic health record (EHR was used to retrieve documentations for the following types of antibiotic interventions: culture surveillance, duplicate therapy, duration of therapy and renal dose adjustments. The numbers of interventions made during the three-month periods before and after implementation of the clinical surveillance software were compared. Antibiotic related interventions aggregated to 144 and 270 in the pre- and post-implementation time frame, respectively (p < 0.0001. The total number of antibiotic interventions overall and interventions in three of the four sub-categories increased significantly from the pre-implementation to post-implementation period. Clinical surveillance software is a valuable tool to assist pharmacists in evaluating antimicrobial therapy.

  13. ANTIMICROBIAL HERBAL DRUGS

    OpenAIRE

    K. Nishteswar

    2011-01-01

    An anti-microbial is a substance that kills or inhibits the growth of microorganisms such as bacteria, fungi, or protozoans. Antimicrobial drugs either kill microbes (microbiocidal) or prevent the growth of microbes (microbiostatic). Sulphonamide drugs were the first antimicrobial drugs, and paved the way for the antibiotic revolution in medicine. The first sulfonamide, trade named Prontosil, was actually a prodrug. However, with the development of antimicrobials, microorganisms have adapted ...

  14. Long-term impact of a chronic disease management program on hospital utilization and cost in an Australian population with heart disease or diabetes.

    Science.gov (United States)

    Hamar, G Brent; Rula, Elizabeth Y; Coberley, Carter; Pope, James E; Larkin, Shaun

    2015-04-22

    To evaluate the longitudinal value of a chronic disease management program, My Health Guardian (MHG), in reducing hospital utilization and costs over 4 years. The MHG program provides individualized support via telephonic nurse outreach and online tools for self-management, behavior change and well-being. In follow up to an initial 18-month analysis of MHG, the current study evaluated program impact over 4 years. A matched-cohort analysis retrospectively compared MHG participants with heart disease or diabetes (treatment, N = 4,948) to non-participants (comparison, N = 28,520) on utilization rates (hospital admission, readmission, total bed days) and hospital claims cost savings. Outcomes were evaluated using regression analyses, controlling for remaining demographic, disease, and pre-program admissions or cost differences between the study groups. Over the 4 year period, program participation resulted in significant reductions in hospital admissions (-11.4%, P hospital claims was $3,549 over 4-years; savings values for each program year were significant and increased with time (P = 0.003 to P hospital utilization and costs for individuals with heart disease or diabetes and demonstrate the increasing program effect with continued participation over time.

  15. Beyond the Price Effect in Time-of-Use Programs: Results from a Municipal Utility Pilot, 2007-2008

    Energy Technology Data Exchange (ETDEWEB)

    Lutzenhiser, Susan; Peters, Jane; Moezzi, Mithra; Woods, James

    2009-08-12

    This paper discusses results of a two-year collaborative research project between the authors and the Demand Response Research Center focused on behavioral response to a voluntary time-of-use pilot rate offered by the Sacramento Municipal Utilities District (SMUD) under the PowerChoice label. The project had two purposes: one was to assess the potential for increasing demand response through the introduction of enhanced information and real-time consumption feedback; the second was to better understand behavioral response to a TOU rate. Three successive waves of telephone surveys collected details about reasons for participation, actions taken, capacities and constraints to altering behavior, and a range of salient conditions, such as demographics and dwelling characteristics. Pre- and post-program interval meter data for participants and a comparison sample of households were also collected and analyzed to consider initial and season-change price effects of the rate and the effect of supplemental information treatments on response. Over half of surveyed participating households reported that they had made a great deal of effort to adjust their electricity consumption to the rate. Despite this, load data analysis revealed only minimal price effects; and, though households subjected to information treatments seemed to have learned from these treatments, load data analysis again detected only minimal effects on load. Given the currently high hopes for behavioral intervention and residential TOU rates, these unexpected results require explanation. We suggest a number of possibilities and discuss some implications for TOU programs, and for understanding demand response behavior and approaches to experiments with TOU rates.

  16. A Norwegian case study of the formation of a research program for utilizing natural gas feedstock from the North Sea

    Energy Technology Data Exchange (ETDEWEB)

    Kasa, Sjur; Underthun, Anders

    2010-07-01

    Full text: This paper explores how political struggles influence innovation policy through a Norwegian case study on the formation of a state-funded research and development program for utilizing natural gas feedstock from the North Sea. Despite the apparent dominance of business, specialized branches of the state, and R et D institutions in the realm of innovation policy, the key argument of this paper is that labor unions and regional interests exert considerable influence in shaping national innovation policy, in particular when reflexively exploiting new forms of state accumulation strategies while retaining a defensive stance against de-industrialization. First, we argue that the struggle for state funding to natural gas-based R et D was particularly effective because appropriate strategic political networks and alliances were mobilized. Second, the construction of strategic arguments to accommodate the social corporatist heritage of state intervention on the one hand and the competition-oriented language of flexible specialization on the other, proved crucial for acceptance as a state strategy. The paper engages a Strategic- Relational Approach to state theory and argues that this is a useful starting point when studying how particular contexts affect how and why certain innovation policies emerge. In doing so, we also address the lack of political analysis in innovation studies. (Author)

  17. High speed graphic program on a personal computer and its utilization in JIPP T-IIU online data-processing system

    International Nuclear Information System (INIS)

    Taniguchi, Yoshiyuki; Noda, Nobuaki; Sasao, Mamiko; Sato, Masahiro

    1986-01-01

    A high speed graphic program was developed on a personal computer PC9801. Using this program, one can draw a waveform of successive 16 bit-integer data, such as obtained by analog-to-digital convertor. The program is written by the machine language and has a form of a subroutine program which can be called from main programs under N 88 BASIC. The time for drawing one waveform is 4 ms, which is two orders faster than the time with standard graphic routines of BASIC interpreter. This program is very convenient for the real-time display of plasma-monitoring raw data, such as plasma current, loop voltage, rf power etc. in tokamak experiments. This program has been utilized in JIPP T-IIU experiments and enables to display data of 8 channel ADC within a few seconds before the system transmits the data from CAMAC to the computer center of the institute. The program and its utilization are presented. (author)

  18. Retrospective evaluation of antimicrobial prescribing pattern in a ...

    African Journals Online (AJOL)

    This was followed by quinolones and cephalosporin. Ciprofloxacin and cephalexin were the most commonly prescribed quinolones and cephalosporins respectively. Gentamycin was ... Conclusion: Broad spectrum and older generation antibacterials were the predominantly utilized antimicrobials in this survey. Agents like ...

  19. Deep Learning Improves Antimicrobial Peptide Recognition.

    Science.gov (United States)

    Veltri, Daniel; Kamath, Uday; Shehu, Amarda

    2018-03-24

    Bacterial resistance to antibiotics is a growing concern. Antimicrobial peptides (AMPs), natural components of innate immunity, are popular targets for developing new drugs. Machine learning methods are now commonly adopted by wet-laboratory researchers to screen for promising candidates. In this work we utilize deep learning to recognize antimicrobial activity. We propose a neural network model with convolutional and recurrent layers that leverage primary sequence composition. Results show that the proposed model outperforms state-of-the-art classification models on a comprehensive data set. By utilizing the embedding weights, we also present a reduced-alphabet representation and show that reasonable AMP recognition can be maintained using nine amino-acid types. Models and data sets are made freely available through the Antimicrobial Peptide Scanner vr.2 web server at: www.ampscanner.com. amarda@gmu.edu for general inquiries and dan.veltri@gmail.com for web server information. Supplementary data are available at Bioinformatics online.

  20. Antimicrobial susceptibility of Escherichia coli from swine, horses, dogs and cats as determined in the BfT-GermVet monitoring program 2004-2006.

    Science.gov (United States)

    Grobbel, Mirjam; Lübke-Becker, Antina; Alesík, Eva; Schwarz, Stefan; Wallmann, Jürgen; Werckenthin, Christiane; Wieler, Lothar H

    2007-01-01

    A total of 417 isolates of Escherichia coli collected from five animal species/organ system combinations from swine [urinary/genital tract (UGT) incl. mastitis metritis agalactia syndrome], horses [genital tract (GT)] and dogs/cats [respiratory tract (RT), UGT and gastrointestinal tract (GIT)] were analysed quantitatively for their susceptibility against different antimicrobial agents by determination of minimum inhibitory concentrations. Regardless of which animal species the strains originated from, resistance appeared most frequently against sulfamethoxazole (18-59%), tetracycline (14-54 %), and ampicillin (14-39%). High percentages of intermediate isolates were observed for cephalothin (39-46 %). In general, low prevalences of resistance were detected for amoxicillin/clavulanic acid (1-4%), gentamicin (1-9%), and cefazolin (0-11%). Generally speaking, the antimicrobial resistance situation among E. coli isolates from horses and small animals is relatively good.

  1. Antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and group A beta-haemolytic streptococci in 2002-2003. Results of the multinational GRASP Surveillance Program

    DEFF Research Database (Denmark)

    Beekmann, Susan E; Heilmann, Kris P; Richter, Sandra S

    2005-01-01

    of MDR strains was above 25% in 8 of the 20 countries studied. Group A streptococcal macrolide resistance rates ranged from 0% to 35% by country, while rates of beta-lactamase production ranged from 0% to 39% for H. influenzae and 80-100% for M. catarrhalis. Antibiotic resistance in S. pneumoniae remains......A multinational surveillance study, GRASP, was conducted between November 2002 and April 2003 with the aim of assessing rates of antimicrobial resistance among 2656 isolates of Streptococcus pneumoniae, 2486 isolates of group A beta-haemolytic streptococci, 1358 isolates of Haemophilus influenzae...... and 1047 of Moraxella catarrhalis from 20 countries in Europe, eastern Asia and southern Africa. Conspicuous differences between various countries were noted in the S. pneumoniae resistance rates observed for penicillin (0-79.2%) and erythromycin (4-66%), along with other antimicrobials. The percentage...

  2. The program for reduction of energy wasting under the electric power utilities viewpoint; O programa de combate ao desperdicio de energia eletrica sob a otica das concessionarias

    Energy Technology Data Exchange (ETDEWEB)

    Bacellar, Fernando L.B. [Elektro Brasil, Sao Paulo, SP (Brazil)

    1999-07-01

    This paper presents the Elektro utility viewing on the program for reduction of electric power wasting, considering the aspects of productivity, the particularities of the commercial, residential and rural sectors. The Elektro, former ELETROPAULO, is responsible by the electric power distribution covering 223 municipal districts in the State of Sao Paulo, and 5 in the State of Mato Grosso do Sul.

  3. Utilization of the state led public private partnership program "Chiranjeevi Yojana" to promote facility births in Gujarat, India: a cross sectional community based study.

