2008 stewardship report

International Nuclear Information System (INIS)

2009-03-01

The Canadian Association of Petroleum Producers prepares an annual stewardship report as part of the industry's commitment to stewardship through the open and transparent reporting of progress on environmental, health and safety, and social issues. These reports also serve to provide annual benchmarking targets for the industry to surpass. This report presented the eighth annual stewardship report for 2008 and discussed indicators relating to several areas. The first involved air quality as it relates to climate change and greenhouse gases and technological solutions such as toe-to-heel air injection; geothermal energy; and carbon capture and sequestration. The issues of releasing greenhouse gases through flaring and venting were also examined along with other issues such as returning the land to a sustainable landscape; using water to produce oil and gas; ensuring the workplace is safe; and maintaining positive relationships. It was concluded that while greenhouse gas intensity has dropped, overall emissions have increase. Surface water use has also slightly increased. figs

Twenty-eight years of wilderness campsite monitoring in Yosemite National Park

Science.gov (United States)

Laurel Boyers; Mark Fincher; Jan van Wagtendonk

2000-01-01

The research, resource management and wilderness staffs in Yosemite National Park recently completed the third 10-year cycle of a wilderness campsite impact monitoring program. Initial results indicate an overall improvement in conditions due to a strong restoration program, decreased use and increased visitor education. Lessons learned point to the necessity for ample...

Environmental Stewardship: A Conceptual Review and Analytical Framework

Science.gov (United States)

Bennett, Nathan J.; Whitty, Tara S.; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H.

2018-04-01

There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.

Environmental Stewardship: A Conceptual Review and Analytical Framework.

Science.gov (United States)

Bennett, Nathan J; Whitty, Tara S; Finkbeiner, Elena; Pittman, Jeremy; Bassett, Hannah; Gelcich, Stefan; Allison, Edward H

2018-04-01

There has been increasing attention to and investment in local environmental stewardship in conservation and environmental management policies and programs globally. Yet environmental stewardship has not received adequate conceptual attention. Establishing a clear definition and comprehensive analytical framework could strengthen our ability to understand the factors that lead to the success or failure of environmental stewardship in different contexts and how to most effectively support and enable local efforts. Here we propose such a definition and framework. First, we define local environmental stewardship as the actions taken by individuals, groups or networks of actors, with various motivations and levels of capacity, to protect, care for or responsibly use the environment in pursuit of environmental and/or social outcomes in diverse social-ecological contexts. Next, drawing from a review of the environmental stewardship, management and governance literatures, we unpack the elements of this definition to develop an analytical framework that can facilitate research on local environmental stewardship. Finally, we discuss potential interventions and leverage points for promoting or supporting local stewardship and future applications of the framework to guide descriptive, evaluative, prescriptive or systematic analysis of environmental stewardship. Further application of this framework in diverse environmental and social contexts is recommended to refine the elements and develop insights that will guide and improve the outcomes of environmental stewardship initiatives and investments. Ultimately, our aim is to raise the profile of environmental stewardship as a valuable and holistic concept for guiding productive and sustained relationships with the environment.

Intergenerational equity and long-term stewardship plans

International Nuclear Information System (INIS)

Hocking, E. K.

2002-01-01

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

The organisational structure of urban environmental stewardship

Science.gov (United States)

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

2012-01-01

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

Proceedings: Twenty years of energy policy: Looking toward the twenty-first century

International Nuclear Information System (INIS)

1992-01-01

In 1973, immediately following the Arab Oil Embargo, the Energy Resources Center, University of Illinois at Chicago initiated an innovative annual public service program called the Illinois Energy Conference. The objective was to provide a public forum each year to address an energy or environmental issue critical to the state, region and nation. Twenty years have passed since that inaugural program, and during that period we have covered a broad spectrum of issues including energy conservation nuclear power, Illinois coal, energy policy options, natural gas, alternative fuels, new energy technologies, utility deregulation and the National Energy Strategy

Proceedings: Twenty years of energy policy: Looking toward the twenty-first century

Energy Technology Data Exchange (ETDEWEB)

1992-12-31

In 1973, immediately following the Arab Oil Embargo, the Energy Resources Center, University of Illinois at Chicago initiated an innovative annual public service program called the Illinois Energy Conference. The objective was to provide a public forum each year to address an energy or environmental issue critical to the state, region and nation. Twenty years have passed since that inaugural program, and during that period we have covered a broad spectrum of issues including energy conservation nuclear power, Illinois coal, energy policy options, natural gas, alternative fuels, new energy technologies, utility deregulation and the National Energy Strategy.

Impact of Stewardship Interventions on Antiretroviral Medication Errors in an Urban Medical Center: A 3-Year, Multiphase Study.

Science.gov (United States)

Zucker, Jason; Mittal, Jaimie; Jen, Shin-Pung; Cheng, Lucy; Cennimo, David

2016-03-01

There is a high prevalence of HIV infection in Newark, New Jersey, with University Hospital admitting approximately 600 HIV-infected patients per year. Medication errors involving antiretroviral therapy (ART) could significantly affect treatment outcomes. The goal of this study was to evaluate the effectiveness of various stewardship interventions in reducing the prevalence of prescribing errors involving ART. This was a retrospective review of all inpatients receiving ART for HIV treatment during three distinct 6-month intervals over a 3-year period. During the first year, the baseline prevalence of medication errors was determined. During the second year, physician and pharmacist education was provided, and a computerized order entry system with drug information resources and prescribing recommendations was implemented. Prospective audit of ART orders with feedback was conducted in the third year. Analyses and comparisons were made across the three phases of this study. Of the 334 patients with HIV admitted in the first year, 45% had at least one antiretroviral medication error and 38% had uncorrected errors at the time of discharge. After education and computerized order entry, significant reductions in medication error rates were observed compared to baseline rates; 36% of 315 admissions had at least one error and 31% had uncorrected errors at discharge. While the prevalence of antiretroviral errors in year 3 was similar to that of year 2 (37% of 276 admissions), there was a significant decrease in the prevalence of uncorrected errors at discharge (12%) with the use of prospective review and intervention. Interventions, such as education and guideline development, can aid in reducing ART medication errors, but a committed stewardship program is necessary to elicit the greatest impact. © 2016 Pharmacotherapy Publications, Inc.

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

Science.gov (United States)

Cardone, Franco; Cheung, Daphne; Han, Angela; Born, Karen B; Alexander, Lisa; Levinson, Wendy; Wong, Brian M

2017-12-19

Resource stewardship is being increasingly recognized as an essential competency for physicians, but medical schools are just beginning to integrate this into education. We describe the evaluation of Choosing Wisely Canada's Students and Trainees Advocating for Resource Stewardship (STARS) campaign, a student-led campaign to advance resource stewardship education in medical schools across Canada. We evaluated the campaign 6 months after its launch, in November 2015. STARS students were administered a telephone survey eliciting a description of the initiatives that they had implemented or planned to implement at their schools to promote resource stewardship, and exploring their perceptions of facilitators of and barriers to successful implementation of their initiatives. We used a mixed-methods approach to analyze and summarize the data. Twenty-seven (82%) of the 33 eligible students representing all 17 medical schools responded. In 14 schools (82%), students led various local activities (e.g., interest groups, campaign weeks) to raise awareness about resource stewardship among medical students and faculty. Students contributed to curriculum change (both planned and implemented) at 10 schools (59%). Thematic analysis revealed key program characteristics that facilitated success (e.g., pan-Canadian student network, local faculty champion) as well as barriers to implementing change (e.g., complex processes to change curriculum, hierarchical nature of medical school). This student-led campaign, with support from local faculty and Choosing Wisely Canada staff, led to awareness-building activities and early curricula change at medical schools across Canada. Future plans will build on the initial momentum created by the STARS campaign to sustain and spread local initiatives. Copyright 2017, Joule Inc. or its licensors.

Radiation curing - twenty five years on

International Nuclear Information System (INIS)

Garnett, J.L.

1995-01-01

Progress in UV/EB curing during the past twenty five years is briefly reviewed. During this time developments in unique polymer chemistry, novel equipment design and the introduction of relevant educational programmes has enabled radiation curing to become an established technology with specific strengths in certain industries. Possible reasons for the emergence of the technology in these niche markets are discussed. Despite the worldwide recession, radiation curing is shown to be expanding at 5% per annum with the prospect of higher growth with improving economic conditions. (Author)

Safety regulation - twenty years after Chernobyl accident

International Nuclear Information System (INIS)

Aleksashin, P.P.; Bukrinskij, A.M.; Gordon, B.G.

2006-01-01

Main stages of development, successes, achievements and shortcomings of activity of supervision body after the Chernobyl NPP accident are analysed. The estimation of the realized variations of the functions of the state supervision department is carried out. Results of the twenty year period of improvement of the supervision body are summed up. The measures for increasing the efficiency of the supervision body operation are outlined [ru

Deformation quantization: Twenty years after

International Nuclear Information System (INIS)

Sternheimer, Daniel

1998-01-01

We first review the historical developments, both in physics and in mathematics, that preceded (and in some sense provided the background of) deformation quantization. Then we describe the birth of the latter theory and its evolution in the past twenty years, insisting on the main conceptual developments and keeping here as much as possible on the physical side. For the physical part the accent is put on its relations to, and relevance for, 'conventional' physics. For the mathematical part we concentrate on the questions of existence and equivalence, including most recent developments for general Poisson manifolds; we touch also noncommutative geometry and index theorems, and relations with group theory, including quantum groups. An extensive (though very incomplete) bibliography is appended and includes background mathematical literature

The Six Principles of Facilities Stewardship

Science.gov (United States)

Kaiser, Harvey H.; Klein, Eva

2010-01-01

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

Long-Term Stewardship Baseline Report and Transition Guidance

Energy Technology Data Exchange (ETDEWEB)

Kristofferson, Keith

2001-11-01

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

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...

Twenty years of diffraction at the Tevatron

International Nuclear Information System (INIS)

Goulianos, K.; Rockefeller U.

2005-01-01

Results on diffractive particle interactions from the Fermilab Tevatron (bar p)p collider are placed in perspective through a QCD inspired phenomenological approach, which exploits scaling and factorization properties observed in data. The results discussed are those obtained by the CDF Collaboration from a comprehensive set of single, double, and multigap soft and hard diffraction processes studied during the twenty year period since 1985, when the CDF diffractive program was proposed and the first Blois Workshop was held

Science-based stockpile stewardship at Los Alamos National Laboratory

International Nuclear Information System (INIS)

Immele, J.

1995-01-01

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

Twenty-five years of simulator training

International Nuclear Information System (INIS)

Anon.

2002-01-01

The first training simulator for nuclear power plant personnel in Germany was commissioned twenty-five years ago. The strategy of training by simulators was developed and pursued consistently and continuously in order to ensure sound training of nuclear power plant personnel. The present thirteen simulators cover a broad range of plants. A systematic training concept also helps to ensure a high level of competence and permanent qualification of plant personnel. The anniversary was marked by a festive event at which Erich K. Steiner read a paper on 'The Importance of Simulator Training', and Professor Dr. Adolf Birkhofer spoke about 'Nuclear Technology Education and Training'. (orig.)

Which Russia, twenty years later?

Directory of Open Access Journals (Sweden)

Carmen Claudín

2011-12-01

Full Text Available Russia is proud of its position among the emerging powers, of the strength provided by its ample energetic resources and its nuclear potential with which it can influence the world and always be taken into account. Nevertheless, the perception within the country is that stagnation has become Russia’s dominant characteristic at present. The objective of this article is to explore how this situation came about, analysing the evolution of domestic processes in Russia during both of its most defining periods: Yeltsin and Putin’s leadership, since the ephemeral presidency of Medvedev proved to be basically a continuation of the latter. During the eight years of Boris Yeltsin’s tenure, the state of crisis, latent or open, developed into the way that political processes are carried out in Russia. With Putin’s arrival, however, stability and State control are imposed, against the backdrop of economic growth, and they become values in themselves, far from the democratic discourse of the first years.

Visit ALEPH experiment on the LEP collider by twenty-eight young scientists chosen to represent their respective countries

CERN Multimedia

Laurent Guiraud

1998-01-01

Following an international meeting of secondary school pupils on the theme of "Future Scientists: Women and Men" in Paris on 23 and 24 April. The aim of this meeting, which was organised by UNESCO, was to encourage young people, and girls in particular, to choose scientific studies and careers. Twenty-eight young scientists chosen to represent their respective countries visited the CERN site this week following an international meeting of secondary school pupils on the theme of "Future Scientists: Women and Men" in Paris on 23 and 24 April. The aim of this meeting, which was organised by UNESCO, was to encourage young people, and girls in particular, to choose scientific studies and careers.

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

Science.gov (United States)

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

2014-02-01

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

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

Science.gov (United States)

Siemer, William F.

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

Twenty Years of French "Didactique" Viewed from the United States

Science.gov (United States)

Kilpatrick, Jeremy

2003-01-01

One cannot begin considering the topic of this colloquium without asking, why twenty years? Why not two hundred? Two hundred years ago, Silvestre Franois Lacroix was about to be named chief officer of the Commission Executive de L'Instruction Publique. Out of that experience, together with his long career in instruction, especially as professor of…

2015 Stewardship Science Academic Programs Annual

Energy Technology Data Exchange (ETDEWEB)

Stone, Terri [NNSA Office of Research, Development, Test, and Evaluation, Washington, DC (United States); Mischo, Millicent [NNSA Office of Research, Development, Test, and Evaluation, Washington, DC (United States)

2015-02-01

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

Idaho National Laboratory Comprehensive Land Use and Environmental Stewardship Report

Energy Technology Data Exchange (ETDEWEB)

No name listed on publication

2011-08-01

Land and facility use planning and decisions at the Idaho National Laboratory (INL) Site are guided by a comprehensive site planning process in accordance with Department of Energy Policy 430.1, 'Land and Facility Use Policy,' that integrates mission, economic, ecologic, social, and cultural factors. The INL Ten-Year Site Plan, prepared in accordance with Department of Energy Order 430.1B, 'Real Property Asset Management,' outlines the vision and strategy to transform INL to deliver world-leading capabilities that will enable the Department of Energy to accomplish its mission. Land use planning is the overarching function within real property asset management that integrates the other functions of acquisition, recapitalization, maintenance, disposition, real property utilization, and long-term stewardship into a coordinated effort to ensure current and future mission needs are met. All land and facility use projects planned at the INL Site are considered through a formal planning process that supports the Ten-Year Site Plan. This Comprehensive Land Use and Environmental Stewardship Report describes that process. The land use planning process identifies the current condition of existing land and facility assets and the scope of constraints across INL and in the surrounding region. Current land use conditions are included in the Comprehensive Land Use and Environmental Stewardship Report and facility assets and scope of constraints are discussed in the Ten-Year Site Plan. This report also presents the past, present, and future uses of land at the INL Site that are considered during the planning process, as well as outlining the future of the INL Site for the 10, 30, and 100-year timeframes.

Evaluation of pharmacy generalists performing antimicrobial stewardship services.

Science.gov (United States)

Carreno, Joseph J; Kenney, Rachel M; Bloome, Mary; McDonnell, Jane; Rodriguez, Jennifer; Weinmann, Allison; Kilgore, Paul E; Davis, Susan L

2015-08-01

Improvements in medication use achieved by pharmacy generalists using a care bundle approach to antimicrobial stewardship are reported. A six-month prospective, repeated-treatment, quasi-experimental study involving three month-long intervention periods and three month-long control periods was conducted in the setting of an existing antimicrobial stewardship program at a large hospital. The intervention involved prospective audit and feedback conducted by pharmacy generalists who were trained in an antimicrobial stewardship care bundle approach. During control months, a pharmacy generalist who was not trained in antimicrobial stewardship rounded with the multidisciplinary team and provided standard-of-care pharmacy services. The primary endpoint was compliance with a care bundle of four antimicrobial stewardship metrics: documentation of indication for therapy in the medical record, selection of empirical therapy according to institutional guidelines, documented performance of indicated culture testing, and deescalation of therapy when indicated. Two-hundred eighty-six patients were enrolled in the study: 124 in the intervention group and 162 in the control group. The cumulative rate of full compliance with all care bundle components during the six-month study was significantly greater during intervention months than during control months (68.5% versus 45.7%, p management. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Antimicrobial Stewardship in Daily Practice: Managing an Important Resource

Directory of Open Access Journals (Sweden)

Nicole Le Saux

2014-01-01

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

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...

Eight years' operation of the SGHWR prototype

International Nuclear Information System (INIS)

Phillips, J.L.

1976-01-01

Experience gained of the SGHWR system during the first eight years of operation of the UKAEA's 100 MW(e) prototype at AEE Winfrith is discussed. Modifications and additions have been made to the plant to overcome problems which only operation of a prototype unit can reveal. No problems have arisen which could not be overcome by the application of normal engineering resources, and there is no reason why the commercial successor to the prototype should be other than a fully viable proposition. (author)

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...

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

Science.gov (United States)

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

2016-01-01

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

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

Directory of Open Access Journals (Sweden)

Muhammad Umair Khan

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

Development of effective hospital-based antibiotic stewardship program. The role of infectious disease specialist

Directory of Open Access Journals (Sweden)

Georgios Chrysos

2017-01-01

Full Text Available Excessive antibiotic consumption and misuse is one of the main factors responsible for the emergence of antibiotic-resistant bacteria and has been associated with increased health care costs. Active intervention is necessary in changing antimicrobial prescribing practices. The Infection Control Committee and the administration of our hospital decided to implement an antibiotic stewardship program beginning in January 2016 in order to reduce inappropriate antibiotic use and to combat antibiotic resistance through improved prescribing practices. The antimicrobial stewardship team includes an ID specialist, physicians, infection control nurses, a microbiologist and a pharmacist who are responsible for the implementation of the program. Preauthorization by an ID specialist and prospective review is necessary for all pharmacy orders of antibiotics under restriction. Pre-intervention, we collected Pharmacy and hospital data regarding antibiotic consumption and numbers of patient-days for the years 2013-2015. We calculated antibiotic use in Defined Daily Doses (DDDs/100 patient-days. After one year, the antibiotic stewardship program was effective in reducing consumption of most antibiotics. The result of the implementation of the program in our hospital was a reduction about 17% of antibiotic DDDs/100 patient-days and about 21% of the antibiotic cost/100 patient-days. Education is an essential element of our program in order to influence prescribing behavior. Lectures and brochures are used to supplement strategies. Antibiotic stewardship programs have been shown from many studies to improve patient outcomes, reduce antibiotic resistance and save money.

Eight to ten years follow-up after carotid endarterectomy

DEFF Research Database (Denmark)

Knudsen Rathenborg, Lisbet; Sillesen, H; Schroeder, T

1990-01-01

Follow-up information was obtained on 185 patients who consecutively underwent carotid endarterectomy eight to ten years previously. Doppler ultrasound examination was performed in 59 patients who were still alive and living within 100 miles of the hospital. Using lifetable analysis, the annual r...

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.

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.

Twenty five years of fundamental theory

International Nuclear Information System (INIS)

Bell, J.S.

1980-01-01

In reviewing the last twenty five years in fundamental physics theory it is stated that there has been no revolution in this field. In the absence of gravitation, Lorentz invariance remains a requirement on fundamental laws. Einstein's theory of gravitation inspires increasing conviction on the astronomical scale. Quantum theory remains the framework for all serious effort in microphysics, and quantum electrodynamics remains the model of a fully articulated microphysical theory, completely successful in its domain. However,a number of ideas have appeared, of great theoretical interest and some phenomenological success, which may well contribute to the next decisive step. Recent work on the following topics is mentioned; gravitational radiation, singularites, black body radiation from black holes, gauge and hidden symmetry in quantum electrodynamics, the renormalization of electromagnetic and weak interaction theory, non-Abelian gauge theories, magnetic monopoles as the most striking example of solitons, and supersymmetry. (UK)

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

Science.gov (United States)

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

2017-03-01

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

An Embedded Librarian Program: Eight Years On.

Science.gov (United States)

Freiburger, Gary; Martin, Jennifer R; Nuñez, Annabelle V

2016-01-01

This article examines an embedded librarian program eight years after implementation in a large academic health center. Librarians were physically moved into the colleges of pharmacy, public health, and nursing. Statistics are reported as well as comments from the participating librarians and faculty members. Strong relationships have been built between librarians, faculty members, and students. Locating the librarians among faculty and students led to a better understanding of client needs and an increased awareness of librarian competencies and services resulting in partnerships and greater utilization of library services.

A broader view of stewardship to achieve conservation and sustainability goals in South Africa

Directory of Open Access Journals (Sweden)

Jaco Barendse

2016-05-01

Full Text Available Stewardship is a popular term for the principles and actions aimed at improving sustainability and resilience of social-ecological systems at various scales and in different contexts. Participation in stewardship is voluntary, and is based on values of altruism and long-term benefits. At a global scale, "earth stewardship" is viewed as a successor to earlier natural resource management systems. However, in South Africa, stewardship is narrowly applied to biodiversity conservation agreements on private land. Using a broader definition of stewardship, we identify all potentially related schemes that may contribute to sustainability and conservation outcomes. Stewardship schemes and actors are represented as a social network and placed in a simple typology based on objectives, mechanisms of action and operational scales. The predominant type was biodiversity stewardship programmes. The main actors were environmental non-governmental organisations participating in prominent bioregional landscape partnerships, together acting as important "bridging organisations" within local stewardship networks. This bridging enables a high degree of collaboration between non-governmental and governmental bodies, especially provincial conservation agencies via mutual projects and conservation objectives. An unintended consequence may be that management accountability is relinquished or neglected by government because of inadequate implementation capacity. Other stewardship types, such as market-based and landscape initiatives, complemented primarily biodiversity ones, as part of national spatial conservation priorities. Not all schemes related to biodiversity, especially those involving common pool resources, markets and supply chains. Despite an apparent narrow biodiversity focus, there is evidence of diversification of scope to include more civic and community-level stewardship activities, in line with the earth stewardship metaphor.

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

Science.gov (United States)

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

2013-01-01

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

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.

Twenty years of society of medical informatics of b&h and the journal acta informatica medica.

Science.gov (United States)

Masic, Izet

2012-03-01

In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.

Investigating the Twenty Year Lag in the Vocational Rehabilitation Process.

Science.gov (United States)

Lowitt, Julian

In the rehabilitation workshop there is insufficient attention to job development oriented to the current and future needs of industry. Many types of work which were done in vocational workshops in contract from industrial firms are now done by automation. Semiskilled labor is thus in diminished demand. There is a twenty year lag in the industrial…

Twenty five years of clusters -- from Bochum to Strasbourg

International Nuclear Information System (INIS)

Betts, R.R.; Chicago Univ., IL

1994-01-01

Developments in the area of clustering aspects of nuclear structure and reactions over the past twenty-five years are reviewed. The viewpoint is that the nucleus is an assembly of clusters. The question is whether clusters actually exist in the nucleus. Although there is abundant evidence for this in light nuclei, the situation for more complex clusters in heavier nuclei is much worse. Differential cross sections for scattering of alpha particles and heavy ions are shown

Earth Stewardship: An initiative by the Ecological Society of America to foster engagement to sustain Planet Earth

Science.gov (United States)

Chapin, F. Stuart; Pickett, S.T.A.; Power, Mary E.; Collins, Scott L.; Baron, Jill S.; Inouye, David W.; Turner, Monica G.

2017-01-01

The Ecological Society of America (ESA) has responded to the growing commitment among ecologists to make their science relevant to society through a series of concerted efforts, including the Sustainable Biosphere Initiative (1991), scientific assessment of ecosystem management (1996), ESA’s vision for the future (2003), Rapid Response Teams that respond to environmental crises (2005), and the Earth Stewardship Initiative (2009). During the past 25 years, ESA launched five new journals, largely reflecting the expansion of scholarship linking ecology with broader societal issues. The goal of the Earth Stewardship Initiative is to raise awareness and to explore ways for ecologists and other scientists to contribute more effectively to the sustainability of our planet. This has occurred through four approaches: (1) articulation of the stewardship concept in ESA publications and Website, (2) selection of meeting themes and symposia, (3) engagement of ESA sections in implementing the initiative, and (4) outreach beyond ecology through collaborations and demonstration projects. Collaborations include societies and groups of Earth and social scientists, practitioners and policy makers, religious and business leaders, federal agencies, and artists and writers. The Earth Stewardship Initiative is a work in progress, so next steps likely include continued nurturing of these emerging collaborations, advancing the development of sustainability and stewardship theory, improving communication of stewardship science, and identifying opportunities for scientists and civil society to take actions that move the Earth toward a more sustainable trajectory.

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

Science.gov (United States)

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

2016-06-01

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

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.

After Twenty-Five Years: A Twenty-Five Year Follow-up Study of Middlesex County Vocational and Technical High School Graduates of the Class of June 1953.

Science.gov (United States)

Rogers, William; Zanzalari, J. Henry

A twenty-five-year follow-up study was conducted to determine the occupational, educational, marital and armed forces experiences of the graduating class of 1953 from the Middlesex County Vocational and Technical high schools located in New Brunswick, Perth, Amboy, and Woodbridge, New Jersey. Data, in the form of questionnaire responses, were…

Perspectives on Peer-Review: Eight Years of Aropä

Science.gov (United States)

Purchase, Helen; Hamer, John

2018-01-01

Drawing on eight years of observation and correspondence from the Aropä project, we report on the issues important to academics who conduct on-line student peer-review activities, and the features they request to support their own instructional designs. The Aropä project is unusually broad, having so far supported over 100 instructors at 20…

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

Science.gov (United States)

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

Government stewardship of the for-profit private health sector in Afghanistan.

Science.gov (United States)

Cross, Harry E; Sayedi, Omarzaman; Irani, Laili; Archer, Lauren C; Sears, Kathleen; Sharma, Suneeta

2017-04-01

Since 2003, Afghanistan's largely unregulated for-profit private health sector has grown at a rapid pace. In 2008, the Ministry of Public Health (MoPH) launched a long-term stewardship initiative to oversee and regulate private providers and align the sector with national health goals. We examine the progress the MoPH has made towards more effective stewardship, consider the challenges and assess the early impacts on for-profit performance. We reviewed publicly available documents, publications and the grey literature to analyse the development, adoption and implementation of strategies, policies and regulations. We carried out a series of key informant/participant interviews, organizational capacity assessments and analyses of hospital standards checklists. Using a literature review of health systems strengthening, we proposed an Afghan-specific definition of six key stewardship functions to assess progress towards MoPH stewardship objectives. The MoPH and its partners have achieved positive results in strengthening its private sector stewardship functions especially in generating actionable intelligence and establishing strategic policy directions, administrative structures and a legal and regulatory framework. Progress has also been made on improving accountability and transparency, building partnerships and applying minimum required standards to private hospitals. Procedural and operational issues still need resolution and the MoPH is establishing mechanisms for resolving them. The MoPH stewardship initiative is notable for its achievements to date under challenging circumstances. Its success is due to the focus on developing a solid policy framework and building institutions and systems aimed at ensuring higher quality private services, and a rational long-term and sustainable role for the private sector. Although the MoPH stewardship initiative is still at an early stage, the evidence suggests that enhanced stewardship functions in the MoPH are leading to a

Antimicrobial stewardship: Limits for implementation

NARCIS (Netherlands)

Sinha, Bhanu

2014-01-01

Antibiotic stewardship programme (ASP) is a multifaceted approach to improve patients' clinical outcomes, prevent the emergence of antimicrobial resistance, and reduce hospital costs by prudent and focused antimicrobial use. Development of local treatment guidelines according to local ecology, rapid

Stewardship Reporting in the DOD Agency-Wide Financial Statements for FY 1998

National Research Council Canada - National Science Library

1999-01-01

...; heritage assets, stewardship land, and stewardship investments were presented on the financial statements accurately and in accordance with generally accepted accounting standards for Federal agencies...

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

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

McPherson, Christopher; Lee, Brian R; Terrill, Cindy; Hersh, Adam L; Gerber, Jeffrey S; Kronman, Matthew P; Newland, Jason G

2018-01-25

In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP) have been rapidly implemented in the United States (US). This study examines the prevalence of the Centers for Disease Control and Prevention's (CDC) seven core elements of a successful ASP within a large subset of US Children's Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94%) had established ASPs and 41 hospitals (79%) included all seven core elements. Physician accountability (87%) and a dedicated ASP pharmacist or drug expert (88%) were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.

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

Directory of Open Access Journals (Sweden)

Christopher McPherson

2018-01-01

Full Text Available In response to the growing epidemic of antibiotic-resistant bacterial infections, antimicrobial stewardship programs (ASP have been rapidly implemented in the United States (US. This study examines the prevalence of the Centers for Disease Control and Prevention’s (CDC seven core elements of a successful ASP within a large subset of US Children’s Hospitals. In 2016, a survey was conducted of 52 pediatric hospitals assessing the presence of the seven core elements: leadership commitment, accountability, drug expertise, action, tracking, reporting, and education. Forty-nine hospitals (94% had established ASPs and 41 hospitals (79% included all seven core elements. Physician accountability (87% and a dedicated ASP pharmacist or drug expert (88% were present in the vast majority of hospitals. However, substantial variability existed in the financial support allotted to these positions. This variability did not predict program actions, tracking, reporting, and education. When compared with previous surveys, these results document a dramatic increase in the prevalence and resources of pediatric stewardship programs, although continued expansion is warranted. Further research is required to understand the feasibility of various core stewardship activities and the impact on patient outcomes in the setting of finite resources.

Final Programmatic Environmental Impact Statement for stockpile stewardship and management

International Nuclear Information System (INIS)

1996-09-01

The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document contains Volume II which consists of Appendices A through H

Twenty years of analysis of light elements at the LARN

International Nuclear Information System (INIS)

Demortier, G.

1992-01-01

We review the applications of ion beam analysis of light elements performed in the LARN during the last twenty years. The works mainly concern: helium bubbles in aluminum foils, Li in aluminum alloys, carbon in high purity MgO crystals and in olivines, nitrogen bubbles in glass and implanted nitrogen in iron and aluminum, oxygen in YBaCuO superconductors, fluorine in tooth enamel and implanted fluorine in metals. (orig.)

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

Science.gov (United States)

Skelton, Felicia; Suda, Katie; Evans, Charlesnika; Trautner, Barbara

2018-01-11

Context Antibiotic stewardship, defined as a multidisciplinary program to reduce the misuse of antibiotics, and in turn, antibiotic resistance, is a high priority. Persons with spinal cord injury/disorder (SCI/D) are vulnerable to receiving multiple courses of antibiotics over their lifetime given frequent healthcare exposure, and have high rates of bacterial infection with multi-drug resistant organisms. Additional challenges to evaluating appropriate use of antibiotics in this population include bacterial colonization in the urine and the differences in the presenting signs and symptoms of infection. Therefore, Veterans Health Administration (VHA) facilities with SCI/D centers need effective antibiotic stewardship programs. Results We analyzed the results of a 2012 VHA-wide survey evaluating available antibiotic stewardship resources, and compared the resources present at facilities with SCI/D (n=23) versus non-SCI/D facilities (n=107). VHA facilities with SCI/D centers are more likely to have components of an antibiotic stewardship program that have led to reduced antibiotic use in previous studies. They are also more likely to have personnel with infectious diseases training. Conclusion VHA facilities with SCI/D centers have the resources needed for antibiotic stewardship. The next step will be to determine how to implement effective antibiotic stewardship tailored for this patient care setting.

A boundary-spanning organization for transdisciplinary science on land stewardship: The Stewardship Network

Directory of Open Access Journals (Sweden)

A. Paige. Fischer

2015-12-01

Full Text Available Although people and organizations in the Great Lakes region, USA take seriously their role as stewards of natural resources, many lack capacity to fulfill that role in a meaningful way. Stepping into that gap, The Stewardship Network (TSN envisions "a world of empowered, connected communities caring for land and water, now and forever," and fulfills that vision through its mission to "connect, equip, and mobilize people and organizations to care for land and water in their communities." TSN uses a scalable model of linked local and regional capacity building, science communication, civic engagement, and on-the-ground stewardship activities to achieve these goals. The model engages local and regional groups in an ongoing process of learning around conservation and restoration that improves social and ecological knowledge. I share the story of TSN to demonstrate how transdisciplinary science can take hold locally and expand regionally to bring people from diverse disciplines and functional roles together to solve common problems. I demonstrate how researchers and practitioners can collaborate to create enduring mechanisms of social and ecological change.

Over Twenty Years Of Experience In ITU TRIGA MARK-II Reactor

International Nuclear Information System (INIS)

Yavuz, Hasbi

2008-01-01

I.T.U. TRIGA MARK-II Training and Research Reactor, rated at 250 kW steady-state and 1200 MW pulsing power is the only research and training reactor owned and operated by a university in Turkey. Reactor has been operating since March 11, 1979; therefore the reactor has been operating successfully for more than twenty years. Over the twenty years of operation: - The tangential beam tube was equipped with a neutron radiography facility, which consists of a divergent collimator and exposure room; - A computerized data acquisition system was designed and installed such that all parameters of the reactor, which are observed from the console, could be monitored both in normal and pulse operations; - An electrical power calibration system was built for the thermal power calibration of the reactor; - Publications related with I.T.U. TRIGA MARK-II Training and Research Reactor are listed in Appendix; - Two majors undesired shutdown occurred; - The I.T.U. TRIGA MARK-II Training and Research Reactor is still in operation at the moment. (authors)

STEWARDSHIP: A Conceptual Imperative For Managerial ...

African Journals Online (AJOL)

resources for the management of the health sector. (Stewardship of ... of health sector development and performance. Examples of ... attempt at health sector decentralization and improving ... organizations could create inherent limitations on.

Studies in taxation, public finance, and related subjects: a compendium. Volume 5. [Twenty-eight studies of the Congressional Research Service

Energy Technology Data Exchange (ETDEWEB)

1981-01-01

This volume had its origin in studies prepared for the US Congress by the Congressional Research Service (CRS), Library of Congress. The CRS works exclusively for the Congress, conducting research, analyzing legislation, and providing information at the request of Committees, Members, and their staffs. Research of the CRS is made available to the Congress, without partisan bias, in many forms including studies, reports, compilations, digests, and background briefings. Due to budget constraints, the CRS distributes its publications solely to the Congress. Their limited circulation prompted the Fund for Public Policy Research to select for publication twenty-eight highly informative CRS studies. They are published with the hope that availability of the information will contribute to the public's intelligent consideration of matters of national importance. A separate abstract was prepared for each of three of the studies.

Twenty years of JHEP

International Nuclear Information System (INIS)

Amati, Daniele; Bonora, Loriano

2017-01-01

On July 1st of twenty years ago we launched the first issue of JHEP. It was a real challenge to try the adventure of a scientific journal thought and managed by scientists, independent of private or institutional publishers. The idea was that physicists who were performing the work, writing the papers, and refereeing those of their peers, could also edit them in an electronic format. Thus, at a limited cost which could be handled by academic or scientific institutions, giving open access to the published information, and avoiding the heavy burden at that time placed on our libraries. In order to avoid the failure that - as we well remember was predicted to us by publishing companies and institutions, we needed the active support of the scientific community. A support in collaborating to the scrutiny of papers and scientific policies but, mainly, in sending to us their good papers. We contacted in that sense several of our most active and renowned colleagues, restricting of course to our high energy physics field. We received many enthusiastic responses as can be specifically seen from the papers that appear in the first issues of the journal, as well as the respected names listed in the advisory and in the editorial boards featuring in the opening page of the first issue of JHEP attached to this letter. We were optimists, but perhaps not as much as to foresee the success of the journal, which, in his first 20 years, turned out to be one of the most (if not the most) prestigious one in our field. Success for which --- as first project chairman and executive editor - we must essentially thank the scientific community who supported JHEP by considering it ''their journal'', as was our intention from the start. In this occasion we would like to recall the important contribution of Marco Fabbrichesi who designed the software on which the journal is based, and the technical personnel who implemented it and made it work. It is our pleasure to mention

Wilderness stewardship challenges in the uKhahlamba Drakensberg Park World Heritage Site

Science.gov (United States)

Sonja Krüger

2007-01-01

The location of the uKhahlamba Drakensberg Park wilderness areas along an international border and within a World Heritage Site and Transfrontier Conservation Area, provides unique opportunities and challenges for the stewardship of these areas. Although the wilderness areas were proclaimed more than 30 years ago, wilderness-specific planning, management and monitoring...

Twenty Years of Australian Educational Computing: A Call for Modern Traditionalism

Science.gov (United States)

McDougall, Anne

2005-01-01

This article reflects on twenty or more years of development and research in educational computing. It argues that the emphasis on exploiting the technology in the service of contemporary ideas about learning held by many of the early workers has been lost to a focus on the technology itself and its capabilities. In schools this has led to an…

The Capacity-Building Stewardship Model: assessment of an agricultural network as a mechanism for improving regional agroecosystem sustainability

Directory of Open Access Journals (Sweden)

Alison J. Duff

2017-03-01

Full Text Available Working lands have potential to meet agricultural production targets while serving as reservoirs of biological diversity and as sources of ecological services. Yet agricultural policy creates disincentives for this integration of conservation and production goals. While necessary, the development of a policy context that promotes agroecosystem sustainability will take time, and successful implementation will depend on a receptive agricultural audience. As the demands placed on working lands grow, there is a need for regional support networks that build agricultural producers' capacity for land stewardship. We used a social-ecological system framework to illustrate the Healthy Grown Potato Program as an agricultural network case study. Our Capacity-Building Stewardship Model reflects a 20-year experience working in collaboration with potato growers certified under an ecolabel in Wisconsin, USA. The model applies an evolving, modular farm stewardship standard to the entire farm - croplands and noncroplands. The model demonstrates an effective process for facilitating communication and shared learning among program participants, including agricultural producers, university extension specialists, nonprofit conservation partners, and industry representatives. The limitation of the model in practice has been securing funding to support expansion of the program and to ensure that the ecolabel standard is responsive to changes in the social-ecological system. Despite this constraint, the Capacity-Building Stewardship Model reveals an important mechanism for building regional commitment to conservation, with agricultural producers in a leadership role as architects, adopters, and advocates for stewardship behavior. Our experience provides important insight for the application of agri-environment schemes on private lands. The durability of a conservation ethic on working farms is likely to be enhanced when networks engage and support producers in an

Sharing Responsibility for Data Stewardship Between Scientists and Curators

Science.gov (United States)

Hedstrom, M. L.