    Science.gov (United States)

    Yasobant, Sandul; Vora, Kranti Suresh; Shewade, Hemant Deepak; Annerstedt, Kristi Sidney; Isaakidis, Petros; Mavalankar, Dileep V; Dholakia, Nishith B; De Costa, Ayesha

    2016-07-15

    "Chiranjeevi Yojana (CY)", a state-led large-scale demand-side financing scheme (DSF) under public-private partnership to increase institutional delivery, has been implemented across Gujarat state, India since 2005. The scheme aims to provide free institutional childbirth services in accredited private health facilities to women from socially disadvantaged groups (eligible women). These services are paid for by the state to the private facility with the intention of service being free to the user. This community-based study estimates CY uptake among eligible women and explores factors associated with non-utilization of the CY program. This was a community-based cross sectional survey of eligible women who gave birth between January and July 2013 in 142 selected villages of three districts in Gujarat. A structured questionnaire was administered by trained research assistant to collect information on socio-demographic details, pregnancy details, details of childbirth and out-of-pocket (OOP) expenses incurred. A multivariable inferential analysis was done to explore the factors associated with non-utilization of the CY program. Out of 2,143 eligible women, 559 (26 %) gave birth under the CY program. A further 436(20 %) delivered at free public facilities, 713(33 %) at private facilities (OOP payment) and 435(20 %) at home. Eligible women who belonged to either scheduled tribe or poor [aOR = 3.1, 95 % CI:2.4 - 3.8] or having no formal education [aOR = 1.6, 95 % CI:1.1, 2.2] and who delivered by C-section [aOR = 2.1,95 % CI: 1.2, 3.8] had higher odds of not utilizing CY program. Of births at CY accredited facilities (n = 924), non-utilization was 40 % (n = 365) mostly because of lack of required official documentation that proved eligibility (72 % of eligible non-users). Women who utilized the CY program overall paid more than women who delivered in the free public facilities. Uptake of the CY among eligible women was low after almost a decade

  4. ECUT: Energy Conversion and Utilization Technologies program. Industry, university and research interest in the US Department of Energy ECUT biocatalysis research activity

    Science.gov (United States)

    Wilcox, R. E.

    1983-01-01

    The results of a Research Opportunity Notice (RON) disseminated by the Jet Propulsion Laboratory for the U.S. Department of Energy Conversion and Utilization Technologies (ECUT) Program's Biocatalysis Research Activity are presented. The RON was issued in late April of 1983 and solicited expressions of interest from petrochemical and chemical companies, bioengineering firms, biochemical engineering consultants, private research laboratories, and universities for participating in a federal research program to investigate potential applications of biotechnology in producing chemicals. The RON results indicate that broad interest exists within the nation's industry, universities, and research institutes for the Activity and its planned research and development program.

  5. Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics.

    Science.gov (United States)

    Gamboa, Jennifer M; Roberts, Leigh A; Maring, Joyce; Fergus, Andrea

    2008-03-01

    Retrospective descriptive cohort study. To describe the distribution and rate of injuries in elite adolescent ballet dancers, and to examine the utility of screening data to distinguish between injured and noninjured dancers. Adolescent dancers account for most ballet injuries. Limited information exists, however, regarding the distribution of, rate of, and risk factors for, adolescent dance injuries. Two hundred four dancers (age, 9-20 years) were screened over 5 years. Screening data were collected at the beginning and injury data were collected at the end of each training year. Descriptive statistics were used to characterize distribution and rate of injuries. Inference statistics were used to examine differences between injured and noninjured dancers. Fifty-three percent of injuries occurred in the foot/ankle, 21.6% in the hip, 16.1% in the knee, and 9.4% in the back. Thirty-two to fifty-one percent of the dancers were injured each year, and, over the 5 years, there were 1.09 injuries per 1000 athletic exposures, and 0.77 injuries per 1000 hours of dance. Significant differences between injured and noninjured dancers were limited to current disability scores (P = .007), history of low back pain (P = .017), right foot pronation (P = .005), insufficient right-ankle plantar flexion (P = .037), and lower extremity strength (P = .045). Distribution of injuries was similar to that of other studies. Injury rates were lower than most reported rates, except when expressed per 1000 hours of dance. Few differences were found between injured and noninjured dancers. These findings should be considered when designing and implementing screening programs.

  6. Cost-utility analysis of a multidisciplinary job retention vocational rehabilitation program in patients with chronic arthritis at risk of job loss.

    Science.gov (United States)

    van den Hout, Wilbert B; de Buck, Petronella D M; Vliet Vlieland, Theodora P M

    2007-06-15

    To estimate from a societal perspective the cost-utility of a multidisciplinary job retention vocational rehabilitation program compared with usual care in patients with chronic rheumatic diseases at risk of job loss. Patients (n = 121) were randomly assigned to either the vocational rehabilitation program or usual outpatient care initiated by the treating rheumatologist. Followup lasted for 2 years. Program costs were estimated using time registrations and other societal costs using quarterly cost questionnaires filled out by the patients. To estimate quality-adjusted life years, utility was assessed using the EuroQol classification system, EuroQol rating scale, Short Form 6D, and Time Trade-Off. As part of the vocational rehabilitation program, patients on average had a total of 7.1 consultations and the total time spent by the multidisciplinary team was 12.7 hours per patient. Program costs were estimated at euro1,426, of which approximately 20% were time and travel costs incurred by the patients. No significant differences were found in other health care consumption, productivity, or quality-adjusted life years. Program costs were outweighed by total savings on other health care and nonhealth care costs, but not significantly. From a societal perspective, it remains unclear whether the program reduces or increases total costs. Further research on effective vocational rehabilitation is warranted, with special attention to early detection of work problems and the collaboration between health care and vocational rehabilitation services.

  7. phytochemical and antimicrobial properties of solanum macranthum ...

    African Journals Online (AJOL)

    MR J.O. OLAYEMI

    reducing sugars and anthraquinones. The in vitro antimicrobial activity was done using agar well diffusion technique. Six clinical strains of human pathogenic microorganisms, comprising two Gram positive, two Gram negative bacteria and two fungi were utilized in the studies. The various plant extracts varied in their high ...

  8. Antimicrobial commodities. part 2. Antimicrobial and odor-preventing fibers; Kokin seikatsu yohin ( 2 ). Kokin boshu sen`i

    Energy Technology Data Exchange (ETDEWEB)

    Yabe, N. [Toray Research Center Inc., Shiga (Japan)

    1998-05-01

    Demand for antimicrobial and order-preventing fibers is still expanding smoothly after a boom during a period from 1982 to 1985 owing to the great progress in its safety, manufacturing technology and evaluation of antimicrobial property. In this paper, the antimicrobial and odor-preventing fibers are described summarily. Main antimicrobial agents used in the antimicrobial and odor-preventing fibers hitherto are aromatic halogen compounds and organic silicon quaternary ammonium salts. In recent years, the kinds of antimicrobial agents are increased corresponding to the expansion of the demand for antimicrobial and odor-preventing fibers. Specifically, metals or inorganic particles containing metals; and quaternary ammonium salts or organic silicon quaternary ammonium salts are used frequently. Recently, the studies in respect to the utilization of chitin and chitosan are executed actively. Mainly employed processing method of the antimicrobial and odor-prevention fibers is a post processing by a working liquid containing kneaded fiber forming (mixed fiber forming) of antimicrobial inorganic particles such as metal powders or metal supporting zeolites; and an antimicrobial agent. 8 refs., 3 figs., 5 tabs.

  9. US utility partnerships

    International Nuclear Information System (INIS)

    Worthington, B.

    1995-01-01

    Activities of the United States Energy Association were reviewed, as well as the manner in which its members are benefitting from the Association's programs. The principal cooperative program set up is the Utility Partnership Program, which was described. Through this program the Association is matching US companies, both electric utilities and gas utilities, with counterparts in Eastern Europe or the former Soviet Union. So far, about 25 partnerships were signed, e.g. in the Czech Republic, in Kazakhstan, in Poland, and in Slovakia. It was estimated that the return to the United States from the investments made by the American government in these Utility Partnership Programs has been well over 100-fold

  10. Impact of a chronic disease self-management program on health care utilization in rural communities: a retrospective cohort study using linked administrative data.

    Science.gov (United States)

    Jaglal, Susan B; Guilcher, Sara J T; Hawker, Gillian; Lou, Wendy; Salbach, Nancy M; Manno, Michael; Zwarenstein, Merrick

    2014-05-01

    Internationally, chronic disease self-management programs (CDSMPs) have been widely promoted with the assumption that confident, knowledgeable patients practicing self-management behavior will experience improved health and utilize fewer healthcare resources. However, there is a paucity of published data supporting this claim and the majority of the evidence is based on self-report. We used a retrospective cohort study using linked administrative health data. Data from 104 tele-CDSMP participants from 13 rural and remote communities in the province of Ontario, Canada were linked to administrative databases containing emergency department (ED) and physician visits and hospitalizations. Patterns of health care utilization prior to and after participation in the tele-CDSMP were compared. Poisson Generalized Estimating Equations regression was used to examine the impact of the tele-CDSMP on health care utilization after adjusting for covariates. There were no differences in patterns of health care utilization before and after participating in the tele-CDSMP. Among participants ≤ 66 years, however, there was a 34% increase in physician visits in the 12 months following the program (OR = 1.34, 95% CI 1.11-1.61) and a trend for decreased ED visits in those >66 years (OR = 0.59, 95% CI 0.33-1.06). This is the first study to examine health care use following participation in the CDSMP in a Canadian population and to use administrative data to measure health care utilization. Similar to other studies that used self-report measures to evaluate health care use we found no differences in health care utilization before and after participation in the CDSMP. Future research needs to confirm our findings and examine the impact of the CDSMP on health care utilization in different age groups to help to determine whether these interventions are more effective with select population groups.

  11. Antibiotic stewardship programs and the internist’s role

    Directory of Open Access Journals (Sweden)

    Massimo Giusti

    2016-12-01

    Full Text Available Antimicrobial resistance (AMR is a worldwide issue, but with significant epidemiological diversity in different countries. A recently observed phenomenon is represented by the diffusion of AMR, initially confined to intensive-care units, to medical wards. This was predictable, since patients hospitalized in medical units are made up of more than 70% of elderly people (over 75 years of age in 1 case out of 2. They are fragile patients, with significant comorbidity (over a half with at least 3 diseases, weakened immune systems, and consequently a higher risk of infection. Given such a scenario, it becomes therefore both necessary and urgent to adopt a multifaceted approach of antimicrobial stewardship programs in order to prevent, detect and control the emergence of antimicrobial resistant organisms. The ideal antimicrobial program is led by an infectious diseases (ID physician and clinical pharmacist with ID training, together with a list of other important staff: clinical microbiologist, information systems specialist, infection control professional, and hospital epidemiologist. In real life, not all the Italian hospitals have got an ID physician and therefore the best canditates for antimicrobial management practices are internists if provided with a specific expertise in ID and antibiotic therapy. Adhering to the principles of optimal antimicrobial therapy in their clinical practice, the internist is able to improve the care and help to reduce the resistance of a patient at his bedside. At the same time, he can achieve other key goals reducing the length of stay and reducing the cost and utilization of health care resources.

  12. Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004-2010.

    Science.gov (United States)

    Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

    2013-01-01

    This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004-2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources.