2012-12-01

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

Microbiological surveillance and antimicrobial stewardship minimise ...

African Journals Online (AJOL)

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

A system simulation to enhance stockpile stewardship (ASSESS)

International Nuclear Information System (INIS)

Yoshimura, A.S.; Plantenga, T.D.; Napolitano, L.M.; Johnson, M.M.

1997-01-01

This paper describes the ASSESS project, whose goal is to construct a policy driven enterprise simulation of the DOE nuclear weapons complex (DOE/NWC). ASSESS encompasses the full range of stockpile stewardship activities by incorporating simulation component models that are developed and managed by local experts. ASSESS runs on a heterogeneous distributed computing environment and implements multi-layered user access capabilities. ASSESS allows the user to create hypothetical policies governing stockpile stewardship, simulate the resulting operation of the DOE/NWC, and analyze the relative impact of each policy

Trends in CPAP adherence over twenty years of data collection: a flattened curve.

Science.gov (United States)

Rotenberg, Brian W; Murariu, Dorian; Pang, Kenny P

2016-08-19

Obstructive sleep apnea (OSA) is a common disorder, and continuous airway positive pressure (CPAP) is considered to be the gold standard of therapy. CPAP however is known to have problems with adherence, with many patients eventually abandoning the device. The purpose of this paper is to assess secular trends in CPAP adherence over the long term to see if there have been meaningful improvements in adherence in light of the multiple interventions proposed to do so. A comprehensive systematic literature review was conducted using the Medline-Ovid, Embase, and Pubmed databases, searching for data regarding CPAP adherence over a twenty year timeframe (1994-2015). Data was assessed for quality and then extracted. The main outcome measure was reported CPAP non-adherence. Secondary outcomes included changes in CPAP non-adherence when comparing short versus long-term, and changes in terms of behavioral counseling. Eighty-two papers met study inclusion/exclusion criteria. The overall CPAP non-adherence rate based on a 7-h/night sleep time that was reported in studies conducted over the twenty year time frame was 34.1 %. There was no significant improvement over the time frame. Behavioral intervention improved adherence rates by ~1 h per night on average. The rate of CPAP adherence remains persistently low over twenty years worth of reported data. No clinically significant improvement in CPAP adherence was seen even in recent years despite efforts toward behavioral intervention and patient coaching. This low rate of adherence is problematic, and calls into question the concept of CPAP as gold-standard of therapy for OSA.

2003 Stewardship progress report : committed to continuous improvement

Energy Technology Data Exchange (ETDEWEB)

NONE

2003-12-01

The stewardship initiative is a mandatory requirement for members of the Canadian Association of Petroleum Producers (CAPP). It involves performance management and benchmarking, voluntary audits and verification, as well as training and improved communication inside and outside the industry. This fourth annual progress report describes the environment, health, safety and socio-economic stewardship initiative. This report presents an aggregate of industry performance. Stewardship of Excellence awards were presented in 2003, celebrating outstanding performance by members who demonstrated their commitment to responsible development and continuous improvement within a business framework. The awards were presented in three categories, namely environment, health and safety, and socio-economic. Northrock Resources was presented with the award in the environment category for its voluntary waste gas reduction. The health and safety recognition went to Burlington Resources Canada Ltd. for superior office ergonomics, while the award in the socio-economic category was presented to Suncor Energy Inc. for Aboriginal business development. A brief overview of the achievements of each of these three companies was presented. tabs., figs.

Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

Energy Technology Data Exchange (ETDEWEB)

Mehta, A.E.; Reyes, F.I.; Faiman, C.

1987-07-01

Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

International Nuclear Information System (INIS)

Mehta, A.E.; Reyes, F.I.; Faiman, C.

1987-01-01

Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy

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

Science.gov (United States)

Tate, Susan

2014-05-01

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

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

Science.gov (United States)

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

2016-07-27

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

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

Science.gov (United States)

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

2016-01-01

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

76 FR 11243 - Solicitation of Input From Stakeholders To Inform the National Framework for Electronics Stewardship

Science.gov (United States)

2011-03-01

... Stakeholders To Inform the National Framework for Electronics Stewardship AGENCY: Environmental Protection... inform the national framework for electronics stewardship that is being developed by the Interagency Task Force on Electronics Stewardship. On November 15, 2010, President Obama signed a presidential...

Stewardship of climate

International Nuclear Information System (INIS)

Brown, P.G.

1997-01-01

A trustee is someone who cares for a resource on behalf of another. In the case of climate, one generation cares for the climate and the myriad things climate effects on behalf of subsequent generations. This article offers reasons for accepting trusteeship as a framework for thinking about climate change; discusses what trustee duties are: considers their implications for the construction of an economics of stewardship; shows how tradeoffs would be assessed within this framework, and points towards a reconceptualization of international relations based on these ideas. 1 ref

Integration of Cloud Technologies for Data Stewardship at the NOAA National Centers for Environmental Information (NCEI)

Science.gov (United States)

Casey, K. S.; Hausman, S. A.

2016-02-01

In the last year, the NOAA National Oceanographic Data Center (NODC) and its siblings, the National Climatic Data Center and National Geophysical Data Center, were merged into one organization, the NOAA National Centers for Environmental Information (NCEI). Combining its expertise under one management has helped NCEI accelerate its efforts to embrace and integrate private, public, and hybrid cloud environments into its range of data stewardship services. These services span a range of tiers, from basic, long-term preservation and access, through enhanced access and scientific quality control, to authoritative product development and international-level services. Throughout these tiers of stewardship, partnerships and pilot projects have been launched to identify technological and policy-oriented challenges, to establish solutions to these problems, and to highlight success stories for emulation during operational integration of the cloud into NCEI's data stewardship activities. Some of these pilot activities including data storage, access, and reprocessing in Amazon Web Services, the OneStop data discovery and access framework project, and a set of Cooperative Research and Development Agreements under the Big Data Project with Amazon, Google, IBM, Microsoft, and the Open Cloud Consortium. Progress in these efforts will be highlighted along with a future vision of how NCEI could leverage hybrid cloud deployments and federated systems across NOAA to enable effective data stewardship for its oceanographic, atmospheric, climatic, and geophysical Big Data.

Final Programmatic Environmental Impact Statement for stockpile stewardship and management: Volume 1

International Nuclear Information System (INIS)

1996-09-01

The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed Stockpile Stewardship and Maintenance Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Program Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document contains Volume I of the PEIS

Without Testing: Stockpile Stewardship in the Second Nuclear Age

Energy Technology Data Exchange (ETDEWEB)

Martz, Joseph C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2014-01-07

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

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

Energy Technology Data Exchange (ETDEWEB)

None, None

1999-10-01

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

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

Science.gov (United States)

Nicolle, Lindsay E

2014-02-12

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicrobial stewardship programs for long term care facilities were identified through a systematic literature search. Interventions included education, guidelines development, feedback to practitioners, and infectious disease consultation. The studies reviewed varied in types of facilities, interventions used, implementation, and evaluation. Comprehensive programs addressing all infections were reported to have improved antimicrobial use for at least some outcomes. Targeted programs for treatment of pneumonia were minimally effective, and only for indicators of uncertain relevance for stewardship. Programs focusing on specific aspects of treatment of urinary infection - limiting treatment of asymptomatic bacteriuria or prophylaxis of urinary infection - were reported to be effective. There were no reports of cost-effectiveness, and the sustainability of most of the programs is unclear. There is a need for further evaluation to characterize effective antimicrobial stewardship for long term care facilities.

Final programmatic environmental impact statement for stockpile stewardship and management

International Nuclear Information System (INIS)

1996-09-01

In response to the end of the Cold War and changes in the world's political regimes, the United States is not producing new-design nuclear weapons. Instead, the emphasis of the U.S. nuclear weapons program is on reducing the size of the Nation's nuclear stockpile by dismantling existing nuclear weapons. The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management PEIS describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program

Communicating the value and benefits of silviculture through partnerships and collaborative stewardship

Science.gov (United States)

1997-01-01

Opening comments to this session share observations on the current management climate within the USDA Forest Service. Partnerships and collaborative stewardship as agency philosophy are discussed. Silviculturists roles, as scientists and managers are compared, and the need for internal and external cooperation stressed as we strive to meet forest stewardship goals....

Myelopathy: Retrospective Evaluation of Twenty-Eight Cases

Directory of Open Access Journals (Sweden)

Yüksel Erdal

2017-12-01

Full Text Available Objective: Myelopathy is used to describe any neurologic deficit related to the spinal cord. Determining the etiology is important for detecting emergency situations and treating the cause. Materials and Methods: We evaluated 28 patients who were diagnosed as having and treated for myelopathy between January 2014 and January 2015 in our hospital. The clinical and laboratory findings of the patients and their response to treatment were assessed. Results: Of the 28 patients, 16 were male and 12 were female, the mean age was 48 years (range, 22-77 years. The most common initial symptoms were sensorial deficits and motor weakness. Demyelinating diseases were the most common diseases and multiple sclerosis was the most frequent etiology among demiyelinating diseases. Cervical spinal cord was the most frequent region involved in myelopathy episodes which was detected by magnetic resonance imaging on T2W images. We observed clinical improvement in 15 of the 20 patients who were treated with corticosteroids. In addition, vitamin B12 treatment led to clinical improvement in two patients who were diagnosed as having subacute combined degeneration. Conclusion: The diagnosis and etiology of myelopathy and identification of rare conditions that require emergency surgery or interventional treatments are of utmost importance

Strategies and challenges of antimicrobial stewardship in long-term care facilities.

Science.gov (United States)

Dyar, O J; Pagani, L; Pulcini, C

2015-01-01

As people are living longer the demand for long-term care facilities (LTCFs) continues to rise. For many reasons, antimicrobials are used intensively in LTCFs, with up to a half of this use considered inappropriate or unnecessary. Over-use of antimicrobials can have direct adverse consequences for LTCF residents and promotes the development and spread of resistant bacteria. It is therefore critical that LTCFs are able to engage in antimicrobial stewardship programmes, which have the potential to minimize the antibiotic selective pressure, while improving the quality of care received by LTCF residents. To date, no antimicrobial stewardship guidelines specific to LTCF settings have been published. Here we outline the scale of antimicrobial use in LTCFs and the underlying drivers for antibiotic over-use. We further describe the particular challenges of antimicrobial stewardship in LTCFs, and review the interventional studies that have aimed to improve antibiotic use in these settings. Practical recommendations are then drawn from this research to help guide the development and implementation of antimicrobial stewardship programmes. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Antecedents and consequences of environmental stewardship in boundary-spanning B2B teams

NARCIS (Netherlands)

Ruyter, de J.C.; Jong, de A.; Wetzels, M.G.M.

2009-01-01

The authors examine antecedents and consequences of environmental stewardship in frontline business-to-business teams. On the basis of data from members of 34 teams organized into regional networks, they demonstrate the differential impact of team environmental stewardship on customer satisfaction

Current evidence on hospital antimicrobial stewardship objectives : A systematic review and meta-analysis

NARCIS (Netherlands)

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

2016-01-01

BACKGROUND: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes:

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

NARCIS (Netherlands)

Schuts, E.C.; Hulscher, M.E.J.L.; Mouton, J.W.; Verduin, C.M.; Stuart, J.W.; Overdiek, H.W.; Linden, P.D. van der; Natsch, S.S.; Hertogh, C.M.; Wolfs, T.F.; Schouten, J.A.; Kullberg, B.J.; Prins, J.M.

2016-01-01

BACKGROUND: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes:

Long-Term Stewardship Science and Technology Requirements

International Nuclear Information System (INIS)

McDonald, J.K.; Nickelson, R.A.

2002-01-01

To ensure technology developed for long-term stewardship will meet existing requirements, a review of requirements was performed. In addition to identifying existing science and technology related requirements, gaps and conflicts of requirements were identified

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

Science.gov (United States)

Tardiff, Robert G

2015-08-01

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

Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

Science.gov (United States)

Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

2009-01-01

Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

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

NARCIS (Netherlands)

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

2016-01-01

Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes,

Twenty years of energy policy: What should we have learned?

International Nuclear Information System (INIS)

Greene, D.L.

1994-07-01

This report examines the past twenty years of energy market events and energy policies to determine what may be useful for the future. The author focuses on two important lessons that should have been learned but which the author feels have been seriously misunderstood. The first is that oil price shocks were a very big and very real problem for oil importing countries, a problem the has not gone away. The second is that automobile fuel economy regulation has worked and worked effectively to reduce oil consumption and the externalities associated with it, and can still work effectively in the future

Twenty years of energy policy: What should we have learned?

Energy Technology Data Exchange (ETDEWEB)

Greene, D.L. [Oak Ridge National Lab., TN (United States). Center for Transportation Analysis

1994-07-01

This report examines the past twenty years of energy market events and energy policies to determine what may be useful for the future. The author focuses on two important lessons that should have been learned but which the author feels have been seriously misunderstood. The first is that oil price shocks were a very big and very real problem for oil importing countries, a problem the has not gone away. The second is that automobile fuel economy regulation has worked and worked effectively to reduce oil consumption and the externalities associated with it, and can still work effectively in the future.

Towards Materials Sustainability through Materials Stewardship

Directory of Open Access Journals (Sweden)

Christopher D. Taylor

2016-10-01

Full Text Available Materials sustainability requires a concerted change in philosophy across the entire materials lifecycle, orienting around the theme of materials stewardship. In this paper, we address the opportunities for improved materials conservation through dematerialization, durability, design for second life, and diversion of waste streams through industrial symbiosis.

A Unified Framework for Measuring Stewardship Practices Applied to Digital Environmental Datasets

Directory of Open Access Journals (Sweden)

Ge Peng

2015-01-01

Full Text Available This paper presents a stewardship maturity assessment model in the form of a matrix for digital environmental datasets. Nine key components are identified based on requirements imposed on digital environmental data and information that are cared for and disseminated by U.S. Federal agencies by U.S. law, i.e., Information Quality Act of 2001, agencies’ guidance, expert bodies’ recommendations, and users. These components include: preservability, accessibility, usability, production sustainability, data quality assurance, data quality control/monitoring, data quality assessment, transparency/traceability, and data integrity. A five-level progressive maturity scale is then defined for each component associated with measurable practices applied to individual datasets, representing Ad Hoc, Minimal, Intermediate, Advanced, and Optimal stages. The rationale for each key component and its maturity levels is described. This maturity model, leveraging community best practices and standards, provides a unified framework for assessing scientific data stewardship. It can be used to create a stewardship maturity scoreboard of dataset(s and a roadmap for scientific data stewardship improvement or to provide data quality and usability information to users, stakeholders, and decision makers.

Defining antimicrobial stewardship competencies for undergraduate health professional education in the United Kingdom: A study protocol.

Science.gov (United States)

Courtenay, Molly; Castro-Sánchez, Enrique; Deslandes, Rhian; Hodson, Karen; Lim, Rosemary; Morris, Gary; Reeves, Scott; Weiss, Marjorie

2018-04-16

Multi-drug resistant infections have been identified as one of the greatest threats to human health. Healthcare professionals are involved in an array of patient care activities for which an understanding of antimicrobial stewardship is important. Although antimicrobial prescribing and stewardship competencies have been developed for healthcare professionals who adopt the role of a prescriber, competencies do not exist for other medicine-related stewardship activities. Undergraduate education provides an ideal opportunity to prepare healthcare professionals for these roles and activities. This report presents a protocol for a study designed to provide national consensus on antimicrobial stewardship competencies appropriate for undergraduate healthcare professional education. A modified Delphi process will be used in which a panel of Experts, comprising members from across the United Kingdom, with expertise in prescribing and medicines management with regard to the education and practice of healthcare professionals, and antimicrobial prescribing and stewardship, will be invited to take part in two survey rounds. The competencies developed will be applicable to all undergraduate healthcare professional education programmes. They will help to standardise curricula content and enhance the impact of antimicrobial stewardship education.

NOAA's Scientific Data Stewardship Program

Science.gov (United States)

Bates, J. J.

2004-12-01

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

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

Multiscale science for science-based stockpile stewardship

Energy Technology Data Exchange (ETDEWEB)

Margolin, L.; Sharp, D.

2000-12-01

This is the final report of a three-year, Laboratory-Directed Research and Development (LDRD) project at the Los Alamos National Laboratory (LANL). The goal of this project has been to develop and apply the methods of multi scale science to the problems of fluid and material mixing due to instability and turbulence, and of materials characterization. Our specific focus has been on the SBSS (science-based stockpile stewardship) issue of assessing the performance of a weapons with off-design, aged, or remanufactured components in the absence of full-scale testing. Our products are physics models, based on microphysical principles and parameters, and suitable for implementation in the large scale design and assessment codes used in the nuclear weapons program.

Optimizing adherence to advice from antimicrobial stewardship audit and feedback rounds.

Science.gov (United States)

Rawlins, Matthew D M; Sanfilippo, Frank M; Ingram, Paul R; McLellan, Duncan G J; Crawford, Colin; D'Orsogna, Luca; Dyer, John

2018-02-01

We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13.8% vs. 7.6%, p risk 1.8 [95% confidence interval 1.3, 2.5]). In the rehabilitation service, referrals were more likely to come from medical staff (61.9% vs. 16.3%, p model potentially applicable to other settings.

GW LIBRAE: STILL HOT EIGHT YEARS POST-OUTBURST

Energy Technology Data Exchange (ETDEWEB)

Szkody, Paula; Mukadam, Anjum S. [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195 (United States); Gänsicke, Boris T.; Chote, Paul; Toloza, Odette [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Nelson, Peter; Myers, Gordon; Waagen, Elizabeth O. [AAVSO, 48 Bay State Road, Cambridge, MA 02138 (United States); Sion, Edward M. [Department of Astrophysics and Planetary Science, Villanova University, Villanova, PA 19085 (United States); Sullivan, Denis J. [School of Chemical and Physical Sciences, Victoria University of Wellington, P.O. Box 600, Wellington (New Zealand); Townsley, Dean M., E-mail: szkody@astro.washington.edu [Department of Physics and Astronomy, University of Alabama, Tuscaloosa, AL 35487 (United States)

2016-08-01

We report continued Hubble Space Telescope ( HST ) ultraviolet spectra and ground-based optical photometry and spectroscopy of GW Librae eight years after its largest known dwarf nova outburst in 2007. This represents the longest cooling timescale measured for any dwarf nova. The spectra reveal that the white dwarf still remains about 3000 K hotter than its quiescent value. Both ultraviolet and optical light curves show a short period of 364–373 s, similar to one of the non-radial pulsation periods present for years prior to the outburst, and with a similar large UV/optical amplitude ratio. A large modulation at a period of 2 hr (also similar to that observed prior to outburst) is present in the optical data preceding and during the HST observations, but the satellite observation intervals did not cover the peaks of the optical modulation, and so it is not possible to determine its corresponding UV amplitude. The similarity of the short and long periods to quiescent values implies that the pulsating, fast spinning white dwarf in GW Lib may finally be nearing its quiescent configuration.

Intermediate polars observed from Brazil in the last eight years

International Nuclear Information System (INIS)

Jablonski, F.

1988-01-01

The results of observations done, in the last eight years, of the Intermidiate Polars (IP): EX Hya, V1223 Sgr, FO Agr and Ao Psc, are presented. The IP define a subclass of cataclysmic variable stars that present coherent oscillations in their optical and/or X-ray emission. The observations were done from Laboratorio Nacional de Astrofisica, in Itajuba (Brazil). The stability of oscillations in IP was analysed to study the nature of compact stars. (M.C.K.) [pt

Final Programmatic Environmental Impact Statement for stockpile stewardship and management: Volume 3

International Nuclear Information System (INIS)

1996-09-01

The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated technical program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management Programmatic Environmental Impact Statement (PEIS) describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program. This document consists of Volume III, Appendix I entitled ''National Ignition Facility Project-Specific Analysis,'' which investigates the environmental impacts resulting from constructing and operating the proposed National Ignition Facility

Product Stewardship in Uranium: A Way for the Industry to Demonstrate its High Performance

International Nuclear Information System (INIS)

Harris, Frank

2014-01-01

Conclusions: • Product stewardship is an means for communicating the high performance on health, safety and environment of the nuclear fuel cycle including uranium mining. • It has been effective with other products and is appropriate for uranium. • Can be a vehicle for addressing public concerns across the industry. • Due to uranium’s unique characteristics it has the potential to be a best practice example of product stewardship. • Work is underway in the international arena to progress uranium product stewardship and it represent a unique opportunity to provide whole of industry benefits

Twenty-five years of post-Bretton Woods experience: some lessons

Directory of Open Access Journals (Sweden)

H. ASKARI

1999-03-01

Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

Improving Wellbeing and Environmental Stewardship Through Volunteering in Nature.

Science.gov (United States)

Molsher, Robyn; Townsend, Mardie

2016-03-01

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

A state-stewardship view on executive compensation

NARCIS (Netherlands)

Liang, Hao; Renneboog, Luc; Li Sun, Sunny; Choi, J.; Powers, M.; Zhang, X.

2016-01-01

We take a state-stewardship view on the corporate governance model and executive compensation policies in economies with strong political involvement. In such a highly politically-oriented institutional environment, the business elites are not just professional managers but are also de facto

Antimicrobial Stewardship and Urinary Tract Infections

Directory of Open Access Journals (Sweden)

Lilian M. Abbo

2014-05-01

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

Airport Capital Improvement Planning: Stewardship for Airport Development

Science.gov (United States)

1997-09-01

"Airport Capital Improvement Planning: Stewardship for Airport Development", was : originally written in October, 1995. It documented an effort to implement the : concept of capital improvement planning with the airport development industry. : Airpor...

Surgical management of an ACM aneurysm eight years after coiling.

Science.gov (United States)

Pogády, P; Fellner, F; Trenkler, J; Wurm, G

2007-04-01

The authors present a case report on rebleeding of a medial cerebral aneurysm (MCA) eight years after complete endovascular coiling. The primarily successfully coiled MCA aneurysm showed a local regrowth which, however, was not the source of the rebleeding. The angiogram demonstrated no evidence of contrast filling of the coiled segment, but according to intraoperative findings (haematoma location, displacement of coils, evident place of rupture) there is no doubt that the coiled segment of the aneurysm was responsible for the haemorrhage.

Role of the hospitalist in antimicrobial stewardship: a review of work completed and description of a multisite collaborative.

Science.gov (United States)

Rohde, Jeffrey M; Jacobsen, Diane; Rosenberg, David J

2013-06-01

Historically, antimicrobial stewardship programs have been led by infectious-disease physicians and pharmacists. With the growing presence of hospitalists in health and hospital systems, combined with their focus on quality improvement and patient safety, this emerging medical specialty has the potential to fill essential roles in antimicrobial stewardship programs. The goal of this article was to present the reasons hospitalists are ideally positioned to fill antimicrobial-stewardship roles, a narrative review of previously reported hospitalist-led antibiotic-stewardship projects, and a description of an ongoing multisite collaborative by the Institute for Healthcare Improvement (IHI) and the Centers for Disease Control and Prevention (CDC). A review of the published literature was performed, including an extensive review of the abstracts submitted to the Society of Hospital Medicine annual meetings. A number of examples of hospitalists developing and leading antimicrobial-stewardship programs are described. The details of a current multisite IHI/CDC hospitalist-focused initiative are discussed in detail. Hospitalists are actively involved with, and even lead, a variety of antimicrobial-stewardship programs in several different hospital systems. A large, multisite collaborative focused on hospitalist-led antimicrobial stewardship is currently in progress. Copyright © 2013 Elsevier HS Journals, Inc. All rights reserved.

Integrating human and natural systems in community psychology: an ecological model of stewardship behavior.

Science.gov (United States)

Moskell, Christine; Allred, Shorna Broussard

2013-03-01

Community psychology (CP) research on the natural environment lacks a theoretical framework for analyzing the complex relationship between human systems and the natural world. We introduce other academic fields concerned with the interactions between humans and the natural environment, including environmental sociology and coupled human and natural systems. To demonstrate how the natural environment can be included within CP's ecological framework, we propose an ecological model of urban forest stewardship action. Although ecological models of behavior in CP have previously modeled health behaviors, we argue that these frameworks are also applicable to actions that positively influence the natural environment. We chose the environmental action of urban forest stewardship because cities across the United States are planting millions of trees and increased citizen participation in urban tree planting and stewardship will be needed to sustain the benefits provided by urban trees. We used the framework of an ecological model of behavior to illustrate multiple levels of factors that may promote or hinder involvement in urban forest stewardship actions. The implications of our model for the development of multi-level ecological interventions to foster stewardship actions are discussed, as well as directions for future research to further test and refine the model.

Antifungal stewardship considerations for adults and pediatrics.

Science.gov (United States)

Hamdy, Rana F; Zaoutis, Theoklis E; Seo, Susan K

2017-08-18

Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via post-prescription review and feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

Predicting volunteer commitment in environmental stewardship programmes

Science.gov (United States)

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

2001-01-01

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

Integrating different understandings of landscape stewardship into the design of agri-environmental schemes

DEFF Research Database (Denmark)

Raymond, Christopher Mark; Reed, Mark; Bieling, Claudia

2016-01-01

While multiple studies have identified land managers’ preferences for agri-environmental schemes (AES), few approaches exist for integrating different understandings of landscape stewardship into the design of these measures. We compared and contrasted rural land managers’ attitudes toward AES...... to the reduced amount of funding available for entry-level and higher-level stewardship schemes in the UK since 2008, changing funding priorities, perceived overstrict compliance and lack of support for farm succession and new entrants into farming. However, there were differences in concerns across...... understandings of landscape stewardship, with production respondents citing that AES do not encourage food production, whereas environmental and holistic farmers citing that AES do not support the development of a local green food culture and associated social infrastructure. These differences also emerged...

Volunteer Environmental Stewardship and Affective Labour in Philadelphia

Directory of Open Access Journals (Sweden)

Alec Foster

2018-01-01

Full Text Available Recent research has critically evaluated the rapid growth of volunteer urban environmental stewardship. Framings of this phenomenon have largely focused upon environmentality and/or neoliberal environments, unfortunately often presenting a totalising picture of the state and/or market utilising power from above to create environmental subjects with limited agency available to local citizens. Based upon qualitative research with volunteer urban environmental stewards in Philadelphia, affective labour is proposed as an alternative explanation for participation. Stewards volunteered their time and labour due to the intense emotional attachments they formed with their neighbourhoods, neighbours, and nonhuman others in relationships of affective labour. Volunteer urban environmental stewardship as affective labour provides room for agency on the part of individuals and groups involved in volunteer urban environmental reproduction and opens up new ways of relating to and being with human and nonhuman others.

Stewardship, Learning, and Memory in Disaster Resilience

Science.gov (United States)

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

2010-01-01

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

Twenty years of operation of Ljubljana's TRIGA Mark II reactor

International Nuclear Information System (INIS)

Dimic, V.

1986-01-01

Twenty years have now passed since the start of the TRIGA Mark II reactor in Ljubljana. The reactor was critical on May 31, 1966. The total energy produced until the end of May 1986 was 14.048 MWh or 585 MWd. For the first 14 years (until 1981) the yearly energy produced was about 600 MWh, since 1981 the yearly energy produced was 1000 MWh when a routine radioactive isotopes production started for medical use as well as other industrial applications, such as doping and irradiation with fast neutrons of silicon monocrystals, production of level indicators (irradiated cobalt wire), production of radioactive iridium for gamma-radiography, leak detection in pipes by sodium, etc. Besides these, applied research around the reactor is being conducted in the following main fields, where- many unique methods have been developed or have found their way into the local industry or hospitals: neutron radiography, neutron induced auto-radiography using solid state nuclear track detectors, nondestructive methods for assessment of nuclear burn-up, neutron dosimetry, calculation of core burn-up for the optimal in-core fuel management strategy. The solvent extraction method was developed for the everyday production of 99m Tc, which is the most widely used radionuclide in diagnostic nuclear medicine. The methods were developed for the production of the following isotopes: 18 F, 85m Kr, 24 Na, 82 Br, 64 Zn, 125 I. Neutron activation analysis represents one of the major usages for the TRIGA reactor. Basic research is being conducted in the following main fields: solid state physics (elastic and inelastic scattering of the neutrons), neutron dosimetry, neutron radiography, reactor physics and neutron activation analysis. The reactor is used very extensively as a main instrument in the Reactor Training Centre in Ljubljana where manpower training for our nuclear power plant and other organisations has been performed. Although the reactor was designed very carefully in order to be used for

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Mathematical Modeling.

Science.gov (United States)

Barnes, Sean L; Kasaie, Parastu; Anderson, Deverick J; Rubin, Michael

2016-11-01

Mathematical modeling is a valuable methodology used to study healthcare epidemiology and antimicrobial stewardship, particularly when more traditional study approaches are infeasible, unethical, costly, or time consuming. We focus on 2 of the most common types of mathematical modeling, namely compartmental modeling and agent-based modeling, which provide important advantages-such as shorter developmental timelines and opportunities for extensive experimentation-over observational and experimental approaches. We summarize these advantages and disadvantages via specific examples and highlight recent advances in the methodology. A checklist is provided to serve as a guideline in the development of mathematical models in healthcare epidemiology and antimicrobial stewardship. Infect Control Hosp Epidemiol 2016;1-7.

Interoperability Across the Stewardship Spectrum in the DataONE Repository Federation

Science.gov (United States)

Jones, M. B.; Vieglais, D.; Wilson, B. E.

2016-12-01

Thousands of earth and environmental science repositories serve many researchers and communities, each with their own community and legal mandates, sustainability models, and historical infrastructure. These repositories span the stewardship spectrum from highly curated collections that employ large numbers of staff members to review and improve data, to small, minimal budget repositories that accept data caveat emptor and where all responsibility for quality lies with the submitter. Each repository fills a niche, providing services that meet the stewardship tradeoffs of one or more communities. We have reviewed these stewardship tradeoffs for several DataONE member repositories ranging from minimally (KNB) to highly curated (Arctic Data Center), as well as general purpose (Dryad) to highly discipline or project specific (NEON). The rationale behind different levels of stewardship reflect resolution of these tradeoffs. Some repositories aim to encourage extensive uptake by keeping processes simple and minimizing the amount of information collected, but this limits the long-term utility of the data and the search, discovery, and integration systems that are possible. Other repositories require extensive metadata input, review, and assessment, allowing for excellent preservation, discovery, and integration but at the cost of significant time for submitters and expense for curatorial staff. DataONE recognizes these different levels of curation, and attempts to embrace them to create a federation that is useful across the stewardship spectrum. DataONE provides a tiered model for repositories with growing utility of DataONE services at higher tiers of curation. The lowest tier supports read-only access to data and requires little more than title and contact metadata. Repositories can gradually phase in support for higher levels of metadata and services as needed. These tiered capabilities are possible through flexible support for multiple metadata standards and services

Stewardship, learning, and memory in disaster resilience

Science.gov (United States)

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

2010-01-01

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

Antimicrobial stewardship in wound care

DEFF Research Database (Denmark)

Lipsky, Benjamin A; Dryden, Matthew; Gottrup, Finn

2016-01-01

BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing...... of experts in infectious diseases/clinical microbiology (from the British Society for Antimicrobial Chemotherapy) and wound management (from the European Wound Management Association) who, after thoroughly reviewing the available literature and holding teleconferences, jointly produced this guidance document...

Enhancing Ecosystem Stewardship in Small-Scale Fisheries: Prospects for Latin America and the Caribbean

Directory of Open Access Journals (Sweden)

Rodrigo Pereira Medeiros

2014-12-01

Full Text Available Despite recognition of small-scale fisheries (SSF contribution to livelihood diversity and food security worldwide, a better understanding of their social and ecological dynamics is required. This paper is a synthesis of the main findings from the special issue “Enhancing ecosystem stewardship in small-scale fisheries” published in this journal. Contributors explored ecosystem stewardship in three dimensions: impacts, monitoring and stewardship. Results suggested that ecosystem stewardship encompasses collaborative action to foster: i new perspectives on SSF management; ii a broader perspective on managers and stakeholders – as stewards for implementing these new perspectives; and iii enabling environments through partnership, networking, communication and collective action. This special issue is an output from the Too Big to Ignore (TBTI Working Group 4 - “Enhancing the Stewardship”. TBTI is a global research network and knowledge mobilization partnership intended to better comprehend SSF contributions on issues such as food security and poverty alleviation, as well as the associated impacts of global changes, through the efforts of diverse partners around the world.

Identifying and Predicting Profiles of Medical Noncompliance: Pediatric Caregivers' Antibiotic Stewardship.

Science.gov (United States)

Smith, Rachel A; Kim, Youllee; M'Ikanatha, Nkuchia M

2018-05-14

Sometimes compliance with medical recommendations is problematic. We investigated pediatric caregivers' (N = 606) patterns of noncompliance with antibiotic stewardship based on the obstacle hypothesis. We tested predictors of noncompliance framed by the obstacle hypothesis, dissonance theory, and psychological reactance. The results revealed four profiles of caregivers' stewardship: one marked by compliance (Stewards) and three marked by types of noncompliance (Stockers, Persuaders, and Dissenters). The covariate analysis showed that, although psychological reactance predicted being noncompliant, it was types of obstacles and discrepant experiences that predicted caregivers' patterns of noncompliance with antibiotic stewardship. Campaign planning often focuses on identifying the belief most associated with the targeted outcome, such as compliance. Noncompliance research, however, points out that persuaders may be successful to the extent to which they anticipate obstacles to compliance and address them in their influence attempts. A shift from medical noncompliance to patient engagement also affords an opportunity to consider how some recommendations create obstacles for others and to find positive ways to embrace conflicting needs, tensions, and reasons for refusal in order to promote collective goals.

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-08-13

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

Twenty years of environmental opposition in the electric sector

International Nuclear Information System (INIS)

Molocchi, Andrea

1997-01-01

This article aims to provide a framework for analysing social opposition In Italy against the construction and management of electric power plants (nuclear and thermoelectric) and big electricity power lines in the past twenty years. First The author provide a history of social environmental opposition in the electric sector. This is followed by a typology of reason for opposition in terms of risk perception, which has been applied to about forty cases of social opposition against electric plants. This study an original experimental methodology which could also yield useful results when applied to other complex social phenomena. In the third phase of the study the author analyse the various roles of the social and institutional actors involved in the opposition, and the obstacles to future consensus building. The most interesting result of the study is the not only social but political nature opposition. This factor necessitates integration of the traditional individual risk perception approach with an approach which analyses political and social action of NGO's

Eight-year randomized clinical evaluation of Class II nanohybrid resin composite restorations bonded with a one-step self-etch or a two-step etch-and-rinse adhesive

DEFF Research Database (Denmark)

van Dijken, Jan WV; Pallesen, Ulla

2015-01-01

(13.5 %) and nine in the two-step etch-and-rinse group (13.0 %). This resulted in nonsignificant different annual failure rates of 1.69 and 1.63 %, respectively. Fracture of restoration was the main reason for failure. Conclusion: Good clinical performance was shown during the 8-year evaluation....... Results: One hundred and fifty-eight restorations were evaluated after 8 years. Three participants with five restorations (three Xeno III, two Excite) were registered as dropouts. Twenty-one failed restorations (13.3 %) were observed during the follow-up. Twelve in the one-step self-etch adhesive group...... and no significant difference in overall clinical performance between the two adhesives. Fracture was the main reason for failure. Clinical relevance: The one-step self-etch adhesive showed a good long-term clinical effectiveness in combination with the nanohybrid resin composite in Class II restorations....

Achievements in the past twenty years and perspective outlook of crop space breeding in China

International Nuclear Information System (INIS)

Liu Luxiang; Guo Huijun; Zhao Linshu; Gu Jiayu; Zhao Shirong

2007-01-01

Space breeding is a novel effective approach to crop mutational improvement, which was firstly founded by the chinese scientists in 1987. A national collaborative research network has been established and significant achievements have been made during the past twenty years. More than forty new mutant varieties derived from space mutagenesis in rice, wheat, cotton, sweet pepper, tomato, sesame and alfalfa have been developed, officially released and put into production. A series of useful rare mutant germplasms which might make a great breakthrough in crop grain yield and/or quality improvement have been obtained. Technique innovations in space breeding and ground simulation of space environmental factors have been made good progresses. Intellective property right protection and industrialization of space mutation techniques and mutant varieties, exploration of the mechanism of space mutation induction have also been stably advanced. In this paper, the main achievements of crop space breeding in the past twenty years had been reviewed. The perspective development strategies of space breeding were also discussed. (authors)

Spatially explicit data: stewardship and ethical challenges in science.

Science.gov (United States)

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

2013-09-01

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

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

Science.gov (United States)

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

2017-02-01

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

Eight year experience in open ended instrumentation laboratory

Science.gov (United States)

Marques, Manuel B.; Rosa, Carla C.; Marques, Paulo V. S.

2015-10-01

When designing laboratory courses in a Physics Major we consider a range of objectives: teaching Physics; developing lab competencies; instrument control and data acquisition; learning about measurement errors and error propagation; an introduction to project management; team work skills and scientific writing. But nowadays we face pressure to decrease laboratory hours due to the cost involved. Many universities are replacing lab classes for simulation activities, hiring PhD. and master students to give first year lab classes, and reducing lab hours. This leads to formatted lab scripts and poor autonomy of the students, and failure to enhance creativity and autonomy. In this paper we present our eight year experience with a laboratory course that is mandatory in the third year of Physics and Physical Engineering degrees. Since the students had previously two standard laboratory courses, we focused on teaching instrumentation and giving students autonomy. The course is divided in two parts: one third is dedicated to learn computer controlled instrumentation and data acquisition (based in LabView); the final 2/3 is dedicated to a group project. In this project, the team (2 or 3 students) must develop a project and present it in a typical conference format at the end of the semester. The project assignments are usually not very detailed (about two or three lines long), giving only general guidelines pointing to a successful project (students often recycle objectives putting forward a very personal project); all of them require assembling some hardware. Due to our background, about one third of the projects are related to Optics.

Investigating the ways in which health information technology can promote antimicrobial stewardship: a conceptual overview.

Science.gov (United States)

King, Abby; Cresswell, Kathrin M; Coleman, Jamie J; Pontefract, Sarah K; Slee, Ann; Williams, Robin; Sheikh, Aziz

2017-08-01

Antimicrobial resistance is now recognised as a threat to health worldwide. Antimicrobial stewardship aims to promote the responsible use of antibiotics and is high on international and national policy agendas. Health information technology has the potential to support antimicrobial stewardship in a number of ways, but this field is still poorly characterised and understood. Building on a recent systematic review and expert roundtable discussions, we take a lifecycle perspective of antibiotic use in hospitals and identify potential targets for health information technology-based interventions to support antimicrobial stewardship. We aim for this work to help chart a future research agenda in this critically important area.

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

Science.gov (United States)

Erika s. Svendsen; Lindsay K. Campbell

2008-01-01

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

The covered distance for twenty five years of the Manche waste storage 1969 - 1994

International Nuclear Information System (INIS)

Gourden, J.M.

2001-01-01

The twenty five years of the Manche plant,are narrated with the difficulties of the beginning, the problems coming from leaks or runoff that have led to improvement in the knowledge of radioactive waste behaviour and the solutions that have been brought. It is from the building of the plant until the radioactive waste management that is related in this book. (N.C.)

Promoting Environmental Stewardship through Project Based Learning (PBL)

DEFF Research Database (Denmark)

Borhan, Mohamad Termizi Bin; Ismail, Zurida

2011-01-01

of our fellow communities: human, plant or animal. It is grounded in an understanding of the importance of environmental quality and natural resources to the human race and the effects of human actions on the environment. Thus, it is important to provide relevant educational experiences that involve......Environmental stewardship is living responsibly as a caretaker of the environment for the benefit of present and future generations and is quickly becoming one of the most pressing public priorities for communities today. As stewards, we are personally responsible for the care and preservation......-service teachers enrolled in a chemistry teaching methods course participated in this study. The pre-service teachers were in their third year of the teacher education program. Data were collected through questionnaires containing Likert-type items designed to assess the degree of environmental concern...

Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

Science.gov (United States)

Pfaller, Michael A; Castanheira, Mariana

2016-01-01

Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

36 CFR 230.6 - Landowner forest stewardship plan.

Science.gov (United States)

2010-07-01

... manage soil, water, aesthetic qualities, recreation, timber, and fish and wildlife resources in a manner... sells or otherwise conveys land covered by a landowner forest stewardship plan, such plan shall remain... plan. 230.6 Section 230.6 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE...

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

Science.gov (United States)

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

2013-02-15

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

Foetal growth restriction is associated with poor reading and spelling skills at eight years to 10 years of age.

Science.gov (United States)

Partanen, Lea; Korkalainen, Noora; Mäkikallio, Kaarin; Olsén, Päivi; Laukkanen-Nevala, Päivi; Yliherva, Anneli

2018-01-01

Foetal growth restriction (FGR) is associated with communication problems, which might lead to poor literacy skills. The reading and spelling skills of eight- to 10-year-old FGR children born at 24-40 gestational weeks were compared with those of their gestational age-matched, appropriately grown (AGA) peers. A prospectively collected cohort of 37 FGR and 31 AGA children was recruited prenatally at a Finnish tertiary care centre during 1998-2001. The children's reading and spelling skills were assessed using standardised tests for Finnish-speaking second and third graders. Significantly more children performed below the 10th percentile normal values for reading and spelling skills in the FGR group than in the AGA group. At nine years of age, the FGR children had significantly poorer performance in word reading skills and reading fluency, reading accuracy and reading comprehension than the AGA controls. No between-group differences were detected at eight years of age. FGR is associated with poor performance in reading and spelling skills. A third of the FGR children performed below the 10th percentile normal values at nine years of age. These results indicate a need to continuously evaluate linguistic and literacy skills as FGR children age to ensure optimal support. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Twenty years of operation of WWER 440/230 units in Jaslovske Bohunice

International Nuclear Information System (INIS)

Tomek, J.

1998-01-01

It is twenty years this year since the first unit WWER 440 of Slovak Nuclear Power Plant Jaslovske Bohunice was commissioned. There are four units WWER 440 in operation Jaslovske Bohunice site. First two units of older soviet PWR design V-230 (also known as V-1) and other two units of newer V-213 type (also known as V-2). The goal of this presentation is to summarize and evaluate the operation of Unit 1 and 2 for this period of time and mainly to describe what has been done and what is planned to be done to increase the nuclear safety and operational reliability of both units. The operating organization and regulatory authority assume that an internationally acceptable level of safety will be reached by accomplishing of the upgrading program.(author)

Organizational ethics in Catholic health care: honoring stewardship and the work environment.

Science.gov (United States)

Magill, G

2001-04-01

Organizational ethics refers to the integration of values into decision making, policies, and behavior throughout the multi-disciplinary environment of a health care organization. Based upon Catholic social ethics, stewardship is at the heart of organizational ethics in health care in this sense: stewardship provides the hermeneutic filter that enables basic ethical principles to be realized practically, within the context of the Catholic theology of work, to concerns in health care. This general argument can shed light on the specific topic of non-executive compensation programs as an illustration of organizational ethics in health care.

Glycemic control paradox: Poor glycemic control associated with higher one-year and eight-year risks of all-cause hospitalization but lower one-year risk of hypoglycemia in patients with type 2 diabetes.

Science.gov (United States)

Li, Tsai-Chung; Kardia, Sharon L R; Li, Chia-Ing; Chen, Ching-Chu; Liu, Chiu-Shong; Yang, Sing-Yu; Muo, Chin-Shin; Peyser, Patricia A; Lin, Cheng-Chieh

2015-09-01

The relationship between glycemic control and adverse outcomes found in a population with diabetes has seldom been evaluated in patients with type 2 diabetes. We explored the association between hemoglobin A1c (HbA1c) and hospitalization risks within one-year and eight-year follow-up periods. We conducted a retrospective cohort study on 57,061 patients with type 2 diabetes from National Diabetes Case Management Program during 2002-2004 in Taiwan. HbA1c at baseline and in-hospital mortality, all-cause and cause-specific hospitalization over one year and eight years were analyzed. After multivariate adjustment, one-year risk was higher for cases with HbA1c level risk of hypoglycemia hospitalization (0.81, 95% CI: 0.74-0.88). For eight-year risk, subjects with HbA1c level risks of all-cause and diabetes-related hospitalization (1.04, 1.03-1.05, and 1.15, 1.14-1.17, respectively). Higher HbA1c level correlated with lower one-year risk due to hypoglycemia hospitalization but increased one-year and eight-year risks due to all-cause and diabetes-specific hospitalization among Chinese people with type 2 diabetes in Taiwan. Future study must ascertain how to meet HbA1c targets and improve outcome without risk to this population. Copyright © 2015 Elsevier Inc. All rights reserved.

The Talar Body Prosthesis: Results at Ten to Thirty-six Years of Follow-up.

Science.gov (United States)

Harnroongroj, Thos; Harnroongroj, Thossart

2014-07-16

Satisfactory results of implantation of the talar body prosthesis were reported in 1997, although some complications associated with the initial design were noted. The present study evaluated outcomes of treatment with a modified talar body prosthesis. Of the thirty-six talar body prostheses implanted with use of a transmalleolar surgical approach from 1974 to 2011, thirty-three were available for follow-up at ten to thirty-six years or had failed prior to that time. The indication for implantation had been osteonecrosis in twenty-three patients, a comminuted talar fracture in eight, and a talar body tumor in two. Twenty-eight of the thirty-three prostheses were still in place at the time of final follow-up and five had failed prior to five years. The duration of follow-up was ten to twenty years in eight patients, twenty to thirty years in eleven, and thirty to thirty-six years in nine. The AOFAS (American Orthopaedic Foot & Ankle Society) ankle-hindfoot score did not differ significantly among these three groups. Patients over sixty-five years of age with underlying disease that impeded walking ability had lower AOFAS scores. Early prosthesis failure occurred as a result of size mismatch in two patients, tumor recurrence in one, infection in one, and osteonecrosis of the talar head and neck in one. These failures, which occurred at eight to fifty-seven months, were treated with tibiotalar arthrodesis in three patients, prosthesis revision in one, and below-the-knee amputation in one. Although early prosthesis failure may occur, survival of the talar body prosthesis can provide satisfactory ankle and foot function. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

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

Science.gov (United States)

Ramdeen, S.; Hills, D. J.

2013-12-01

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

Twenty years' application of agricultural countermeasures following the Chernobyl accident: lessons learned

International Nuclear Information System (INIS)

Fesenko, S V; Alexakhin, R M; Balonov, M I; Bogdevich, I M; Howard, B J; Kashparov, V A; Sanzharova, N I; Panov, A V; Voigt, G; Zhuchenka, Yu M

2006-01-01

The accident at the Chernobyl NPP (nuclear power plant) was the most serious ever to have occurred in the history of nuclear energy. The consumption of contaminated foodstuffs in affected areas was a significant source of irradiation for the population. A wide range of different countermeasures have been used to reduce exposure of people and to mitigate the consequences of the Chernobyl accident for agriculture in affected regions in Belarus, Russia and Ukraine. This paper for the first time summarises key data on countermeasure application over twenty years for all three countries and describes key lessons learnt from this experience. (review)

Twenty years of „post-communism”: the radiography of a political failure

Directory of Open Access Journals (Sweden)

Aurora Martin

2011-11-01

Full Text Available This empirical view on the current „state” of Romania has as main objective to emphasize that the contemporary economic crisis actually revealed some other escalated crises in the very heart of the Romanian society. The vicious circle determined by three crises – one political, another social-institutional and last, but not least, a cultural one, continuously weakened the state for the last twenty years. Romania will overcome the economic crisis but the key for walking out of the above-mentioned circle would be the real transformation of its core systems – political, institutional and educational.

Eco-Visualization: Promoting Environmental Stewardship in the Museum

Science.gov (United States)

Holmes, Tiffany

2007-01-01

Eco-visualizations are artworks that reinterpret environmental data with custom software to promote stewardship. Eco-visualization technology offers a new way to dynamically picture environmental data and make it meaningful to a museum population. The questions are: How might museums create new projects and programs around place-based information?…

Twenty years on: Poverty and hardship in urban Fiji

Directory of Open Access Journals (Sweden)

Jenny Bryant-Tokalau

2012-09-01

Full Text Available Through ‘official statistics’, academic and donor interpretations as well as the eyes of Suva residents, this paper presents an overview and case study of twenty years of growing poverty and hardship in the contemporary Pacific. Focusing on the past two decades, the paper notes how much, and yet so little, has changed for those attempting to make a living in the rapidly developing towns and cities. Changing interpretations of poverty and hardship are presented, moving from the ‘no such thing’ view, to simplification, and finally to an understanding that Pacific island countries, especially Fiji, are no longer an ‘extension’ of Australia and New Zealand, but independent nations actively trying to find solutions to their issues of economic, social and political hardship whilst facing challenges to traditional institutions and networks. Fiji is in some respects a very particular case as almost half of the population has limited access to secure land, but the very nature of that vulnerability to hardship and poverty holds useful lessons for wider analysis.

Next Generation Cloud-based Science Data Systems and Their Implications on Data and Software Stewardship, Preservation, and Provenance

Science.gov (United States)

Hua, H.; Manipon, G.; Starch, M.

2017-12-01

NASA's upcoming missions are expected to be generating data volumes at least an order of magnitude larger than current missions. A significant increase in data processing, data rates, data volumes, and long-term data archive capabilities are needed. Consequently, new challenges are emerging that impact traditional data and software management approaches. At large-scales, next generation science data systems are exploring the move onto cloud computing paradigms to support these increased needs. New implications such as costs, data movement, collocation of data systems & archives, and moving processing closer to the data, may result in changes to the stewardship, preservation, and provenance of science data and software. With more science data systems being on-boarding onto cloud computing facilities, we can expect more Earth science data records to be both generated and kept in the cloud. But at large scales, the cost of processing and storing global data may impact architectural and system designs. Data systems will trade the cost of keeping data in the cloud with the data life-cycle approaches of moving "colder" data back to traditional on-premise facilities. How will this impact data citation and processing software stewardship? What are the impacts of cloud-based on-demand processing and its affect on reproducibility and provenance. Similarly, with more science processing software being moved onto cloud, virtual machines, and container based approaches, more opportunities arise for improved stewardship and preservation. But will the science community trust data reprocessed years or decades later? We will also explore emerging questions of the stewardship of the science data system software that is generating the science data records both during and after the life of mission.

The persistence of predictors of wellbeing among refugee youth eight years after resettlement in Melbourne, Australia.

Science.gov (United States)

Correa-Velez, Ignacio; Gifford, Sandra M; McMichael, Celia

2015-10-01

This short report assesses the predictors of subjective health and happiness among a cohort of refugee youth over their first eight years in Australia. Five waves of data collection were conducted between 2004 (n = 120) and 2012-13 (n = 51) using mixed methods. Previous schooling, self-esteem, moving house in the previous year, a supportive social environment, stronger ethnic identity and perceived discrimination were significant predictors of wellbeing after adjusting for demographic and pre-migration factors. When compared with a previous analysis of this cohort over their first three years of settlement, experiences of social exclusion still have a significant impact on wellbeing eight years after arriving in Australia. This study contributes to mounting evidence in support of policies that discourage discrimination and promote social inclusion and cultural diversity and which underpin the wellbeing of resettled refugee youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stewardship - De nieuwe facilitaire werkelijkheid, Facto Magazine, nr. 12

NARCIS (Netherlands)

Kok, H.B.

2011-01-01

Voor het succesvol besturen van organisaties bestaan in de managementliteratuur diverse modellen en theorieën. Het lijkt er op dat de stewardship-theorie, die uitgaat van wederzijds vertrouwen, beter past bij de ontwikkeling die FM op dit moment doormaakt dan de agencytheorie

Antimicrobial Stewardship Initiatives Throughout Europe: Proven Value for Money

NARCIS (Netherlands)

Oberje, E.J.M.; Tanke, M.A.C.; Jeurissen, P.P.T.

2017-01-01

Antimicrobial stewardship is recognized as a key component to stop the current European spread of antimicrobial resistance. It has also become evident that antimicrobial resistance is a problem that cannot be tackled by single institutions or physicians. Prevention of antimicrobial resistance needs

Principles and principals : do customer stewardship and agency control compete or complement when shaping frontline employee behavior?

NARCIS (Netherlands)

Schepers, J.J.L.; Falk, T.; Ruyter, de J.C.; Jong, de A.; Hammerschmidt, M.

2012-01-01

This article introduces customer stewardship control to the marketing field. This concept represents a frontline employee’s felt ownership of and moral responsibility for customers’ overall welfare. In two studies, the authors show that customer stewardship control is a more encompassing construct

Eight years' experience with an IVF surrogate gestational pregnancy programme.

Science.gov (United States)

Raziel, Arieh; Schachter, Morey; Strassburger, Deborah; Komarovsky, Dafna; Ron-El, Raphael; Friedler, Shevach

2005-08-01

The aim of this study was to retrospectively audit eight years' experience of an IVF surrogate gestational programme and to compare the outcome of surrogacy due to absence of the uterus with surrogacy indicated for repeated IVF failure and recurrent abortions. A total of 60 cycles of IVF surrogate pregnancy were initiated in 19 treated couples. Absence of the uterus was the indication for surrogacy in 10 cases: Rokitansky syndrome (eight cases) and post-hysterectomy (two cases) designated as group A. The indications in the remaining nine patients (group B) were: IVF implantation failure (three cases), habitual abortions (four cases) and deteriorating maternal diseases (two cases). IVF performance and subsequent pregnancy outcome of groups A and B were compared. There was no difference in ovarian stimulation parameters and in IVF performance between the groups A and B. The overall pregnancy rate per transfer was 10/60 (17%). The pregnancy rates per patient and per transfer were 7/10 (70%) and 7/35 (20%) in group A compared with 3/9 (33%) and 3/25 (12%) in group B. A median number of three treatment cycles were needed to achieve pregnancy. In conclusion, the existence or absence of the uterus in the commissioning mothers is irrelevant for their IVF performance and conception rates. In patients who conceived after more than three IVF cycles, an additional 'oocyte factor' might be present.

The Roles of the Accountant and Auditor in Stewardship and ...

African Journals Online (AJOL)

While much attention has been given to accountability in public sector which has not even yielded the desired result, the same can not be said of organised private sector. ... Keywords: Stewardship, corporate governance, accountability,

Antibiotic stewardship and empirical antibiotic treatment: How can they get along?

Science.gov (United States)

Zuccaro, Valentina; Columpsi, Paola; Sacchi, Paolo; Lucà, Maria Grazia; Fagiuoli, Stefano; Bruno, Raffaele

2017-06-01

The aim of this review is to focus on the recent knowledge on antibiotic stewardship and empiric antibiotic treatment in cirrhotic patients. The application of antimicrobial stewardship (AMS) rules appears to be the most appropriate strategy to globally manage cirrhotic patients with infectious complications: indeed they represent a unique way to provide both early diagnosis and appropriate therapy in order to avoid not only antibiotic over-prescription but, more importantly, selection and spread of antimicrobial resistance. Moreover, cirrhotic patients must be considered "frail" and susceptible to healthcare associated infections: applying AMS policies would assure a cost reduction and thus contribute to the improvement of public health strategies. Copyright © 2017. Published by Elsevier Ltd.

Urban Ecological Stewardship: Understanding the Structure, Function and Network of Community-based Urban Land Management

Directory of Open Access Journals (Sweden)

Lindsay K. Campbell

2008-01-01

Full Text Available Urban environmental stewardship activities are on the rise in cities throughout the Northeast. Groups participating in stewardship activities range in age, size, and geography and represent an increasingly complex and dynamic arrangement of civil society, government and business sectors. To better understand the structure, function and network of these community-based urban land managers, an assessment was conducted in 2004 by the research subcommittee of the Urban Ecology Collaborative. The goal of the assessment was to better understand the role of stewardship organizations engaged in urban ecology initiatives in selected major cities in the Northeastern U.S.: Boston, New Haven, New York City, Pittsburgh, Baltimore, and Washington, D.C. A total of 135 active organizations participated in this assessment. Findings include the discovery of a dynamic social network operating within cities, and a reserve of social capital and expertise that could be better utilized. Although often not the primary land owner, stewardship groups take an increasingly significant responsibility for a wide range of land use types including street and riparian corridors, vacant lots, public parks and gardens, green roofs, etc. Responsibilities include the delivery of public programs as well as daily maintenance and fundraising support. While most of the environmental stewardship organizations operate on staffs of zero or fewer than ten, with small cohorts of community volunteers, there is a significant difference in the total amount of program funding. Nearly all respondents agree that committed resources are scarce and insufficient with stewards relying upon and potentially competing for individual donations, local foundations, and municipal support. This makes it a challenge for the groups to grow beyond their current capacity and to develop long-term programs critical to resource management and education. It also fragments groups, making it difficult for planners and

FY 2017 Stockpile Stewardship and Management Plan - Biennial Plan Summary

Energy Technology Data Exchange (ETDEWEB)

None, None

2016-03-01

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

Twenty years of RERTR in Russia: Past, present and future

International Nuclear Information System (INIS)

Arkhangelsky, N.

2000-01-01

The Russian RERTR Program started approximately 20 years ago. The USSR always supported principles and goals of the policy of nonproliferation and at the end of 70's the Soviet Government decided to create such national program. Twenty years is the sufficient time to estimate preliminary results of the realization of the program and its prospects on the future. After the first successes of the program, when the enrichment of uranium in fuel elements for foreign supplies was reduced from 80 % to 36 %, the realization of the program was suspended in connection with financial difficulties. But in the beginning of the 90's the Program has received a new pulse connected to the inclusion of Russian scientists and engineers in the international Program. Now basic directions in development of new kinds of fuel are development of works on fuel on a basis dioxide of uranium and development of fuel on a basis of U-Mo alloy. In the future to basic goals of the program the problem of the management of the spent nuclear fuel should be added. The management of HEU at the final stage of a fuel cycle becomes an important objective of the program, since the basic amount of HEU is concentrated in storage of SNF. (author)

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.

Cost Estimates for the Decontamination and Decommissioning of Eight ORNL Buildings

International Nuclear Information System (INIS)

Hogan, M.

2006-01-01

The U.S. Department of Energy's Oak Ridge National Laboratory (ORNL) contains a number of buildings that are antiquated and no longer used. These buildings historically were used for the production of atomic weapons and often remain contaminated with radioactive materials. Certain costs and risks are associated with the long-term stewardship of the buildings. One way to reduce these liabilities is to eliminate the buildings that are no longer in use and are not expected to be used in the future. Some of these buildings at ORNL are located in an area known as 'Isotope Circle'. From this area, eight buildings that are expected to be decontaminated and decommissioned (D and D) in the next five to ten years were chosen to have cost estimates completed. The specific facilities are Buildings 3030, 3031, 3118, 3032, 3033, 3033 Annex, 3034, and 3093. There are many challenges for estimating the costs to D and D buildings potentially contaminated with radionuclides. Each building is unique, has various types and levels of contamination, and (as in this case) often lacks up-to-date information. Because of these limitations, order-of- magnitude cost estimates for each of the eight ORNL buildings were completed using parametric cost modeling software known as RACER TM (Remedial Action Cost Engineering and Requirements System). This type of cost estimate is useful for screening technical concepts and is used for budgetary planning. For the eight buildings evaluated in this study, the total cost to D and D was estimated to be nearly $6 M. This value includes the direct cost of approximately $3.5 M to complete D and D and $2.5 M in cost markups. Also, assuming the actual project does not begin until the year 2010, this total cost is escalated to almost $6.7 M, which accounts for expected inflation. Although the cost estimates in this study were expected to have a wide range in accuracy, there are various factors that could impact these estimates in a negative or positive fashion

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

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

An integrated stewardship model : Antimicrobial, infection prevention and diagnostic (AID)

NARCIS (Netherlands)

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

2016-01-01

Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship

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

NARCIS (Netherlands)

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

2015-01-01

Considering the threat of antimicrobial resistance and the difficulties it entails in treating infections, it is necessary to cross borders and approach infection management in an integrated, multidisciplinary manner. We propose the antimicrobial, infection prevention and diagnostic stewardship

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

Science.gov (United States)

Weiss, Marjorie D

2013-08-01

Strategically leveraging health and safety initiatives with sustainability and stewardship helps organizations improve profitability and positively impact team member and customer attachment to the organization. Collective efficacy enhances the triple bottom line: healthy people, healthy planet, and healthy profits. The HS(3)™ Best Practice Exchanges group demonstrated that collective efficacy can leverage the social cohesion, communication channels, and activities within workplaces to promote a healthy, sustainable work culture. This in turn (1) protects the health and safety of workers, (2) preserves the natural environment, and (3) increases attachment to the organization. Community-based participatory research using the Attach21 survey assessed the progress of these companies in their efforts to integrate health, safety, sustainability, and stewardship. Monthly Best Practice Exchanges promoted collective efficacy by providing support, encouragement, and motivation to share and adopt new ideas. Copyright 2013, SLACK Incorporated.

The deep, hot biosphere: Twenty-five years of retrospection.

Science.gov (United States)

Colman, Daniel R; Poudel, Saroj; Stamps, Blake W; Boyd, Eric S; Spear, John R

2017-07-03

Twenty-five years ago this month, Thomas Gold published a seminal manuscript suggesting the presence of a "deep, hot biosphere" in the Earth's crust. Since this publication, a considerable amount of attention has been given to the study of deep biospheres, their role in geochemical cycles, and their potential to inform on the origin of life and its potential outside of Earth. Overwhelming evidence now supports the presence of a deep biosphere ubiquitously distributed on Earth in both terrestrial and marine settings. Furthermore, it has become apparent that much of this life is dependent on lithogenically sourced high-energy compounds to sustain productivity. A vast diversity of uncultivated microorganisms has been detected in subsurface environments, and we show that H 2 , CH 4 , and CO feature prominently in many of their predicted metabolisms. Despite 25 years of intense study, key questions remain on life in the deep subsurface, including whether it is endemic and the extent of its involvement in the anaerobic formation and degradation of hydrocarbons. Emergent data from cultivation and next-generation sequencing approaches continue to provide promising new hints to answer these questions. As Gold suggested, and as has become increasingly evident, to better understand the subsurface is critical to further understanding the Earth, life, the evolution of life, and the potential for life elsewhere. To this end, we suggest the need to develop a robust network of interdisciplinary scientists and accessible field sites for long-term monitoring of the Earth's subsurface in the form of a deep subsurface microbiome initiative.

Designing Program Roadmaps to Catalyze Community Formation: A Case Study of the Long-Term Stewardship Science and Technology Roadmapword

International Nuclear Information System (INIS)

Dixon, Brent; Hanson, Duane; Matthern, Gretchen

2003-01-01

A number of broad perspective technology roadmaps have been developed in the last few years as tools for coordinating nation-wide research in targeted areas. These roadmaps share a common characteristic of coalescing the associated stakeholder groups into a special-interest community that is willing to work cooperatively in achieving the roadmap goals. These communities are key to roadmap implementation as they provide the collaborative energy necessary to obtain the political support and funding required for identified science and technology development efforts. This paper discusses the relationship between roadmaps and special-interest communities, using the recently drafted Department of Energy's Long-Term Stewardship Science and Technology Roadmap as a case study. Specific aspects this roadmap's design facilitated the development of a long-term stewardship community while specific realities during roadmap development impacted the realization of the design

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

Science.gov (United States)

Herrera, Tania; Sánchez, Sergio

2014-11-26

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

The absence of stewardship in the Chilean health authority after the 2004 health reform

Directory of Open Access Journals (Sweden)

Tania Herrera

2014-11-01

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

Final programmatic environmental impact statement for stockpile stewardship and management. Comment response document. Volume 4

International Nuclear Information System (INIS)

1996-09-01

In response to the end of the Cold War and changes in the world's political regimes, the United States is not producing new-design nuclear weapons. Instead, the emphasis on the U.S. nuclear weapons program is on reducing the size of the Nation's nuclear stockpile by dismantling existing nuclear weapons. The Department of Energy (DOE) has been directed by the President and Congress to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground nuclear testing. In order to fulfill that responsibility, DOE has developed a Stockpile Stewardship and Management Program to provide a single highly integrated program for maintaining the continued safety and reliability of the nuclear stockpile. The Stockpile Stewardship and Management PEIS describes and analyzes alternative ways to implement the proposed actions for the Stockpile Stewardship and Management Program

US antibiotic stewardship and penicillin allergy.

Science.gov (United States)

Wada, Kara J; Calhoun, Karen H

2017-06-01

The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics. This permits use of narrower-spectrum antibiotics and saves money.

Ecosystem stewardship: sustainability strategies for a rapidly changing planet

Science.gov (United States)

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

2010-01-01

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

Still Not Adult-Like: Lexical Stress Contrastivity in Word Productions of Eight- to Eleven-Year-Olds

Science.gov (United States)

Arciuli, Joanne; Ballard, Kirrie J.

2017-01-01

Lexical stress is the contrast between strong and weak syllables within words. Ballard et al. (2012) examined the amount of stress contrastivity across adjacent syllables in word productions of typically developing three- to seven-year-olds and adults. Here, eight- to eleven-year-olds are compared with the adults from Ballard et al. using acoustic…

Twenty Years of Research on RNS for DSP: Lessons Learned and Future Perspectives

DEFF Research Database (Denmark)

Albicocco, Pietro; Cardarilli, Gian Carlo; Nannarelli, Alberto

2014-01-01

In this paper, we discuss a number of issues emerged from our twenty-year long experience in applying the Residue Number System (RNS) to DSP systems. In early days, RNS was mainly used to reach the maximum performance in speed. Today, RNS is also used to obtain powerefficient (tradeoffs speed......-power) and reliable systems (redundant RNS). Advances in microelectronics and CAD tools play an important role in favoring one technology over another, and a winning choice of the past may become at disadvantage today. In this paper, we address a number of factors influencing the choice of RNS as the winning solution...

Twenty years' application of agricultural countermeasures following the Chernobyl accident: lessons learned

Energy Technology Data Exchange (ETDEWEB)

Fesenko, S V [International Atomic Energy Agency, 1400 Vienna (Austria); Alexakhin, R M [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Balonov, M I [International Atomic Energy Agency, 1400 Vienna (Austria); Bogdevich, I M [Research Institute for Soil Science and Agrochemistry, Minsk (Belarus); Howard, B J [Centre for Ecology and Hydrology, Lancaster Environment Centre, Library Avenue, Bailrigg, Lancaster LAI 4AP (United Kingdom); Kashparov, V A [Ukrainian Institute of Agricultural Radiology (UIAR), Mashinostroiteley Street 7, Chabany, Kiev Region 08162 (Ukraine); Sanzharova, N I [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Panov, A V [Russian Institute of Agricultural Radiology and Agroecology, 249020 Obninsk (Russian Federation); Voigt, G [International Atomic Energy Agency, 1400 Vienna (Austria); Zhuchenka, Yu M [Research Institute of Radiology, 246000 Gomel (Belarus)

2006-12-15

The accident at the Chernobyl NPP (nuclear power plant) was the most serious ever to have occurred in the history of nuclear energy. The consumption of contaminated foodstuffs in affected areas was a significant source of irradiation for the population. A wide range of different countermeasures have been used to reduce exposure of people and to mitigate the consequences of the Chernobyl accident for agriculture in affected regions in Belarus, Russia and Ukraine. This paper for the first time summarises key data on countermeasure application over twenty years for all three countries and describes key lessons learnt from this experience. (review)

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

Directory of Open Access Journals (Sweden)

Storey Donald F

2012-10-01

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

Controlling endemic multidrug-resistant Acinetobacter baumannii in Intensive Care Units using antimicrobial stewardship and infection control.

Science.gov (United States)

Cheon, Shinhye; Kim, Mi-Ja; Yun, Seon-Jin; Moon, Jae Young; Kim, Yeon-Sook

2016-03-01

Nosocomial infections caused by multidrug-resistant (MDR) Acinetobacter baumannii have become public-health problem. However, few studies have evaluated the control of endemic MDR A. baumannii in Intensive Care Units (ICUs). Therefore, we investigated the effectiveness of antimicrobial stewardship and comprehensive intensified infection control measures for controlling endemic MDR A. baumannii in ICUs at a tertiary care center. Carbapenem use was strictly restricted through antimicrobial stewardship. Environmental cleaning and disinfection was performed at least 3 times per day in addition to basic infection control measures. Isolation using plastic curtains and contact precautions were applied to patients who were colonized or infected with MDR A. baumannii. The outcome was measured as the incidence density rate of hospital-onset MDR A. baumannii among patients in the ICUs. The incidence density rate of hospital-onset MDR A. baumannii decreased from 22.82 cases per 1,000 patient-days to 2.68 cases per 1,000 patient-days after the interventions were implemented (odds ratio, 0.12; 95% confidence interval, 0.03 to 0.4; p baumannii in our ICUs within 1 year.

A History of the Atomic Energy Commission

Science.gov (United States)

Buck, Alice L.

1983-07-01

This pamphlet traces the history of the US Atomic Energy Commission's twenty-eight year stewardship of the Nation's nuclear energy program, from the signing of the Atomic Energy Act on August 1, 1946 to the signing of the Energy Reorganization Act on October 11, 1974. The Commission's early concentration on the military atom produced sophisticated nuclear weapons for the Nation's defense and made possible the creation of a fleet of nuclear submarines and surface ships. Extensive research in the nuclear sciences resulted in the widespread application of nuclear technology for scientific, medical and industrial purposes, while the passage of the Atomic Energy Act of 1954 made possible the development of a nuclear industry, and enabled the United States to share the new technology with other nations.

History of the Atomic Energy Commission

International Nuclear Information System (INIS)

Buck, A.L.

1983-07-01

This pamphlet traces the history of the US Atomic Energy Commission's twenty-eight year stewardship of the Nation's nuclear energy program, from the signing of the Atomic Energy Act on August 1, 1946 to the signing of the Energy Reorganization Act on October 11, 1974. The Commission's early concentration on the military atom produced sophisticated nuclear weapons for the Nation's defense and made possible the creation of a fleet of nuclear submarines and surface ships. Extensive research in the nuclear sciences resulted in the widespread application of nuclear technology for scientific, medical and industrial purposes, while the passage of the Atomic Energy Act of 1954 made possible the development of a nuclear industry, and enabled the United States to share the new technology with other nations

History of the Atomic Energy Commission

International Nuclear Information System (INIS)

Buck, A.L.

1982-08-01

This pamphlet traces the history of the Atomic Energy Commission's twenty-eight year stewardship of the Nation's nuclear energy program, from the signing of the Atomic Energy Act on August 1, 1946, to the signing of the Energy Reorganization Act on October 11, 1974. The Commission's early concentration on the military atom produced sophisticated nuclear weapons for the Nation's defense and made possible the creation of a fleet of nuclear submarines and surface ships. Extensive research in the nuclear sciences resulted in the widespread application of nuclear technology for scientific, medical and industrial purposes, while the passage of the Atomic Energy Act of 1954 made possible the development of a nuclear industry, and enabled the United States to share the new technology with other nations

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

Science.gov (United States)

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

2013-02-15

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

Twenty-Five Year Site Plan FY2013 - FY2037

Energy Technology Data Exchange (ETDEWEB)

Jones, William H. [Los Alamos National Laboratory

2012-07-12

Los Alamos National Laboratory (the Laboratory) is the nation's premier national security science laboratory. Its mission is to develop and apply science and technology to ensure the safety, security, and reliability of the United States (U.S.) nuclear stockpile; reduce the threat of weapons of mass destruction, proliferation, and terrorism; and solve national problems in defense, energy, and the environment. The fiscal year (FY) 2013-2037 Twenty-Five Year Site Plan (TYSP) is a vital component for planning to meet the National Nuclear Security Administration (NNSA) commitment to ensure the U.S. has a safe, secure, and reliable nuclear deterrent. The Laboratory also uses the TYSP as an integrated planning tool to guide development of an efficient and responsive infrastructure that effectively supports the Laboratory's missions and workforce. Emphasizing the Laboratory's core capabilities, this TYSP reflects the Laboratory's role as a prominent contributor to NNSA missions through its programs and campaigns. The Laboratory is aligned with Nuclear Security Enterprise (NSE) modernization activities outlined in the NNSA Strategic Plan (May 2011) which include: (1) ensuring laboratory plutonium space effectively supports pit manufacturing and enterprise-wide special nuclear materials consolidation; (2) constructing the Chemistry and Metallurgy Research Replacement Nuclear Facility (CMRR-NF); (3) establishing shared user facilities to more cost effectively manage high-value, experimental, computational and production capabilities; and (4) modernizing enduring facilities while reducing the excess facility footprint. Th is TYSP is viewed by the Laboratory as a vital planning tool to develop an effi cient and responsive infrastructure. Long range facility and infrastructure development planning are critical to assure sustainment and modernization. Out-year re-investment is essential for sustaining existing facilities, and will be re-evaluated on an annual

Antimicrobial stewardship initiatives throughout Europe: proven value for money

Directory of Open Access Journals (Sweden)

Edwin J.M. Oberjé

2017-03-01

Full Text Available Antimicrobial stewardship is recognized as a key component to stop the current European spread of antimicrobial resistance. It has also become evident that antimicrobial resistance is a problem that cannot be tackled by single institutions or physicians. Prevention of antimicrobial resistance needs rigorous actions at ward level, institution level, national level and at supra-national levels. Countries can learn from each other and possibly transplant best practices across borders to prevent antimicrobial resistance. The aim of this study is to highlight some of the success stories of proven cost-effective interventions, and to describe the actions that have been taken, the outcomes that have been found, and the difficulties that have been met. In some cases we came across substantial scope for real-life cost savings. Although the best approach to effectively hinder the spread of antimicrobial resistance remains unclear and may vary significantly among settings, several EU-wide examples demonstrate that cost-effective antimicrobial stewardship is possible. Such examples can encourage others to implement (the most cost-effective elements in their system.

Twenty years of experience with central softening in The Netherlands : Water quality – Environmental benefits – Costs

NARCIS (Netherlands)

Hofman, J.A.M.H.; Kramer, O.J.I.; van der Hoek, J.P.; Nederlof, M; Groenendijk, M

2006-01-01

Central softening has been utilized by the Dutch water utilities since the late 1970s. It was introduced in the water treatment process as a method to supply water with an optimum water composition to prevent lead and copper release and to prevent excessive scaling. Twenty years of experience show

Elevated dioxin levels in chloracne cases twenty years after the Seveso, Italy accident

Energy Technology Data Exchange (ETDEWEB)

Baccarelli, A.; Pesatori, A.C.; Consonni, D.; Bonzini, M.; Giacomini, S.M.; Bertazzi, P.A. [EPOCA Research Center, Univ. of Milan (Italy); Mocarelli, P. [Dept. of Lab. Medicine, Univ. of Milan-Bicocca, Desio (Italy); Patterson, D.G. Jr. [Centers for Disease Control and Prevention, Atlanta, GA (United States); Caporaso, N.E.; Landi, M.T. [Div. of Cancer Epidemiology and Genetics, National Cancer Inst., NIH, DHHS, Bethesda, MD (United States)

2004-09-15

In July 1976, an industrial accident contaminated a residential area surrounding Seveso, Italy, with high levels of 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD). The exposure was acute, relatively pure, and affected more than 45,000 men, women, and children. By February 1978, 193 chloracne cases, mostly children, had been identified in the exposed population. Twenty years after, we conducted a case-control study on subjects diagnosed with chloracne and control subjects, who had not developed chloracne after the accident, to evaluate their TCDD plasma levels, as well as the exposure-response relationship and possible determinants of susceptibility to TCDD effects in this population.