  13. Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

    Science.gov (United States)

    Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

    2013-01-01

    Background This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. Methods The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald’s business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). Results The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources. PMID:23439724

  14. UMCP-BG and E collaboration in nuclear power engineering in the framework of DOE-Utility Nuclear Power Engineering Education Matching Grant Program

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, Lothar PhD

    2000-03-01

    The DOE-Utility Nuclear Power Engineering Education Matching Grant Program has been established to support the education of students in Nuclear Engineering Programs to maintain a knowledgeable workforce in the United States in order to keep nuclear power as a viable component in a mix of energy sources for the country. The involvement of the utility industry ensures that this grant program satisfies the needs and requirements of local nuclear energy producers and at the same time establishes a strong linkage between education and day-to-day nuclear power generation. As of 1997, seventeen pairs of university-utility partners existed. UMCP was never a member of that group of universities, but applied for the first time with a proposal to Baltimore Gas and Electric Company in January 1999 [1]. This proposal was generously granted by BG&E [2,3] in the form of a gift in the amount of $25,000 from BG&E's Corporate Contribution Program. Upon the arrival of a newly appointed Director of Administration in the Department of Materials and Nuclear Engineering, the BG&E check was deposited into the University's Maryland Foundation Fund. The receipt of the letter and the check enabled UMCP to apply for DOE's matching funds in the same amount by a proposal.

  15. Antimicrobials and oral health.

    Science.gov (United States)

    Rubinstein-DeVore, L

    1991-10-01

    Effective control of plaque and gingivitis are among our most important treatment goals. Several antimicrobial products have demonstrated safety and various degrees of effectiveness as adjuncts to mechanical plaque control. Our clinical decisions relating to antimicrobial products should be based on the expanding body of research that documents product safety and effectiveness in reducing both plaque and gingivitis. Antimicrobials present exciting prospects for in-office and home use, but they do not replace thorough root debridement and traditional plaque control. However, when selected based on individual patient needs and used in recommended regimens, antimicrobials can be important additions to both professional treatment and oral hygiene practices.

  16. Examination of psychosocial predictors of Virginia pharmacists' intention to utilize a prescription drug monitoring program using the theory of planned behavior.

    Science.gov (United States)

    Gavaza, Paul; Fleming, Marc; Barner, Jamie C

    2014-01-01

    Little is known about the main drivers of pharmacists' intention to utilize prescription drug monitoring programs (PDMPs) when making care decisions and the actual contribution of these factors in explaining intention and behavior. This study examined what theory of planned behavior (TPB) model constructs (i.e., attitude, subjective norm [SN], perceived behavioral control [PBC]), past utilization behavior (PUB) and perceived moral obligation (PMO) were significant predictors of Virginia community pharmacists' intention to utilize a PDMP. A cover letter with a link to a 28-item online survey was e-mailed to 600 members of the Virginia Pharmacists Association. Multiple regression analyses were used to determine the association between pharmacists' intention to utilize the PDMP database and attitude, SN, PBC, PUB and PMO. Ninety-seven usable responses were received, for a response rate of 16.2%. A majority of the respondents were Caucasian (96.4%), female (50.5%), working in independent community pharmacies (60.4%) with an average age of 49.5 ± 13.4 years. Overall, pharmacists intended to utilize a PDMP (mean = 5.3 ± 4.6; possible range: -9 to 9), had a positive attitude toward utilizing PDMP (mean = 6.3 ± 5.3; possible range: -12 to 12), perceived that others wanted them to utilize a PDMP (SN score = 3.7 ± 2.4; range: -6 to 6), and believed that they had control over utilization behavior (PBC score = 4.5 ± 4.0; range: -9 to 9). Attitude (β = 0.723, P < 0.001), SN (β = 0.230, P = 0.014) and PBC (β = -0.215, P = 0.026) significantly predicted pharmacists' intent, accounting for 56.7% of the variance in intention to utilize the PDMP database (P < 0.001). The addition of PMO (P < 0.001) significantly contributed to explaining the variance in intention but PUB did not. Members of the Virginia Pharmacists Association who responded to the survey showed a strong positive intent to utilize PDMP database. Pharmacists' attitudes, subjective norm, perceived behavioral

  17. Stimulating utilities to promote energy efficiency: Process evaluation of Madison Gas and Electric's Competition Pilot Program

    Energy Technology Data Exchange (ETDEWEB)

    Vine, E.; De Buen, O.; Goldfman, C.

    1990-12-01

    This report describes the process evaluation of the design and implementation of the Energy Conservation Competition Pilot (hereafter referred to as the Competition), ordered by the Public Service Commission of Wisconsin (PSCW) with a conceptual framework defined by PSCW staff for the Madison Gas and Electric (MGE) Company. This process evaluation documents the history of the Competition, describing the marketing strategies adopted by MGE and its competitors, customer service and satisfaction, administrative issues, the distribution of installed measures, free riders, and the impact of the Competition on MGE, its competitors, and other Wisconsin utilities. We also suggest recommendations for a future Competition, compare the Competition with other approaches that public utility commissions (PUCs) have used to motivate utilities to promote energy efficiency, and discuss its transferability to other utilities. 48 refs., 8 figs., 40 tabs.

  18. Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals. A challenge to hospital leadership.

    Science.gov (United States)

    Goldmann, D A; Weinstein, R A; Wenzel, R P; Tablan, O C; Duma, R J; Gaynes, R P; Schlosser, J; Martone, W J

    1996-01-17

    To provide hospital leaders with strategic goals or actions likely to have a significant impact on antimicrobial resistance, outline outcome and process measures for evaluating progress toward each goal, describe potential barriers to success, and suggest countermeasures and novel improvement strategies. A multidisciplinary group of experts was drawn from the following areas: hospital epidemiology and infection control, infectious diseases (including graduate training programs), clinical practice (including nursing, surgery, internal medicine, and pediatrics), pharmacy, administration, quality improvement, appropriateness evaluation, behavior modification, practice guideline development, medical informatics, and outcomes research. Representatives from appropriate federal agencies, the Joint Commission on Accreditation of Healthcare Organizations, and the pharmaceutical industry also participated. Published literature, guidelines, expert opinion, and practical experience regarding efforts to improve antibiotic utilization and prevent and control the emergence and dissemination of antimicrobial-resistant microorganisms in hospitals. Participants were divided into two quality improvement teams: one focusing on improving antimicrobial usage and the other on preventing and controlling transmission of resistant microorganisms. The teams modeled the process a hospital might use to develop and implement a strategic plan to combat antimicrobial resistance. Ten strategic goals and related process and outcome measures were agreed on. The five strategic goals to optimize antimicrobial use were as follows: optimizing antimicrobial prophylaxis for operative procedures; optimizing choice and duration of empiric therapy; improving antimicrobial prescribing by educational and administrative means; monitoring and providing feedback regarding antibiotic resistance; and defining and implementing health care delivery system guidelines for important types of antimicrobial use. The five

  19. Impact of a Problem-Based Learning (PBL) Health Literacy Program on Immigrant Women's Health Literacy, Health Empowerment, Navigation Efficacy, and Health Care Utilization.

    Science.gov (United States)

    Tsai, Tzu-I; Lee, Shoou-Yih D; Yu, Wen-Ry

    2018-03-15

    We evaluated the effectiveness of a problem-based learning (PBL) health literacy program aimed to improve health literacy, health empowerment, navigation efficacy, and health care utilization among immigrant women in Taiwan. We employed a quasi-experimental design that included surveys at the baseline, immediately after the intervention, and 6 months after the intervention. The intervention group participated in a 10-session PBL health literacy program and the comparison group did not. Results showed that 6 months after the intervention, the intervention group had significantly fewer ER visits and hospitalizations than the comparison group. The intervention group reported a greater decrease in delaying/avoiding health care due to communication barriers. Although the intervention group showed improvement in health literacy, health empowerment and navigation self-efficacy, the differences were not statistically significant. The PBL health literacy program resulted in fewer ER visits and hospitalizations, and better health care access among immigrant women. Cognitive and psychological outcomes examined in the study appeared more difficult to change. The PBL health literacy program effectively improved health care utilization and reduced barriers to health care access among immigrant women in Taiwan. It would be useful to examine the effectiveness of the program in other populations.

  20. Full-scale utility FGD (flue gas desulfurization) system adipic acid demonstration program. Volume 2. Continuous emissions monitoring results. Final report Jun 80-Nov 82

    Energy Technology Data Exchange (ETDEWEB)

    Hargrove, O.W. Jr.; Colley, J.D.; Glover, R.L.; Owen, M.L.

    1983-06-01

    The report culminates a series of projects sponsored by the EPA, investigating the use of adipic acid as an additive to enhance SO/sub 2/ removal in aqueous flue gas desulfurization (FGD) systems, using limestone reagent. A 9-month program at the 194-MW Southwest Power Plant (SWPP) of City Utilities, Springfield, MO, demonstrated the effectiveness of adipic acid and dibasic acids (the latter, by-products of the production of adipic acid). The program examined the effect of adipic acid addition on a limestone FGD system under natural and forced-oxidation modes of operation.

  1. Full-scale utility FGD (flue gas desulfurization) system adipic acid demonstration program. Volume 1. Process results. Final report Jun 80-Nov 82

    Energy Technology Data Exchange (ETDEWEB)

    Hargrove, O.W. Jr; Colley, J.D.; Glover, R.L.; Owen, M.L.

    1983-06-01

    The report culminates a series of projects sponsored by the EPA, investigating the use of adipic acid as an additive to enhance SO/sub 2/ removal in aqueous flue gas desulfurization (FGD) systems, using limestone reagent. A 9-month program at the 194-MW Southwest Power Plant (SWPP) of City Utilities, Springfield, MO, demonstrated the effectiveness of adipic acid and dibasic acids (the latter, by-products of the production of adipic acid). The program examined the effect of adipic acid addition on a limestone FGD system under natural and forced-oxidation modes of operation.

  2. Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

    Directory of Open Access Journals (Sweden)

    Charles Hoffmann

    2016-02-01

    Full Text Available Antimicrobial stewardship programs (ASPs focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.

  3. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... use of antimicrobial drugs will result in the development of resistant strains of bacteria, complicating clinician's efforts to select the appropriate antimicrobial for treatment. Accordingly, efforts are underway in both veterinary and human medicine to preserve the effectiveness of these drugs. ...

  4. Antimicrobial Peptides in 2014

    Directory of Open Access Journals (Sweden)

    Guangshun Wang

    2015-03-01

    Full Text Available This article highlights new members, novel mechanisms of action, new functions, and interesting applications of antimicrobial peptides reported in 2014. As of December 2014, over 100 new peptides were registered into the Antimicrobial Peptide Database, increasing the total number of entries to 2493. Unique antimicrobial peptides have been identified from marine bacteria, fungi, and plants. Environmental conditions clearly influence peptide activity or function. Human α-defensin HD-6 is only antimicrobial under reduced conditions. The pH-dependent oligomerization of human cathelicidin LL-37 is linked to double-stranded RNA delivery to endosomes, where the acidic pH triggers the dissociation of the peptide aggregate to release its cargo. Proline-rich peptides, previously known to bind to heat shock proteins, are shown to inhibit protein synthesis. A model antimicrobial peptide is demonstrated to have multiple hits on bacteria, including surface protein delocalization. While cell surface modification to decrease cationic peptide binding is a recognized resistance mechanism for pathogenic bacteria, it is also used as a survival strategy for commensal bacteria. The year 2014 also witnessed continued efforts in exploiting potential applications of antimicrobial peptides. We highlight 3D structure-based design of peptide antimicrobials and vaccines, surface coating, delivery systems, and microbial detection devices involving antimicrobial peptides. The 2014 results also support that combination therapy is preferred over monotherapy in treating biofilms.