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

Science.gov (United States)

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

2015-03-01

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

Sex steroid hormone levels and reproductive development of eight-year-old children following in utero and environmental exposure to phthalates.

Directory of Open Access Journals (Sweden)

Pen-Hua Su

Full Text Available In utero exposure to phthalates may adversely affect reproductive development in children due to the anti-androgenic properties of the pthalates. Accordingly, we aimed to determine the effects of in utero and environmental phthalate exposure on the reproductive development of eight-year-old children. We recruited 180 children in central Taiwan during November 2001 and followed them until August 2009 when all children became eight years old. Birth outcomes were collected. Bone age, hormone concentrations, and reproductive developmental stages were determined. Phthalate metabolite levels, including mono-2-ethylhexyl phthalate [MEHP], mono-n-butyl phthalate [MnBP], and mono-benzyl phthalate [MBzP], were assessed. No significant gender differences were found in in utero phthalate exposure. Maternal urinary levels of phthalate metabolites did not correlate significantly with birth outcomes, physical characteristics, and reproductive hormones of the eight-year-old children. Regarding the urinary phthalate metabolite levels of the eight-year-old children, MEHP correlated significantly with serum progesterone levels. MEHP levels in girls correlated significantly with serum progesterone levels. MnBP correlated significantly with serum FSH in all children. In girls, MnBP correlated with serum FSH, and MBzP correlated with serum progesterone and FSH levels. Urinary phthalate metabolite levels did not correlate with female developmental stages or the development of female reproductive organs. Phthalate metabolites did not correlate with the physical characteristics and reproductive hormones in boys. Therefore, environmental exposure to phthalates, as determined by urinary phthalate metabolite levels of eight-year-old children, may affect reproductive hormone levels in children, indicating that further studies on the environmental health effects of phthalates are warranted.

The Stewardship Role of Analyst Forecasts, and Discretionary Versus Non-Discretionary Accruals

DEFF Research Database (Denmark)

Christensen, Peter Ove; Frimor, Hans; Sabac, Florin

We examine the interaction between discretionary and non-discretionary accruals in a stewardship setting. Contracting includes multiple rounds of renegotiation based on contractible accounting information and non-contractible but more timely non-accounting information. We show that accounting...... timely non-accounting information (analyst earnings forecasts) increases the ex ante value of the firm and reduces costly earnings management. There is an optimal level of reversible non-discretionary accrual noise introduced through revenue recognition policies. Tight rules-based accounting regulation...... regulation aimed at increasing earnings quality from a valuation perspective (earnings persistence) may have a significant impact on how firms rationally respond in terms of allowing accrual discretion in order to alleviate the impact on the stewardship role of earnings. Increasing the precision of more...

The Stewardship Role of Analyst Forecasts, and Discretionary Versus Non-Discretionary Accruals

DEFF Research Database (Denmark)

Christensen, Peter Ove; Frimor, Hans; Sabac, Florin

2013-01-01

We examine the interaction between discretionary and non-discretionary accruals in a stewardship setting. Contracting includes multiple rounds of renegotiation based on contractible accounting information and non-contractible but more timely non-accounting information. We show that accounting...... timely non-accounting information (analyst earnings forecasts) increases the ex ante value of the firm and reduces costly earnings management. There is an optimal level of reversible non-discretionary accrual noise introduced through revenue recognition policies. Tight rules-based accounting regulation...... regulation aimed at increasing earnings quality from a valuation perspective (earnings persistence) may have a significant impact on how firms rationally respond in terms of allowing accrual discretion in order to alleviate the impact on the stewardship role of earnings. Increasing the precision of more...

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

Science.gov (United States)

Prescott, John F

2014-07-16

Modern medicine is built on antibiotics. Antibiotics are something that we take for granted. We have however spent over 60 years educating bacteria to become resistant, and the global resistance tsunami has caught everyone unawares. Since bacteria have changed, we also have to change, and to change most of the practices of how we use antibiotics. Because the development of new antibiotics is so expensive, a stewardship approach may help to preserve those that we have now while we work to develop new antibiotics and to develop other approaches to controlling and treating infections. We need to adopt the ethic of Good Stewardship Practice (GSP) as an active and dynamic process of continuous improvement in antibiotic use, a process with many steps of different sizes involving everyone involved in antibiotic use. All antibiotic users have an important role to play in GSP. Although the resistance situation is pessimistic, and the future of antibiotics looks uncertain, we are fortunately entering what may be seen as the golden age of microbiology. This encompasses an astonishing array of technologies for rapid pathogen and resistance gene detection, for clone identification by genome sequencing, for identification of novel bacterial genes and for identification of the Achilles' heels of different pathogens. Future antibiotics may have to be far more targeted to the individual pathogen and the site of infection. A global tax on antibiotics might reduce their use while funding the cost of developing new antibiotics and new approaches to control of infectious diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

Portrayal of Life Form in Selected Biographies for Children Eight to Twelve Years of Age.

Science.gov (United States)

Koch, Shirley Lois

This study describes and analyzes, in a critical literary manner, selected biographies for children eight to twelve years of age. Biographies of Jane Addams, Cesar Chavez, Mohandas Gandhi, Toyohiko Kagawa, Martin Luther King, Jr., and Albert Schweitzer are viewed from the perspective of a literary criterion based on the principles of design to…

Staff perceptions of change resulting from participation in a European cancer accreditation programme: a snapshot from eight cancer centres

NARCIS (Netherlands)

Rajan, A.; Wind, Anke; Saghatchian, Mahasti; Thonon, Frederique; Boomsma, Femke; van Harten, Willem H.

2015-01-01

Background: Healthcare accreditation is considered to be an essential quality improvement tool. However, its effectiveness has been critiqued. Methods: Twenty-four interviews were conducted with clinicians (five), nurses (six), managers (eight), and basic/translational researchers (five) from eight

Prevalence of scholastic backwardness among five to eight year old children.

Science.gov (United States)

Shenoy, J; Kapur, M

1996-10-01

The present paper reports the findings of a study of scholastic backwardness among five to eight year old school going children. 1535 children were screened by their class teachers, of which 10.23% were found to have scholastic backwardness. No gender differences were noticed. The rates of specific difficulties such as reading, writing and arithmetic were found to be 4.69%, 5.15% and 15.96% respectively. About 26% of the scholastically backward children were also found to have psychological disturbance. In addition, they most often came from families which could not afford basic amenities, had fathers with alcohol dependence, inconsistent disciplining and poor parental interaction. They also had more frequent school changes, tution attendence and fewer hobbies compared to the scholastically superior children.

Antimicrobial Stewardship: A Call to Action for Surgeons

Science.gov (United States)

Duane, Therese M.; Catena, Fausto; Tessier, Jeffrey M.; Coccolini, Federico; Kao, Lillian S.; De Simone, Belinda; Labricciosa, Francesco M.; May, Addison K.; Ansaloni, Luca; Mazuski, John E.

2016-01-01

Abstract Despite current antimicrobial stewardship programs (ASPs) being advocated by infectious disease specialists and discussed by national and international policy makers, ASPs coverage remains limited to only certain hospitals as well as specific service lines within hospitals. The ASPs incorporate a variety of strategies to optimize antimicrobial agent use in the hospital, yet the exact set of interventions essential to ASP success remains unknown. Promotion of ASPs across clinical practice is crucial to their success to ensure standardization of antimicrobial agent use within an institution. To effectively accomplish this standardization, providers who actively engage in antimicrobial agent prescribing should participate in the establishment and support of these programs. Hence, surgeons need to play a major role in these collaborations. Surgeons must be aware that judicious antibiotic utilization is an integral part of any stewardship program and necessary to maximize clinical cure and minimize emergence of antimicrobial resistance. The battle against antibiotic resistance should be fought by all healthcare professionals. If surgeons around the world participate in this global fight and demonstrate awareness of the major problem of antimicrobial resistance, they will be pivotal leaders. If surgeons fail to actively engage and use antibiotics judiciously, they will find themselves deprived of the autonomy to treat their patients. PMID:27828764

Development, problem behavior, and quality of life in a population based sample of eight-year-old children with Down syndrome.

Directory of Open Access Journals (Sweden)

Helma B M van Gameren-Oosterom

Full Text Available OBJECTIVE: Children with Down syndrome (DS have delayed psychomotor development. We investigated levels of development, problem behavior, and Health-Related Quality of Life (HRQoL in a population sample of Dutch eight-year-old children with DS. Developmental outcomes were compared with normative data of eight-year-old children from the general population. METHOD: Over a three-year-period all parents with an eight-year-old child with DS were approached by the national parent organization. Developmental skills were assessed by means of the McCarthy Scales of Children's Ability. To measure emotional and behavioral problems we used the Child Behavior Checklist. HRQoL was assessed with the TNO-AZL Children's Quality of Life questionnaire. Analyses of variance were applied to compare groups. RESULTS: A total of 337 children participated. Mean developmental age was substantially lower than mean calendar age (3.9 years, SD 0.87 and 8.1 years, SD 0.15 respectively. Mean developmental age was significantly lower among boys than girls (3.6 (SD 0.85 and 4.2 years (SD 0.82 respectively; p<0.001. Compared with the general population, children with DS had more emotional and behavioral problems (p<0.001. However on the anxious/depressed scale, they scored significantly more favorably (p<0.001. Significantly lower HRQoL scores for the scales gross motor skills, autonomy, social functioning and cognitive functioning were found (p-values<0.001. Hardly any differences were observed for the scales physical complaints, positive and negative emotions. CONCLUSION: Eight-year-old children with DS have an average developmental delay of four years, more often have emotional and behavioral problems, and have a less favorable HRQoL compared with children from the general population.

Level-2 perspectives computed quickly and spontaneously: Evidence from eight- to 9.5-year-old children.

Science.gov (United States)

Elekes, Fruzsina; Varga, Máté; Király, Ildikó

2017-11-01

It has been widely assumed that computing how a scene looks from another perspective (level-2 perspective taking, PT) is an effortful process, as opposed to the automatic capacity of tracking visual access to objects (level-1 PT). Recently, adults have been found to compute both forms of visual perspectives in a quick but context-sensitive way, indicating that the two functions share more features than previously assumed. However, the developmental literature still shows the dissociation between automatic level-1 and effortful level-2 PT. In the current paper, we report an experiment showing that in a minimally social situation, participating in a number verification task with an adult confederate, eight- to 9.5-year-old children demonstrate similar online level-2 PT capacities as adults. Future studies need to address whether online PT shows selectivity in children as well and develop paradigms that are adequate to test preschoolers' online level-2 PT abilities. Statement of Contribution What is already known on this subject? Adults can access how objects appear to others (level-2 perspective) spontaneously and online Online level-1, but not level-2 perspective taking (PT) has been documented in school-aged children What the present study adds? Eight- to 9.5-year-olds performed a number verification task with a confederate who had the same task Children showed similar perspective interference as adults, indicating spontaneous level-2 PT Not only agent-object relations but also object appearances are computed online by eight- to 9.5-year-olds. © 2017 The British Psychological Society.

76 FR 17180 - Meeting of the Regional Resource Stewardship Council

Science.gov (United States)

2011-03-28

... area components of the draft NRP and the benefits and challenges stemming from such programs. 5. Public... and will be called on during the public comment period. Handout materials should be limited to one printed page. Written comments are also invited and may be mailed to the Regional Resource Stewardship...

Mercury pollution control in industrial area in Rosignano Marittimo (Italy) during last twenty years (1971-1991)

International Nuclear Information System (INIS)

Bertani, R.

1995-01-01

Author takes into account some papers dealing with mercury environmental pollution, appeared in different scientific journals over the last twenty years, in the aim of defining a homogeneous frame for the comprehension of the environmental situation development. Data relating to air, marine water, sediments, animal and vegetal organisms, show a consistent decreasing of mercury emissions with the passing of time. Nevertheless, author fearfully points out the environmental fate of the mercury which has been heavily released from the plant in the past years and to whom he wishes to turn attention for the assessment of an adequate control procedure

Nutritional quality at eight U.S. fast-food chains: 14-year trends.

Science.gov (United States)

Hearst, Mary O; Harnack, Lisa J; Bauer, Katherine W; Earnest, Alicia A; French, Simone A; Michael Oakes, J

2013-06-01

Frequent consumption of fast-food menu items that are high in fat, sugar, and sodium contribute to poor dietary quality, increasing individuals' risk for diet-related chronic diseases. To assess 14-year trends in the nutritional quality of menu offerings at eight fast-food restaurant chains in the U.S. Data on menu items and food and nutrient composition were obtained in 2011 from archival versions of the University of Minnesota Nutrition Coordinating Center Food and Nutrient Database for eight fast-food restaurant chains. In this database, ingredient and nutrition information for all foods sold by the fast-food restaurants were updated biannually between 1997/1998 and 2009/2010. Healthy Eating Index (HEI)-2005 scores were calculated for each restaurant menu as a measure of the extent to which menu offerings were consistent with Dietary Guidelines for Americans and compared over time. Of a possible index total of 100 (healthiest), the HEI-2005 score across all eight fast-food restaurants was 45 in 1997/1998 and 48 in 2009/2010. Individually, restaurant scores in 1997/1998 ranged from 37 to 56 and in 2009/2010 ranged from 38 to 56. The greatest improvements in nutritional quality were seen in the increase of meat/beans, decrease in saturated fat, and decrease in the proportion of calories from solid fats and added sugars. The HEI-2005 score improved in six restaurants and decreased in two. The nutritional quality of menu offerings at fast-food restaurant chains included in this study increased over time, but further improvements are needed. Fast-food restaurants have an opportunity to contribute to a healthy diet for Americans by improving the nutritional quality of their menus. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Normal Health-Related Quality of Life and Ability to Work Twenty-nine Years After in Situ Arthrodesis for High-Grade Isthmic Spondylolisthesis.

Science.gov (United States)

Joelson, Anders; Hedlund, Rune; Frennered, Karin

2014-06-18

The purpose of this mixed prospective and retrospective case series was to evaluate the long-term health-related quality of life and physical disability after in situ arthrodesis for high-grade isthmic spondylolisthesis. Thirty-five of forty consecutive patients who had in situ spinal arthrodesis for high-grade isthmic spondylolisthesis at a mean age of fifteen years (range, nine to twenty-five years) completed validated questionnaires (Short Form-36 [SF-36], EuroQol-5 Dimensions [EQ-5D], Zung depression scale, Oswestry disability index [ODI], Million score, and back and leg pain visual analog scale [VAS]) and underwent physical examination twenty-nine years (range, twenty-three to thirty-five years) after surgery. The mean age at the time of follow-up was forty-three years (range, thirty-seven to fifty-one years). In the absence of a formal control group, the scores on the SF-36 and EQ-5D were compared with Swedish normative data. The proportion of patients at work was compared with an age-matched control group derived from official statistics of Sweden. The Million score at the long-term follow-up was compared with the corresponding results at the mid-term follow-up of the same patients at a mean age of twenty-two years. The scores on the SF-36 and EQ-5D were similar to the scores of the general Swedish population. The mean Zung depression scale score was 30 (range, 20 to 52), the mean ODI score was 10 (range, 0 to 34), the mean back pain VAS score was 13 (range, 0 to 72), and the mean leg pain VAS score was 9 (range, 0 to 60). The Million score averaged 28 (range, 0 to 109) and was slightly worsened compared with the score of 19 (range, 0 to 94) at the mid-term follow-up (p = 0.034). The proportion of patients at work was the same as that for the age-matched general Swedish population. Our study shows good outcomes in health-related quality of life, disability, pain, and ability to work at up to twenty-nine years after in situ lumbar spine arthrodesis for high

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

Science.gov (United States)

Turner, R Brigg; Valcarlos, Elena; Loeffler, Ann M; Gilbert, Michael; Chan, Dominic

2017-09-01

Pediatric stewardship programs have been successful at reducing unnecessary antibiotic use. Data from nonfreestanding children's hospitals are currently limited. This study is an analysis of antibiotic use after implementation of an antimicrobial stewardship program at a community nonfreestanding children's hospital. In April 2013, an antimicrobial stewardship program that consisted of physician-group engagement and pharmacist prospective auditing and feedback was initiated. We compared antibiotic use in the preintervention period (April 2012 to March 2013) with that in the postintervention period (April 2013 to March 2015) in all units except the neonatal intensive care unit and the emergency department. In addition, drug-acquisition costs, antibiotic-specific use, death, length of stay, and case-mix index were examined. Antibiotic use decreased by 16.8% (95% confidence interval, 18.0% to -9.2%; P antibiotic use without an overt negative impact on overall clinical outcomes. The results of this study suggest that nonfreestanding children's hospitals can achieve substantial reductions in antibiotic use despite limited resources. © The Author 2016. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Building On Builder: The Persistent Icarus Syndrome at Twenty Years

Science.gov (United States)

2013-06-01

mission of the United States Air Force is to "fly, fight, and win…in air, space and cyberspace"--as an intergral member of the Joint team that...Scenarios: A Military Futurist Explores War in the Twenty-First Century (New York: Bantam Books Trade Paperbacksl, 2009), 17. 33 Carl H. Builder

CND twenty years on

International Nuclear Information System (INIS)

Taylor, R.; Pritchard, C.

1980-01-01

A study is presented of people who were supporters or leaders in the Campaign for Nuclear Disarmament (CND) in the 1950s and 1960s. Information is given from questionnaires completed by 403 respondents, about their social and political development during the past 20 years. (author)

Medical table: A major tool for antimicrobial stewardship policy.

Science.gov (United States)

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

2017-09-01

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

Twenty years of renewable energy law; 20 Jahre Recht der Erneuerbaren Energien

Energy Technology Data Exchange (ETDEWEB)

Mueller, Thorsten (ed.)

2012-07-01

The present volume was compiled as part of a project funded by the German Federal Ministry for Environment, Nature Conservation and Reactor Safety, one event under which was the seventh Wuerzburg conference on environmental energy law with the title ''Twenty Years of Renewable Energy Law'' which took place on 13/14 October 2010. It comprises 36 contributions which, from different scientific perspectives, take stock of the significance of renewable energies for climate protection and the energy supply, examine the developments of the past 20 years and draw conclusions for the future use of renewable energy. The authors are scientists from the areas of climate research, economics, political science, engineering, environmental psychology and jurisprudence who have dedicated their work to issues that directly or indirectly relate to the expansion of renewable energies. Together they have created an overall picture of renewable energies with its many different aspects and related topics, a picture that necessarily cannot be complete but which nevertheless provides many rich insights. The great majority of articles were written around the turn of the year to 2011, just after the granting of lifetime extension for German nuclear power plants. They thus only take sparse account of the diverse and for some part far-reaching changes in German energy policy that came about after the reactor disaster in Fukushima.

Idiopathic eosinophilic parotitis in an eight-year-old boy: a case report

Directory of Open Access Journals (Sweden)

Gelardi Matteo

2011-08-01

Full Text Available Abstract Introduction A number of medical conditions, some of them recently reported, are associated with an increased production of eosinophils. We report the first case of eosinophilic parotitis in the literature. Case presentation The patient was an eight-year-old Caucasian boy who presented with a two-year history of recurring acute parotitis with no fever. He had had a total of five episodes with no response to antibiotics, but remission had been achieved with oral corticosteroid therapy. We performed allergy tests for inhalant and food allergens and for haptens, but the results were all negative. The results of echography ruled out sialodochitis. Instead, a swab from the parotid duct led to the detection of a high number of eosinophils. Conclusions This report is first in the literature to describe a case of eosinophilic parotitis, and we suggest that a cytological assessment, which is quite simple yet rarely used by physicians, be performed when patients with parotitis of uncertain origin are under evaluation.

CHILDREN´S ANXIETY AND PARENTING STYLES IN FAMILY IN EIGHT-YEAR-OLDS

Directory of Open Access Journals (Sweden)

Ivana Poledňová

2013-12-01

Full Text Available Anxiety is a recurrent topic in personality psychology of today. According to Z. Matějček’s (1991 estimation, the issue of anxiety assumes the third place as for the number of clients in children’s counselling service (behind the issue of intellectual capabilities and ADHD in the Czech Republic. In children where it occurs to a higher degree, it can have a negative impact on their socialisation, achievements, development of self-confidence. The most influential factor in developing an anxious personality appears to be family environment. If the family fails to satisfy the child’s basic needs – feeling of security and confidence – the child’s development can be in jeopardy. The current research is concentrated on how the style of parenting in families (the so-called parenting styles is related to anxiety in children at a younger school age. The aim of the research is to find out what relationship there is between the individual components of parenting in families (positive – negative component, component of requirements – freedom and anxiety in eight-year-olds. These relationships were inquired into from mothers’ perspective by means of questionnaire surveys (Children’s Manifest Anxiety Scale and Questionnaire for acquiring the parenting style in family. The data from 407 mothers of eight-year-old children have been analysed. An assumption that anxiety in children of younger school age is significantly influenced by parenting styles in family has been confirmed. The most anxious children appear to be children raised in families with a negative parental emotional involvement towards the child and at the same time with discordant control. They were also some differences in the importance of individual components of parenting by fathers and mothers for anxious orientation of the child identified.

Serum concentrations and profiles of polychlorinated biphenyls in Taiwan Yu-cheng victims twenty years after the incident

Energy Technology Data Exchange (ETDEWEB)

Lung, S.-C. Candice [Research Center for Environmental Changes, Academia Sinica, Nankang, Taipei, Taiwan 115 (China); Guo, Y.-L.L. [Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan 70428 (China); Chang, H.-Y.[Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Rd., Tainan, Taiwan 70428 (China)]. E-mail: h7154@mail.ncku.edu.tw

2005-07-15

In 1979, about 2000 people in central Taiwan were intoxicated via rice oil consumption that was contaminated with polychlorinated biphenyls (PCBs). This 'Yu-cheng' incident was one of the two known major human PCB intoxication episodes. Twenty years after the intoxication, serum samples of 435 Yu-cheng victims, 414 adults and 21 children, were collected. Sixteen PCB congeners were analyzed with a gas chromatograph-electron capture detector. We found the median concentration of total PCBs in the adult serum was 1500 ng/g lipid, still substantially higher than that of the general population in Taiwan (3.7-fold) and most seafood consumers in the world. Most of analyzed PCB congeners in children were below or around the detection limits. Congener no. 138, however, had the highest concentrations, approximately accounting for 55% and 29% in the child and adult groups, respectively. Given that PCBs are persistent organic pollutants and endocrine disruptors, the concentrations and congener-specific profiles regarding the Yu-cheng victims provide valuable information for the investigation of such chemicals in humans. - Total serum PCBs in the Yu-cheng adult victims twenty years after the incident were still higher than that of the general population in Taiwan.

Evaluation of Penicillin Allergy in the Hospitalized Patient: Opportunities for Antimicrobial Stewardship.

Science.gov (United States)

Chen, Justin R; Khan, David A

2017-06-01

Penicillin allergy is often misdiagnosed and is associated with adverse consequences, but testing is infrequently done in the hospital setting. This article reviews historical and contemporary innovations in inpatient penicillin allergy testing and its impact on antimicrobial stewardship. Adoption of the electronic medical record allows rapid identification of admitted patients carrying a penicillin allergy diagnosis. Collaboration with clinical pharmacists and the development of computerized clinical guidelines facilitates increased testing and appropriate use of penicillin and related β-lactams. Education of patients and their outpatient providers is the key to retaining the benefits of penicillin allergy de-labeling. Penicillin allergy testing is feasible in the hospital and offers tangible benefits towards antimicrobial stewardship. Allergists should take the lead in this endeavor and work towards overcoming personnel limitations by partnering with other health care providers and incorporating technology that improves the efficiency of allergy evaluation.

Twenty-eight years after the complete ban on the physical punishment of children in Finland: trends and psychosocial concomitants.

Science.gov (United States)

Österman, Karin; Björkqvist, Kaj; Wahlbeck, Kristian

2014-01-01

In 1983 Finland became the second country in the world, after Sweden, to adopt a law prohibiting all kinds of physical punishment towards children, also by parents. The present investigation was carried out in 2011, 28 years after the law was adopted. Changes in exposure to various types of physical punishment towards respondents born between 1931 and 1996 are presented. A representative sample from Western Finland, consisting of 4,609 respondents (2,632 females, 1,977 males) between 15 and 80 years, filled in a paper-and-pencil questionnaire. A number of psychosocial concomitants were measured. The results showed a significant drop in reports of being slapped and beaten with an object among respondents who were born after the law was adopted. The decline in physical punishment was associated with a similar decline in the number of murdered children. Respondents who had been exposed to higher amounts of physical punishment than average scored significantly higher on alcohol abuse, depression, mental health problems, and schizotypal personality. Divorced respondents had been significantly more physically punished than others. Respondents who had attempted suicide during the last 12 months had been exposed to physical punishment during childhood significantly more often than those who had not attempted suicide. © 2014 Wiley Periodicals, Inc.

Antibiotic stewardship er etableret på Herlev Hospital

DEFF Research Database (Denmark)

Arpi, Magnus; Gjørup, Ida; Boel, Jonas Bredtoft

2014-01-01

A high incidence of Clostridium difficile and multiresistant organisms and increasing consumption of cephalosporins and quinolones have required an antibiotic stewardship programme, and antibiotic audits with feedback, revised guidelines and stringent prescription rules have been successful....... The hospital intervention was managed by an antibiotic team combined with contact persons in all departments, a pocket edition of the guideline was available, and monthly commented reports about antibiotic consumption in each department were presented on the intranet. Declining use of restricted antibiotics...

Water appropriation and ecosystem stewardship in the Baja desert

OpenAIRE

de las Heras Alejandro; Rodriguez Mario A.; Islas-Espinoza Marina

2014-01-01

The UNESCO San Francisco Rock Paintings polygon within El Vizcaino Biosphere Reserve in the Baja California Peninsula derives its moisture from the North American monsoon. There, ranchers have depended on the desert since the 18th century. More recently, the desert has depended on the environmental stewardship of the ranchers who have allayed mining exploitation and archaeological looting. Using a Rapid Assessment Procedure (RAP), climate data, and geographical informa...

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

Science.gov (United States)

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

2016-01-01

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

77 FR 6820 - Proposed Information Collection; Comment Request: Creating Stewardship Through Biodiversity...

Science.gov (United States)

2012-02-09

... Information Collection; Comment Request: Creating Stewardship Through Biodiversity Discovery in National Parks... collection (IC) described below. This collection will survey participants of Biodiversity Discovery efforts... Biodiversity Discovery refers to a variety of efforts to discover living organisms through public involvement...

Long-Term Stewardship At DOE's Hanford Site - 12575

International Nuclear Information System (INIS)

Moren, R.J.; Grindstaff, K.D.

2012-01-01

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

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

Science.gov (United States)

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

2016-11-01

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

NCDC International Best Track Archive for Climate Stewardship (IBTrACS) Project, Version 3

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The International Best Track Archive for Climate Stewardship (IBTrACS) dataset was developed by the NOAA National Climatic Data Center, which took the initial step...

Gasoline toxicology: overview of regulatory and product stewardship programs.

Science.gov (United States)

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

2014-11-01

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

Ten-year decrease of acquired methicillin-resistant Staphylococcus aureus (MRSA bacteremia at a single institution: the result of a multifaceted program combining cross-transmission prevention and antimicrobial stewardship

Directory of Open Access Journals (Sweden)

Chalfine Annie

2012-05-01

Full Text Available Abstract Background In France, the proportion of MRSA has been over 25% since 2000. Prevention of hospital-acquired (HA MRSA spread is based on isolation precautions and antibiotic stewardship. At our institution, before 2000, the Infection Disease and the Infection Control teams had failed to reduce HA-MRSA rates. Objectives and methods We implemented a multifaceted hospital-wide prevention program and measured the effects on HA-MRSA colonization and bacteremia rates between 2000 and 2009. From 2000 to 2003, active screening and decontamination of ICU patients, hospital wide alcohol based hand rubs (ABHR use, control of specific classes of antibiotics, compliance audits, and feed-backs to the care providers were successively implemented. The efficacy of the program was assessed by HA-MRSA colonized and bacteremic patient rates per 1000 patient-days in patients hospitalized for more than twenty-four hours. Results Compliance with the isolation practices increased between 2000 and 2009. Consumption of ABHR increased from 6.8 L to 27.5 L per 1000 patient-days. The use of antibiotic Defined Daily Doses (DDD per 1000 patient-days decreased by 31%. HA-MRSA colonization decreased by 84% from 1.09 to 0.17 per 1000 patient-days and HA-MRSA bacteremia by 93%, from 0.15 to 0.01 per 1000 patient-days (p −7 for each rate. Conclusions In an area highly endemic for MRSA, a multifaceted prevention program allows for sustainable reduction in HA-MRSA bacteremia rates.

One hundred and twenty-five years of the Annals of Botany. Part 2: the years 1937 to 2012

Science.gov (United States)

Jackson, Michael B.

2016-01-01

Background Annals of Botany is a peer-reviewed plant biology journal. It was started in 1887, making it the oldest continuously published plant science title. A previous article [Jackson MB. 2015. One hundred and twenty-five years of the Annals of Botany. Part 1: the first 50 years (1887–1936). Annals of Botany 115: 1–18] summarized events leading to its founding, highlighted the individuals involved and examined the Journal’s achievements and management practices over the first 50 years to 1937. This second article covers the next 75 years. Sources of information The account draws principally on the Journal’s own records, minute books, financial accounts, original letters and notes held by the Annals of Botany Company, the Journal’s owners and managers. Content In 1937, its 51st year, the Journal was re-launched as Annals of Botany New Series and its volume numbers were reset to No. I. The present article evaluates the evolution of the New Series up to 2012, Annals of Botany’s 125th anniversary year. The period includes a 2-year run-up to World War II, six war years and their immediate aftermath, and then on through increasingly competitive times. The ebb and flow of the Journal’s fortunes are set against a roll-call of the often highly distinguished scientists who managed and edited the Journal. The article also examines an internal crisis in the 1980s that radically altered the Journal’s organization in ways that were, ultimately, to its benefit. The narrative is set against changes to economic conditions in Great Britain over the period, to the evolving nature and geographical distribution of much experimental plant science and to the digital revolution that, from the late 20th century, transformed the workings of Annals of Botany and of scientific publishing more generally. PMID:27974325

Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme.

Science.gov (United States)

Nathwani, Dilip; Sneddon, Jacqueline; Malcolm, William; Wiuff, Camilla; Patton, Andrea; Hurding, Simon; Eastaway, Anne; Seaton, R Andrew; Watson, Emma; Gillies, Elizabeth; Davey, Peter; Bennie, Marion

2011-07-01

In 2008, the Scottish Management of Antimicrobial Resistance Action Plan (ScotMARAP) was published by the Scottish Government. One of the key actions was initiation of the Scottish Antimicrobial Prescribing Group (SAPG), hosted within the Scottish Medicines Consortium, to take forward national implementation of the key recommendations of this action plan. The primary objective of SAPG is to co-ordinate and deliver a national framework or programme of work for antimicrobial stewardship. This programme, led by SAPG, is delivered by NHS National Services Scotland (Health Protection Scotland and Information Services Division), NHS Quality Improvement Scotland, and NHS National Education Scotland as well as NHS board Antimicrobial Management Teams. Between 2008 and 2010, SAPG has achieved a number of early successes, which are the subject of this review: (i) through measures to optimise prescribing in hospital and primary care, combined with infection prevention measures, SAPG has contributed significantly to reducing Clostridium difficile infection rates in Scotland; (ii) there has been engagement of all key stakeholders at local and national levels to ensure an integrated approach to antimicrobial stewardship within the wider healthcare-associated infection agenda; (iii) development and implementation of data management systems to support quality improvement; (iv) development of training materials on antimicrobial stewardship for healthcare professionals; and (v) improving clinical management of infections (e.g. community-acquired pneumonia) through quality improvement methodology. The early successes achieved by SAPG demonstrate that this delivery model is effective and provides the leadership and focus required to implement antimicrobial stewardship to improve antimicrobial prescribing and infection management across NHS Scotland. Copyright © 2011 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

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

NARCIS (Netherlands)

Berrevoets, M.A.H.; Oever, J. ten; Sprong, T.; Hest, R.M. van; Groothuis, I.; Heijl, I. van; Schouten, J.A.; Hulscher, M.E.J.L.; Kullberg, B.J.

2017-01-01

BACKGROUND: The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the

Twenty Years After the 1988 Yellowstone Fires: Lessons About Disturbance and Ecosystems

Science.gov (United States)

Romme, W.H.; Boyce, M.S.; Gresswell, R.; Merrill, E.H.; Minshall, G.W.; Whitlock, C.; Turner, M.G.

2011-01-01

The 1988 Yellowstone fires were among the first in what has proven to be an upsurge in large severe fires in the western USA during the past 20 years. At the time of the fires, little was known about the impacts of such a large severe disturbance because scientists had had few previous opportunities to study such an event. Ecologists predicted short- and long-term effects of the 1988 fires on vegetation, biogeochemistry, primary productivity, wildlife, and aquatic ecosystems based on scientific understanding of the time. Twenty-plus years of subsequent study allow these early predictions to be evaluated. Most of the original predictions were at least partially supported, but some predictions were refuted, others nuanced, and a few postfire phenomena were entirely unexpected. Post-1988 Yellowstone studies catalyzed advances in ecology focused on the importance of spatial and temporal heterogeneity, contingent influences, and multiple interacting drivers. Post-1988 research in Yellowstone also has changed public perceptions of fire as an ecological process and attitudes towards fire management. Looking ahead to projected climate change and more frequent large fires, the well-documented ecological responses to the 1988 Yellowstone fires provide a foundation for detecting and evaluating potential changes in fire regimes of temperate mountainous regions. ?? 2011 Springer Science+Business Media, LLC.

An Eight-Year Study of Online Lecture Use in a Medical Gross Anatomy and Embryology Course

Science.gov (United States)

Nieder, Gary L.; Borges, Nicole J.

2012-01-01

Online lectures have been used in lieu of live lectures in our gross anatomy and embryology course for the past eight years. We examined patterns of online lecture use by our students and related that use to academic entry measures, gender and examination performance. Detailed access records identified by student were available from server logs.…

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.

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

Science.gov (United States)

Pollack, Loria A; Srinivasan, Arjun

2014-10-15

The proven benefits of antibiotic stewardship programs (ASPs) for optimizing antibiotic use and minimizing adverse events, such as Clostridium difficile and antibiotic resistance, have prompted the Centers for Disease Control and Prevention (CDC) to recommend that all hospitals have an ASP. This article summarizes Core Elements of Hospital Antibiotic Stewardship Programs, a recently released CDC document focused on defining the infrastructure and practices of coordinated multidisciplinary programs to improve antibiotic use and patient care in US hospitals. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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

NARCIS (Netherlands)

Berrevoets, Marvin Ah; ten Oever, Jaap; Sprong, Tom; van Hest, Reinier M.; Groothuis, Ingeborg; van Heijl, Inger; Schouten, Jeroen A.; Hulscher, Marlies E.; Kullberg, Bart-Jan

2017-01-01

The Dutch Working Party on Antibiotic Policy is developing a national antimicrobial stewardship registry. This registry will report both the quality of antibiotic use in hospitals in the Netherlands and the stewardship activities employed. It is currently unclear which aspects of the quality of

Twenty-five years of the common market in coal, 1953--1978. [genesis and growth

Energy Technology Data Exchange (ETDEWEB)

1978-01-01

Twenty-five years have passed since the European Coal and Steel commmunity was established. An attempt is made to show what economic integration is, what problems have arisen, and how the community has tried to overcome them. Three phases can be distinguished during the period under review--a first phase of growth in the coal industry between 1953 and 1957; a second phase marked by a plentiful supply of cheap hydrocarbons and a rapid reduction in coal output despite exceptional growth, linked with a parallel increase in overall energy requirements; and a third phase from 1973, marked by sharp price increases by the oil producing countries with repercussions on the world market in coal.

Reactions to combat stress in Israeli veterans twenty years after the 1982 Lebanon war.

Science.gov (United States)

Solomon, Zahava; Shklar, Rami; Singer, Yaffa; Mikulincer, Mario

2006-12-01

During the war or shortly thereafter, the most common manifestation of combat induced psychopathology is combat stress reaction (CSR). The long-term consequences of CSR have so far received little scientific attention. The aim of this study was to examine whether CSR is a marker for long-term PTSD and other psychiatric comorbidities. Two groups of veterans from the 1982 Lebanon war were assessed 20 years after the war: one comprised 286 CSR casualties and the other comprised 218 matched non-CSR soldiers. Participants were assessed for PTSD, psychiatric symptomatology, social functioning, physical health, and postwar life events. Twenty years after the war, veterans with antecedent CSR reported more PTSD, psychiatric symptomatology and distress, social dysfunction, and health problems than did non-CSR veterans. We conclude that CSR should be seen as a marker for long-term psychiatric distress and impairment. In addition, the implications of combat-related trauma are broad and varied, and go beyond the narrow scope of PTSD.

Data Stewardship: Environmental Data Curation and a Web-of-Repositories

Directory of Open Access Journals (Sweden)

Karen S. Baker

2009-10-01

Full Text Available Scientific researchers today frequently package measurements and associated metadata as digital datasets in anticipation of storage in data repositories. Through the lens of environmental data stewardship, we consider the data repository as an organizational element central to data curation. One aspect of non-commercial repositories, their distance-from-origin of the data, is explored in terms of near and remote categories. Three idealized repository types are distinguished – local, center, and archive - paralleling research, resource, and reference collection categories respectively. Repository type characteristics such as scope, structure, and goals are discussed. Repository similarities in terms of roles, activities and responsibilities are also examined. Data stewardship is related to care of research data and responsible scientific communication supported by an infrastructure that coordinates curation activities; data curation is defined as a set of repeated and repeatable activities focusing on tending data and creating data products within a particular arena. The concept of “sphere-of-context” is introduced as an aid to distinguishing repository types. Conceptualizing a “web-of-repositories” accommodates a variety of repository types and represents an ecologically inclusive approach to data curation.

Twenty-five years of transient counting experience in French PWR units

Energy Technology Data Exchange (ETDEWEB)

Barthelet, B. [Electricite de France (EDF DPN), 93 - Saint-Denis (France); Savoldelli, D.; Fritz, R. [Electricite de France (EDF DPN), 93 - Noisy le Grand (France)

2001-07-01

For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

Twenty-five years of transient counting experience in French PWR units

International Nuclear Information System (INIS)

Barthelet, B.; Savoldelli, D.; Fritz, R.

2001-01-01

For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

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

OpenAIRE

Nicolle, Lindsay E

2014-01-01

Intense antimicrobial use in long term care facilities promotes the emergence and persistence of antimicrobial resistant organisms and leads to adverse effects such as C. difficile colitis. Guidelines recommend development of antimicrobial stewardship programs for these facilities to promote optimal antimicrobial use. However, the effectiveness of these programs or the contribution of any specific program component is not known. For this review, publications describing evaluation of antimicro...

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

Science.gov (United States)

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

2008-01-01

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

Understanding Contamination; Twenty Years of Simulating Radiological Contamination

Energy Technology Data Exchange (ETDEWEB)

Emily Snyder; John Drake; Ryan James

2012-02-01

A wide variety of simulated contamination methods have been developed by researchers to reproducibly test radiological decontamination methods. Some twenty years ago a method of non-radioactive contamination simulation was proposed at the Idaho National Laboratory (INL) that mimicked the character of radioactive cesium and zirconium contamination on stainless steel. It involved baking the contamination into the surface of the stainless steel in order to 'fix' it into a tenacious, tightly bound oxide layer. This type of contamination was particularly applicable to nuclear processing facilities (and nuclear reactors) where oxide growth and exchange of radioactive materials within the oxide layer became the predominant model for material/contaminant interaction. Additional simulation methods and their empirically derived basis (from a nuclear fuel reprocessing facility) are discussed. In the last ten years the INL, working with the Defense Advanced Research Projects Agency (DARPA) and the National Homeland Security Research Center (NHSRC), has continued to develop contamination simulation methodologies. The most notable of these newer methodologies was developed to compare the efficacy of different decontamination technologies against radiological dispersal device (RDD, 'dirty bomb') type of contamination. There are many different scenarios for how RDD contamination may be spread, but the most commonly used one at the INL involves the dispersal of an aqueous solution containing radioactive Cs-137. This method was chosen during the DARPA projects and has continued through the NHSRC series of decontamination trials and also gives a tenacious 'fixed' contamination. Much has been learned about the interaction of cesium contamination with building materials, particularly concrete, throughout these tests. The effects of porosity, cation-exchange capacity of the material and the amount of dirt and debris on the surface are very important factors

Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

NARCIS (Netherlands)

van Limburg, Maarten; Sinha, Bhanu; Lo-Ten-Foe, Jerome R; van Gemert-Pijnen, Julia Ewc

2014-01-01

BACKGROUND: Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital.

Understanding micro-processes of institutionalization: stewardship contracting and national forest management

Science.gov (United States)

Cassandra Moseley; Susan Charnley

2014-01-01

This paper examines micro-processes of institutionalization, using the case of stewardship contracting within the US Forest Service. Our basic premise is that, until a new policy becomes an everyday practice among local actors, it will not become institutionalized at the macro-scale. We find that micro-processes of institutionalization are driven by a mixture of large-...

Successful control of resistance in Pseudomonas aeruginosa using antibiotic stewardship and infection control programs at a Chinese university hospital: a 6-year prospective study

Directory of Open Access Journals (Sweden)

Liu L

2018-05-01

Full Text Available Lei Liu,1 Bin Liu,1 Yu Li,2 Wei Zhang1 1Department of Respiratory Medicine, The First Affiliated Hospital of Harbin Medical University, 2Department of Respiratory Medicine, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China Objective: Pseudomonas aeruginosa is emerging as a highly multidrug-resistant (MDR nosocomial pathogen. Data on the efficacy of infection control measures in endemic situations are lacking. We investigated the effect of antimicrobial stewardship (AMS and infection control programs (ICPs in controlling the resistance of P. aeruginosa at a tertiary hospital center.Methods: Susceptibility and resistance were investigated using broth microdilution, as per the guidelines of the Clinical and Laboratory Standards Institute. Antibiotic use was restricted through AMS, which included a classification management system for antibiotic use. The ICPs included environmental cleaning and disinfection, hand hygiene, active surveillance of P. aeruginosa, and education about infection control.Results: A total of 2,241 P. aeruginosa isolates were evaluated between 2012 and 2017. Sensitivity and resistance of the isolates to the antipseudomonal antimicrobials colistin and tigecycline were stable. The sensitivity and resistance to other antipseudomonal antimicrobials improved after 2014, after the AMS and ICPs were implemented in 2013. The use of alcohol-based hand gel significantly increased from 0.6 to 10.9 L per 1,000 patient-days (PD during the study period (P=0.005. The incidence rates of extensively drug-resistant (XDR and MDR P. aeruginosa showed a sustained decrease from 2013 (4.9 and 22% to 2017 (1 and 15%, respectively. The yearly consumption of antimicrobial agents also showed a sustained and significant decrease from 45 defined daily doses (DDDs per 1,000 PD to 38.15 DDDs per 1,000 PD (P=0.04. A significant correlation was found between the incidence rate of MDR P. aeruginosa and the

Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

NARCIS (Netherlands)

van Limburg, A.H.M.; Sinha, Bhanu; Lo-Ten-Foe, Jerome R.; van Gemert-Pijnen, Julia E.W.C.

2014-01-01

Background Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital. Earlier

Improving Stewardship of Marine Resources: Linking Strategy to Opportunity

Directory of Open Access Journals (Sweden)

Franciska von Heland

2014-07-01

Full Text Available The need for improved stewardship of coastal and marine resources is evident worldwide. However, complex ecosystem dynamics, institutional inertia, and budgetary constraints impede such action. This study explores how networks of change-oriented individuals or “institutional entrepreneurs” can introduce new types of human-environment interaction. The focus is on investigating the interplay between the strategies of institutional entrepreneurs and broader system dynamics that shape the context in which they are working, and possible impacts of institutional entrepreneurship on marine governance. We explore these issues in the context of Wakatobi National Park in eastern Indonesia. We suggest that creating links between different social spheres, such as between marine resource management and spirituality or between marine resource management and education, may accelerate the development of a new ecosystem stewardship. We further suggest that the use of media has significant power to show alternative futures, but that media may also serve to objectify certain resource users and increase the complexity of marine resource management. In general, institutional entrepreneurs play an important role in capturing and managing opportunity to open up space for experimentation and novel ideas, for example by linking their ideas to broader political priorities. Yet, such strategies bear the risk of institutional capture. Finally, institutional entrepreneurs sometimes have vested interests in certain solutions that may forsake experimentation toward a sustainable future.

"Europe" as an Alibi: An Overview of Twenty Years of Policy, Curricula and Textbooks in the Republic of Cyprus--and Their Review

Science.gov (United States)

Philippou, Stavroula

2012-01-01

This article compares discourses on "Europe" in Greek-Cypriot policy, curricula and textbooks over approximately the last twenty years, from the early 1990s, when Cyprus applied for European Union (EU) membership, until 2011-12, the school year during which the recently revised curricula were gradually introduced to schools for…

Effect of Foster Care on Language Learning at Eight Years: Findings from the Bucharest Early Intervention Project

Science.gov (United States)

Windsor, Jennifer; Moraru, Ana; Nelson, Charles A., III.; Fox, Nathan A.; Zeanah, Charles H.

2013-01-01

This study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care.…

Antimicrobial Stewardship: A Cross-Sectional Survey Assessing the Perceptions and Practices of Community Pharmacists in Ethiopia

Directory of Open Access Journals (Sweden)

Daniel Asfaw Erku

2016-01-01

Full Text Available Background. Community pharmacists are key healthcare professionals for antimicrobial stewardship programs owing to their role in dispensing of antimicrobials. The aim of the present study was to assess the perception and practices of community pharmacists towards antimicrobial stewardship (AMS in Ethiopia. Methods. A cross-sectional survey was conducted by selecting pharmacy sites through stratified simple random sampling technique. Descriptive and inferential statistics were used to analyze the data. Results. Majority of respondents strongly agreed or agreed that AMS program is vital for the improvement of patient care. Almost all of respondents agreed that pharmacists can play a prominent role in AMS and infection prevention (93.2%, median = 5; IQR = 2–5. However, only 26.5% of respondents strongly agreed or agreed that AMS should be practiced at community pharmacy level (median = 4, IQR = 1–3 and more than half of community pharmacists (59.9% often/always dispense antimicrobial without a prescription. Conclusion. The present study revealed positive perceptions and practices of community pharmacists towards antimicrobial stewardship. Yet, some weak areas like integration of AMS program in community pharmacies, the significance of interprofessional involvement, and dispensing of antimicrobials without a valid prescription still need improvement.

One hundred and twenty-five years of the Annals of Botany. Part 2: the years 1937 to 2012.

Science.gov (United States)

Jackson, Michael B

2016-12-01

Annals of Botany is a peer-reviewed plant biology journal. It was started in 1887, making it the oldest continuously published plant science title. A previous article [Jackson MB. 2015. One hundred and twenty-five years of the Annals of Botany Part 1: the first 50 years (1887-1936). Annals of Botany 115: : 1-18] summarized events leading to its founding, highlighted the individuals involved and examined the Journal's achievements and management practices over the first 50 years to 1937. This second article covers the next 75 years. The account draws principally on the Journal's own records, minute books, financial accounts, original letters and notes held by the Annals of Botany Company, the Journal's owners and managers. In 1937, its 51st year, the Journal was re-launched as Annals of Botany New Series and its volume numbers were reset to No. I. The present article evaluates the evolution of the New Series up to 2012, Annals of Botany's 125th anniversary year. The period includes a 2-year run-up to World War II, six war years and their immediate aftermath, and then on through increasingly competitive times. The ebb and flow of the Journal's fortunes are set against a roll-call of the often highly distinguished scientists who managed and edited the Journal. The article also examines an internal crisis in the 1980s that radically altered the Journal's organization in ways that were, ultimately, to its benefit. The narrative is set against changes to economic conditions in Great Britain over the period, to the evolving nature and geographical distribution of much experimental plant science and to the digital revolution that, from the late 20th century, transformed the workings of Annals of Botany and of scientific publishing more generally. © The Author 2016. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Integration of environmental stewardship and local economic development to enhance community health.

Science.gov (United States)

Levine, Jay F

2011-01-01

Environmental groups working to preserve natural ecosystems and groups working to enhance local economic development often find themselves on philosophically opposite sides of the negotiation table. Case histories of cooperative engagement are provided that serve as examples of how environmental stewardship is compatible with local economic development and community health.

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

Science.gov (United States)

Schotsmans, Paul T

2003-01-01

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

Development and impact of a massive open online course (MOOC) for antimicrobial stewardship.

Science.gov (United States)

Sneddon, Jacqueline; Barlow, Gavin; Bradley, Sally; Brink, Adrian; Chandy, Sujith J; Nathwani, Dilip

2018-04-01

The University of Dundee and the BSAC developed a massive open online course (MOOC) to address the global need for education to support antimicrobial stewardship in low- and middle-income countries. An interactive course, Antimicrobial Stewardship: Managing Antibiotic Resistance, was developed and delivered via the FutureLearn© platform. The course ran over four 6 week periods during 2015 and 2016 supported by educators and was evaluated via data on uptake and feedback from learners on impact on clinical practice. In total, 32 944 people, 70% of them healthcare professionals, from 163 countries joined the course from Europe (49%), Asia (16%), Africa (13%), North America (9%), Australia (8%) and South America (5%). Between 33% and 37% of joiners in each run completed at least one step in any week of the course and 219 participants responded to a post-course survey. The course was rated good or excellent by 208 (95%) of the participants, and 83 (38%) intended to implement stewardship interventions in their own setting. A follow-up survey 6 months later suggested that 49% had implemented such interventions. The MOOC has addressed a global learning need by providing education free at the point of access, and learning from its development will help others embarking upon similar educational solutions. Initial quantitative and qualitative feedback suggests it has engaged participants and complements traditional educational methods. Measuring its real impact on clinical practice remains a challenge. The FutureLearn© platform offers flexibility for MOOCs to be sustainable through modification to remove educator facilitation but maintain active participant discussion.

Irrigation quality of ground water of twenty villages in Lahore district

Directory of Open Access Journals (Sweden)

M.S. Ali

2009-05-01

Full Text Available study was conducted in twenty villages of Lahore district to assess the suitability of ground water for irrigation. Three water samples were collected from each of twenty villages and were analyzed for electrical conductivity (EC, sodium adsorption ratio (SAR, residual sodium carbonate (RSC and chloride concentration. Out of total 60 water samples, 7 (11.7% were fit, 7 (11.7% were marginally fit, and remaining 46 (76.6% were unfit for irrigation. Twenty eight samples (46.6% had electrical conductivity higher than permissible limit (i.e. >1250 µS cm-1, 19 samples (31.6% were found with high SAR (i.e. >10 (m mol L-10. 5, 44 samples (73.3% had high RSC (i.e. >2.5 me L-1 and 10 samples (16.6% were found unfit for irrigation due to high concentration of chloride (i.e. >3.9 me L-1. It can be inferred from data that quality of available ground water in most ofthe villages is not suitable for sustainable crop production and soil health.

Surgical Approach, Findings, and Eight-Year Follow-Up in a Twenty-Nine Year Old Female With Freeman-Sheldon Syndrome Presenting With Blepharophimosis Causing Near-Complete Visual Obstruction.

Science.gov (United States)

Portillo, Augusto L; Poling, Mikaela I; McCormick, Rodger J

2016-07-01

The authors describe the surgical approach, findings, and 8-year follow-up in a 29-year-old woman, with severe Freeman-Sheldon syndrome, presenting with congenital blepharophimosis of both upper eyelids resulting in near-complete functional visual obstruction. To avoid possible Freeman-Sheldon syndrome-associated complications of malignant hyperthermia, difficult vascular access, and challenging endotracheal intubation, the surgery was completed under local anesthesia without sedation, and anatomical and functional correction was immediate and remained stable at 8-year follow-up. Unlike many congenital craniofacial syndromes, which frequently involve life-long impairments, important implications exist for plastic surgeons to facilitate opportunities for patients to overcome functional limitations.

"The First Twenty Years," by Bernard J. Siegel. Annual Review of Anthropology, 22 (1993, pp. 1-34, Annual Reviews, Inc, Palo Alto

Directory of Open Access Journals (Sweden)

James A. Delle

1995-05-01

Full Text Available After twenty years as editor of the Annual Review ofAnthropology (ARA, Professor Siegel took on a daunting task with this article. In his words, he set out to "ponder the developments in the several subfields of anthropol­ogy over this period of time, as reflected in the topics selected for review in this enterprise" (p. 8. To this end Siegel, a cultural anthropologist, mined the collective knowledge contained within twenty years of the ARA. In his presentation, he considers the intellectual developments within each of the five subdisciplines separately (he includes applied anthropology, concluding with some brief remarks on the importance of maintaining a four or five field approach to anthropology. For our purposes here, I will limit my comments to his section on archaeology.

Science and society: the role of long-term studies in environmental stewardship

Science.gov (United States)

Charles T. Driscoll; Kathleen F. Lambert; F. Stuart Chapin; David J. Nowak; Thomas A. Spies; Frederick J. Swanson; David B. Kittredge; Clarisse M. Hart

2012-01-01

Long-term research should play a crucial role in addressing grand challenges in environmental stewardship. We examine the efforts of five Long Term Ecological Research Network sites to enhance policy, management, and conservation decisions for forest ecosystems. In these case studies, we explore the approaches used to inform policy on atmospheric deposition, public...

Twenty years research of chronic gamma-ray irradiation on seed crops

International Nuclear Information System (INIS)

Yamashita, Atsushi

1983-01-01

Twenty years of the works on the chronic gamma-ray irradiation of seed crops are summarized. Radiosensitivity and the mutation rate per unit exposure varies not only with the genetic factor but also depend on whether treatment is given to seeds or growing plants. The relation between the radiosensitivity of seeds and growing plants also varies with plant species. In Hordeum, Avena and Nicotiana, the highest mutation rate obtained by the chronic irradiation of growing plants is similar to that in seed irradiation, but in Oryza and Setalia, chronic irradiation was two to three times more effective for attaining a higher mutation rate. The mutation spectrum also varies with the mutagen, the factors modifying the effects of mutagen, and the dose of mutagen. The suitability of a particular mutagenic treatment to a species should be taken into consideration in the evaluation of mutagenic treatment. For instance, NaN 3 is highly mutagenic to barley, but less mutagenic to rice. The gene ea7 controlling the maturing earliness of barley seems to be mutable in chronic irradiation, and the mutants obtained by chronic irradiation are healthy. The author emphasized that the chronic irradiation at the gamma-field is a useful mutagenic treatment, even though some negative results have been reported in European countries. (Kaihara, S.)

Development of an Evidence-Based Antimicrobial Stewardship Smartphone App in a Tertiary Academic Pediatric and Women’s Health Centre in Canada

OpenAIRE

Slayter, Kathryn; Turple, Jennifer; Comeau, Jeannette L; Top, Karina A; Langley, Joanne M; Mailman, Tim; Halperin, Scott A

2017-01-01

Abstract Background Smart phone use by medical professionals is ubiquitous. In a recent survey, > 90% of health care providers were interested in locally developed antimicrobial stewardship (AMS) and infectious diseases applications (“apps”). We describe the process by which our antimicrobial stewardship program (ASP) developed an app to provide guidance regarding empiric antimicrobial choice, and education about antimicrobials and pathogens, integrating local laboratory data. We also describ...

Cryptococcal meningoencephalitis relapse after an eight-year delay: an interplay of infection and immune reconstitution.

Science.gov (United States)

Katchanov, Juri; Blechschmidt, Cristiane; Nielsen, Kirsten; Branding, Gordian; Arastéh, Keikawus; Tintelnot, Kathrin; Meintjes, Graeme; Boulware, David R; Stocker, Hartmut

2015-10-01

We report a case of a symptomatic relapse of HIV-related cryptococcal meningoencephalitis eight years after the first diagnosis on the background of immune reconstitution. The findings as well as the clinical course suggests a combination of smouldering localised infection and enhanced inflammatory reaction related to immune restoration due to antiretroviral therapy. A combination of antifungal and anti-inflammatory therapy resulted in clinical and radiological improvement. Our case challenges the concept that immune reconstitution inflammatory syndrome and microbiological relapse are dichotomous entities. © The Author(s) 2015.

Eight Year Climatologies from Observational (AIRS) and Model (MERRA) Data

Science.gov (United States)

Hearty, Thomas; Savtchenko, Andrey; Won, Young-In; Theobalk, Mike; Vollmer, Bruce; Manning, Evan; Smith, Peter; Ostrenga, Dana; Leptoukh, Greg

2010-01-01

We examine climatologies derived from eight years of temperature, water vapor, cloud, and trace gas observations made by the Atmospheric Infrared Sounder (AIRS) instrument flying on the Aqua satellite and compare them to similar climatologies constructed with data from a global assimilation model, the Modern Era Retrospective-Analysis for Research and Applications (MERRA). We use the AIRS climatologies to examine anomalies and trends in the AIRS data record. Since sampling can be an issue for infrared satellites in low earth orbit, we also use the MERRA data to examine the AIRS sampling biases. By sampling the MERRA data at the AIRS space-time locations both with and without the AIRS quality control we estimate the sampling bias of the AIRS climatology and the atmospheric conditions where AIRS has a lower sampling rate. While the AIRS temperature and water vapor sampling biases are small at low latitudes, they can be more than a few degrees in temperature or 10 percent in water vapor at higher latitudes. The largest sampling biases are over desert. The AIRS and MERRA data are available from the Goddard Earth Sciences Data and Information Services Center (GES DISC). The AIRS climatologies we used are available for analysis with the GIOVANNI data exploration tool. (see, http://disc.gsfc.nasa.gov).

Twenty-year survivors of kidney transplantation.

LENUS (Irish Health Repository)

Traynor, C

2012-12-01

There have been few studies of patients with renal allografts functioning for more than 20 years. We sought to identify clinical factors associated with ultra long-term (>20 year) renal allograft survival and to describe the clinical features of these patients. We performed a retrospective analysis of the Irish Renal Transplant Database and included 1174 transplants in 1002 patients. There were 255 (21.74%) patients with graft function for 20 years or more. Multivariate analysis identified recipient age (HR 1.01, CI 1.01-1.02), gender (male HR 1.25, CI 1.08-1.45), acute rejection (HR 1.26, CI 1.09-1.45) and transplant type (living related donor vs. deceased donor) (HR 0.52, CI 0.40-0.66) as significantly associated with long-term graft loss. Median serum creatinine was 115 μmol\\/L. The 5-year graft survival in 20-year survivors was 74.7%. The mean age at death was 62.7 years (±10.6). The most common causes of death were cardiovascular disease and malignancy. The two major causes of graft loss were death (with function) and interstitial fibrosis\\/tubular atrophy. Comorbidities included skin cancer (36.1%), coronary heart disease (17.3%) and other malignancies (14.5%). This study identifies factors associated with long-term allograft survival and a high rate of morbidity and early mortality in long-term transplant recipients.

Twenty Years after Philippine Trade Liberalization and Industrialization: What Has Happened and Where Do We Go from Here

OpenAIRE

Aldaba, Rafaelita M.

2013-01-01

The paper aims to review our trade liberalization policy and its contribution to the country`s industrial growth and performance. After more than twenty years of liberalization, the overall performance of the manufacturing industry has been weak, growth has been slow, and contribution to value added and employment has been limited. Total factor productivity growth declined from 1996 to 2006. The industrial structure has remained "hollow" or "missing" in the middle and medium enterprises have ...

Book review: Twenty-Five Years on the Cutting Edge of Obsidian Studies: Selected Readings from the IAOS Bulletin

Directory of Open Access Journals (Sweden)

Sean Dolan

2017-03-01

Full Text Available Edited by Carolyn D. Dillian (Coastal Carolina University, Twenty-Five Years on the Cutting Edge of Obsidian Studies: Selected Readings from the IAOS Bulletin consists of 19 previously published articles from the International Association for Obsidian Studies (IAOS Bulletin. Dillian selected these articles because they provide a range of methodological and theoretical approaches concerning archaeological obsidian studies from around the world like Eretria, California, and the Near East, for example.

Strategic Plan for Sustainable Energy Management and Environmental Stewardship for Los Angeles Unified School District

Energy Technology Data Exchange (ETDEWEB)

Walker, A.; Beattie, D.; Thomas, K.; Davis, K.; Sim, M.; Jhaveri, A.

2007-11-01

This Strategic Plan for Sustainable Energy Management and Environmental Stewardship states goals, measures progress toward goals and how actions are monitored to achieve continuous improvement for the Los Angeles Unified School District.

Metronidazole stewardship initiative at Christchurch hospitals-achievable with immediate benefits.

Science.gov (United States)

Gardiner, Sharon J; Metcalf, Sarah Cl; Chin, Paul Kl; Doogue, Matthew P; Dalton, Simon C; Chambers, Stephen T

2018-04-13

To evaluate an antimicrobial stewardship (AMS) initiative to change hospital prescribing practice for metronidazole. In October 2015, the Canterbury District Health Board (CDHB) AMS committee changed advice for metronidazole to promote two times daily dosing for most indications, prioritisation of the oral route and avoidance of double anaerobic cover. Adoption of the initiative was facilitated via change in prescribing guidelines, education and ongoing pharmacy support. Usage and expenditure on metronidazole for adult inpatients were compared for the five years pre- and two years post-change. Other district health boards (DHBs) were surveyed to determine their dosing recommendation for metronidazole IV. Mean annual metronidazole IV use, as defined daily doses per 1,000 occupied bed days, decreased by 43% post-initiative. Use of non-IV (oral or rectal) formulations increased by 104%. Total savings associated with the initiative were approximately $33,400 in drug costs plus $78,200 per annum in IV giving sets and post-dose flushes. Twelve of 20 (60%) DHBs (including CDHB) endorse twice daily IV dosing. In addition to financial savings, reduction in IV doses has potential benefits, including avoidance of IV catheter-associated complications such as bloodstream infections. Approaches to metronidazole dosing vary across DHBs and could benefit from national coordination.

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

Energy Technology Data Exchange (ETDEWEB)

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

2004-11-01

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

Hypopigmented mycosis fungoides in a twenty-year-old Saudi woman with fair skin

Directory of Open Access Journals (Sweden)

Al-Ratrout J

2006-01-01

Full Text Available The hypopigmented variant of mycosis fungoides (MF is charactrized by the presence of hypopigmented patches as the sole manifestation of the disease. This variant is usually observed in the dark skin of African or Asian individuals particularly children, but nevertheless is an uncommonly reported presentation of the disease. The incidence of hypopigmented MF in Caucasian patients and others of fair skin color is rare. We describe hypopigmented lesions arising in a twenty-year-old Saudi woman with type IV skin color. The diagnosis of mycosis fungoides stage IA was made based on the clinico-radiological and histological features. The patient responded well to PUVA therapy and is currently clear of lesions. MF should be considered in the differential diagnosis of hypopigmented macular lesions in patients of any skin color and age. Multiple skin biopsies must be performed on different occasions so as not to miss the diagnosis; and long term follow up is recommended since recurrence is common and occasional cases behave aggressively.

Specialist trainees on rotation cannot replace dedicated consultant clinicians for antimicrobial stewardship of specialty disciplines

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Yeo Chay Leng

2012-11-01

Full Text Available Abstract Our prospective-audit-and-feedback antimicrobial stewardship (AS program for hematology and oncology inpatients was switched from one led by dedicated clinicians to a rotating team of infectious diseases trainees in order to provide learning opportunities and attempt a “de-escalation” of specialist input towards a more protocol-driven implementation. However, process indicators including the number of recommendations and recommendation acceptance rates fell significantly during the year, with accompanying increases in broad-spectrum antibiotic prescription. The trends were reversed only upon reverting to the original setup. Dedicated clinicians play a crucial role in AS programs involving immunocompromised patients. Structured training and adequate succession/contingency planning is critical for sustainability.

Campaign Preparation for Complex Initiatives: A Person-Centered Approach to Audience Segmentation of Parents' Antibiotic Stewardship.

Science.gov (United States)

Smith, Rachel A; MacGeorge, Erina L; Hackman, Nicole M; M'ikanatha, Nkuchia M

2017-10-25

The evolution of antibiotic resistance is outpacing the speed at which new antibiotics will reach the marketplace. To slow the rate of resistance, people need to engage in antibiotic stewardship, which includes acts to prevent the spread of bacteria and judicious use of antibiotics to treat infections. This study identified the patterns and predictors of antibiotic stewardship behaviors of parents (N = 516) related to their children. The latent class analysis revealed three profiles of parental stewardship, labeled Stewards, Requesters, and Non-Stewards. The findings implied different campaign goals: to encourage Stewards to follow through on their intentions, to encourage Requesters to stop asking providers for antibiotics when their children have ear infections, and to influence Non-Stewards to accept medical advice when an antibiotic is not indicated and to dispose of leftover antibiotics. The covariate analysis provided theoretical insight into the strategies to pursue in campaigns targeting these three groups. For example, parents who perceived antibiotic-resistant infections as less serious health conditions, felt less worry when thinking about their child getting an antibiotic-resistant infection, and had stronger misattributions of antibiotics' efficacy to treat multiple symptoms were more likely to be Requesters and Non-Stewards, instead of Stewards.

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

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Enrique Castro-Sánchez

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

Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

Science.gov (United States)

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

2016-01-01

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

Enhancing stewardship in Latin America and Caribbean small-scale fisheries : challenges and opportunities

NARCIS (Netherlands)

Gasalla, M.A.; de Castro, F.

2016-01-01

This thematic series, entitled “Enhancing Stewardship in Latin America and Caribbean Small-Scale Fisheries”, emerged as part of a joint effort to bridge Latin-American scholars interested in networking on small-scale fisheries in the region. Built on results presented at two meetings (‘Too Big to

Antimicrobial Stewardship for a Geriatric Behavioral Health Population

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Kristen Ellis

2016-01-01

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

Fast-food consumption among 17-year-olds in the Birth to Twenty ...

African Journals Online (AJOL)

Objectives: Assessment of fast-food consumption in urban black adolescents. Design: The current research was a descriptive cross-sectional study. Setting: Subjects attending the Birth to Twenty (Bt20) research facility at the Chris Hani Baragwanath Hospital in Soweto, Johannesburg between September 2007 and May ...

NASA'S Earth Science Data Stewardship Activities

Science.gov (United States)

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

2015-01-01

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

DEVELOPMENT OF THE INFORMATION COMPETENCE OF THE ACADEMIC COMMUNITY: TWENTY YEARS AFTER

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Glosiene, Audrone

2006-12-01

Full Text Available Twenty years ago, reading culture, library skills’ development used to be one of the core directions in research and teaching policy of the Department of Library Science at Vilnius University. Lateron, the topic was marginalized and today we return to the field that meanwhile has developed huge knowledge and experience base worldwide. A stimulus for the return was participation in BIBLIONOVA project. The aim of the article is to present a holistic approach towards information competency development in a modern academic institution. Prescriptive approach based on information literacy standards proved to be limited and not always effective in the academic environment.Information competency development is problem-specific, domain-specific, and disciplinespecific. It is interrelated with critical thinking, analytical skills as well as creativity and computerliteracy skills. Holistically, information competency development is an integral part of university’s life-long learning strategy. Critical success factors for information competency development areopen and problem-based learning and cooperative, inclusive strategies of the whole university. Academic libraries continue to play a major role in the process but the connections with faculty and administration in the process are of major importance.

Twenty years after the embargo

International Nuclear Information System (INIS)

Geller, H.; DeCicco, J.; Laitner, S.; Dyson, C.

1994-01-01

This paper reviews the direct and indirect oil import costs and examines actions that can be taken to reduce future imports. We find that the USA could greatly reduce its oil imports during the next 20 years by increasing energy efficiency and accelerating the introduction of fuels derived from renewable energy sources, particularly in the transport sector. (author)

Twenty years of the national program of surveillance radiation of the atmosphere and terrestrial environment; Veinte anos del programa nacional de vigilancia radiologica de la atmosfera y medio terrestre

Energy Technology Data Exchange (ETDEWEB)

Rey del Castillo, C.; Luque Heredia, S.; Marugan Tovar, I.; Salas Collantes, R.; Serling Carmona, A.; Lorente Lorente, P.; Ramos Salvador, L.

2013-07-01

This paper presents a global basis the information provided by the program in twenty years of operation, describing the main changes introduced and analyzing how they have influenced the results. The use of program data to inform and in response to questions from individuals or incidents is reviewed. And finally the prospects and major milestones expected to address in the next twenty years are described. (Author)

Twenty Years of National Minority Protection in the Republic of Croatia

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Siniša Tatalović

2011-12-01

Full Text Available The paper contains a review of policies towards national minorities in the Republic of Croatia in the past twenty years, with reference to the perspective of minority rights implementation. The topic has been analysed in relation to two independent variables – the influence of external factors, i.e. the international community, and internal political processes that have had influence on the realisation of national minority rights. Today, as a country and society on the eve of accession to the European Union, along with a legislatively developed and institutionally branched model of the implementation of national minority rights, we can not claim to have established permanent protection of their rights. The degree of national minority integration in society is the only true indicator of policy success in relation to national minorities. The goal of this policy ought to be complete integration of national minorities into public, cultural, economic and political life, but accompanied by the preservation of their cultural and national identity. The Croatian model has been set up in such a way, but the manner in which it functions will depend on the political will to implement it, the willingness of national minority members to be active subjects of social and political life, as well as on civil society and Croatian society as a whole.

Nuclear materials stewardship: Our enduring mission

International Nuclear Information System (INIS)

Isaacs, T.H.

1998-01-01

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

Effect of antibiotic stewardship on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infection: a systematic review and meta-analysis.

Science.gov (United States)

Baur, David; Gladstone, Beryl Primrose; Burkert, Francesco; Carrara, Elena; Foschi, Federico; Döbele, Stefanie; Tacconelli, Evelina

2017-09-01

Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients. Two authors independently assessed the eligibility of trials and extracted data. Studies involving long-term care facilities were excluded. The main outcomes were incidence ratios (IRs) of target infections and colonisation per 1000 patient-days before and after implementation of antibiotic stewardship. Meta-analyses were done with random-effect models and heterogeneity was calculated with the I 2 method. We included 32 studies in the meta-analysis, comprising 9 056 241 patient-days and 159 estimates of IRs. Antibiotic stewardship programmes reduced the incidence of infections and colonisation with multidrug-resistant Gram-negative bacteria (51% reduction; IR 0·49, 95% CI 0·35-0·68; pdifficile infections (32%; 0·68, 0·53-0·88; p=0·0029). Antibiotic stewardship programmes were more effective when implemented with infection control measures (IR 0·69, 0·54-0·88; p=0·0030), especially hand-hygiene interventions (0·34, 0·21-0·54; pinfections and colonisation with antibiotic-resistant bacteria and C difficile infections in hospital inpatients. These results provide stakeholders and policy makers with evidence for implementation of antibiotic stewardship interventions to reduce the burden of infections from antibiotic-resistant bacteria. German Center for Infection Research

Higher Alu methylation levels in catch-up growth in twenty-year-old offsprings.

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Kittipan Rerkasem

Full Text Available Alu elements and long interspersed element-1 (LINE-1 or L1 are two major human intersperse repetitive sequences. Lower Alu methylation, but not LINE-1, has been observed in blood cells of people in old age, and in menopausal women having lower bone mass and osteoporosis. Nevertheless, Alu methylation levels also vary among young individuals. Here, we explored phenotypes at birth that are associated with Alu methylation levels in young people. In 2010, 249 twenty-years-old volunteers whose mothers had participated in a study association between birth weight (BW and nutrition during pregnancy in 1990, were invited to take part in our present study. In this study, the LINE-1 and Alu methylation levels and patterns were measured in peripheral mononuclear cells and correlated with various nutritional parameters during intrauterine and postnatal period of offspring. This included the amount of maternal intake during pregnancy, the mother's weight gain during pregnancy, birth weight, birth length, and the rate of weight gain in the first year of life. Catch-up growth (CUG was defined when weight during the first year was >0.67 of the standard score, according to WHO data. No association with LINE-1 methylation was identified. The mean level of Alu methylation in the CUG group was significantly higher than those non-CUG (39.61% and 33.66 % respectively, P < 0.0001. The positive correlation between the history of CUG in the first year and higher Alu methylation indicates the role of Alu methylation, not only in aging cells, but also in the human growth process. Moreover, here is the first study that demonstrated the association between a phenotype during the newborn period and intersperse repetitive sequences methylation during young adulthood.

[Comparison of eight screening tests for ant-HCV antibody].

Science.gov (United States)

Deguchi, Matsuo; Kagita, Masanori; Yamashita, Naoko; Nakano, Takasi; Tahara, Kazuko; Asari, Seishi; Iwatani, Yoshinori

2002-09-01

We compared eight HCV screening tests for detection of anti-HCV antibody; Ortho Quick Chaser HCV Ab (QC), Ortho HCV Ab ELISA III (ELISA), Ortho HVC Ab PA test III (PA), Lumipulse II Ortho HCV (LUMI), IMx HCV.DAINAPACKII (IMx), ARCHITECT HCV (ARCH), Immucheck.F-HCV C50 Ab (Immu), RANREAM HCV Ab Ex II (RAN). Sera from six hundred patients were examined by these eight screening tests. The positive rates of the eight screening tests were from 9.0% to 13.2%. Forty-five sera showed discrepant results between the eight screening tests, and about half of them showed weak positive reaction and/or false positive. Twenty-five of the forty-five sera were negative for ant-HCV antibody in the CHIRON RIBA III confirmatory test, and forty-four of them were negative for HCV-RNA in the PCR method. The agreement rates between the two reagents were from 95.5% to 99.2%, but were not always high between the two reagents that used similar antigen. The specificities and sensitivities evaluated by using the RIBA III confirmatory test were excellent in ELISA, LUMI, IMx, ARCH and Immu. Three BBI seroconversion panels were used to compare the positive readings in the initial stage of HCV infection by eight screening tests. ELISA and ARCH showed the earliest positive readings, and then IMx, LUMI = RAN, PA, QC and Immu in this order. These findings indicate that ELISA and ARCH were the most excellent in the sensitivity, specificity and early diagnosis of HCV infection. However, we must pay attention to the weak positive reaction in the screening tests, because there is a possibility of "false positive".

About Chernobyl - Twenty Years Later

International Nuclear Information System (INIS)

Tubiana, M.