  5. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... ol Search FDA Submit search Popular Content Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share ...

  6. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and Drug Administration ... Tobacco Products Animal & Veterinary Home Animal & Veterinary Safety & Health Antimicrobial Resistance Animation of Antimicrobial Resistance Share Tweet ...

  7. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... topics menu Skip to common links HHS U.S. Department of Health and Human Services U.S. Food and ... More in Antimicrobial Resistance National Antimicrobial Resistance Monitoring System ... If you need help accessing information in different file formats, see Instructions for Downloading ...

  8. Alternative Antimicrobial Approach: Nano-Antimicrobial Materials

    Directory of Open Access Journals (Sweden)

    Nurit Beyth

    2015-01-01

    Full Text Available Despite numerous existing potent antibiotics and other antimicrobial means, bacterial infections are still a major cause of morbidity and mortality. Moreover, the need to develop additional bactericidal means has significantly increased due to the growing concern regarding multidrug-resistant bacterial strains and biofilm associated infections. Consequently, attention has been especially devoted to new and emerging nanoparticle-based materials in the field of antimicrobial chemotherapy. The present review discusses the activities of nanoparticles as an antimicrobial means, their mode of action, nanoparticle effect on drug-resistant bacteria, and the risks attendant on their use as antibacterial agents. Factors contributing to nanoparticle performance in the clinical setting, their unique properties, and mechanism of action as antibacterial agents are discussed in detail.

  9. Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Connecticut. Preliminary background report

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.; Gallagher, K.C.; Hejna, D.; Rielley, K.J.

    1980-01-01

    The Connecticut statutes expressly provide for the regulation of public utilities. As of January 1, 1979, responsibility for the regulation of utilities is vested in the Public Utilities Control Authority (PUCA). Formerly such authority was exercised by the Public Utilities Commission which has been abolished and replaced by the PUCA. The Public Utilities Act provides that the PUCA is to consist of five members appointed by the governor with the advice and consent of both houses of the general assembly. It should be noted that statutory references to the Public Utilities Commission are deemed to mean the Public Utilities Control Authority. The statute gives only a minor role to local government in regulating public utilities. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.

  10. Antimicrobial susceptibility of streptococci from various indications of swine, horses, dogs and cats as determined in the BfT-GermVet monitoring program 2004-2006.

    Science.gov (United States)

    Schwarz, Stefan; Alesík, Eva; Grobbel, Mirjam; Lübke-Becker, Antina; Werckenthin, Christiane; Wieler, Lothar H; Wallmann, Jürgen

    2007-01-01

    A total of 500 streptococci from two indications of swine (beta-haemolytic streptococci from infections of the urinary/genital tract including strains from the mastitis metritis agalactia syndrome as well as S. suis from infections of the central nervous system and the musculoskeletal system), two indications of horses (S. equi from respiratory tract infections and beta-haemolytic streptococci from infections of the genital tract), as well as three indications of dogs and cats (beta-haemolytic streptococci from infections of the respiratory tract, the urinary/genital tract, and skin/ear/mouth) were investigated for their susceptibility to antimicrobial agents. Regardless of the animal origin and indication, the most frequently detected resistance properties were resistances against sulfamethoxazole (20-78%), tetracycline (17-93%) as well as gentamicin (14-79%). Resistance to penicillins or cephalosporins was very rarely detected - if at all.

  11. [An oral function improvement program utilizing health behavior theories ameliorates oral functions and oral hygienic conditions of pre-frail elderly persons].

    Science.gov (United States)

    Sakaguchi, Hideo

    2014-06-01

    Oral function improvement programs utilizing health behavior theories are considered to be effective in preventing the need for long-term social care. In the present study, an oral function improvement program based upon health behavior theories was designed, and its utility was assessed in 102 pre-frail elderly persons (33 males, 69 females, mean age: 76.9 +/- 5.7) considered to be in potential need of long-term social care and attending a long-term care prevention class in Sayama City, Saitama Prefecture, Japan. The degree of improvement in oral functions (7 items) and oral hygienic conditions (3 items) was assessed by comparing oral health before and after participation in the program. The results showed statistically significant improvements in the following oral functions: (1) lip functions (oral diadochokinesis, measured by the regularity of the repetition of the syllable "Pa"), (2) tongue functions, (3) tongue root motor skills (oral diadochokinesis, measured by the regularity of the repetition of the syllables "Ta" and "Ka"), (4) tongue extension/retraction, (5) side-to-side tongue movement functions, (6) cheek motor skills, and (7) repetitive saliva swallowing test (RSST). The following measures of oral hygiene also showed a statistically significant improvement: (1) debris on dentures or teeth, (2) coated tongue, and (3) frequency of oral cleaning. These findings demonstrated that an improvement program informed by health behavior theories is useful in improving oral functions and oral hygiene conditions.

  12. Evaluation of lead/carbon devices for utility applications : a study for the DOE Energy Storage Program.

    Energy Technology Data Exchange (ETDEWEB)

    Walmet, Paula S. (MeadWestvaco Corporation,North Charleston, SC)

    2009-06-01

    This report describes the results of a three-phase project that evaluated lead-based energy storage technologies for utility-scale applications and developed carbon materials to improve the performance of lead-based energy storage technologies. In Phase I, lead/carbon asymmetric capacitors were compared to other technologies that used the same or similar materials. At the end of Phase I (in 2005) it was found that lead/carbon asymmetric capacitors were not yet fully developed and optimized (cost/performance) to be a viable option for utility-scale applications. It was, however, determined that adding carbon to the negative electrode of a standard lead-acid battery showed promise for performance improvements that could be beneficial for use in utility-scale applications. In Phase II various carbon types were developed and evaluated in lead-acid batteries. Overall it was found that mesoporous activated carbon at low loadings and graphite at high loadings gave the best cycle performance in shallow PSoC cycling. Phase III studied cost/performance benefits for a specific utility application (frequency regulation) and the full details of this analysis are included as an appendix to this report.

  13. Demonstration program for coal-oil mixture combustion in an electric utility boiler - Category III A. 1978 annual report

    Energy Technology Data Exchange (ETDEWEB)

    1980-04-01

    The 1978 annual report covers New England Power Service Company's participation in the Department of Energy coal-oil mixture (COM) program. Continued world-wide unrest resulting in an unstable fuel oil supply coupled with rapidly inflating costs have caused continued interest in a demonstrable viable solution. NEPSCO's program, while not attaining all the milestones forecast, has made considerable progress. As of January 31, 1979, ninety-five (95% percent of engineering and design has been completed. Construction of facilities and installation of required equipment was approximately 75% complete and the six-week Feasibility Testing program was expected to commence during April 1979.

  14. Two programs of utility in the performance of histograms and Dalitz plots by means of a CALCOMP-563 plotter

    International Nuclear Information System (INIS)

    Carcedo, A.; Ladron de Guevara, P.

    1973-01-01

    Full description of the whole structure and of the operation of every routine is given for both programs, as well as the data setup in punched cards and binary tape. To help the users we present and comment several examples of data sets and the corresponding output plots. The list of instructions in FORTRAN IV language is included. The same version of both programs is operative in the series 7090-94-IBM and 1106-08-UNIVAC. (Author)

  15. User's guide to the MESOI diffusion model and to the utility programs UPDATE and LOGRVU

    Energy Technology Data Exchange (ETDEWEB)

    Athey, G.F.; Allwine, K.J.; Ramsdell, J.V.

    1981-11-01

    MESOI is an interactive, Lagrangian puff trajectory diffusion model. The model is documented separately (Ramsdell and Athey, 1981); this report is intended to provide MESOI users with the information needed to successfully conduct model simulations. The user is also provided with guidance in the use of the data file maintenance and review programs; UPDATE and LOGRVU. Complete examples are given for the operaton of all three programs and an appendix documents UPDATE and LOGRVU.

  16. Declines in Outpatient Antimicrobial Use in Canada (1995–2010)

    Science.gov (United States)

    Finley, Rita; Glass-Kaastra, Shiona K.; Hutchinson, Jim; Patrick, David M.; Weiss, Karl; Conly, John

    2013-01-01

    Background With rising reports of antimicrobial resistance in outpatient communities, surveillance of antimicrobial use is imperative for supporting stewardship programs. The primary objective of this article is to assess the levels of antimicrobial use in Canada over time. Methods Canadian antimicrobial use data from 1995 to 2010 were acquired and assessed by four metrics: population-adjusted prescriptions, Defined Daily Doses, spending on antimicrobials (inflation-adjusted), and average Defined Daily Doses per prescription. Linear mixed models were built to assess significant differences among years and antimicrobial groups, and to account for repeated measurements over time. Measures were also compared to published reports from European countries. Results Temporal trends in antimicrobial use in Canada vary by metric and antimicrobial grouping. Overall reductions were seen for inflation-adjusted spending, population-adjusted prescription rates and Defined Daily Doses, and increases were observed for the average number of Defined Daily Doses per prescription. The population-adjusted prescription and Defined Daily Doses values for 2009 were comparable to those reported by many European countries, while the average Defined Daily Dose per prescription for Canada ranked high. A significant reduction in the use of broad spectrum penicillins occurred between 1995 and 2004, coupled with increases in macrolide and quinolone use, suggesting that replacement of antimicrobial drugs may occur as new products arrive on the market. Conclusions There have been modest decreases of antimicrobial use in Canada over the past 15 years. However, continued surveillance of antimicrobial use coupled with data detailing antimicrobial resistance within bacterial pathogens affecting human populations is critical for targeting interventions and maintaining the effectiveness of these products for future generations. PMID:24146863

  17. Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.

    Directory of Open Access Journals (Sweden)

    Giulio DiDiodato

    Full Text Available The incidence rate of healthcare-associated Clostridium difficile infection (HA-CDI is estimated at 1 in 100 patients. Antibiotic exposure is the most consistently reported risk factor for HA-CDI. Strategies to reduce the risk of HA-CDI have focused on reducing antibiotic utilization. Prospective audit and feedback is a commonly used antimicrobial stewardship intervention (ASi. The impact of this ASi on risk of HA-CDI is equivocal. This study examines the effectiveness of a prospective audit and feedback ASi on reducing the risk of HA-CDI.Single-site, 339 bed community-hospital in Barrie, Ontario, Canada. Primary outcome is HA-CDI incidence rate. Daily prospective and audit ASi is the exposure variable. ASi implemented across 6 wards in a non-randomized, stepped wedge design. Criteria for ASi; any intravenous antibiotic use for ≥ 48 hrs, any oral fluoroquinolone or oral second generation cephalosporin use for ≥ 48 hrs, or any antimicrobial use for ≥ 5 days. HA-CDI cases and model covariates were aggregated by ward, year and month starting September 2008 and ending February 2016. Multi-level mixed effect negative binomial regression analysis was used to model the primary outcome, with intercept and slope coefficients for ward-level random effects estimated. Other covariates tested for inclusion in the final model were derived from previously published risk factors. Deviance residuals were used to assess the model's goodness-of-fit.The dataset included 486 observation periods, of which 350 were control periods and 136 were intervention periods. After accounting for all other model covariates, the estimated overall ASi incidence rate ratio (IRR was 0.48 (95% 0.30, 0.79. The ASi effect was independent of antimicrobial utilization. The ASi did not seem to reduce the risk of Clostridium difficile infection on the surgery wards (IRR 0.87, 95% CI 0.45, 1.69 compared to the medicine wards (IRR 0.42, 95% CI 0.28, 0.63. The ward-level burden of

  18. Antimicrobial Peptides in Reptiles

    Science.gov (United States)

    van Hoek, Monique L.

    2014-01-01

    Reptiles are among the oldest known amniotes and are highly diverse in their morphology and ecological niches. These animals have an evolutionarily ancient innate-immune system that is of great interest to scientists trying to identify new and useful antimicrobial peptides. Significant work in the last decade in the fields of biochemistry, proteomics and genomics has begun to reveal the complexity of reptilian antimicrobial peptides. Here, the current knowledge about antimicrobial peptides in reptiles is reviewed, with specific examples in each of the four orders: Testudines (turtles and tortosises), Sphenodontia (tuataras), Squamata (snakes and lizards), and Crocodilia (crocodilans). Examples are presented of the major classes of antimicrobial peptides expressed by reptiles including defensins, cathelicidins, liver-expressed peptides (hepcidin and LEAP-2), lysozyme, crotamine, and others. Some of these peptides have been identified and tested for their antibacterial or antiviral activity; others are only predicted as possible genes from genomic sequencing. Bioinformatic analysis of the reptile genomes is presented, revealing many predicted candidate antimicrobial peptides genes across this diverse class. The study of how these ancient creatures use antimicrobial peptides within their innate immune systems may reveal new understandings of our mammalian innate immune system and may also provide new and powerful antimicrobial peptides as scaffolds for potential therapeutic development. PMID:24918867

  19. Antimicrobial resistance of mastitis pathogens.

    Science.gov (United States)

    Oliver, Stephen P; Murinda, Shelton E

    2012-07-01

    Antibiotics are used extensively in the dairy industry to combat disease and to improve animal performance. Antibiotics such as penicillin, cephalosporin, streptomycin, and tetracycline are used for the treatment and prevention of diseases affecting dairy cows caused by a variety of gram-positive and gram-negative bacteria. Antibiotics are often administrated routinely to entire herds to prevent mastitis during the dry period. An increase in the incidence of disease in a herd generally results in increased use of antimicrobials, which in turn increases the potential for antibiotic residues in milk and the potential for increased bacterial resistance to antimicrobials. Continued use of antibiotics in the treatment and prevention of diseases of dairy cows will continue to be scrutinized. It is clear that strategies employing the prudent use of antimicrobials are needed. This clearly illustrates the importance of effective herd disease prevention and control programs. Based on studies published to date, scientific evidence does not support widespread, emerging resistance among mastitis pathogens to antibacterial drugs even though many of these antibiotics have been used in the dairy industry for treatment and prevention of disease for several decades. However, it is clear that use of antibiotics in dairy cows can contribute to increased antimicrobial resistance. While antimicrobial resistance does occur, we are of the opinion that the advantages of using antibiotics for the treatment of mastitis far outweigh the disadvantages. The clinical consequences of antimicrobial resistance of dairy pathogens affecting humans appear small. Antimicrobial resistance among dairy pathogens, particularly those found in milk, is likely not a human health concern as long as the milk is pasteurized. However, there are an increasing number of people who choose to consume raw milk. Transmission of an antimicrobial-resistant mastitis pathogen and/or foodborne pathogen to humans could occur

  20. Geothermal direct-heat utilization assistance: Federal assistance program. Quarterly project progress report, October--December 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    The report summarizes geothermal technical assistance, R&D and technology transfer activities of the Geo-Heat Center at Oregon Institute of Technology for the first quarter of FY-96. It describes 90 contacts with parties during this period related to technical assistance with geothermal direct heat projects. Areas dealt with include geothermal heat pumps, space heating, greenhouses, aquaculture, equipment and resources. Research activities are summarized on low-temperature resource assessment, geothermal district heating system cost evaluation and silica waste utilization project. Outreach activities include the publication of a geothermal direct use Bulletin, dissemination of information, geothermal library, technical papers and seminars, development of a webpage, and progress monitor reports on geothermal resources and utilization.

  1. Impacto de un programa de control en los consumos de antibióticos en pacientes quirúrgicos Impact of a control program on the antimicrobial consumption by surgical patients

    Directory of Open Access Journals (Sweden)

    Rafael Pinilla González

    2013-03-01

    related with a control program. Methods: Intervention study conducted in the surgical services of "Joaquin Albarrán" hospital in the period of May 2008 to December 2010. It included evaluations of quality of prescription and of feedback in the medical assistance team, educational sessions, checking of antimicrobial use policies and consultations with the antibiotic regulatory committee. The monthly antimicrobial consumption rates were registered and expressed as dose prescribed per 1000 patient-days. Results: The most frequently used antibiotics were cephalosporins, metronidazole, ciprofloxacin, penicillin and cotrimoxazole. The high consumption rates of ceftriaxone (94.4 DPD and cefazoline (88. 3 DPD was underlined along with the evident decrease in the consumption of first, third and fourth generation cephalosporins, whereas cefuroxime consumption increased from 23.8 (2008 to 35.7 (2010 DPD. Sodium penicillin (36.0 DPD, amoxicillin (7.2 DPD and amoxicillin plus sulbactam (5.8 DPD represented the most used penicillin. The consumption rate of metronidazole decreased from 312.4 to 75.7 DPD, that of ciprofloxacin from 220.8 to 52.4 DPD, chloramphenicol from 27.9 to 3.5 DDP and cotrimoxazole from 99.4 to 26.6 DDP in the years 2008 and 2010 respectively. Conclusions: It was evident that the control program implemented in the surgical services has brought about changes in the consumption patterns indicating improvement in the quality of prescribing patterns.

  2. Antimicrobials in beekeeping.

    Science.gov (United States)

    Reybroeck, Wim; Daeseleire, Els; De Brabander, Hubert F; Herman, Lieve

    2012-07-06

    The bee diseases American and European foulbrood and nosemosis can be treated with anti-infectious agents. However, in the EU and the USA the use of these agents in beekeeping is strictly regulated due to the lack of tolerance (e.g. Maximum Residue Limit) for residues of antibiotics and chemotherapeutics in honey. This article reviews the literature dealing with antimicrobials of interest in apiculture, stability of these antimicrobials in honey, and disposition of the antimicrobials in honeybee hives. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Geothermal Program Review X: proceedings. Geothermal Energy and the Utility Market -- the Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market

    Energy Technology Data Exchange (ETDEWEB)

    1992-01-01

    Each year the Geothermal Division of the US Department of Energy conducts an in-depth review of its entire geothermal R&D program. The conference serves several purposes: a status report on current R&D activities, an assessment of progress and problems, a review of management issues, and a technology transfer opportunity between DOE and the US geothermal city. This year`s conference, Program Review X, was held in San Francisco on March 24--26, 1992. The theme of the review, ``Geothermal Energy and the Utility Market -- The Opportunities and Challenges for Expanding Geothermal Energy in a Competitive Supply Market,`` focused on the needs of the electric utility sector. Geothermal energy, with its power capacity potential of 10 GWe by the year 2010, can provide reliable, enviromentally clean electricity which can help offset the projected increase in demand. Program Review X consisted of seven sessions including an opening session with presentations by Mr. Vikram Budhraja, Vice President of System Planning and Operations, Southern California Edison Company, and Mr. Richard Jaros, President and Chief Operating Officer, California Energy Company. The six technical sessions included presentations by the relevant field researchers covering DOE-sponsored R&D in hydrothermal, hot dry rock, and geopressured energy. Individual projects are processed separately for the data bases.

  4. A screening program to test and treat for Helicobacter pylori infection: Cost-utility analysis by age, sex and ethnicity.

    Science.gov (United States)

    Teng, Andrea M; Kvizhinadze, Giorgi; Nair, Nisha; McLeod, Melissa; Wilson, Nick; Blakely, Tony

    2017-02-20

    The World Health Organization recommends all countries consider screening for H. pylori to prevent gastric cancer. We therefore aimed to estimate the cost-effectiveness of a H. pylori serology-based screening program in New Zealand, a country that includes population groups with relatively high gastric cancer rates. A Markov model was developed using life-tables and morbidity data from a national burden of disease study. The modelled screening program reduced the incidence of non-cardia gastric cancer attributable to H. pylori, if infection was identified by serology screening, and for the population expected to be reached by the screening program. A health system perspective was taken and detailed individual-level costing data was used. For adults aged 25-69 years old, nation-wide screening for H. pylori was found to have an incremental cost of US$196 million (95% uncertainty interval [95% UI]: $182-$211 million) with health gains of 14,200 QALYs (95% UI: 5,100-26,300). Cost per QALY gained was US$16,500 ($7,600-$38,400) in the total population and 17% (6%-29%) of future gastric cancer cases could be averted with lifetime follow-up. A targeted screening program for Māori only (indigenous population), was more cost-effective at US$8,000 ($3,800-$18,500) per QALY. This modeling study found that H. pylori screening was likely to be cost-effective in this high-income country, particularly for the indigenous population. While further research is needed to help clarify the precise benefits, costs and adverse effects of such screening programs, there seems a reasonable case for policy-makers to give pilot programs consideration, particularly for any population groups with relatively elevated rates of gastric cancer.