2006-01-01

The author discusses the reactor accident of Chernobyl, the information on its consequences so contradictory in the former USSR countries, the status of the effects observed, the forecasting concerning the onset of cancers in the coming years among the populations that were exposed to radiations, the public opinion facing the pessimists. He concludes on the lessons which can be drawn from Chernobyl. (A.L.B.)

Impact of an antimicrobial stewardship programme on antibiotic usage and resistance in a tertiary hospital in China.

Science.gov (United States)

Zhang, Z-G; Chen, F; Ou, Y

2017-10-01

Antimicrobial misuse has been commonly observed in China. This phenomenon can cause antibiotic resistance. This study was designed to evaluate the impact of an antimicrobial stewardship programme implemented in a tertiary hospital in China from 2011 to 2014. The antimicrobial stewardship programme began in 2011. Data on the consumption of antibiotics and antimicrobial resistance between 2011 and 2014 were collected. Comparison of the 2011 data with those of 2014 showed that antibiotic defined daily doses/per 100 patient-days decreased from 92.5±2.8 to 35.8±1.2 (Padministrative management, especially information management, was effective in reducing antibiotic consumption and lessening antibiotic resistance. © 2017 John Wiley & Sons Ltd.

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

Science.gov (United States)

Worley, Debra A.; Little, Jennifer K.

2002-01-01

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

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

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

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

2017-01-01

Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

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

Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

The effect of eight half-yearly single-dose treatments with DEC on Wuchereria bancrofti circulating antigenaemia

DEFF Research Database (Denmark)

Simonsen, Paul E; Magesa, Stephen M; Meyrowitsch, Dan W

2005-01-01

The effect of eight half-yearly treatment rounds with diethylcarbamazine (DEC; 6mg/kg bodyweight) on Wuchereria bancrofti-specific circulating filarial antigen (CFA), a marker of adult worm infection, was followed in 79 individuals who were CFA-positive before start of treatment. Half of these we...... values. Repeated DEC therapy thus appears to have a slow but profound and persistent macrofilaricidal effect, which in the long run may be beneficial to populations undergoing DEC-based control interventions by reducing the probability of future morbidity development....

Industries processing naturally occurring radioactive materials: twenty years of emission data in the Netherlands

International Nuclear Information System (INIS)

Tanzi, C.P.

2008-01-01

This paper provides a review of the dose assessment of discharges to air of two industries processing NORM (Naturally Occurring Radioactive Materials) in the Netherlands. An industrial plant producing elemental phosphorus (thermal process, unique within Europe) reports since 1987 its emission data to the Dutch Ministry of the Environment (VROM: Ministry of Housing, Spatial Planning and the Environment). This plant accounts for the highest release of Po-210 to air in the Netherlands, with a yearly average of approximately 500 GBq. Other significant NORM discharges to air arise from an industrial plant with blast-furnaces for steel production. Yearly discharges fall under permit, and are reported, since 1993. RIVM, the National Institute for Public Health and the Environment, is tasked by the Ministry to assess the dose to the general public arising from these discharges to air. Air transport modelling is used to determine both air concentration (for inhalation exposure) and deposition rate of the radionuclides. A (conservative) committed ingestion dose is determined by modelling the uptake of radionuclides from contaminated farmland, and assuming a food basket to be fairly representative for the population of the Netherlands. Discharges to water in the Netherlands have decreased in the past twenty years, due both to the closure of two phosphoric acid plants a decade ago and the improved treatment of waste fluids by other NORM industries. The collective dose assessed from discharges to air since 1987 is presented here. (author)

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

International Nuclear Information System (INIS)

Nelson, Jody K.

2013-01-01

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

Development, problem behavior, and quality of life in a population based sample of eight-year-old children with down syndrome

NARCIS (Netherlands)

Gameren-Oosterom, H.B.M. van; Fekkes, M.; Buitendijk, S.E.; Mohangoo, A.D.; Bruil, J.; Wouwe, J.P. van

2011-01-01

Objective: Children with Down syndrome (DS) have delayed psychomotor development. We investigated levels of development, problem behavior, and Health-Related Quality of Life (HRQoL) in a population sample of Dutch eight-year-old children with DS. Developmental outcomes were compared with normative

Rural Community-Based Tourism and its Impact on Ecological Consciousness, Environmental Stewardship and Social Structures

DEFF Research Database (Denmark)

Raftopoulos, Malayna

2018-01-01

Since rural community-based tourism (RCBT) emerged, it has been widely considered to be an effective means of promoting development and conserving natural resources. Through a political ecology approach, this article explores the potential of RCBT to foster long-term stewardship and transformations...

Environmental stewardship for gold mining in tropical regions

Directory of Open Access Journals (Sweden)

A Isahak

2013-10-01

Full Text Available Mining has gained strong popularity in recent years due to the increase in global demand for metals and other industrial raw material derived from the ground. However, information and good governance regarding activities related to mining is still very much lacking especially in underdeveloped and developing countries in the tropics. In Malaysia, the importance of environmental stewardship in mining is a new phenomenon. The new National Mineral Policy 2 calls for compliance with existing standards and guidelines, stresses on progressive and post mining rehabilitation as well as promotes the gathering and dissemination of information, best mining practices, public disclosure and corporate social responsibility. Our preliminary studies however have shown that its implementation may have been hampered by inadequate legal and administrative structures, lack of freedom of information, physical inaccessibility, lack of information and public participation. In this presentation, the above issues and measures to reduce the impact of mining, particularly that of gold on the environment with a special focus on Malaysia is discussed. These measures include alternative gold extraction methods, appropriate tailing dam construction and management, health risk assessment and risk management, compliance with the Cyanide Code and liberalization of access to information, facilitation of access to justice, the strengthening of legal and administrative structures as well as corporate accountability to the public as part of corporate social responsibility.

Fundamental Movement Skill Proficiency and Body Composition Measured by Dual Energy X-Ray Absorptiometry in Eight-Year-Old Children

Science.gov (United States)

Slotte, Sari; Sääkslahti, Arja; Metsämuuronen, Jari; Rintala, Pauli

2015-01-01

Objective: The main aim was to examine the association between fundamental movement skills (FMS) and objectively measured body composition using dual energy X-ray absorptiometry (DXA). Methods: A study of 304 eight-year-old children in Finland. FMS were assessed with the "Test of gross motor development," 2nd ed. Total body fat…

Late-diagnosed phenylketonuria in an eight-year-old boy with dyslexia and attention-deficit hyperactivity disorder.

Science.gov (United States)

Yıldız, Yılmaz; Dursun, Ali; Tokatlı, Ayşegül; Coşkun, Turgay; Sivri, Hatice Serap

2016-01-01

Phenylketonuria, previously a common cause of severe intellectual disability, is a metabolic disorder now promptly diagnosed and effectively treated thanks to newborn screening programs. Here, we report a male patient presenting with dyslexia and attention-deficit hyperactivity disorder, who was diagnosed with mild phenylketonuria at eight years of age. Earlier recognition and treatment before the establishment of irreversible brain damage would have resulted in better neurobehavioural outcomes. Classical phenylketonuria and milder phenotypes of phenylalanine hydroxylase deficiency need to be considered in the differential diagnosis of all cognitive and behavioural problems of unknown cause.

Guillain-Barre Syndrome – rehabilitation outcome, residual deficits and requirement of lower limb orthosis for locomotion at 1 year follow-up.

Science.gov (United States)

Gupta, Anupam; Taly, Arun B; Srivastava, Abhishek; Murali, Thyloth

2010-01-01

To analyse long-term functional recovery, deficits and requirement of lower limb orthosis (LLO) for locomotion in patients with Guillain-Barre Syndrome (GBS). Prospective longitudinal follow-up study. Neurological Rehabilitation unit of university hospital. Sixty-nine patients of GBS admitted for inpatient rehabilitation. Thirty-five patients (M:F, 19:16) reporting after 1 year follow-up (50.72%) were included in study (between September 2005 and July 2009). Their residual deficits and requirement of LLO were recorded and analysed. Age ranged from 4 to 65 year (29.74 ± 15.75). Twenty-seven patients had typical GBS and eight patients had acute motor axonal neuropathy variant. Twenty-eight patients (80%) had neuropathic pain needing medication with 11 required more than one drug. Twenty-one patients (60%) had foot drop and advised ankle-foot orthosis-AFO (20 bilateral AFO). Thirty patients (85.71%) needed assistive devices also for locomotion at discharge. After 1 year, foot drop was still present in 12 patients (34.28%) using orthosis. Modified Barthel Index scores, Modified Rankin Scale and Hughes Disability Scale were used to assess functional disabilities. Significant recovery was observed at the time of discharge and after 1 year (p < 0.001 each). Patients with GBS continue to show significant functional recovery for long period. They have residual deficits even after 1 year with requirement of orthosis in large number of patients.

Antimicrobial stewardship in long-term care facilities in Belgium: a questionnaire-based survey of nursing homes to evaluate initiatives and future developments

Directory of Open Access Journals (Sweden)

François Kidd

2016-03-01

Full Text Available Abstract Background The use of antimicrobials is intense and often inappropriate in long-term care facilities. Antimicrobial resistance has increased in acute and chronic care facilities, including those in Belgium. Evidence is lacking concerning antimicrobial stewardship programmes in chronic care settings. The medical coordinator practicing in Belgian nursing homes is a general practitioner designated to coordinate medical activity. He is likely to be the key position for effective implementation of such programmes. The aim of this study was to evaluate past, present, and future developments of antimicrobial stewardship programmes by surveying medical coordinators working in long-term care facilities in Belgium. Methods We conducted an online questionnaire-based survey of 327 Belgian medical coordinators. The questionnaire was composed of 33 questions divided into four sections: characteristics of the respondents, organisational frameworks for implementation of the antimicrobial stewardship programme, tools to promote appropriate antimicrobial use and priorities of action. Questions were multiple choice, rating scale, or free text. Results A total of 39 medical coordinators (12 % completed the questionnaire. Past or present antimicrobial stewardship initiatives were reported by 23 % of respondents. The possibility of future developments was rated 2.7/5. The proposed key role of medical coordinators was rated <3/5 by 36 % of respondents. General practitioners, nursing staff, and hospital specialists are accepted as important roles. The use of antimicrobial guidelines was reported by only 19 % of respondents. Education was considered the cornerstone for any future developments. Specific diagnostic recommendations were considered useful, but chest x-rays were judged difficult to undertake. The top priority identified was to reduce unnecessary treatment of asymptomatic urinary infections. Conclusions Our study shows that the implementation of

Self-reported mental health in children ages 6-12 years across eight European countries.

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Husky, Mathilde M; Boyd, Anders; Bitfoi, Adina; Carta, Mauro Giovanni; Chan-Chee, Christine; Goelitz, Dietmar; Koç, Ceren; Lesinskiene, Sigita; Mihova, Zlatka; Otten, Roy; Pez, Ondine; Shojaei, Taraneh; Kovess-Masfety, Viviane

2018-06-01

Worldwide, approximately one in eight children or adolescents suffers from a mental disorder. The present study was designed to determine the self-reported prevalence of mental health problems in children aged 6-11 years across eight European countries including Italy, France, Germany, the Netherlands, Lithuania, Bulgaria, Romania, and Turkey. Data were drawn from 6245 children participating in the School Children Mental Health in Europe (SCHME) study and a large cross-sectional survey in France. Self-reported child mental health was assessed using the Dominique Interactive (DI). Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems. The net completion rates of 4.1-74.3% preclude conclusions about national differences in prevalence rates.

Understanding Contextual and Social Meaning in Typically Developing Finnish-Speaking Four- To Eight-Year-Old Children

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Loukusa Soile

2017-12-01

Full Text Available This study examined the development of social-pragmatic comprehension in 170 Finnish four- to eight-year-old children. The children were asked to respond to socially and contextually demanding questions targeting their social-pragmatic language processing, and to explain their correct answers in order to elicit their awareness of how they had derived the answers from the context. The results showed that the number of correct answers increased especially between the ages of four and seven years. We found that questions demanding contextual processing without mind-reading were the easiest to understand, followed by questions demanding processing of feelings of others and false beliefs. The questions demanding understanding of relevant language use and processing of contextual factors including mental states and intentions were the most challenging for the children. Between four and five years of age there was a remarkable developmental phase in children’s ability to give proper explanations.

Establishing the R&D Agenda for Twenty-First Century Learning

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Kay, Ken; Honey, Margaret

2006-01-01

Much ink has flowed over the past few years describing the need to incorporate twenty-first century skills into K-12 education. Preparing students to succeed as citizens, thinkers, and workers--the bedrock of any educational system--in this environment means arming them with more than a list of facts and important dates. Infusing twenty-first…

Storyline and Associations Pyramid as Methods of Creativity Enhancement: Comparison of Effectiveness in 5-Year-Old Children

Science.gov (United States)

Smogorzewska, Joanna

2012-01-01

This article presents the results of a study comparing the originality, the length, the number of neologisms and the syntactic complexity of fairy tales created with "Storyline" and "Associations Pyramid." Both methods were developed to enhance children's language abilities and their creative thinking. One hundred twenty eight 5-year-old children…

Twenty years after the Chernobyl accident

International Nuclear Information System (INIS)

2006-01-01

Full text: The April 1986 accident at the Chernobyl nuclear power plant remains a painful memory in the lives of the hundreds of thousands of people who were most affected by the accident. In addition to the emergency rescue workers who died, thousands of children contracted thyroid cancer, and thousands of other individuals will eventually die of other cancers caused by the release of radiation. Vast areas of cropland, forests, rivers and urban centres were contaminated by environmental fallout. Hundreds of thousands of people were evacuated from these affected areas - forced to leave behind their homes, possessions, and livelihoods - and resettled elsewhere, in a traumatic outcome that has had long-lasting psychological and social impacts. The commemoration of the Chernobyl tragedy is taking place in many forums this month - in Minsk, in Kiev and in other locations. At the IAEA, it might be said that we have been responding to the accident and its consequences for twenty years, in a number of ways: first, through a variety of programmes designed to help mitigate the environmental and health consequences of the accident; second, by analyzing the lessons of what went wrong to allow such an accident to occur at all; and third, by working to prevent any such accident from occurring in the future. Building a strong and effective global nuclear safety regime is a central objective of our work. This requires effective international cooperation. The explosions that destroyed the Unit 4 reactor core, and discharged its contents in a cloud of radionuclides, made painfully clear that the safety risks associated with nuclear and radiological activities extend beyond national borders. International cooperation on nuclear safety matters - sharing information, setting clear safety standards, assisting with safety upgrades, and reviewing operational performance - has therefore become a hallmark of IAEA activity, particularly at a time when we are witnessing an expansion of

Review of the Journal Acta Informatica Medica During Eight Year Period: 2008-2015.

Science.gov (United States)

Masic, Izet; Begic, Edin; Zunic, Lejla

2016-04-01

Acta Informatica Medica is official journal of the Academy for Medical Sciences of Bosnia and Herzegovina (from 2014 Acta Inform Med is published bimonthly). To evaluate journal "Acta Informatica Medica" in 2015 and compare findings to previous years. The study has retrospective and descriptive character, and included the period 2008-2015 (included 36 issues of journal). A total of 83 (average 13,8 articles per journal) articles were published in Acta Informatica Medica during 2015. Analyzing the type of articles, original articles are present in majority during 2015 (68,6%) (by analyzing last eight years, 310 (67,3%) were original). During 2015, 27,7% of articles were related to the applied of Health informatics in field of clinical medicine, 63,8% preclinical medicine and 8,5% to public health. Collaboration rate in 2015 was 0,84. Most often the time required for decision on acceptance of article in 2015 is between 50 and 60 days. Articles came from 16 countries. According to scimagojr.com for 2014, Acta Informatica Medica has SCImago Journal Rank 0,166, while Cites / Doc. (2 years) parameter (widely used as impact index) is 0,70. According to GoogleScholar, h5 index is 11 and h5 median is 19. We analyzed the Acta Informatica Medica by "Publish or Perish" software - H index was 14, g index was 19 and e-index was 10.39. Year after year the highest number of original articles are published. Although the period of revision of articles is acceptable, the period up to two months is certainly not long, the goal is to reduce this period. Although the magazine in mentioned field found its place, although it is indexed in numerous bases, including: PubMed, PubMed Central, SCOPUS, EMBASE, EBSCO, etc. The main goal for next year is that the magazine becomes part of the Web of Science. Imperative is further internationalization of the magazine.

Twenty years of student sexual behavior: subcultural adaptations to a changing health environment.

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Netting, Nancy S; Burnett, Matthew L

2004-01-01

This twenty-year study analyzes changes in sexual behavior among students at Okanagan University College in British Columbia, Canada. Surveys conducted in 1980, 1990, and 2000 reveal a steady increase in safer sexual practices. Most students now question potential partners about their past, use condoms with a new sexual partner, and maintain fairly long-term monogamous relationships. Three sexual subcultures continue to coexist in fairly stable proportions: celibacy (about 30%), monogamy (about 60%), and free experimentation (about 10%). Each subculture has created its own response to the danger of HIV/AIDS: celibates exaggerate the danger they face, monogamists rely on love and fidelity for protection, and free experimenters have increased their use of condoms. While romantic feelings lead many monogamous couples to abandon condoms without objective HIV/AIDS knowledge, free experimenters still face the highest risk. Although they now use condoms more than half the time, their lifestyle, which involves multiple partners, risky sexual acts, and frequent drug and/or alcohol use, clearly remains dangerous. The persistence of distinct subcultures has implications for health education programs, which would be most effective if based on key values held by specific target groups.

Health of Europeans twenty years after the fall of Berlin wall.

Science.gov (United States)

Ginter, E; Simko, V

2010-01-01

The failure of central planning in the totalitarian systems of the USSR and its satellites adversely affected not only the economy and social relations but also the population health. While in the countries with established democracy (DEM) the general health and the life expectancy (LE) steadily improved, in countries declaring socialism (SOC) the LE was stagnant and in the USSR even decreased. Dramatic changes in Russia after the demise of Soviet Union resulted in an extraordinary destabilization of LE that reached a minimum in 1994. Remarkably, even twenty years after the breakdown of the Iron Curtain there persists a gap in the general health between the DEM and the SOC regions of Europe. Within the territory of the former Soviet influence there are additional differences in LE: Central Europe is much better off than Russia and its neighbours. Main cause of relatively high mortality in the post totalitarian Europe is the cardiovascular disease (CVD). Among females about 80% difference in LE between DEM and SOC countries is related to premature CVD mortality. In SOC males compared to DEM, about 50% of the higher mortality is caused by CVD, 20% is related to external factors (trauma, suicide) and 10% is oncologic disorders. The main suggested cause of such excess mortality, besides a low socioeconomic level and limited funding for health care, is an improper life style: alcoholism, smoking and inadequate intake of protective nutrients. Alcoholism, especially binge drinking is a prominent factor in Russia, Belarus, Ukraine and in the Baltic Republics (Fig. 6, Tab. 4, Ref. 20).

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

International Nuclear Information System (INIS)

Failey, Elisabeth L; Dilling, Lisa

2010-01-01

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

The second twenty-five years.

Science.gov (United States)

Kippley, J F

1993-01-01

Between 1964 and 1968, the liberal Catholic press had prepared the laity for the change expected to occur after the release of Pope Paul VI's encyclical "Humanae Vitae," but almost no one read it when it was released in July 1968. The media gave the impression that no one agreed with the Pope. The Archbishop of Baltimore denounced his dissenting priests. The media publicized the discord, resulting in his fellow bishops not supporting him or the Pope. Sound theology was limited then. Today many Catholic leaders and scholars openly defend the encyclical, e.g., since 1978, Pope John Paul II has supported the doctrine of marital noncontraception. Pope Pius XII called for every woman to breast feed. The 1969 publication of the Breastfeeding and Natural Child Spacing was the catalyst for 10 years of research which confirmed breast feeding's contraceptive effect. Family planning specialists and demographers agreed in the Bellagio Consensus in 1988 that mothers who practiced exclusive breast feeding and were amenorrheic need not use a contraceptive for the first 6 months postpartum. Recent research shows that this rule depends on the population, e.g., women in Bangladesh meeting the criteria do not need to use contraceptives for 1 year. Few natural family planning groups existed in 1968 (e.g., 1 diocese), but today there are natural family planning teachers in 49 US states and in 13 countries. Some Catholics are calling for couples wanting to marry to take a course in natural family planning. The media widely publicized the new unnatural family planning methods, especially the pill. Recently a baby magazine allocated natural family planning 2/3rd of a page. A reporter for the "Washington Post" plans to interview a Catholic leader about natural family planning, completely on his/her own initiative.

Twenty lectures on thermodynamics

CERN Document Server

Buchdahl, H A

2013-01-01

Twenty Lectures on Thermodynamics is a course of lectures, parts of which the author has given various times over the last few years. The book gives the readers a bird's eye view of phenomenological and statistical thermodynamics. The book covers many areas in thermodynamics such as states and transition; adiabatic isolation; irreversibility; the first, second, third and Zeroth laws of thermodynamics; entropy and entropy law; the idea of the application of thermodynamics; pseudo-states; the quantum-static al canonical and grand canonical ensembles; and semi-classical gaseous systems. The text

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

Science.gov (United States)

Aspen Institute, 2009

2009-01-01

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

Cost Analysis of Implementing Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry Plus Real-Time Antimicrobial Stewardship Intervention for Bloodstream Infections.

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Patel, Twisha S; Kaakeh, Rola; Nagel, Jerod L; Newton, Duane W; Stevenson, James G

2017-01-01

Studies evaluating rapid diagnostic testing plus stewardship intervention have consistently demonstrated improved clinical outcomes for patients with bloodstream infections. However, the cost of implementing new rapid diagnostic testing can be significant, and such testing usually does not generate additional revenue. There are minimal data evaluating the impact of adding matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for rapid organism identification and dedicating pharmacy stewardship personnel time on the total hospital costs. A cost analysis was performed utilizing patient data generated from the hospital cost accounting system and included additional costs of MALDI-TOF equipment, supplies and personnel, and dedicated pharmacist time for blood culture review and of making interventions to antimicrobial therapy. The cost analysis was performed from a hospital perspective for 3-month blocks before and after implementation of MALDI-TOF plus stewardship intervention. A total of 480 patients with bloodstream infections were included in the analysis: 247 in the preintervention group and 233 in the intervention group. Thirty-day mortality was significantly improved in the intervention group (12% versus 21%, P cost per bloodstream infection was lower in the intervention group ($42,580 versus $45,019). Intensive care unit cost per bloodstream infection accounted for the largest share of the total costs in each group and was also lower in the intervention group ($10,833 versus $13,727). Implementing MALDI-TOF plus stewardship review and intervention decreased mortality for patients with bloodstream infections. Despite the additional costs of implementing MALDI-TOF and of dedicating pharmacy stewardship personnel time to interventions, the total hospital costs decreased by $2,439 per bloodstream infection, for an approximate annual cost savings of $2.34 million. Copyright © 2016 American Society for Microbiology.

A Study in Critical Listening Using Eight to Ten Year Olds in an Analysis of Commercial Propaganda Emanating from Television.

Science.gov (United States)

Cook, Jimmie Ellis

Selected eight to ten year old Maryland children were used in this study measuring the effect of lessons in becoming aware of propaganda employed by commercial advertisers in television programs. Sixteen 45-minute lessons directed to the propaganda techniques of Band Wagon, Card Stacking, Glittering Generalities, Name Calling, Plain Folks,…

50 Years of the Macedonian Academy of Sciences and Arts 1967-2017 and 48 Years of Publishing the Journal Prilozi (Contributions) of MASA.

Science.gov (United States)

Polenakovic, Momir; Pop-Jordanova, Nada; Gucev, Zoran

2017-12-01

Papers on medical subjects have been published since the first issue of the journal Prilozi in 1969, totalling a number of of 957 (nine hundred and fifty seven) papers have been published in Prilozi. Two hundred and twenty nine cover subjects on natural sciences and mathematics, and 728 (seven hundred and twenty eight) subjects on medical sciences. So far, 2017 No. XXXVIII-2, 622 (six hundred and twenty two) papers published in Prilozi are in Pubmed. Prilozi is published three times a year and it is covered by the following services: Baidu Scholar, Case, Celdes, CNKI Scholar (China National Knowledge Infrastructure), CNPIEC, DOAJ (Directory of Open Access Journals), EBSCO (relevant databases), EBSCO Discovery Service, Elsevier - SCOPUS, Google Scholar, J-Gate, JournalTOCs, KESLI-NDSL (Korean National Discovery for Science Leaders), Naviga (Softweco), Primo Central (ExLibris), Publons, PubMed, ReadCube, ResearchGate, SCImago (SJR), Summon (Serials Solutions/ProQuest), TDNet, Ulrich's Periodicals Directory/ulrichsweb WanFang Data, WorldCat (OCLC).

Antimicrobial Stewardship in Acute Care Centres: A Survey of 68 Hospitals in Quebec

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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.

Applying a Data Stewardship Maturity Matrix to the NOAA Observing System Portfolio Integrated Assessment Process

Science.gov (United States)

Peng, G.; Austin, M.

2017-12-01

Identification and prioritization of targeted user community needs are not always considered until after data has been created and archived. Gaps in data curation and documentation in the data production and delivery phases limit data's broad utility specifically for decision makers. Expert understanding and knowledge of a particular dataset is often required as a part of the data and metadata curation process to establish the credibility of the data and support informed decision-making. To enhance curation practices, content from NOAA's Observing System Integrated Assessment (NOSIA) Value Tree, NOAA's Data Catalog/Digital Object Identifier (DOI) projects (collection-level metadata) have been integrated with Data/Stewardship Maturity Matrices (data and stewardship quality information) focused on assessment of user community needs. This results in user focused evidence based decision making tools created by NOAA's National Environmental Satellite, Data, and Information Service (NESDIS) through identification and assessment of data content gaps related to scientific knowledge and application to key areas of societal benefit. Through enabling user need feedback from the beginning of data creation through archive allows users to determine the quality and value of data that is fit for purpose. Data gap assessment and prioritization are presented in a user-friendly way using the data stewardship maturity matrices as measurement of data management quality. These decision maker tools encourages data producers and data providers/stewards to consider users' needs prior to data creation and dissemination resulting in user driven data requirements increasing return on investment. A use case focused on need for NOAA observations linked societal benefit will be used to demonstrate the value of these tools.

Collaboration in Long-Term Stewardship at DOE's Hanford Site - 13019

International Nuclear Information System (INIS)

Moren, Rick; Brown, David; Feist, Ella; Grindstaff, Keith; Zeisloft, Jamie

2013-01-01

The U.S. Department of Energy's (DOE) Hanford Site comprises approximately 1,517 km 2 (586 mi 2 ) of land in southeastern Washington. The site was established in 1943 as part of the Manhattan Project to produce plutonium for the nation's nuclear weapons program. As the Cold War era came to an end, the mission of the site transitioned from weapons production to environmental cleanup. As the River Corridor area of the site cleanup is completed, the mission for that portion of the site will transition from active cleanup to continued protection of environment through the Long-Term Stewardship (LTS) Program. The key to successful transition from cleanup to LTS is the unique collaboration among three (3) different DOE Programs and three (3) different prime contractors with each contractor having different contracts. The LTS Program at the site is a successful model of collaboration resulting in efficient resolution of issues and accelerated progress that supports DOE's Richland Office 2015 Vision for the Hanford Site. The 2015 Vision for the Hanford Site involves shrinking the active cleanup footprint of the surface area of the site to approximately 20 mi 2 on the Central Plateau. Hanford's LTS Program is defined in DOE's planning document, Hanford Long-Term Stewardship Program Plan [1]. The Plan defines the relationship and respective responsibilities between the federal cleanup projects and the LTS Program along with their respective contractors. The LTS Program involves these different parties (cleanup program and contractors) who must work together to achieve the objective for transition of land parcels. Through the collaborative efforts with the prime contractors on site over the past two years,, 253.8 km 2 (98 mi 2 ) of property has been successfully transitioned from the cleanup program to the LTS Program upon completion of active surface cleanup. Upcoming efforts in the near term will include transitioning another large parcel that includes one of the six (6

A Case: Eight-and-A-Half Syndrome

Directory of Open Access Journals (Sweden)

Cennet Nalan Kuş

2007-12-01

Full Text Available Scientific BACKGROUND: The combination of clinical one-and-a-half syndrome together with cranial nerve VII palsy is known to as eight-and-a-half syndrome. It localized the pathology to the pons. OBJECTIVE: To report a case having clinical and radiologic findings typical of eight-and-a-half syndrome. CASE: 65 year old man with hypertension presented with sudden onset of binocular diplopia left facial weakness. Magnetic resonance imaging demostrated a small lesion in the left paramedian pontine tegmentum. CONCLUSION: To our knowledge, this is the first report of a case of eight-and-a-half syndrome in Turkish literature

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

Science.gov (United States)

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

2014-05-01

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

Integrating societal perspectives and values for improved stewardship of a coastal ecosystem engineer

Directory of Open Access Journals (Sweden)

Steven B. Scyphers

2014-09-01

Full Text Available Oyster reefs provide coastal societies with a vast array of ecosystem services, but are also destructively harvested as an economically and culturally important fishery resource, exemplifying a complex social-ecological system (SES. Historically, societal demand for oysters has led to destructive and unsustainable levels of harvest, which coupled with multiple other stressors has placed oyster reefs among the most globally imperiled coastal habitats. However, more recent studies have demonstrated that large-scale restoration is possible and that healthy oyster populations can be sustained with effective governance and stewardship. However, both of these require significant societal support or financial investment. In our study, we explored relationships among how coastal societies (1 perceive and value oyster ecosystem services, (2 recognize and define problems associated with oyster decline, and (3 perceive or support stewardship initiatives. We specifically focused on the SES of eastern oysters (Crassostrea virginica and coastal societies in the northern Gulf of Mexico, a region identified as offering among the last and best opportunities to sustainably balance conservation objectives with a wild fishery. We found that, in addition to harvest-related benefits, oysters were highly valued for providing habitat, mitigating shoreline erosion, and improving water quality or clarity. Our results also showed that although most respondents recognized that oyster populations have declined, many respondents characterized the problem differently than most scientific literature does. Among a variety of initiatives for enhancing sustainability, spawning sanctuaries and reef restoration were well supported in all states, but support for harvest reductions was less consistent. Our study suggests that public support for maintaining both harvest and ecosystem services exists at societal levels and that enhancing public awareness regarding the extent and causes

Collaboration in long-term stewardship at DOE Hanford Site

Energy Technology Data Exchange (ETDEWEB)

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

2013-01-10

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

The effectiveness of agricultural stewardship for improving water quality at the catchment scale: Experiences from an NVZ and ECSFDI watershed

Science.gov (United States)

Kay, Paul; Grayson, Richard; Phillips, Martin; Stanley, Karen; Dodsworth, Alan; Hanson, Ann; Walker, Andrew; Foulger, Miles; McDonnell, Iain; Taylor, Simon

2012-02-01

SummaryAgriculture is estimated to be responsible for 70% of nitrate and 30-50% of phosphorus pollution, contributing to ecological and water treatment problems. Despite the fact that significant gaps remain in our understanding, it is known that agricultural stewardship can be highly effective in controlling water pollution at the plot and field scales. Knowledge at the catchment scale is, to a large extent, entirely lacking though and this is of paramount concern given that the catchment is the management unit used by regulatory authorities. The few studies that have examined the impact of agricultural stewardship at the catchment scale have found that Nitrate Vulnerable Zones (NVZs) in the UK have resulted in little improvement in water quality which concurs with the current catchment study. In addition to NVZs, there was little evidence to suggest that the England Catchment Sensitive Farming Delivery Initiative had impacted water quality and suggestions have been made for improvements, such as ensuring that stewardship measures are used in key pollution source areas and their implementation and impacts are monitored more closely. This will be essential if agricultural catchment management schemes are going to provide the benefits expected of them. Nevertheless, more intensive monitoring than that carried out by regulators showed a significant trend in decreasing winter nitrate peaks in some streams which is hypothesised to be due to recent reduced inorganic fertiliser application as a result of increasing prices. It was concluded that, collectively, these findings indicate that agricultural stewardship measures have the potential to improve water quality at the catchment scale but that voluntary schemes with insufficient financial reward or regulatory pressure are unlikely to be successful.

Resilience design: toward a synthesis of cognition, learning, and collaboration for adaptive problem solving in conservation and natural resource stewardship

Directory of Open Access Journals (Sweden)

Charles G. Curtin

2014-06-01

Full Text Available Through the resilience design approach, I propose to extend the resilience paradigm by re-examining the components of adaptive decision-making and governance processes. The approach can be divided into three core components: (1 equity design, i.e., the integration of collaborative approaches to conservation and adaptive governance that generates effective self-organization and emergence in conservation and natural resource stewardship; (2 process design, i.e., the generation of more effective knowledge through strategic development of information inputs; and (3 outcome design, i.e., the pragmatic synthesis of the previous two approaches, generating a framework for developing durable and dynamic conservation and stewardship. The design of processes that incorporate perception and learning is critical to generating durable solutions, especially in developing linkages between wicked social and ecological challenges. Starting from first principles based on human cognition, learning, and collaboration, coupled with nearly two decades of practical experience designing and implementing ecosystem-level conservation and restoration programs, I present how design-based approaches to conservation and stewardship can be achieved. This context is critical in helping practitioners and resources managers undertake more effective policy and practice.

Evaluation of the short-term effects of antimicrobial stewardship in the intensive care unit at a tertiary hospital in China.

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Dapeng Hou

Full Text Available Antibiotic abuse can lead to antibiotic resistance, which is a severe problem in China. The purpose of this study is to evaluate the short-term effects of antimicrobial stewardship strategies, including formulary restriction, preauthorization, perioperative quinolone restriction, and control of total antibiotic consumption in the ICU at a tertiary hospital in China. After implementation of antimicrobial stewardship, the total antibiotic consumption in the ICU significantly decreased. The defined daily doses (DDDs per 100 patient-days decreased from 197.65 to 143.41; however, the consumption of cephalosporins increased from 53.65 to 63.17 DDDs. Significant improvements in resistance to amikacin, gentamicin, ciprofloxacin, ofloxacin, ceftriaxone, ceftazidime, and piperacillin in Enterobacteriaceae and resistance to ceftazidime, imipenem, and meropenem in non-fermenting Gram-negative rods were observed. In addition, the initial use of no antibiotics or of a single antibiotic significantly increased (P<0.001 and the use of two antibiotics in combination significantly decreased (P<0.001. Our results demonstrate that implementation of antimicrobial stewardship in a short period in the ICU dramatically reduced antibiotic consumption and significantly improved antibiotic resistance, which leads to more reasonable antibiotic selections by ICU physicians.

Muiris O’Sullivan’s “New Storytelling”: The Art of Twenty Years A-Growing

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Thomas F. Shea

2018-03-01

Full Text Available Since its publication in 1933, Muiris O’Sullivan’s Fiche Blian ag Fás (Twenty Years A-Growing has been limited and distorted by critics who view the memoir through a lens shaped by prior assessments of Tomás Ó Criomhthain’s earlier Blasket autobiography, An tOileánach (The Islandman. Muiris Mac Conghail voices the standard perspective when he states, “It was the publication of Tomás Ó Criomhthain’s An tOileánach, in 1929, which both acted as an incentive and provided an exemplar to Muiris” (150. O’Crohan’s autobiography certainly inspired O’Sullivan; however, Muiris’s more literary sensibility set him on his own inscriptive journey during which he creates a new type of narrative, one which creatively interweaves oral traditions with the contours of the novel. As we investigate what Pádraig Ó Fiannachta terms the author’s nua scéalaíocht, or “new storytelling” techniques, we can more fully appreciate O’Sullivan’s subtle dexterities as both traditional storyteller and novelistic craftsman.

Twenty-five years of life lessons

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Smit, Annemieke; Dorren, Luuk; Noord, Van Hans; Veraart, Josja; Cusell, Casper; Sterk, Henk Pieter

2017-01-01

For 25 years, Physical Geography students of the University of Amsterdam have experienced a 6-week field training in the cuesta landscape in Luxembourg around Diekirch. They studied the geology of the Gutland and surrounding areas, such as Ardennes and Eiffel. They mapped geomorphological patterns,

OPTIMIZING ANTIMICROBIAL PHARMACODYNAMICS: A GUIDE FOR YOUR STEWARDSHIP PROGRAM

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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.

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

Science.gov (United States)

Collado, Roberto; Losa, Juan Emilio; Álvaro, Elena Alba; Toro, Piedad; Moreno, Leonor; Pérez, Montserrat

2015-12-01

Monitoring antimicrobial consumption in hospitals is a necessary measure. The indicators commonly employed do not clearly reflect the antibiotic selection pressure. The objective of this study is to evaluate two different methods that analyze antimicrobial consumption based on DDD, per stay and per discharge, before and after the implementation an antimicrobial stewardship program. Comparative pre-post study of antimicrobial consumption with the implementation of an antimicrobial stewardship program using DDD per 100 bed-days and DDD per 100 discharges as indicators. Hospital bed days remained stable and discharges increased slightly along the period of study Antibiotic consumption in DDD per 100 bed-days decreased by 2.5% versus 3.8% when expressed as DDD per 100 discharges. Antifungal consumption decreased by more than 50%. When average hospital stay decreases, reductions in the consumption of antimicrobials with an antimicrobial stewardship program system occur at the expense of reducing the number of patients receiving treatment, while increases occur due to longer durations of treatment.

Reconstructive surgery in eight children with solitary kidneys

DEFF Research Database (Denmark)

Thorup, Jørgen Mogens

1989-01-01

Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two of t...... months of age. Postoperatively, the renal function was subnormal (although improved) in two children; in six it was normal. The most important prognostic factors in solitary kidneys with urinary tract obstruction are infection and developmental injury.......Within a 10-year period reconstructive urinary tract surgery has been carried out in eight children with solitary kidneys. The children were 0-5 years old. Six had unilateral renal agenesis and two had unilateral multicystic kidney. In five children ureteroneocystostomy was performed, in two...