  5. Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

    Directory of Open Access Journals (Sweden)

    Tirumalasetti Rao V

    2013-02-01

    Full Text Available Vasudha Tirumalasetti Rao,1 Bidhubhusan Mahapatra,2 Sachin Juneja,1 Indra R Singh11Transport Corporation of India Foundation, Gurgaon, Haryana, India 2Population Council, New Delhi, IndiaBackground: This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV prevention intervention for long-distance truck drivers operating on the national highways of India.Methods: The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010 and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402 and July 2009 (n = 1407.Results: The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001. A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001, and participated in health exhibitions (6% to 35%, P < 0.001. Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001, and attended one-one counseling (15% to 21%, P < 0.01. Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001.Conclusion: Adoption of a business model for HIV prevention helped to

  6. Utilization of a Web-Based vs Integrated Phone/Web Cessation Program Among 140,000 Tobacco Users: An Evaluation Across 10 Free State Quitlines

    Science.gov (United States)

    Vickerman, Katrina A; Kellogg, Elizabeth S; Zbikowski, Susan M

    2015-01-01

    Background Phone-based tobacco cessation program effectiveness has been established and randomized controlled trials have provided some support for Web-based services. Relatively little is known about who selects different treatment modalities and how they engage with treatments in a real-world setting. Objective This paper describes the characteristics, Web utilization patterns, and return rates of tobacco users who self-selected into a Web-based (Web-Only) versus integrated phone/Web (Phone/Web) cessation program. Methods We examined the demographics, baseline tobacco use, Web utilization patterns, and return rates of 141,429 adult tobacco users who self-selected into a Web-Only or integrated Phone/Web cessation program through 1 of 10 state quitlines from August 2012 through July 2013. For each state, registrants were only included from the timeframe in which both programs were offered to all enrollees. Utilization data were limited to site interactions occurring within 6 months after registration. Results Most participants selected the Phone/Web program (113,019/141,429, 79.91%). After enrollment in Web services, Web-Only were more likely to log in compared to Phone/Web (21,832/28,410, 76.85% vs 23,920/56,892, 42.04%; PPhone/Web were also more likely to return if they had completed a coaching call, identified as white non-Hispanic or “other” race, or were commercially insured (all Pphone. The interactive Tobacco Tracker, Cost Savings Calculator, and Quitting Plan were the most widely used features overall. Web-Only were more likely than Phone/Web to use most key features (all PPhone/Web and Web-Only, Web-Only were less likely to have received quitline NRT. Conclusions This paper adds to our understanding of who selects different cessation treatment modalities and how they engage with the program in a real-world setting. Web-Only were younger, healthier smokers of higher socioeconomic status who interacted more intensely with services in a single session

  7. Decomposition of Economic Inequality in Needle and Syringe Programs Utilization to its Determinants among Men Who Inject Drugs in Tehran using Blinder-Oaxaca Decomposition Method.

    Science.gov (United States)

    Noroozi, Mehdi; Rahimi, Ebrahim; Ghisvand, Hessam; Qorbani, Mostafa; Sharifi, Hamid; Noroozi, Alireza; Farhoudian, Ali; Marshall, Brandon D L; Jorjoran Shoshtari, Zahra; Karimi, Salah Eddin; Rezaei, Omid; Armoon, Bahram

    2017-11-22

    According to latest available data there are more of 300,000 people injects drug users (PWID) in Iran. In this study, we used a Blinder-Oaxaca (BO) decomposition to explore the relative contributions of inequality in utilization of NSPs and to decompose it to its determinants in Teheran. We used data from a cross-sectional survey using snowball sampling to recruit 500 PWID from June to July 2016 in Tehran. Participants were reported injecting drug use in the past month, were able to speak and comprehend Farsi enough to respond to survey questions, and were able to provide informed consent to complete the interview. We used a BO method to decompose the role of economic inequality on utilization of needle and syringe programs. A total 520 of clients participated in the study of which data was fully complete for 500. The selected predictor variables (age, education level, marital status, homelessness, HIV risk perception, and HIV knowledge) together explain 54% (8.5% out of 16%) of total inequality in utilization of needle and syringe programs and the remaining 46% constitute the unexplained residual. HIV risk perception status contributed about 38% (3.3% out of 8.5%) to the total health inequality, followed by HIV knowledge (26%) and education level were contributed 20% each, respectively. The results showed that contribution of economic inequalities in utilization of NSPs was primarily explained by the differential effects of HIV risk perception and HIV knowledge among PWID. Reducing HIV risk perception and increasing HIV knowledge might be essential to efforts to eliminate inequalities in access to NSPs among PWID.

  8. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... to make the concept of antimicrobial resistance more real and understandable to veterinarians, livestock producers, lawmakers, consumer ... FEAR Act Site Map Nondiscrimination Website Policies U.S. Food and Drug Administration 10903 New Hampshire Avenue Silver ...

  9. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... Monitoring System About NARMS 2015 NARMS Integrated Report Data Meetings and Publications Resources Judicious Use of Antimicrobials ... Federal, State & Local Officials Consumers Health Professionals Science & Research Industry Scroll back to top Popular Content Home ...

  10. What are Antimicrobial Pesticides?

    Science.gov (United States)

    Antimicrobial pesticides are substances or mixtures of substances used to destroy or suppress the growth of harmful microorganisms such as bacteria, viruses, or fungi on inanimate objects and surfaces.

  11. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... complex. This video was designed to make the concept of antimicrobial resistance more real and understandable to ... audiences. We hope this animation will make the concept more understandable to non-scientists by showing how ...

  12. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... More sharing options Linkedin Pin it Email Print The Food and Drug Administration's (FDA's) Center for Veterinary ... both emerges and proliferates among bacteria. Over time, the use of antimicrobial drugs will result in the ...

  13. Animation of Antimicrobial Resistance

    Medline Plus

    Full Text Available ... issue of antimicrobial resistance is that the subject material appears abstract and is complex. This video was ... can develop and spread. All FDA CVM produced material may be copied, reproduced, and distributed as long ...

  14. SYNTHESIS, STEREOCHEMISTRY AND ANTIMICROBIAL ...

    African Journals Online (AJOL)

    Preferred Customer

    KEY WORDS: 4-Phenylsemicarbazone, Metal complexes, Stereochemistry, Antimicrobial activity. INTRODUCTION ... stereochemistry of semicarbazone metal complexes [8-13], this group of ligands deserve further investigations. ..... The cytotoxicity of tested compounds generally increased with increase concentration and ...

  15. Utilization of an Anti-Gravity Treadmill in a Physical Activity Program with Female Breast Cancer Survivors: A Pilot Study.

    Science.gov (United States)

    Fairman, Ciaran M; Kendall, Kristina L; Harris, Brandonn S; Crandall, Kenneth J; McMillan, Jim

    Breast Cancer survivors can experience a myriad of physical and psychological benefits as a result of regular exercise. This study aimed to build on previous research using lower impact exercise programs by using an antigravity (Alter-G ® ) treadmill to administer cardiovascular training. The purpose of this study was to determine the effectiveness a physical activity program, including an Alter-G ® treadmill, for improving physiological and psychosocial measures in female breast cancer survivors. A 14-week intervention using an AB-AB study design was employed. Six female breast cancer survivors were recruited to participate in the study. Participants attended three 60-minute sessions per week, consisting of a combination of muscular strength/endurance, and cardiovascular endurance exercises. Consistent with current literature and guidelines, exercise interventions were individualized and tailored to suit individuals. Data was collected and analyzed in 2013. Visual inspection of results found improvements in cardiovascular endurance and measures of body composition. Quality of life was maintained and in some cases, improved. Finally, no adverse effects were reported from the participants, and adherence to the program for those who completed the study was 97%. The results of this study suggest that the use of a physical activity program in combination with an Alter-G ® treadmill may provide practical and meaningful improvements in measures of cardiovascular endurance and body composition.

  16. Blazing an Evaluation Pathway: Lessons Learned from Applying Utilization-Focused Evaluation to a Conservation Education Program

    Science.gov (United States)

    Flowers, Alice B.

    2010-01-01

    In 2005, state fish and wildlife agency wanted to examine how one of its conservation education programs was providing science-based understanding and outdoor experiences by evaluating students' knowledge, skills, attitudes and intended behavioral outcomes related to fish, fishing and aquatic habitats in Montana. A key factor in this study was the…

  17. From Theory to Practice: Utilizing Integrative Seminars as Bookends to the Master of Public Administration Program of Study

    Science.gov (United States)

    Stout, Margaret; Holmes, Maja Husar

    2013-01-01

    Integrative seminar style courses are most often used as an application-oriented capstone in place of a thesis or comprehensive exam requirement in Master of Public Administration (MPA) degree programs. This article describes and discusses the benefits of a unique approach of one National Association of Schools of Public Affairs and Administration…

  18. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care.

    Science.gov (United States)

    Milgrom, Peter; Sutherland, Marilynn; Shirtcliff, R Mike; Ludwig, Sharity; Smolen, Darlene

    2010-02-18

    A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid) in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93). The mean (SD) number of teeth with any decay was .75 (2.5) in the test population and 1.6 (2.5) in the comparison population (t = 2.08, p = .04). The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  19. Children's tooth decay in a public health program to encourage low-income pregnant women to utilize dental care

    Directory of Open Access Journals (Sweden)

    Shirtcliff R Mike

    2010-02-01

    Full Text Available Abstract Background A community-based public health program to provide a dental home for women covered by the Oregon Health Plan (Medicaid in Klamath County, Oregon USA was instituted with the long-term goal to promote preventive oral care for both mothers and their new infants provided by dental managed care companies. Methods As part of the evaluation of the program, children in Klamath and comparable non-program counties were examined in their 2nd year of life to begin to determine if benefits accrued to the offspring of the mothers in Klamath County. Results Eighty-five and 58.9% of the children were caries free in the Klamath and comparison county samples, respectively (RR = 1.48, 95% CI 1.13, 1.93. The mean (SD number of teeth with any decay was .75 (2.5 in the test population and 1.6 (2.5 in the comparison population (t = 2.08, p = .04. Conclusions The assessment showed that children of mothers in the Klamath County program were about one and a half times more likely to be caries free than children in the comparison counties. Additional controlled studies are being undertaken.

  20. Science teachers' utilization of Internet and inquiry-based laboratory lessons after an Internet-delivered professional development program

    Science.gov (United States)

    Lee, Kathryn Martell

    Much of the professional development in the past decades has been single incident experiences. The heart of inservice growth is the sustained development of current knowledge and practices, vital in science education, as reflected in the National Science Education Standards' inquiry and telecommunications components. This study was an exploration of an Internet-delivered professional development experience, utilizing multiple session interactive real-time data sources and semester-long sustained telementoring. Two groups of inservice teachers participated in the study, with only one group receiving a telementored coaching component. Measures of the dependent variable (delivery of an inquiry-based laboratory lesson sequence) were obtained by videotape, and predictive variables (self-analysis of teaching style and content delivery interviews) were administered to the forty veteran secondary school science teacher volunteers. Results showed that teachers in the group receiving semester-long coaching performed significantly better on utilizing the Internet for content research and inquiry-based lesson sequence delivery than the group not receiving the coaching. Members of the coached group were able to select a dedicated listserv, e-mail, chatline or telephone as the medium of coaching. While the members of the coached group used the listserv, the overwhelming preference was to be coached via the telephone. Qualitative analysis indicated that the telephone was selected for its efficiency of time, immediacy of response, and richer dialogue. Perceived barriers to the implementation of the Internet as a real-time data source in science classrooms included time for access, obsolesce of equipment, and logistics of computer to student ratios. These findings suggest that the group of science teachers studied (1) benefited from a sustained coaching experience for inquiry-based lesson delivery, (2) perceived the Internet as a source of content for their curriculum rather than a

  1. Geothermal direct-heat utilization assistance. Quarterly project progress report, July 1996--September 1996. Federal Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.

    1996-11-01

    This report summarizes geothermal technical assistance, R&D and technology transfer activities of the Geo-Heat Center at Oregon Institute of Technology for the fourth quarter of FY-96. It describes 152 contacts with parties during this period related to technical assistance with geothermal direct heat projects. Areas dealt with include geothermal heat pumps, space heating, greenhouses, aquaculture, equipment, economics and resources. Research activities are summarized on greenhouse peaking. Outreach activities include the publication of a geothermal direct use Bulletin, dissemination of information, geothermal library, technical papers and seminars, and progress monitor reports on geothermal resources and utilization.

  2. Geothermal direct-heat utilization assistance. Federal Assistance Program, Quarterly project progress report, October--December 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-12-31

    The report summarizes activities of the Geo-Heat Center (GHC) at Oregon Institute of Technology for the first quarter of Fiscal Year 1995. It describes contacts with parties during this period related to assistance with geothermal direct heat projects. Areas dealt with include geothermal heat pumps, space heating, greenhouses, aquaculture, resources and equipment. Research is also being conducted on geothermal energy cost evaluation, low-temperature geothermal resource assessment, use of silica waste from the Cerro Prieto geothermal field as construction materials and geothermal heat pumps. Outreach activities include the publication of a quarterly Bulletin on direct heat applications and dissemination of information on low-temperature geothermal resources and utilization.

  3. Virginia Solar Pathways Project: Economic Study of Utility-Administered Solar Programs: Soft Costs, Community Solar, and Tax Normalization Considerations

    Energy Technology Data Exchange (ETDEWEB)

    Reiter, Emerson [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lowder, Travis [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mathur, Shivani [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mercer, Megan [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-06-23

    This report presents economic considerations for solar development in support of the Virginia Solar Pathways Project (VSPP), an effort funded by the U.S. Department of Energy (DOE) SunShot Initiative that seeks to develop a collaborative utility-administered solar strategy for the Commonwealth of Virginia. The results presented are intended to be considered alongside the results of other studies conducted under the VSPP that evaluate the impacts of solar energy on the electric distribution, transmission, and generation systems in Virginia.

  4. QUEST/Ada (Query Utility Environment for Software Testing) of Ada: The development of a program analysis environment for Ada

    Science.gov (United States)

    Brown, David B.

    1988-01-01

    A history of the Query Utility Environment for Software Testing (QUEST)/Ada is presented. A fairly comprehensive literature review which is targeted toward issues of Ada testing is given. The definition of the system structure and the high level interfaces are then presented. The design of the three major components is described. The QUEST/Ada IORL System Specifications to this point in time are included in the Appendix. A paper is also included in the appendix which gives statistical evidence of the validity of the test case generation approach which is being integrated into QUEST/Ada.

  5. Novel antimicrobial textiles

    Science.gov (United States)

    Cho, Unchin

    2003-10-01

    Many microorganisms can survive, and perhaps proliferate on textiles, generating adverse effects such as: disease transmission, odor generation, pH changes, staining, discoloration and loss of performance. These adverse effects may threaten users' health, deteriorate textile properties and degrade service quality. It may, therefore, be desirable to incorporate antimicrobials on textiles for controlling the growth of microorganisms. This dissertation focuses on the development of antimicrobial fibers and fabrics by integration of antimicrobials with these textiles. The applications of hydantoin-based halamines were mainly investigated in the research. The typical process is that hydantoin containing compounds are grafted onto textiles and transformed to halamine by chlorination. Hydantoin-based halamines are usually chloramines that release chlorine (Cl+) via cleavage of the -NCl functional group which attacks and kills microbes. The antimicrobial behavior is rechargeable many times by rinsing the fiber or fabric with chlorine-containing solution. Some quaternary ammonium type antimicrobials were also investigated in this research. The choice of integrating techniques is dependant on both the textile and antimicrobial compounds. In this dissertation, the nine approaches were studied for incorporating antimicrobial with various textiles: (1) co-extrusion of fibers with halamine precursor additive; (2) grafting of the quaternary ammonium compounds onto ethylene-co-acrylic acid fiber for creating quaternary ammonium type antimicrobial fiber; (3) entrapment of the additives in thermally bonded bicomponent nonwoven fabrics; (4) attaching antimicrobial additives to surfaces with latex adhesive coating; (5) grafting of antimicrobial compounds onto rubber latex via UV exposure; (6) reaction of halamine with needle-punched melamine formaldehyde nonwoven fabric and laminates; (7) coating melamine resin onto tent fabrics and laminates; (8) synthesis of super absorbent polymer

  6. AMDD: Antimicrobial Drug Database

    OpenAIRE

    Danishuddin, Mohd; Kaushal, Lalima; Hassan Baig, Mohd; Khan, Asad U.

    2012-01-01

    Drug resistance is one of the major concerns for antimicrobial chemotherapy against any particular target. Knowledge of the primary structure of antimicrobial agents and their activities is essential for rational drug design. Thus, we developed a comprehensive database, anti microbial drug database (AMDD), of known synthetic antibacterial and antifungal compounds that were extracted from the available literature and other chemical databases, e.g., PubChem, PubChem BioAssay and ZINC, etc. The ...

  7. Novel Endogenous Antimicrobial Peptides

    OpenAIRE

    Nordahl, Emma

    2009-01-01

    Antimicrobial peptides serve as a first line of defence against invading microorganisms and are an essential part of our fast innate immune system. They are ancient molecules found in all classes of life. Antimicrobial peptides rapidly kill a broad spectrum of microbes and are immunomodulatory, i.e. having additional actions influencing inflammation and other innate immune responses. Results presented in this thesis demonstrate that proteases of common human pathogens degrade and inactivate t...

  8. 21st Century Power Partnership Fellowship Program: Supporting Next-generation Planning Modeling Practices at South Africa's Power Utility Eskom

    Energy Technology Data Exchange (ETDEWEB)

    Zinaman, Owen

    2016-10-01

    This presentation details the 21st Century Power Partnership's fellowship program accomplishments from 2016. This fellowship brought two fellows from South Africa's power utility, Eskom, to the U.S. Department of Energy's National Renewable Energy Laboratory. The fellows spent two weeks working to improve the fidelity of Eskom's PLEXOS long-term and short-term models, which are used in long-term generation planning exercises and capacity adequacy assessments. The fellows returned to Eksom equipped with a new suite of tools and skills to enhance Eksom's PLEXOS modeling capabilities.

  9. Electric utility transmission and distribution upgrade deferral benefits from modular electricity storage : a study for the DOE Energy Storage Systems Program.

    Energy Technology Data Exchange (ETDEWEB)

    Eyer, James M. (Distributed Utility Associates, Inc., Livermore, CA)

    2009-06-01

    The work documented in this report was undertaken as part of an ongoing investigation of innovative and potentially attractive value propositions for electricity storage by the United States Department of Energy (DOE) and Sandia National Laboratories (SNL) Electricity Storage Systems (ESS) Program. This study characterizes one especially attractive value proposition for modular electricity storage (MES): electric utility transmission and distribution (T&D) upgrade deferral. The T&D deferral benefit is characterized in detail. Also presented is a generalized framework for estimating the benefit. Other important and complementary (to T&D deferral) elements of possible value propositions involving MES are also characterized.

  10. VA health service utilization for homeless and low-income Veterans: a spotlight on the VA Supportive Housing (VASH) program in greater Los Angeles.

    Science.gov (United States)

    Gabrielian, Sonya; Yuan, Anita H; Andersen, Ronald M; Rubenstein, Lisa V; Gelberg, Lillian

    2014-05-01

    The US Department of Housing and Urban Development (HUD)-VA Supportive Housing (VASH) program-the VA's Housing First effort-is central to efforts to end Veteran homelessness. Yet, little is known about health care utilization patterns associated with achieving HUD-VASH housing. We compare health service utilization at the VA Greater Los Angeles among: (1) formerly homeless Veterans housed through HUD-VASH (HUD-VASH Veterans); (2) currently homeless Veterans; (3) housed, low-income Veterans not in HUD-VASH; and (4) housed, not low-income Veterans. We performed a secondary database analysis of Veterans (n=62,459) who received VA Greater Los Angeles care between October 1, 2010 and September 30, 2011. We described medical/surgical and mental health utilization [inpatient, outpatient, and emergency department (ED)]. We controlled for demographics, need, and primary care use in regression analyses of utilization data by housing and income status. HUD-VASH Veterans had more inpatient, outpatient, and ED use than currently homeless Veterans. Adjusting for demographics and need, HUD-VASH Veterans and the low-income housed Veterans had similar likelihoods of medical/surgical inpatient and outpatient utilization, compared with the housed, not low-income group. Adjusting first for demographics and need (model 1), then also for primary care use (model 2), HUD-VASH Veterans had the greatest decrease in incident rates of specialty medical/surgical, mental health, and ED care from models 1 to 2, becoming similar to the currently homeless, compared with the housed, not low-income group. Our findings suggest that currently homeless Veterans underuse health care relative to housed Veterans. HUD-VASH may address this disparity by providing housing and linkages to primary care.

  11. Reports on the utilization of the grant-in-aid for computational programs (the fiscal year 1990)

    International Nuclear Information System (INIS)

    1991-06-01

    In the Research Center for Nuclear Physics, Osaka University, as a part of the common utilization activities, the computation expense for common utilization has been instituted, and the mainly theoretical numerical computation in the field of nuclear physics has been supported since 1976. This computation expense invites the participation of the subjects of more than 50,000 yen every year, and the subjects are adopted through the opinion of referees and the discussion of the ad hoc committee. When this computation expense is used, the simple report in definite form and the more detailed report on the contents of computation shall be presented after the use was finished. In the former, the period and expense of computation, the publication of result and the main results are included, and in the latter, the abstract in English, the explanation of the results obtained by the computation and the physical contents, the new development, difficulty and the method of resolution in computation techniques, the subroutine, function and block diagram used for the computation are included. In this book, the latter reports of 27 subjects are collected. (K.I.)

  12. The Clinical Utility of Next Generation Sequencing Results in a Community-Based Hereditary Cancer Risk Program.

    Science.gov (United States)

    Bunnell, A E; Garby, C A; Pearson, E J; Walker, S A; Panos, L E; Blum, Joanne L

    2017-02-01

    Since the 2013 Supreme Court ruling on BRCA1/BRCA2 patenting, hereditary cancer gene panels now include BRCA1 and BRCA2, making these panels an option for first-tier testing. However, questions remain about the clinical utility and implications of these panels for medical management with inclusion of genes of unknown to moderate penetrance. To better understand how use of these panels affected our practice, we reviewed patients who underwent testing in our clinic from July 1, 2013 through May 23, 2014. Indications for testing included personal and/or family history of breast and/or ovarian cancer. A total of 136 patients underwent panel testing via a single commercial laboratory; 12 (8.8 %) patients were positive for a pathogenic or likely pathogenic mutation (four BRCA2 mutations, two TP53 mutations, one CDH1 mutation, two ATM mutations, and one patient each with a CHEK2, NBN, or PALB2 mutation). Of these positive patients, 100 % met the National Comprehensive Cancer Network (NCCN) guidelines for Hereditary Breast and Ovarian Cancer genetic testing (2.2014). Mutations in seven of twelve (58 %) patients led to changes in medical management; three of seven (43 %) had a non-BRCA1 or BRCA2 gene mutation. Our findings suggest that there is clinical utility of panels that include genes of unknown to moderate penetrance.