Radiotherapy for tongue cancer in young adults less than 40 years

International Nuclear Information System (INIS)

Yoshida, Ken; Koizumi, Masahiko; Inoue, Toshihiko; Inoue, Takehiro; Yamazaki, Hideya; Kagawa, Kazufumi; Teshima, Teruki; Shimizutani, Kimishige; Furukawa, Souhei; Murayama, Shigeyuki; Nose, Takayuki; Tanaka, Eiichi

1996-01-01

Purpose/Objective: Radiotherapy for tongue cancer in young adults less than 40 years is studied, retrospectively. Some reports say young tongue cancer patient has worse prognosis. We investigate treatment results of them treated in our department, compared with elder patients. Materials and Methods: Our department registered 1289 patients with tongue cancer during 26 years between Jan. 1967 and Dec. 1992. One hundred and eighty-eight patients were under 40 years old. One hundred and forty-eight patients were primarily treated by radiotherapy. Follow-up terms are among 2 and 25 years (median; 15 years). They consisted of 99 males and 49 females. They were divided into 3 age groups, 3 teenagers, 39 twenties, and 106 thirties. The youngest was 18 years old. T and N categories were T1: 33, T2: 77, T3: 34, T4: 4, N0: 111, N1: 25, N2: 4, and N3: 8 patients, respectively. One hundred and twenty patients were treated only with radiotherapy. Twenty-four and 4 patients were treated with chemotherapy and surgery adding to radiotherapy respectively. Radiotherapy consisted of 29 external, 60 brachytherapy, and 59 both. One hundred and nineteen brachytherapies consisted of Ir: 66, Ra: 50, Ir+Ra: 1, and Au: 2. Eighty-one patients with T1 or2N0M0 treated only by radiotherapy were compared with the similar 454 patients more and equal to 40 years old. Results: The 5-and 10-year survival rates of 148 patients were 69% and 65%, respectively. The 5-and 10-year local control rates were 77% and 76%, respectively. The 5-year survival rates of T1, T2, T3, and T4 patients were 90%, 70%, 50%, and 43%, respectively. The corresponding 10-year survival rates were 81%, 66%, 50%, and 43%, respectively. The 5-year local control rates were 87%, 79%, 71%, and 25%, respectively. With respect to T1 or 2N0M0 patients, the 5-and 10-year local control rates were 80% and 75% under 40 years old, 77% and 73% over 40 years old patients. (p=0.99) The 5-and 10-year cause-specific survival rates were 79% and 72

B. F. Skinner’s legacy twenty years after (1990-2010: Behavior analysis in Ibero-America

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Wilson M. López López

2010-01-01

Full Text Available Twenty years after his death (August 18th 1990,B. F. Skinner leaves five major living legacies: 1radical behaviorism; 2 the experimental analysis ofbehavior; 3 applied behavior analysis; 4 the Skinnerbox; 5 the Horcones community (Mexico.Behavior analysis is recognized for its internationalactive presence. Its growth provides a set of opportunitiesfor knowledge and technology transferenceand reminds us the importance of working for thedevelopment of educational and research programsand the arrangement of contingencies which enableits advance. In Ibero-America, behavior analysis, asa Skinnerian legacy, has been an important traditionwithin psychology. In this article we will presenta current synthesis of the central Ibero-Americancontributions to Behavior analysis. The panoramaof Behavior analysis in Ibero-America will beanalyzed according to the following dimensions:1 the most relevant figures; 2 the academic communityrelated to the Behavior Analytic tradition;and 3 the most important research lines. Finally,some of the most general characteristics of Ibero-American Behavior analysis are included.

Revising Payment for Ecosystem Services in the Light of Stewardship: The Need for a Legal Framework

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Alessandra Solazzo

2015-11-01

Full Text Available Since the Millennium Ecosystem Assessment (MEA highlighted the importance of ecosystem services for human well-being, the payments for such services have increasingly been drawing the attention of governments, the private sector and academia. Nonetheless, there is not yet a specific legal framework which is able to capture the complexity of managing natural resources and, at the same time, deal with the numerous drawbacks that have been identified by critics, who are opposed to using financialisation of the environment as a tool. This paper, after briefly summarizing some of the main features and criticisms of the Payment for Ecosystem Services (PES, will critically assess the understanding of property rights over natural resources as stewardship, rather than as entitlement, because this interpretation is more coherent with the inherent characteristics of natural resources and, consequently, of ecosystem services. The novel usage of a stewardship dimension to property rights underlines the necessity for a legal framework for PES, constituted by “property-liability rules”.

Review: Devan Pillay, Gilbert M. Khadiagala, Prishani Naidoo and Roger Southall (eds, New South African Review 4: A Fragile Democracy – Twenty Years On (2014

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Ian Taylor

2015-01-01

Full Text Available Review of the edited volume:Devan Pillay, Gilbert M. Khadiagala, Prishani Naidoo and Roger Southall (eds, New South African Review 4: A Fragile Democracy – Twenty Years On, Johannesburg: Wits University Press, 2014, ISBN 9781868147632, 380 pp.

Patient and public understanding and knowledge of antimicrobial resistance and stewardship in a UK hospital: should public campaigns change focus?

Science.gov (United States)

Micallef, Christianne; Kildonaviciute, Kornelija; Castro-Sánchez, Enrique; Scibor-Stepien, Aleksandra; Santos, Reem; Aliyu, Sani H; Cooke, Fiona J; Pacey, Sarah; Holmes, Alison H; Enoch, David A

2017-01-01

The rising global tide of antimicrobial resistance is a well-described phenomenon. Employing effective and innovative antimicrobial stewardship strategies is an essential approach to combat this public health threat. Education of the public and patients is paramount to enable the success of such strategies. A panel of hospital multidisciplinary healthcare professionals was set up and a short quiz containing true/false statements around antimicrobial stewardship and resistance was designed and piloted. An educational leaflet with the correct replies and supporting information was also produced and disseminated. Participants were recruited on a single day (18 November 2015) from the hospital outpatient clinics and the hospital outpatient pharmacy waiting room. One hundred and forty-five completed quizzes were returned, providing a total of 1450 answers. Overall, 934 of 1450 (64%) statements were scored correctly whilst 481 (33%) were scored incorrectly; 35 (3%) statements were left unscored. We speculate that these results may demonstrate that respondents understood the statements, as only a small proportion of statements were left unanswered. The question dealing with the definition of antimicrobial resistance and the question dealing with the definition of antimicrobial stewardship obtained the most incorrect replies (85% and 72%, respectively). However, a specific factual recall question regarding only one microorganism (MRSA) received the most correct responses (99%). We describe a simple, innovative method of engagement with patients and the general public to help educate and disseminate important public health messages around antimicrobial resistance and stewardship. We also identified the need for public health campaigns to address the knowledge gaps found around this topic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

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

Energy Technology Data Exchange (ETDEWEB)

Nelson, Jody K. [Stoller LMS Team, Contractor to the U.S. Department of Energy Office of Legacy Management, 11025 Dover Street, Suite 1000, Westminster, Colorado 80021 (United States)

2013-07-01

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

Early twenty-first-century droughts during the warmest climate

Directory of Open Access Journals (Sweden)

Felix Kogan

2016-01-01

Full Text Available The first 13 years of the twenty-first century have begun with a series of widespread, long and intensive droughts around the world. Extreme and severe-to-extreme intensity droughts covered 2%–6% and 7%–16% of the world land, respectively, affecting environment, economies and humans. These droughts reduced agricultural production, leading to food shortages, human health deterioration, poverty, regional disturbances, population migration and death. This feature article is a travelogue of the twenty-first-century global and regional droughts during the warmest years of the past 100 years. These droughts were identified and monitored with the National Oceanic and Atmospheric Administration operational space technology, called vegetation health (VH, which has the longest period of observation and provides good data quality. The VH method was used for assessment of vegetation condition or health, including drought early detection and monitoring. The VH method is based on operational satellites data estimating both land surface greenness (NDVI and thermal conditions. The twenty-first-century droughts in the USA, Russia, Australia and Horn of Africa were intensive, long, covered large areas and caused huge losses in agricultural production, which affected food security and led to food riots in some countries. This research also investigates drought dynamics presenting no definite conclusion about drought intensification or/and expansion during the time of the warmest globe.

The global wilderness seminar for government agencies: a meeting at the crossroads of wildlands stewardship

Science.gov (United States)

Nancy Roeper; Peter Landres; Don Fisher

2006-01-01

Two days before the 8th World Wilderness Congress began in Alaska, nearly 200 government wildlands managers from 17 countries met to share ideas about common challenges and to explore ways to improve wildland stewardship globally. The goal for this Global Wilderness Seminar for Government Agencies was to lay the foundation for an operating peer network of government...

Twenty-year trends in the prevalence of Down syndrome and other trisomies in Europe

DEFF Research Database (Denmark)

Loane, Maria; Morris, Joan K; Addor, Marie-Claude

2013-01-01

This study examines trends and geographical differences in total and live birth prevalence of trisomies 21, 18 and 13 with regard to increasing maternal age and prenatal diagnosis in Europe. Twenty-one population-based EUROCAT registries covering 6.1 million births between 1990 and 2009 participa...

Wegner′s granulomatosis developing for the first time in a patient eight years after starting maintenance hemodialysis

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Ahmad Ramadan Ali

2015-01-01

Full Text Available Wegener′s granulomatosis is a serious autoimmune disorder characterized by necrotizing small-vessel vasculitis. It is a multisystem disease that primarily affects the lung and kidneys. Previous studies indicated few relapses of vasculitis after hemodialysis due to uremic immunosuppression. Our case report describes an end-stage renal failure patient who had developed non-caseating lung granulomata with giant cell formation and fibrinoid necrosis of arterial media that is consistent with Wegner′s granulomatosis for the first time and eight years after initiation of maintenance hemodialysis. We believe that such a phenomenon has rarely been reported.

Fourteen-year trends in sodium content of menu offerings at eight leading fast-food restaurants in the USA.

Science.gov (United States)

Rudelt, Amanda; French, Simone; Harnack, Lisa

2014-08-01

To examine changes in the Na content of lunch/dinner menu offerings at eight of the leading fast-food restaurants in the USA between 1997/1998 and 2009/2010. Menu offerings and nutrient composition information for the menu items were obtained from archival versions of the University of Minnesota Nutrition Coordinating Center (NCC) Food and Nutrient Database. Nutrient composition information for lunch/dinner menu items sold by the fast-food restaurants included in the present study was updated in the database biannually. Menus were analysed for changes in mean Na content of all menu offerings (except beverages) and specific categories of menu items among all restaurants and for each individual restaurant. Lunch/dinner food menu of eight leading US fast-food restaurants. Between 1997/1998 and 2009/2010 the mean Na content of menu offerings across the eight restaurants increased by 23·4 %. Examining specific food categories, mean Na content of entrées by increased 17·2 % and that of condiments increased by 26·1 %. Only side dishes showed a decrease of 6·6 %. None of the restaurants examined had a decrease in Na across the lunch/dinner menu offerings over the 14 years examined. Results suggest that over the time period studied there has been no meaningful reduction in the Na content of lunch/dinner menu offerings at the leading fast-food restaurants examined in the present study.

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

Science.gov (United States)

Rogers Van Katwyk, Susan; Jones, Sara L; Hoffman, Steven J

2018-02-05

Antimicrobial resistance is an important global issue facing society. Healthcare workers need to be engaged in solving this problem, as advocates for rational antimicrobial use, stewards of sustainable effectiveness, and educators of their patients. To fulfill this role, healthcare workers need access to training and educational resources on antimicrobial resistance. To better understand the resources available to healthcare workers, we undertook a global environmental scan of educational programs and resources targeting healthcare workers on the topic of antimicrobial resistance and antimicrobial stewardship. Programs were identified through contact with key experts, web searching, and academic literature searching. We summarized programs in tabular form, including participating organizations, region, and intended audience. We developed a coding system to classify programs by program type and participating organization type, assigning multiple codes as necessary and creating summary charts for program types, organization types, and intended audience to illustrate the breadth of available resources. We identified 94 educational initiatives related to antimicrobial resistance and antimicrobial stewardship, which represent a diverse array of programs including courses, workshops, conferences, guidelines, public outreach materials, and online-resource websites. These resources were developed by a combination of government bodies, professional societies, universities, non-profit and community organizations, hospitals and healthcare centers, and insurance companies and industry. Most programs either targeted healthcare workers collectively or specifically targeted physicians. A smaller number of programs were aimed at other healthcare worker groups including pharmacists, nurses, midwives, and healthcare students. Our environmental scan shows that there are many organizations working to develop and share educational resources for healthcare workers on antimicrobial

The cost-benefit of federal investment in preventing Clostridium difficile infections through the use of a multifaceted infection control and antimicrobial stewardship program.

Science.gov (United States)

Slayton, Rachel B; Scott, R Douglas; Baggs, James; Lessa, Fernanda C; McDonald, L Clifford; Jernigan, John A

2015-06-01

To determine the potential epidemiologic and economic value of the implementation of a multifaceted Clostridium difficile infection (CDI) control program at US acute care hospitals Markov model with a 5-year time horizon Patients whose data were used in our simulations were limited to hospitalized Medicare beneficiaries ≥65 years old. CDI is an important public health problem with substantial associated morbidity, mortality, and cost. Multifaceted national prevention efforts in the United Kingdom, including antimicrobial stewardship, patient isolation, hand hygiene, environmental cleaning and disinfection, and audit, resulted in a 59% reduction in CDI cases reported from 2008 to 2012. Our analysis was conducted from the federal perspective. The intervention we modeled included the following components: antimicrobial stewardship utilizing the Antimicrobial Use and Resistance module of the National Healthcare Safety Network (NHSN), use of contact precautions, and enhanced environmental cleaning. We parameterized our model using data from CDC surveillance systems, the AHRQ Healthcare Cost and Utilization Project, and literature reviews. To address uncertainty in our parameter estimates, we conducted sensitivity analyses for intervention effectiveness and cost, expenditures by other federal partners, and discount rate. Each simulation represented a cohort of 1,000 hospitalized patients over 1,000 trials. RESULTS In our base case scenario with 50% intervention effectiveness, we estimated that 509,000 CDI cases and 82,000 CDI-attributable deaths would be prevented over a 5-year time horizon. Nationally, the cost savings across all hospitalizations would be $2.5 billion (95% credible interval: $1.2 billion to $4.0 billion). The potential benefits of a multifaceted national CDI prevention program are sizeable from the federal perspective.

Antimicrobial stewardship through telemedicine and its impact on multi-drug resistance.

Science.gov (United States)

Dos Santos, Rodrigo P; Dalmora, Camila H; Lukasewicz, Stephani A; Carvalho, Otávio; Deutschendorf, Caroline; Lima, Raquel; Leitzke, Tiago; Correa, Nilson C; Gambetta, Marcelo V

2018-01-01

Introduction Telemedicine technologies are increasingly being incorporated into infectious disease practice. We aimed to demonstrate the impact of antimicrobial stewardship through telemedicine on bacterial resistance rates. Methods We conducted a quasi-experimental study in a 220-bed hospital in southern Brazil. An antimicrobial stewardship program incorporating the use of telemedicine was implemented. Resistance and antimicrobial consumption rates were determined and analysed using a segmented regression model. Results After the intervention, the rate of appropriate antimicrobial prescription increased from 51.4% at baseline to 81.4%. Significant reductions in the consumption of fluoroquinolones (level change, β = -0.80; P change, β = -0.01; P = 0.98), first-generation cephalosporins (level change, β = -0.91; P change, β = +0.01; P = 0.96), vancomycin (level change, β = -0.47; P = 0.04; trend change, β = +0.17; P = 0.66) and polymyxins (level change, β = -0.15; P = 0.56; trend change, β = -1.75; P change, β = +0.84; P change, β = +0.14; P = 0.41) and cefuroxime (level change, β = +0.21; P = 0.17; trend change, β = +0.66; P = 0.02). A significant decrease in the rate of carbapenem-resistant Acinetobacter spp. isolation (level change, β = +0.66; P = 0.01; trend change, β = -1.26; P resistance.

Health effects following long-term exposure to thorium dusts: a twenty-year follow-up study in China

International Nuclear Information System (INIS)

Chen, X.A.; Cheng, Y.E.; Xiao, H.; Chen, L.; Yang, Y.J.; Dong, Z.H.; Zheng, R.; Feng, G.; Deng, Y.H.; Feng, Z.L.; Han, X.M.

2004-01-01

A twenty-year follow-up study was carried out at Baiyun Obo Rare-earth Iron Mine in China, This mine has been mined since 1958. Its ore contains 0.04% of ThO 2 and 10% of SiO 2 . The purpose of this study is to investigate possible health effects in dust-exposed miners following long-term exposure to thorium-containing dusts and thoron progeny. By using the negative high voltage exhaled thoron progeny measurement system to estimate the miner's thorium lung burden. The highest thorium lung burden among 1 158 measurements of 638 miners was 11.11 Bq. The incidence of stage 0 + pneumoconiosis was increased among dust-exposed miners. An epidemiological study showed that the lung cancer mortality of the dust-exposed miners was significantly (p 2 and SiO 2 ) and thoron progeny. This is the first evidence in humans of the carcinogenicity after long-term inhalation of thorium-containing dusts and thoron progeny. The total person-years of observation for the dust-exposed miners and the controls were 62 712 and 34 672 respectively. (author)

Antibiotic stewardship programs and the internist’s role

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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.

Recognizing Stewardship Practices as Indicators of Social Resilience: In Living Memorials and in a Community Garden

Science.gov (United States)

Heather McMillen; Lindsay Campbell; Erika Svendsen; Renae Reynolds

2016-01-01

Resilience theory has received increased attention from researchers across a range of disciplines who have developed frameworks and articulated categories of indicators; however, there has been less discussion of how to recognize, and therefore support, social resilience at the community level, especially in urban areas. The value of urban environmental stewardship for...

Collaboration in long-term stewardship at DOE Hanford Site-13019

International Nuclear Information System (INIS)

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

2013-01-01

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

Digital earth applications in the twenty-first century

NARCIS (Netherlands)

de By, R.A.; Georgiadou, P.Y.

2014-01-01

In these early years of the twenty-first century, we must look at how the truly cross-cutting information technology supports other innovations, and how it will fundamentally change the information positions of government, private sector and the scientific domain as well as the citizen. In those

Twenty-five years of modeling multiphase flow and heat transfer

International Nuclear Information System (INIS)

Lyczkowski, R.W.

1999-01-01

This presentation will cover some of the highlights of multiphase modeling in collaboration with Professor Dimitri Gidaspow (DG) over the last roughly twenty-five years. It all started in 1972 in Idaho Falls with Charles Solbrig, who planned and initiated a project for the former USAEC to develop a computer code to replace RELAP4 to analyze the loss of coolant accident (LOCA). DG spent his sabbatical on the project in 1973. One highlight was the discovery of complex characteristics, the implications of which are still pondered by some. Fluidization research began in 1978 when the author collaboratively developed a step-by-step building-block approach to understanding the hydrodynamics of fluidized beds, an approach closely coupled to validation experiments. A grant from the USDOE to study solids circulation around a jet in a fluidized bed was awarded to DG in 1978. Following that, grants from GRI, NSF, and a contract from Westinghouse Electric Corp. allowed the early work to continue. Progress was slow since computer costs were high. Subsequent continuing support from the USDOE, NSF, EPRI, and industry has allowed research to continue, as has his collaboration. A highlight of this collaboration was the development of the monolayer energy dissipation (MED) erosion model. Multiphase flow and fluidization theory took quantum leaps with the publication of DG's Multiphase Flow and Fluidization: Continuum and Kinetic Theory Descriptions (MFF), Academic Press, San Diego (1994), for which there is essentially no competition. Only the late Professor S.L. Soo's Particulates and Continuum: Multiphase Fluid Dynamics, Hemisphere Publishing Corp., New York (1989), a textbook version of the classic monograph Multiphase Fluid Dynamics, Science Press, Beijing, China (1990), comes close. In MFF, the kinetic theory of granular flow has evolved as a potentially viable adjunct to the continuum multiphase theory, of which fluidization is one important manifestation. It must be

Twenty years of operation of the Radioisotope Department of the 3rd Medical Clinic, Faculty of General Medicine, Charles University in Prague

International Nuclear Information System (INIS)

Kapitola, J.

1983-01-01

Twenty years ago a radioisotope department was established in the old building of the 3rd Medical Clinic in Prague 2. The department is suitably placed and meets present requirements. It was set up as part of the 3rd Medical Clinic and of the Laboratory for endocrinology and Metabolism which gave it its main orientation and scope. Its present scope is much broader. In the twenty years since it was established 115,800 examinations were carried out, some 40 examination methods were introduced, 103 publications published, members of the department were co-authors of another 113 publications, they completed 11 research projects. The production of the department represents a substantial part of laboratory material especially in the diagnosis of endocrinopathy and metabolic disorders at the Clinic and is a significant part of the material of a number of research projects. The department has significantly contributed to the development of nuclear medicine in the Czechoslovak Socialist Republic in thyroid diagnosis, by the first introduction of radioimmunoassay methods, by the introduction of certain other special examination and laboratory methods and is currently taking part in the fulfilment of tasks given by the zoning of nuclear medicine in health care in Czechoslovakia in general and in Prague in particular. (author)

Skin Infections and Antibiotic Stewardship: Analysis of Emergency Department Prescribing Practices, 2007-2010

Directory of Open Access Journals (Sweden)

Daniel J. Pallin

2014-05-01

Full Text Available Introduction: National guidelines suggest that most skin abscesses do not require antibiotics, and that cellulitis antibiotics should target streptococci, not community-associated MRSA (CA-MRSA. The objective of this study is to describe antimicrobial treatment of skin infections in U.S. emergency departments (EDs and analyze potential quality measures. Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS is a 4-stage probability sample of all non-federal U.S. ED visits. In 2007 NHAMCS started recording whether incision and drainage was performed at ED visits. We conducted a retrospective analysis, pooling 2007-2010 data, identified skin infections using diagnostic codes, and identified abscesses by performance of incision and drainage. We generated national estimates and 95% confidence intervals using weighted analyses; quantified frequencies and proportions; and evaluated antibiotic prescribing practices. We evaluated 4 parameters that might serve as quality measures of antibiotic stewardship, and present 2 of them as potentially robust enough for implementation. Results: Of all ED visits, 3.2% (95% confidence interval 3.1-3.4% were for skin infection, and 2.7% (2.6-2.9% were first visits for skin infection, with no increase over time (p=0.80. However, anti-CA-MRSA antibiotic use increased, from 61% (56-66% to 74% (71-78% of antibiotic regimens (p<0.001. Twenty-two percent of visits were for abscess, with a non-significant increase (p=0.06. Potential quality measures: Among discharged abscess patients, 87% were prescribed antibiotics (84-90%, overuse. Among antibiotic regimens for abscess patients, 84% included anti-CA-MRSA agents (81-89%, underuse. Conclusion: From 2007-2010, use of anti-CA-MRSA agents for skin infections increased significantly, despite stable visit frequencies. Antibiotics were over-used for discharged abscess cases, and CA-MRSA-active antibiotics were underused among regimens when antibiotics were used for

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

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

Directory of Open Access Journals (Sweden)

Vanessa M Adams

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

Integrating rapid diagnostics and antimicrobial stewardship improves outcomes in patients with antibiotic-resistant Gram-negative bacteremia.

Science.gov (United States)

Perez, Katherine K; Olsen, Randall J; Musick, William L; Cernoch, Patricia L; Davis, James R; Peterson, Leif E; Musser, James M

2014-09-01

An intervention for Gram-negative bloodstream infections that integrated mass spectrometry technology for rapid diagnosis with antimicrobial stewardship oversight significantly improved patient outcomes and reduced hospital costs. As antibiotic resistance rates continue to grow at an alarming speed, the current study was undertaken to assess the impact of this intervention in a challenging patient population with bloodstream infections caused by antibiotic-resistant Gram-negative bacteria. A total of 153 patients with antibiotic-resistant Gram-negative bacteremia hospitalized prior to the study intervention were compared to 112 patients treated post-implementation. Outcomes assessed included time to optimal antibiotic therapy, time to active treatment when inactive, hospital and intensive care unit length of stay, all-cause 30-day mortality, and total hospital expenditures. Integrating rapid diagnostics with antimicrobial stewardship improved time to optimal antibiotic therapy (80.9 h in the pre-intervention period versus 23.2 h in the intervention period, P Gram-negatives. The intervention decreased hospital and intensive care unit length of stay, total hospital costs, and reduced all-cause 30-day mortality. Copyright © 2014. Published by Elsevier Ltd.

Commercial NAA — Is It a Success? Evaluation of a Twenty Year Experiment

International Nuclear Information System (INIS)

Parry, S.

2013-01-01

The commercial service at Imperial College was maintained for twenty years by juggling staff, equipment and irradiation facilities, building when required and downsizing when necessary. At no point was the service entirely self-sufficient since staff had more than one role and participated in teaching and research as well as the analytical service. The balance was of benefit everyone concerned, including students who have studied with us and gained experience of working within a well maintained and quality assured laboratory. The benefits of collaborating with industry cannot be overestimated, with the secondary effects for research and teaching identified previously. A key change took place in the early 2000s, which can be seen in Figure 5 by the fall in income from 2002. The author’s academic department became a separate cost centre to the Reactor Centre, and irradiations were charged at a more realistic price. Once the true costs were built in, including space, overheads and irradiation charges, it was not possible to maintain a viable business plan without reducing staff to a non-viable number. As a result, in 2003 the analytical service was handed to the Reactor Centre, in which the business could remain viable because the irradiation charge became income not expenditure. Without the continued interactions that academic research generated, the NAA service has diminished with very few customers in the past few years. Staff are occupied with internal work for the reactor such as routine monitoring using gamma spectrometry. In summary the introduction and operation of a commercial service is to be recommended, particularly in those situations where it can complement other parts of the organisation such other analytical or academic activities. It is not practical to fund reactor operations entirely on commercial activities, but it can result in a number of spin-offs that can increase other income streams such as teaching and research projects. Over the past 28

Environmental stewardship practices of veterinary professionals and educators related to use and disposal of pharmaceuticals and personal care products.

Science.gov (United States)

Lam, Jennifer; Chan, Samuel S; Conway, Flaxen D L; Stone, David

2018-03-01

OBJECTIVE To document the environmental stewardship practices (decisions and actions regarding use and disposal) of pet and human pharmaceuticals and personal care products (PPCPs) among pet-owning veterinary-care professionals (practicing veterinarians, veterinary students, and veterinary technicians and trainees) and environmental educators. DESIGN Internet-based cross-sectional survey. SAMPLE 191 pet owners (103 veterinary-care professionals and 88 environmental educators). PROCEDURES Study participants were recruited by means of a 2-part internet survey distributed to veterinary-care professional and environmental educator networks of individuals residing in Washington state, Oregon, and southern California. Survey questions addressed motivators for environmental stewardship practices (ie, decisions and actions regarding use and disposal of pet and human PPCPs). RESULTS Data were collected from 191 respondents; the response rate for individuals who self-selected to opt in was 78% (191/246). Of the 191 respondents, 42 (22%) stored pet pharmaceuticals indefinitely. The most common disposal method was the garbage (88/191 [46%]). Veterinary-care professionals counseled clients infrequently regarding environmental stewardship practices for PPCPs. Fifty-five percent (105/191) of all respondents preferred more environmentally friendly and clinically effective PPCPs. CONCLUSIONS AND CLINICAL RELEVANCE Results of the present survey emphasized the urgent need for improved educational resources to minimize environmental contamination from improper disposal of PPCPs. Environmental and economic motivations among pet owners in the veterinary-care and education professions indicate further opportunities for outreach and institutional support.

A special issue of the Journal of Forestry - Wilderness science and its role in wilderness stewardship

Science.gov (United States)

Susan F. Fox

2016-01-01

This special issue of the Journal of Forestry provides an overview of America’s National Wilderness Preservation System and highlights the important role that science serves in informing wilderness stewardship. The lead authors of the articles in this volume selected the Journal because it is highly respected and widely circulated among foresters and federal...

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

Science.gov (United States)

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

2010-01-01

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

Assessing the distribution of environmental stewardship organizations and their relationship to the demographics of Los Angeles County

Science.gov (United States)

Krystle M. Golly

2017-01-01

An equal distribution of environmental stewardship organizations across the urban landscape provides an environment that facilitates community empowerment. The systemic issues found in Los Angeles County play an important role in the social development of the area. Through the utilization of modern technology and geographical mapping software, spatial distribution of...

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship-Quasi-Experimental Designs.

Science.gov (United States)

Schweizer, Marin L; Braun, Barbara I; Milstone, Aaron M

2016-10-01

Quasi-experimental studies evaluate the association between an intervention and an outcome using experiments in which the intervention is not randomly assigned. Quasi-experimental studies are often used to evaluate rapid responses to outbreaks or other patient safety problems requiring prompt, nonrandomized interventions. Quasi-experimental studies can be categorized into 3 major types: interrupted time-series designs, designs with control groups, and designs without control groups. This methods paper highlights key considerations for quasi-experimental studies in healthcare epidemiology and antimicrobial stewardship, including study design and analytic approaches to avoid selection bias and other common pitfalls of quasi-experimental studies. Infect Control Hosp Epidemiol 2016;1-6.

EBR-II: twenty years of operating experience

International Nuclear Information System (INIS)

Lentz, G.L.; Buschman, H.W.; Smith, R.N.

1985-01-01

Experimental Breeder Reactor No. 2 (EBR-II) is an unmoderated, sodium-cooled reactor with a design power of 62.5 MWt. For the last 20 years EBR-II has operated safely, has demonstrated stable operating characteristics, has shown excellent performance of its sodium components, and has had an excellent plant factor. These years of operating experience provide a valuable resource to the nuclear community for the development and design of future liquid metal fast reactors. This report provides a brief description of the EBR-II plant and its early operating experience, describes some recent problems of interest to the nuclear community, and also mentions some of the significant operating achievements of EBR-II. Finally, a few words and speculations on EBR-II's future are offered. 4 figs., 1 tab

Twenty years of meta-analyses in orthopaedic surgery: has quality kept up with quantity?

Science.gov (United States)

Dijkman, Bernadette G; Abouali, Jihad A K; Kooistra, Bauke W; Conter, Henry J; Poolman, Rudolf W; Kulkarni, Abhaya V; Tornetta, Paul; Bhandari, Mohit

2010-01-01

As the number of studies in the literature is increasing, orthopaedic surgeons highly depend on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedics-related topics over time. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969 to 1999. A search of electronic databases (MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators independently assessed the quality of the studies, using the Oxman and Guyatt index, and abstracted relevant data. We included forty-five and forty-four meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased fivefold from 1999 to 2008, the mean quality score did not change significantly over time (p = 0.067). In the later years, a significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared with meta-analyses published prior to 2000 (88%) (p = 0.006). In 2005 and 2008, respectively, 18% and 30% of the meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions used and described appropriate criteria for the validity assessment less often than did those with negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Although the methodological quality of orthopaedic meta-analyses has increased in the past twenty years, a substantial proportion continues to show major to extensive flaws. As the number of published meta-analyses is increasing, a routine checklist for

Exploring the Relationship between Participation in a Structured Sports Program and Development of Gross Motor Skills in Children Ages 3 to 6 Years

Science.gov (United States)

Jahagirdar, Ishanee; Venditti, Laura Anne; Duncan, Andrea; Reed, Nick; Fleming, Sean

2017-01-01

This study looked at the relationship between participation in a structured sports program and gross-motor-skills development in children aged 3 to 6 years. Twenty-seven children participated in the study, with 16 children receiving an eight-week sports program intervention. Children were assessed at pre- and postintervention using a modified…

Draft Programmatic Environmental Impact Statement for Stockpile Stewardship and Management: Volume 3, Appendix I, Appendix J, Appendix K

International Nuclear Information System (INIS)

1996-02-01

In response to the end of the Cold War and changes in the world's political regimes, United States is no longer producing new nuclear weapons. Instead, the US nuclear weapons program is reducing the size of the nuclear stockpile by dismantling existing weapons. DOE has been directed to maintain the safety and reliability of the reduced nuclear weapons stockpile in the absence of underground testing. Therefore, DOE has developed a stewardship and management program to provide a single highly integrated technical program. The stockpile stewardship portion of the PEIS evaluates the potential impacts of three proposed facilities: the National Ignition Facility, the Contained Firing facility, and the Atlas Facility. This volume contains appendices for these 3 facilities; alternatives affecting LANL, LLNL, SNL, and NTS are addressed. Impacts on land resources, site infrastructure, air qualaity, water resources, geology and soils, biotic resources, cultural resources, etc., are evaluated. This PEIS presents unclassified information only

The Effect of Eight Weeks Plyometric Training on Anaerobic Power, Counter Movement Jumping and Isokinetic Strength in 15-18 Years Basketball Players

Science.gov (United States)

Adigüzel, Niyazi Sidki; Günay, Mehmet

2016-01-01

The purpose of this study was to investigate the effect of eight weeks plyometric training on anaerobic power, counter movement jumping and isokinetic strength in 15-18 years aged basketball players. This study was including 30 male Basketball players. The subjects were divided into two groups as: the experimental group (n = 15) and the control…

Ten Years, Twenty Issues, and Two Hundred Papers of Numeracy: Toward International Reach and Transdisciplinary Utility

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H.L. Vacher

2017-07-01

Full Text Available This issue completes the first ten years of Numeracy. The purpose of this introductory editorial is to review what has happened to the journal in those ten years. In the twenty issues, Numeracy’s output has been 201 papers counting the one or two editorials per issue. More than 50% of the papers are full, peer-reviewed articles, including 13 papers in two theme collections. The others are peer-reviewed notes and perspectives, editor-reviewed book reviews (15% of the total, and a column by contributing co-editor, Dorothy Wallace. The current issue marks an upswing in the number of notes, and our first discussion/reply. The number of papers per year has been increasing (e.g., 66% more in the last three years than in the first three years. The download rate has increased from about 5,000 in the first two years to 5,000 in about 40 days now. The editorial goes on to document two main outcomes. First, the journal is gaining an international reach: more than half the downloads occur outside the United States now, and the number of contributions from outside the United States has increased from 4 in the first five years to 15 in the second five years. Second, the across-the-curriculum nature of quantitative literacy is coming to the fore. The transdisciplinarity of QL is strikingly evident in this issue, which is discussed in some detail, especially how it conforms to the mission of the Association of American Colleges and Universities. The editorial ends with some results from a small ad hoc study of Google Scholar Citation Profiles. The question was, of the profiles that used “numeracy” or “quantitative literacy” as keywords, what other keywords did those profiles use, and what were the source countries? The results show that (1 QL is very much an American term, (2 there is, metaphorically, a vast and interesting numeracy ecosystem out there for Numeracy to engage and serve, and (3 as we become more global, the transdisciplinary relevance

Cancer epidemiology from Guayaquil city, years 1990-2000

International Nuclear Information System (INIS)

Arreaga, Carlos; Paulson, Guillermo; Ceballos, Francisco; Grijalva, Peter; Rhor, Alba

2003-01-01

All sites cancer is in increase in Guayaquil, Ecuador, while the expectations of life when being born they go improving and being infectious contagious illnesses controlled continue adult it will be the increase the cancer like illness causing morbidity and death, in the year 2000 according to official publications the National Institute Statistical and Censuses (INEC) there were 56.420 deaths for different causes, 56.7% corresponded to masculine sex and 43.3% to feminine sex. All registered deaths in Ecuador during the year 2000, 10% corresponded to cancer in men and 14% was in women. According world statistical information it is calculated that in next twenty years, on the world population eight thousand millions inhabitants, annually twenty millions will appear new cancer cases, which twelve millions for this cause will die. For our cancer registry, of Guayaquil city, taking figures published in the periods 1990-2000, the numbers give annual incident cases they have had an increment in men 21% and in women 15%. The reason man/woman has stayed stable 0.6/1, that is to say the woman has more probability to suffer some type cancer that the man and this is due to the great impact gynecological carcinoma. (The author)

Collaboration in Long-Term Stewardship at DOE's Hanford Site - 13019

Energy Technology Data Exchange (ETDEWEB)

Moren, Rick; Brown, David [Mission Support Alliance, LLC, Richland, WA (United States); Feist, Ella [Washington Closure Hanford, LLC, Richland WA (United States); Grindstaff, Keith; Zeisloft, Jamie [US Department of Energy, Richland Operations, Richland WA (United States)

2013-07-01

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

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

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship – Quasi-Experimental Designs

Science.gov (United States)

Schweizer, Marin L.; Braun, Barbara I.; Milstone, Aaron M.

2016-01-01

Quasi-experimental studies evaluate the association between an intervention and an outcome using experiments in which the intervention is not randomly assigned. Quasi-experimental studies are often used to evaluate rapid responses to outbreaks or other patient safety problems requiring prompt non-randomized interventions. Quasi-experimental studies can be categorized into three major types: interrupted time series designs, designs with control groups, and designs without control groups. This methods paper highlights key considerations for quasi-experimental studies in healthcare epidemiology and antimicrobial stewardship including study design and analytic approaches to avoid selection bias and other common pitfalls of quasi-experimental studies. PMID:27267457

Twenty-Five Years of Gene Therapy for ADA-SCID: From Bubble Babies to an Approved Drug.