  13. Behavioral Approach to Appropriate Antimicrobial Prescribing in Hospitals: The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) Participatory Intervention Study.

    Science.gov (United States)

    Sikkens, Jonne J; van Agtmael, Michiel A; Peters, Edgar J G; Lettinga, Kamilla D; van der Kuip, Martijn; Vandenbroucke-Grauls, Christina M J E; Wagner, Cordula; Kramer, Mark H H

    2017-08-01

    Inappropriate antimicrobial prescribing leads to antimicrobial resistance and suboptimal clinical outcomes. Changing antimicrobial prescribing is a complex behavioral process that is not often taken into account in antimicrobial stewardship programs. To examine whether an antimicrobial stewardship approach grounded in behavioral theory and focusing on preserving prescriber autonomy and participation is effective in improving appropriateness of antimicrobial prescribing in hospitals. The Dutch Unique Method for Antimicrobial Stewardship (DUMAS) study was a prospective, stepped-wedge, participatory intervention study performed from October 1, 2011, through December 31, 2015. Outcomes were measured during a baseline period of 16 months and an intervention period of 12 months. The study was performed at 7 clinical departments (2 medical, 3 surgical, and 2 pediatric) in a tertiary care medical center and a general teaching hospital in the Netherlands. Physicians prescribing systemic antimicrobial drugs for any indication for patients admitted to the participating departments during the study period were included in the study. We offered prescribers a free choice of how to improve their antimicrobial prescribing. Prescribers were stimulated to choose interventions with higher potential for success based on a root cause analysis of inappropriate prescribing. Appropriateness of antimicrobial prescriptions was determined using a validated approach based on guideline adherence and motivated guideline deviation and measured with repeated point prevalence surveys (6 per year). Appropriateness judgment was masked for the study period. Antimicrobial consumption was extracted from pharmacy records and measured as days of therapy per admission. We used linear and logistic mixed-model regression analysis to model outcomes over time. A total of 1121 patient cases with 700 antimicrobial prescriptions were assessed during the baseline period and 882 patient cases with 531

  14. Preliminary assessment of anticipated availability and utilization of independent test laboratories to support certification and enforcement of DOE's Energy-Efficiency Standards Program

    Energy Technology Data Exchange (ETDEWEB)

    1981-02-13

    The DOE Conservation Program for Consumer Products requires the testing of products to determine whether they meet applicable energy-efficiency standards. Certification testing will take place at the manufacturers' facilities, while monitoring and enforcement usually take place at or by an independent test laboratory (ITL). Specifically, monitoring will take place at ITLs except in the case of trade-association programs where testing is generally conducted by trade-association representatives. ITLs will be utilized by DOE for all enforcement testing. Monitoring- and enforcement-test requirements are provided in Sections 2 and 3. Estimates and associated analysis of existing ITL capacity are given in Section 4. Section 5 compares ITL capacity and projected test-facility requirements and examines the cost and difficulty of eliminating projected deficits. A summary and conclusions are presented in Section 6. Appendix A presents an analysis of the sensitivity of projected ITL requirements to changes in key variables.

  15. Antimicrobial outcomes in plasma medicine

    Science.gov (United States)

    Ryan, Thomas P.; Stalder, Kenneth R.; Woloszko, Jean

    2015-03-01

    Plasma is referred to as the fourth state of matter and is frequently generated in the environment of a strong electric field. The result consists of highly reactive species--ions, electrons, reactive atoms and molecules, and UV radiation. Plasma Medicine unites a number of fields, including Physics, Plasma Chemistry, Cell Biology, Biochemistry, and Medicine. The treatment modality utilizes Cold Atmospheric Plasma (CAP), which is able to sterilize and treat microbes in a nonthermal manner. These gas-based plasma systems operate at close to room temperature and atmospheric pressure, making them very practical for a range of potential treatments and are highly portable for clinical use throughout the health care system. The hypothesis is that gas based plasma kills bacteria, fungus, and viruses but spares mammalian cells. This paper will review systematic work which shows examples of systems and performance in regards to antimicrobial effects and the sparing of mammalian cells. The mechanism of action will be discussed, as well as dosing for the treatment of microbial targets, including sterilization processes, another important healthcare need. In addition, commercial systems will be overviewed and compared, along with evidence-based, patient results. The range of treatments cover wound treatment and biofilms, as well as antimicrobial treatment, with little chance for resistance and tolerance, as in drug regimens. Current clinical studies include applications in dentistry, food treatment, cancer treatment, wound treatment for bacteria and biofilms, and systems to combat health care related infections.

  16. Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Alabama. Preliminary background report

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D.A.; Weaver, C.L.; Gallagher, K.C.; Hejna, D.; Rielley, K.J.

    1980-01-01

    The Alabama legislature has created the Public Service Commission which has general supervisory powers over utilities. The PSC consists of a president and two associates, who are elected to four-year terms. The PSC has no jurisdiction over municipal utilities and, as a result, local governments retain the power to regulate the operation of their municipally-owned utilities. Municipalities also retain their police power over streets and highways within their territory. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.

  17. Utilization of 3-Month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kyeongra Yang

    2011-01-01

    Full Text Available Various modes of physical activity, combined with dieting, have been widely recommended to prevent or delay type 2 diabetes. Among these, yoga holds promise for reducing risk factors for type 2 diabetes by promoting weight loss, improving glucose levels and reducing blood pressure and lipid levels. This pilot study aimed to assess the feasibility of implementing a 12-week yoga program among adults at high risk for type 2 diabetes. Twenty-three adults (19 Whites and 4 non-Whites were randomly assigned to the yoga intervention group or the educational group. The yoga group participated in a 3-month yoga intervention with sessions twice per week and the educational group received general health educational materials every 2 weeks. All participants completed questionnaires and had blood tests at baseline and at the end of 3 months. Effect sizes were reported to summarize the efficacy of the intervention. All participants assigned to the yoga intervention completed the yoga program without complication and expressed high satisfaction with the program (99.2%. Their yoga session attendance ranged from 58.3 to 100%. Compared with the education group, the yoga group experienced improvements in weight, blood pressure, insulin, triglycerides and exercise self-efficacy indicated by small to large effect sizes. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for this group.

  18. Study of the impacts of regulations affecting the acceptance of Integrated Community Energy Systems: public utility, energy facility siting and municipal franchising regulatory programs in Indiana. Preliminary background report

    Energy Technology Data Exchange (ETDEWEB)

    Feurer, D A; Weaver, C L; Gallagher, K C; Hejna, D; Rielley, K J

    1980-01-01

    The authority to regulate public utilities is vested generally in the Public Service Commission of Indiana. The Commission is comprised of three members appointed by the governor. Commissioners are appointed for four-year terms. They must be free from any employment or pecuniary interest in any public utility. Indiana courts have stated that the Commission was created and vested with regulatory authority over public utilities in order to relieve these utilities from local regulation. Local governments do, however, have specific statutory authority to determine, by contract or ordinance, the quality and character of service to be provided by public utilities within the municipality. Local governments may also regulate the use of streets and other public property by public utilities. Public utility regulatory statutes, energy facility siting programs, and municipal franchising authority are examined to identify how they may impact on the ability of an organization, whether or not it be a regulated utility, to construct and operate an ICES.

  19. Ceftaroline activity tested against bacterial isolates from pediatric patients: results from the assessing worldwide antimicrobial resistance and evaluation program for the United States (2011-2012).

    Science.gov (United States)

    Sader, Helio S; Mendes, Rodrigo E; Farrell, David J; Flamm, Robert K; Jones, Ronald N

    2014-08-01

    Ceftaroline, the active form of ceftaroline fosamil, is a cephalosporin with broad-spectrum bactericidal activity against resistant Gram-positive organisms, including methicillin-resistant Staphylococcus aureus, ceftriaxone-resistant Streptococcus pneumoniae and many Enterobacteriaceae species. Ceftaroline fosamil is approved in the United States for treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia in adults. A total of 5291 consecutive unique pediatric patient strains of clinical significance were collected from 157 US medical centers. The isolates were identified locally and forwarded to a central monitoring laboratory for reference antimicrobial susceptibility testing. S. pneumoniae isolates from the 2011 to 2012 respiratory season were serotyped. Susceptibility results were analyzed according to patient age as follows: ≤ 1 years old (yo; 1857 strains); 2-5 (1342); 6-12 (1281) and 13-17 (811). Methicillin-resistant Staphylococcus aureus rates were slightly lower in isolates from patients 13-17 yo (39.9%) compared with other age groups (48.2-51.5%), and ceftaroline was consistently active against S. aureus isolates from all 4 age groups [minimal inhibitory concentration (MIC50/90): 0.25-05/1 μg/mL; 99.8-100.0% susceptible]. Overall, 99.8% of methicillin-resistant Staphylococcus aureus were ceftaroline susceptible (MIC50/90: 0.5/1 μg/mL). All S. pneumoniae strains (1178) were ceftaroline susceptible (MIC50/90: ≤ 0.015/0.12 μg/mL), whereas ceftriaxone susceptibility varied from only 84.8 (≤ 1 yo) to 89.7% (13-17 yo). 19A was the most frequent serotype identified among S. pneumoniae and these isolates exhibited low susceptibility to ceftriaxone (42.4%) and most other antimicrobials tested. The highest ceftaroline MIC among Haemophilus influenzae (587 strains) was 0.12 μg/mL (100.0% susceptible), and β-lactamase production rates varied from 24.2 (13-17 yo) to 30.1% (6-12 yo); 27.9% overall

  20. The Argonne Radiological Impact Program (ARIP). Part II. MONITOR: A Program and Data Base for Retrieval and Utilization of Pollutant Monitoring Data

    Energy Technology Data Exchange (ETDEWEB)

    Eckerman, Keith F.; Stowe, Ralph F.; Frigerio, Norman A.

    1977-02-01

    The Argonne Radiological Impact Program (ARIP) is an ongoing project of the Laboratory's Division of Environmental Impact Studies that aims at developing methodologies for assessing the carcinogenic hazards associated with nuclear power development. The project's first report (ANL/ES-26, Part I), published in September.l973, discussed models of radiation carcinogenesis and the contribution of U .. S. background radiation levels to hazardous dose rates. The current report (Part II) treats the storage and access of available data on radiation and radioactivity levels in the u. S. A compute-r code. (the MONITOR program) is prf!sented, which can serve as a ready-access data. bank for all monitoring data acquired over the past two decades. The MONITOR program currently stores data on monitoring locations, types of monitoring efforts, and types of monitoring data. reported in Radiation Data and Reports by the various state and federal ne-tworks; expansion of this data base to include nuclear power facilities in operation or on order is ongoing