Science.gov (United States)

Ferrua, Francesca; Aiuti, Alessandro

2017-11-01

Twenty-five years have passed since first attempts of gene therapy (GT) in children affected by severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) defect, also known by the general public as bubble babies. ADA-SCID is fatal early in life if untreated. Unconditioned hematopoietic stem cell (HSC) transplant from matched sibling donor represents a curative treatment but is available for few patients. Enzyme replacement therapy can be life-saving, but its chronic use has many drawbacks. This review summarizes the history of ADA-SCID GT over the last 25 years, starting from first pioneering studies in the early 1990s using gamma-retroviral vectors, based on multiple infusions of genetically corrected autologous peripheral blood lymphocytes. HSC represented the ideal target for gene correction to guarantee production of engineered multi-lineage progeny, but it required a decade to achieve therapeutic benefit with this approach. Introduction of low-intensity conditioning represented a crucial step in achieving stable gene-corrected HSC engraftment and therapeutic levels of ADA-expressing cells. Recent clinical trials demonstrated that gamma-retroviral GT for ADA-SCID has a favorable safety profile and is effective in restoring normal purine metabolism and immune functions in patients >13 years after treatment. No abnormal clonal proliferation or leukemia development have been observed in >40 patients treated experimentally in five different centers worldwide. In 2016, the medicinal product Strimvelis™ received marketing approval in Europe for patients affected by ADA-SCID without a suitable human leukocyte antigen-matched related donor. Positive safety and efficacy results have been obtained in GT clinical trials using lentiviral vectors encoding ADA. The results obtained in last 25 years in ADA-SCID GT development fundamentally contributed to improve patients' prognosis, together with earlier diagnosis thanks to newborn screening. These advances

Implementation of a Mobile Clinical Decision Support Application to Augment Local Antimicrobial Stewardship.

Science.gov (United States)

Hoff, Brian M; Ford, Diana C; Ince, Dilek; Ernst, Erika J; Livorsi, Daniel J; Heintz, Brett H; Masse, Vincent; Brownlee, Michael J; Ford, Bradley A

2018-01-01

Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.

Career patterns : A twenty-year panel study

NARCIS (Netherlands)

Biemann, Torsten; Zacher, Hannes; Feldman, Daniel C.

2012-01-01

Using 20 years of employment and job mobility data from a representative German sample (N=1259), we employ optimal matching analysis (OMA) to identify six career patterns which deviate from the traditional career path of long-term, full-time employment in one organization. Then, in further analyses,

Twenty years of chemistry associated with the needs and utilization of nuclear reactors at the 'Boris Kidric' Institute of nuclear sciences, Vinca, Yugoslavia

International Nuclear Information System (INIS)

1969-01-01

This publication covers nine review papers on the following topics related to the needs and utilization of nuclear reactors in the Boris Kidric Institute of nuclear sciences during previous twenty years: radiochemistry, hot atom chemistry, isotope production, spent nuclear fuel reprocessing, chemistry of transuranium elements; liquid radioactive waste processing, purification of reactor coolant water by inorganic ion exchangers, research related to deuterium concentration processes, and chemical dosimetry at the RA reactor [sr

Twenty years of radiation sterilization in Croatia

Science.gov (United States)

Ražem, Dus̆an

2004-09-01

The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m 3 kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m 3 kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made.

Twenty years of radiation sterilization in Croatia

International Nuclear Information System (INIS)

Razem, Dusan

2004-01-01

The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m 3 kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m 3 kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made

Twenty years of radiation sterilization in Croatia

Energy Technology Data Exchange (ETDEWEB)

Razem, Dusan E-mail: razem@irb.hr

2004-10-01

The development of radiation processing in Croatia is described from its inception 20 years ago up to the present time. Annual throughputs of treated materials are given by the categories of materials and pertaining volumes. The pasteurization of hard gelatine capsules occured during the early stages, while sterilization of disposable medical supplies has been dominant in the later stages. Irradiation of foods and of cosmetics and toiletries has been a minor fraction of the total throughput. Since the recovery of everyday life and economy of the country after the war, the total throughput has increased steadily to reach 13,000 m{sup 3} kGy in 2002, 90% of which are medical supplies. Estimates of the present maximum capacity of 30,000 m{sup 3} kGy and of future needs indicate that the present rate of growth could be sustained for the next several years only, unless a major upgrading is undertaken. An estimate of potential future needs is made.

Training should be the first step toward an antifungal stewardship program.

Science.gov (United States)

Valerio, Maricela; Muñoz, Patricia; Rodríguez-González, Carmen; Sanjurjo, María; Guinea, Jesús; Bouza, Emilio

2015-04-01

The frequency of use of systemic antifungal agents has increased significantly in most tertiary centers. However, antifungal stewardship has received very little attention. The objective of this article was to assess the knowledge of prescribing physicians in our institution as a first step in the development of an antifungal stewardship program. Attending physicians from the departments that prescribe most antifungals were invited to complete a questionnaire based on current guidelines on diagnosis and therapy of invasive candidiasis and invasive aspergillosis (IA). The survey was completed by 60.8% (200/329) of the physicians who were invited to participate. The physicians belonged to the following departments: medical (60%), pediatric (19%), intensive care (15.5%), and surgical (5.5%). The mean (±SD) score of correct responses was 5.16±1.73. In the case of candidiasis, only 55% of the physicians clearly distinguished between colonization and infection, and 17.5% knew the local rate of fluconazole resistance. Thirty-three percent knew the accepted indications for antifungal prophylaxis, and 23% the indications for empirical therapy. However, most physicians knew which antifungals to choose when starting empirical therapy (73.5%). As for aspergillosis, most physicians (67%) could differentiate between colonization and infection, and 34.5% knew the diagnostic value of galactomannan. The radiological features of IA were well recognized by 64%, but only 31.5% were aware of the first line of treatment for IA, and 36% of the recommended duration of therapy. The usefulness of antifungal levels was known by 67%. This simple, easily completed questionnaire enabled us to identify which areas of our training strategy could be improved. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Impact of the PROVAUR stewardship programme on linezolid resistance in a tertiary university hospital: a before-and-after interventional study.

Science.gov (United States)

García-Martínez, Lucrecia; Gracia-Ahulfinger, Irene; Machuca, Isabel; Cantisán, Sara; De La Fuente, Soraya; Natera, Clara; Pérez-Nadales, Elena; Vidal, Elisa; Rivero, Antonio; Rodríguez-Lopez, Fernando; Del Prado, José Ramón; Torre-Cisneros, Julián

2016-09-01

There is little evidence of the impact of antimicrobial stewardship programmes on antimicrobial resistance. To study the efficacy and safety of a package of educational and interventional measures to optimize linezolid use and its impact on bacterial resistance. A quasi-experimental study was designed and carried out before and after implementation of a stewardship programme in hospitalized patients with Gram-positive infections treated with linezolid. The intervention reduced linezolid consumption by 76%. The risk of linezolid-resistant CoNS isolates (OR = 0.37; 95% CI = 0.27-0.49; P linezolid use can contribute to reducing the resistance rate of CoNS and E. faecalis to this antibiotic. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Prevalence of trachoma in the Kayes region of Mali eight years after stopping mass drug administration.

Science.gov (United States)

Traoré, Lamine; Dembele, Benoit; Keita, Modibo; Reid, Steven D; Dembéle, Mahamadou; Mariko, Bréhima; Coulibaly, Famolo; Goldman, Whitney; Traoré, Dramane; Coulibaly, Daouda; Guindo, Boubacar; Amon, Joseph J; Knieriemen, Marily; Zhang, Yaobi

2018-02-01

In 2009, three years after stopping mass treatment with azithromycin, a trachoma impact survey in four health districts in the Kayes region of Mali found a prevalence of trachomatous inflammation-follicular (TF) among children aged 1 to 9 years of >5% and a trachomatous trichiasis (TT) prevalence within the general population (≥1-year-old) of <1%. As a result, the government's national trachoma program expanded trichiasis surgery and related activities required to achieve trachoma elimination. In 2015, to assess progress towards elimination, a follow-up impact survey was conducted in the Kayes, Kéniéba, Nioro and Yélimané health districts. The survey used district level two-stage cluster random sampling methodology with 20 clusters of 30 households in each evaluation unit. Subjects were eligible for examination if they were ≥1 year. TF and TT cases were identified and confirmed by experienced ophthalmologists. In total 14,159 people were enumerated and 11,620 (82%) were examined. TF prevalence (95% confidence interval (CI)) was 0.5% (0.3-1%) in Kayes, 0.8% (0.4-1.7%) in Kéniéba, 0.2% (0-0.9%) in Nioro and 0.3% (0.1-1%) in Yélimané. TT prevalence (95% CI) was 0.04% (0-0.25%) in Kayes, 0.29% (0.11-0.6%) in Kéniéba, 0.04% (0-0.25%) in Nioro and 0.07% (0-0.27%) in Yélimané. Eight years after stopping MDA and intensifying trichiasis surgery outreach campaigns, all four districts reached the TF elimination threshold of <5% and three of four districts reached the TT elimination threshold of <0.1%.

Participatory action research in antimicrobial stewardship: a novel approach to improving antimicrobial prescribing in hospitals and long-term care facilities

NARCIS (Netherlands)

van Buul, L.W.; Sikkens, J.J.; van Agtmael, M.A.; Kramer, M.H.H.; van der Steen, J.T.; Hertogh, C.M.P.M.

2014-01-01

It is challenging to change physicians' antimicrobial prescribing behaviour. Although antimicrobial prescribing is determined by contextual (e.g. a lack of guidelines), cultural (e.g. peer practice) and behavioural (e.g. perceived decision making autonomy) factors, most antimicrobial stewardship

Social cognitions about food choice in children aged five to eight years: Feasibility and predictive validity of an age appropriate measurement.

Science.gov (United States)

Fernandes-Machado, Sandra; Gellert, Paul; Goncalves, Sonia; Sniehotta, Falko F; Araujo-Soares, Vera

2016-10-01

There are currently no instruments available to measure social cognitions towards food choice in children. This study aimed to test the feasibility and predictive validity of a novel measurement tool to assess food-related social cognitions. Sixty-eight children, five to eight years old, were asked to sort cards with photographs of four fruit and four sweet/savoury snacks as a mean to measure attitudes, subjective norms, perceived behavioural control (PBC), and intention. Subsequently, food choice (dependent variable) was assessed using a laboratory food choice task in which children could gain access to sweet and savoury or fruit items, or a combination. All participants completed the tasks successfully, demonstrating feasibility of the procedure. The order in which the cards were sorted for each construct differed sufficiently and correlations between constructs were in line with previous studies. Measures of PBC, intention, attitude, and subjective norm from the mother, but not from teachers or friends, correlated significantly with subsequent food choice. It is possible to measure food-related social cognitions in children aged five to eight and these measures were predictive of observed behaviour. The new instrument can contribute to our understanding of psychological determinants of food choice in young children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Career Patterns: A Twenty-Year Panel Study

Science.gov (United States)

Biemann, Torsten; Zacher, Hannes; Feldman, Daniel C.

2012-01-01

Using 20years of employment and job mobility data from a representative German sample (N = 1259), we employ optimal matching analysis (OMA) to identify six career patterns which deviate from the traditional career path of long-term, full-time employment in one organization. Then, in further analyses, we examine which socio-demographic predictors…

Twenty-first century learning in schools: A case study of New Technology High School in Napa, California.

Science.gov (United States)

Pearlman, Bob

2006-01-01

The most pertinent question concerning teaching and learning in the twenty-first century is not what knowledge and skills students need--that laundry list was identified over a decade ago--but rather how to foster twenty-first century learning. What curricula, experiences, assessments, environments, and technology best support twenty-first century learning? New Technology High School (NTHS) in Napa, California, is one example of a successful twenty-first century school. In this chapter, the author describes the components of this exemplary high school, illustrating an environment that will cultivate twenty-first century student learning. New Technology High School began by defining eight learning outcomes, aligned with the standards of the Partnership for 21st Century Skills; to graduate, students demonstrate mastery of these outcomes through an online portfolio. To help students achieve the outcomes, NTHS employs project- and problem-based learning. Whereas in traditional classrooms students work alone on short-term assignments that do not lend themselves to deep understanding, the project-based learning approach has students working in teams on long-term, in-depth, rigorous projects. Students' work is supported by the school's workplace-like environment and effectiv use of technology. Meaningful assessment is essential to project-based learning; students receive continuous feedback, helping them become self-directed learners. In fact, NTHS uses outcome-based grading through which students constantly know how they are performing on the twenty-first century outcomes. Research has shown that NTHS graduates are better prepared for postsecondary education, careers, and citizenship than their peers from other schools. To facilitate twenty-first century learning, all schools need to rethink their approach to teaching and learning. New Technology High School is one way to do so.

Why the American public supports twenty-first century learning.

Science.gov (United States)

Sacconaghi, Michele

2006-01-01

Aware that constituent support is essential to any educational endeavor, the AOL Time Warner Foundation (now the Time Warner Foundation), in conjunction with two respected national research firms, measured Americans' attitudes toward the implementation of twenty-first century skills. The foundation's national research survey was intended to explore public perceptions of the need for changes in the educational system, in school and after school, with respect to the teaching of twenty-first century skills. The author summarizes the findings of the survey, which were released by the foundation in June 2003. One thousand adults were surveyed by telephone, including African Americans, Latinos, teachers, and business executives. In general, the survey found that Americans believe today's students need a "basics-plus" education, meaning communication, technology, and critical thinking skills in addition to the traditional basics of reading, writing, and math. In fact, 92 percent of respondents stated that students today need different skills from those of ten to twenty years ago. Also, after-school programs were found to be an appropriate vehicle to teach these skills. Furthermore, the survey explored how well the public perceives schools to be preparing youth for the workforce and postsecondary education, which twenty-first century skills are seen as being taught effectively, and the level of need for after-school and summer programs. The survey results provide conclusive evidence of national support for basics-plus education. Thus, a clear opportunity exists to build momentum for a new model of education for the twenty-first century.

Twenty years of artificial directional selection have shaped the genome of the Italian Large White pig breed.

Science.gov (United States)

Schiavo, G; Galimberti, G; Calò, D G; Samorè, A B; Bertolini, F; Russo, V; Gallo, M; Buttazzoni, L; Fontanesi, L

2016-04-01

In this study, we investigated at the genome-wide level if 20 years of artificial directional selection based on boar genetic evaluation obtained with a classical BLUP animal model shaped the genome of the Italian Large White pig breed. The most influential boars of this breed (n = 192), born from 1992 (the beginning of the selection program of this breed) to 2012, with an estimated breeding value reliability of >0.85, were genotyped with the Illumina Porcine SNP60 BeadChip. After grouping the boars in eight classes according to their year of birth, filtered single nucleotide polymorphisms (SNPs) were used to evaluate the effects of time on genotype frequency changes using multinomial logistic regression models. Of these markers, 493 had a PBonferroni  selection program. The obtained results indicated that the genome of the Italian Large White pigs was shaped by a directional selection program derived by the application of methodologies assuming the infinitesimal model that captured a continuous trend of allele frequency changes in the boar population. © 2015 Stichting International Foundation for Animal Genetics.

Magnetic resonance imaging of the wrist in rheumatoid arthritis: demonstration of progression between 1 and 6 years

Energy Technology Data Exchange (ETDEWEB)

Stewart, Neal R. [Auckland Hospital, Department of Radiology, Private Bag 92024, Auckland (New Zealand); Auckland Radiology Group, Auckland (New Zealand); Crabbe, Jeffrey P. [Auckland Radiology Group, Auckland (New Zealand); McQueen, Fiona M. [Auckland Hospital, Department of Rheumatology, Auckland (New Zealand)

2004-12-01

To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years. A cohort of patients with RA has been studied prospectively from symptom onset. MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis. Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients. MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA. (orig.)

Magnetic resonance imaging of the wrist in rheumatoid arthritis: demonstration of progression between 1 and 6 years

International Nuclear Information System (INIS)

Stewart, Neal R.; Crabbe, Jeffrey P.; McQueen, Fiona M.

2004-01-01

To describe the changes seen in the wrist in rheumatoid arthritis (RA) on magnetic resonance (MR) imaging obtained at 1 year and 6 years. A cohort of patients with RA has been studied prospectively from symptom onset. MR scans of the dominant wrist in 31 patients obtained at 1 year and 6 years were compared for bone erosions, marrow signal change (oedema), synovial thickness and tenosynovitis. Twenty-two patients had an increase in erosion score in the interval and three patients showed a decrease in erosion score suggesting erosion healing. Fourteen patients had an increase in oedema score in the interval and eight patients had a decrease in oedema score. Synovial thickness increased in 13 patients and decreased in eight. Tenosynovitis increased in 15 patients and decreased in five. Bone erosions developed immediately adjacent to the tenosynovitis in two patients. MR imaging is useful in following the progress of bone erosions, marrow oedema, synovitis and tenosynovitis in RA. (orig.)

Shifts in soil bacterial community after eight years of land-use change.

Science.gov (United States)

Suleiman, Afnan Khalil Ahmad; Manoeli, Lupatini; Boldo, Juliano Tomazzoni; Pereira, Marcos G; Roesch, Luiz Fernando Wurdig

2013-03-01

The interaction between plants, soil and microorganisms is considered to be the major driver of ecosystem functions and any modification of plant cover and/or soil properties might affect the microbial structure, which, in turn, will influence ecological processes. Assuming that soil properties are the major drivers of soil bacterial diversity and structure within the same soil type, it can be postulated whether plant cover causes significant shifts in soil bacterial community composition. To address this question, this study used 16S rRNA pyrosequencing to detect differences in diversity, composition and/or relative abundance of bacterial taxa from an area covered by pristine forest, as well as eight-year-old grassland surrounded by the same forest. It was shown that a total of 69% of the operational taxonomic units (OTUs) were shared between environments. Overall, forest and grassland samples presented the same diversity and the clustering analysis did not show the occurrence of very distinctive bacterial communities between environments. However, 11 OTUs were detected in statistically significant higher abundance in the forest samples but in lower abundance in the grassland samples, whereas 12 OTUs occurred in statistically significant higher abundance in the grassland samples but in lower abundance in the forest samples. The results suggested the prevalence of a resilient core microbial community that did not suffer any change related to land use, soil type or edaphic conditions. The results illustrated that the history of land use might influence present-day community structure. Copyright © 2012 Elsevier GmbH. All rights reserved.

Emergence of Global Adaptive Governance for Stewardship of Regional Marine Resources

Directory of Open Access Journals (Sweden)

Henrik Österblom

2013-06-01

Full Text Available Overfishing has historically caused widespread stock collapses in the Southern Ocean. Until recently, illegal, unreported, and unregulated (IUU fishing threatened to result in the collapse of some of the few remaining valuable fish stocks in the region and vulnerable seabird populations. Currently, this unsustainable fishing has been reduced to less than 10% of former levels. We describe and analyze the emergence of the social-ecological governance system that made it possible to curb the fisheries crisis. For this purpose, we investigated the interplay between actors, social networks, organizations, and institutions in relation to environmental outcomes. We drew on a diversity of methods, including qualitative interviews, quantitative social network and survey data, and literature reviews. We found that the crisis triggered action of an informal group of actors over time, which led to a new organization (ISOFISH that connected two independent networks (nongovermental organizations and the fishing industry, and later (COLTO linked to an international body and convention (CCAMLR. The emergence of the global adaptive governance systems for stewardship of a regional marine resource took place over a 15-year period. We describe in detail the emergence process and illustrate the usefulness of analyzing four features of governance and understanding social-ecological processes, thereby describing structures and functions, and their link to tangible environmental outcomes.

Isolation and characterization of eight polymorphic microsatellites for the spotted spiny lobster, Panulirus guttatus

Directory of Open Access Journals (Sweden)

Nathan Truelove

2016-01-01

Full Text Available Microsatellite sequences were isolated from enriched genomic libraries of the spotted spiny lobster, Panulirus guttatus using 454 pyrosequencing. Twenty-nine previously developed polymerase chain reaction primer pairs of Panulirus argus microsatellite loci were also tested for cross-species amplification in Panulirus guttatus. In total, eight consistently amplifying, and polymorphic loci were characterized for 57 individuals collected in the Florida Keys and Bermuda. The number of alleles per locus ranged from 8 to 20 and observed heterozygosities ranged from 0.409 to 0.958. Significant deviations from Hardy–Weinberg equilibrium were found in one locus from Florida and three loci from Bermuda. Quality control testing indicated that all loci were easy to score, highly polymorphic and showed no evidence of linkage disequilibrium. Null alleles were detected in three loci with moderate frequencies ranging from (20% to 22%. These eight microsatellites provide novel molecular markers for future conservation genetics research of P. guttatus.

Increased Prevalence of Dental Fluorosis after Twenty Years

DEFF Research Database (Denmark)

Richards, Alan; Larsen, Mogens Joost; Maare, L.

2006-01-01

tooth types in children born and reared in an area with drinking water with (regularly monitored, naturally-occurring) fluoride concentrations of 1 ppm and compare with data recorded for a similar group of children examined in the same way and residing in the same area 20 years ago. Methods: Dental...... children, of similar ages, examined in the same area in 1984. Results: The prevalence and severity of fluorosis varied between tooth types so that the later in childhood the teeth are mineralized the higher the prevalence of dental fluorosis. When the data were compared to those collected 20 years...... in the (later formed) premolars and second molars. Conclusions: A significant increase in fluorosis prevalence has occurred over the last 20 years due to increased fluoride exposure of pre-school children. These findings may be explained by increased use of fluoride toothpaste by this age group from...

The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

NARCIS (Netherlands)

Sartelli, M.; Labricciosa, F.M.; Barbadoro, P.; Pagani, L.; Ansaloni, L.; Brink, A.J.; Carlet, J.; Khanna, A.; Chichom-Mefire, A.; Coccolini, F.; Saverio, S. Di; May, A.K.; Viale, P.; Watkins, R.R.; Scudeller, L.; Abbo, L.M.; Abu-Zidan, F.M.; Adesunkanmi, A.K.; Al-Dahir, S.; Al-Hasan, M.N.; Alis, H.; Alves, C.; Araujo da Silva, A.R.; Augustin, G.; Bala, M.; Barie, P.S.; Beltran, M.A.; Bhangu, A.; Bouchra, B.; Brecher, S.M.; Cainzos, M.A.; Camacho-Ortiz, A.; Catani, M.; Chandy, S.J.; Jusoh, A.C.; Cherry-Bukowiec, J.R.; Chiara, O.; Colak, E.; Cornely, O.A.; Cui, Y.; Demetrashvili, Z.; Simone, B. De; Waele, J.J. De; Dhingra, S.; Marzo, F. Di; Dogjani, A.; Dorj, G.; Dortet, L.; Duane, T.M.; Elmangory, M.M.; Enani, M.A.; Ferrada, P.; Esteban Foianini, J.; Gachabayov, M.; Gandhi, C.; Ghnnam, W.M.; Giamarellou, H.; Gkiokas, G.; Gomi, H.; Goranovic, T.; Griffiths, E.A.; Guerra Gronerth, R.I.; Haidamus Monteiro, J.C.; Hardcastle, T.C.; Hecker, A.; Hodonou, A.M.; Ioannidis, O.; Isik, A.; Iskandar, K.A.; Kafil, H.S.; Kanj, S.S.; Kaplan, L.J.; Kapoor, G.; Karamarkovic, A.R.; Kenig, J.; Kerschaever, I.; Khamis, F.; Khokha, V.; Kiguba, R.; Kim, H.B.; Ko, W.C.; Koike, K.; Kozlovska, I.; Kumar, A.; Lagunes, L.; Latifi, R.; Lee, J.G.; Lee, Y.R.; Leppaniemi, A.; Li, Y.; Liang, S.Y.; Lowman, W.; Machain, G.M.; Maegele, M.; Major, P.; Malama, S.; Manzano-Nunez, R.; Marinis, A.; Casas, I.; Goor, H. van; Zuidema, W.P.; Catena, F.

2017-01-01

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on

Sustainable Stewardship of the Landrace Diversity

Directory of Open Access Journals (Sweden)

Ioannis Tokatlidis

2016-12-01

Full Text Available Landraces are heterogeneous populations and their variability goes through continuous alterations because of physical, genetic, and epigenetic procedures exacerbated by the ongoing climatic changes. Appropriate stewardship of landrace diversity is pivotal to promote its longevity in a manner that is sustainable from the farming perspective. A seed multiplication procedure is presented based on the assumption that in order to improve effectiveness in resource use and increase seed productivity, landraces should comprise genotypes which minimize intra-species competition. These aforementioned genotypes should be of the “weak competitor” ideotype, which are selected so as to alleviate the interplant competition and reach as high as possible crop stand uniformity. Stand uniformity is essential to ensure the same growing conditions for each plant. Reduced intra-crop inequality and equal use of inputs by individual plants will optimize crop performance. Precisely, the “weak competitor” is most often of high yield potential due to a negative association between yielding and competitive ability. Therefore, the suggested procedure involves initial reproduction at nil-competition (widely spaced plants to preclude any plant-to-plant interference for inputs where “off-type” and low yielding plants are omitted, followed by subsequent multiplication at dense stands. This may represent an effective cultural practice to improve also the landrace health status concerning seed-borne diseases in the absence of certification systems.

Five Years of IT Management Improvement Eight Cases from the Master of IT Management

CERN Document Server

De Mari, G

2009-01-01

Displays the results of a handful of graduates of the postgraduate Master of IT Management at TU Delft. This title presents summaries of eight these written between 2003 and 2008, selected to provide a picture of a range of graduation projects

The effect of eight weeks endurance training and high-fat diet on appetite-regulating hormones in rat plasma

Directory of Open Access Journals (Sweden)

Rouhollah Haghshenas

2014-04-01

Full Text Available Objective(s:Consumption of high-fat foods is one of the major causes of obesity. Physical exercise is a strategy used to counteract obesity. The aim of this study was to investigate the effect of eight weeks endurance training and high-fat diet (HFD on appetite-regulating hormones in rat plasma. Materials and Methods:Twenty eight male Wistar rats were randomly divided into four groups: Control group with standard diet (CSD, endurance training with a standard diet (ESD, control group with high-fat diet (CHFD and endurance training with high-fat diet (EHFD. Twenty-four hr after the last training session, the blood samples were obtained and analyzed for hormones levels. Results: The significant increased weight gain and food intake and decreased plasma nesfatin-1 and PYY3-36 levels were observed in CHFD group, while exercise under the HFD antagonized these effects. There were no significant changes in ghrelin, insulin and leptin levels in different groups. Conclusion: These results suggest that exercise can prevent fattening effect of HFD. Probably, performing exercise makes a reduction of food intake and weight gain in rat via the increase in nesfatin-1 and PYY levels. However, further studies are necessary to understand the exact mechanisms involved in this field.

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

Science.gov (United States)

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

Networked governance and the management of ecosystem services: The case of urban environmental stewardship in New York City

Science.gov (United States)

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

2014-01-01

Urban environmental stewardship groups have become an essential component of the governance structure that regulates ecosystem services in cities. New York City is one example where these groups have grown rapidly in number, size, and visibility since the 1970s. In this article, we combine quantitative survey data with qualitative interview data to examine the...

For CERN's Golden Jubilee, the Canton of Geneva, supported by the Pays de Gex local authorities, lit up eight points around the LHC ring.

CERN Multimedia

Patrice Loiez

2004-01-01

On the date of CERN's fiftieth anniversary, 29 September 2004, the Organization's Host State authorities gave the Laboratory a gift of light. As night fell, twenty-four powerful floodlights blazed into the night sky from the eight access points to the future LHC. (View from Mourex, France)

Transformative leadership: an ethical stewardship model for healthcare.

Science.gov (United States)

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

2008-01-01

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

Technology Education: Twenty-five years of progress

OpenAIRE

Miranda, Michael A. De; Miyakawa, Hidetoshi

2005-01-01

The past 25 years has brought significant changes in the field of technology education. Contributing to these changes has been the evolution of a curriculum from the early days of industrial arts that addressed human productive practice to an emerging contemporary technological curriculum shaped by the exponential growth of technology and its impact on the extension of human capabilities, society, and the environment. The recent literature that focuses on the exponential growth of technology ...

Energy Systems Integration Facility (ESIF) Facility Stewardship Plan: Revision 2.1

Energy Technology Data Exchange (ETDEWEB)

Torres, Juan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Anderson, Art [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-01-02

The U.S. Department of Energy (DOE), Office of Energy Efficiency and Renewable Energy (EERE), has established the Energy Systems Integration Facility (ESIF) on the campus of the National Renewable Energy Laboratory (NREL) and has designated it as a DOE user facility. This 182,500-ft2 research facility provides state-of-the-art laboratory and support infrastructure to optimize the design and performance of electrical, thermal, fuel, and information technologies and systems at scale. This Facility Stewardship Plan provides DOE and other decision makers with information about the existing and expected capabilities of the ESIF and the expected performance metrics to be applied to ESIF operations. This plan is a living document that will be updated and refined throughout the lifetime of the facility.

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

Science.gov (United States)

Marc Coles-Ritchie; Stephen J. Solem; Abraham E. Springer; Burton Pendleton

2014-01-01

In the desert Southwest, springs are an important ecological feature and serve as a focal point for both biological and human interactions on the landscape. As a result, attention has been placed on the stewardship and protection of these important resources. Management has traditionally focused on the more accessible and heavily used eastern canyons within the Spring...

Visual impairment from uveitis in a reference hospital of Southeast Brazil: a retrospective review over a twenty years period.

Science.gov (United States)

Silva, Luci Meire Pereira da; Muccioli, Cristina; Oliveira, Filipe de; Arantes, Tiago Eugênio; Gonzaga, Lucas Renó; Nakanami, Célia Regina

2013-01-01

To identify the frequency and causes of uveitis leading to visual impairment in patients referred to the Low Vision Service - Department of Ophthalmology - UNIFESP, over a twenty years period. In a retrospective study, medical records of 5,461 patients were reviewed. Data from the first clinical evaluation at the Low Vision Service were collected, patient's age, gender and cause of visual impairment were analyzed. Patients with uveitis had their chart reviewed for anatomical classification and clinical diagnosis. The mean age of the patients referred to the Low Vision Service was 42.86 years and the mean age of patients with uveitis diagnosis was 25.51 years. Retinal disorders were the most common cause of visual impairment (N=2,835 patients; 51.9%) followed by uveitis (862 patients, 15.7%). Uveitis was posterior in 792 patients (91.9% of uveitis) and toxoplasmosis was the most common diagnosis (765 patients, 88.7%). In our study, uveitis represents the second cause of visual impairment in patients referred for visual rehabilitation and toxoplasmic retinochoroiditis was the most common clinical diagnosis. It affects a young working age population with a relevant social and economic impact, but the early diagnosis and treatment can improve the quality of life of these patients.

Cardiac myxoma: diagnostic approach, surgical treatment and follow-up. A twenty years experience.

Science.gov (United States)

Jelic, J; Milicić, D; Alfirević, I; Anić, D; Baudoin, Z; Bulat, C; Corić, V; Dadić, D; Husar, J; Ivanćan, V; Korda, Z; Letica, D; Predrijevac, M; Ugljen, R; Vućemilo, I

1996-12-01

At the University Department of Cardiovascular Surgery in Zagreb, Croatia, we treated 81 patients with primary intracardiac myxoma, in a period from January 1975 to December 1994. There were 55 female and 26 male pts, in age from 1 month to 80 years, mean 46+/-15 years. Clinical manifestations varied from no symptoms and very poor or no clinical signs to various manifestations of chronic or acute congestive heart failure, syncope and arrhythmias with or without systemic findings such as high erythrocyte sedimentation rate, anaemia, leucocytosis, elevated gamma globulin, thrombocytopenia or low grade fever, as well as cerebrovascular accidents due to tumour embolization. Cardiac symptoms were predominant in 54 pts (66.6%) and cerebrovascular in 20 pts (24.7%). Seven pts (8.6%) were symptomless and discovered accidentally, mostly regarding on an unexplained heart murmur. In almost all the patients preoperative diagnosis of intracardiac myxoma was sufficiently established by echocardiography. The tumour was located in the left atrium in 62 pts (76.5%) and in the right atrium in 19 pts (23.5%). Delay from the onset of symptoms to the diagnosis was 6 months in average (range 10 days to 25 months). The average waiting for the operation was 9 days (range from 1 to 60 days). The echocardiographic diagnosis was confirmed during intraoperative examination followed by histological analysis. All pts underwent excision of myxoma using cardiopulmonary bypass with core and topical hypothermia and cold crystaloid cardioplegia. According to the additional preoperative and intraoperative findings, in 6 pts sinchronous mitral valve reconstruction, in 3 pts artificial mitral valve implantation and in 2 pts atrial wall reconstruction was performed. There was no perioperative mortality. After the operation, we could not evaluate all the patients long enough, mostly because of some paramedical circumstancies, such as war, migrations, etc. Twenty two pts undevent evaluation for at least 5

Juvenile osteochondritis dissecans: a 5-year review of the natural history using clinical and MRI evaluation

International Nuclear Information System (INIS)

Hughes, Jacqueline A.; Cook, Jane V.; Warren, Mary E.; Churchill, Mark A.

2003-01-01

Although MRI prognostic features for juvenile osteochondritis dissecans (JOCD) have been determined, the natural history of JOCD on serial MRI has not been fully documented. To document the natural history of JOCD on serial MRI and to correlate this with arthroscopy and clinical outcome over a 5-year follow-up. Twenty-one knees in 19 patients (15 boys, 4 girls; age range 5-15 years) with JOCD underwent MRI and clinical follow-up over 5 years. Lesions were classified as stable or unstable on MRI and compared with clinical and arthroscopic data. On 5-year follow-up, 17 of 19 patients were asymptomatic and 2 of 19 had minimal pain. Fourteen arthroscopies were performed on 11/21 knees. One of twenty-one had fragment fixation. On initial MRI, eight knees had marked fragmentation, high signal at the fragment/bone interface and incomplete defects in the hyaline cartilage (MRI stage III-stable), but no tear. Of these, five had arthroscopy, all confirming intact cartilage. One of twenty-one knees was unstable (MRI stage IVb) with a detached osteochondral fragment, requiring surgery. Despite extensive subchondral bone changes on MRI, all cases with intact cartilage (95%) improved with conservative treatment. Early MRI allows prompt diagnosis and institution of conservative treatment. This results in healing and avoidance of surgery in most patients. (orig.)

Juvenile osteochondritis dissecans: a 5-year review of the natural history using clinical and MRI evaluation

Energy Technology Data Exchange (ETDEWEB)

Hughes, Jacqueline A.; Cook, Jane V.; Warren, Mary E. [Radiology Department, Queen Mary' s Hospital for Children, Epsom and St Helier NHS Trust, Carshalton, Surrey SM5 1AA (United Kingdom); Churchill, Mark A. [Orthopaedic Department, Queen Mary' s Hospital for Children, Epsom and St Helier NHS Trust, Carshalton (United Kingdom)

2003-06-01

Although MRI prognostic features for juvenile osteochondritis dissecans (JOCD) have been determined, the natural history of JOCD on serial MRI has not been fully documented. To document the natural history of JOCD on serial MRI and to correlate this with arthroscopy and clinical outcome over a 5-year follow-up. Twenty-one knees in 19 patients (15 boys, 4 girls; age range 5-15 years) with JOCD underwent MRI and clinical follow-up over 5 years. Lesions were classified as stable or unstable on MRI and compared with clinical and arthroscopic data. On 5-year follow-up, 17 of 19 patients were asymptomatic and 2 of 19 had minimal pain. Fourteen arthroscopies were performed on 11/21 knees. One of twenty-one had fragment fixation. On initial MRI, eight knees had marked fragmentation, high signal at the fragment/bone interface and incomplete defects in the hyaline cartilage (MRI stage III-stable), but no tear. Of these, five had arthroscopy, all confirming intact cartilage. One of twenty-one knees was unstable (MRI stage IVb) with a detached osteochondral fragment, requiring surgery. Despite extensive subchondral bone changes on MRI, all cases with intact cartilage (95%) improved with conservative treatment. Early MRI allows prompt diagnosis and institution of conservative treatment. This results in healing and avoidance of surgery in most patients. (orig.)

The Changing Role of Data Stewardship in Creating Trustworthy, Interdisciplinary High Performance Data Platforms for the Future.

Science.gov (United States)

Richards, C. J.; Evans, B. J. K.; Wyborn, L. A.; Wang, J.; Trenham, C. E.; Druken, K. A.

2016-12-01

The Australian National Computational Infrastructure (NCI) has ingested over 10PB of national and international environmental, Earth systems science and geophysics reference data onto a single platform to advance high performance data (HPD) techniques that enable interdisciplinary Data-intensive Science. Improved Data Stewardship is critical to evolve both data and data services that support the increasing need for programmatic usability and that prioritises interoperability rather than just traditional data download or portal access. A data platform designed for programmatic access requires quality checked collections that better utilise interoperable data formats and standards. Achieving this involves strategies to meet both the technical and `social' challenges. Aggregating datasets used by different communities and organisations requires satisfying multiple use cases for the broader research community, whilst addressing existing BAU requirements. For NCI, this requires working with data stewards to manage the process of replicating data to the common platform, community representatives and developers to confirm their requirements, and with international peers to better enable globally integrated data communities. It is particularly important to engage with representatives from each community who can work collaboratively to a common goal, as well as capture their community needs, apply quality assurance, determine any barriers to change and to understand priorities. This is critical when managing the aggregation of data collections from multiple producers with different levels of stewardship maturity, technologies and standards, and where organisational barriers can impact the transformation to interoperable and performant data access. To facilitate the management, development and operation of the HPD platform, NCI coordinates technical and domain committees made up of user representatives, data stewards and informatics experts to provide a forum to discuss

Eight new genomes and synthetic controls increase the accessibility of rapid melt-MAMA SNP typing of Coxiella burnetii.

Directory of Open Access Journals (Sweden)

Edvin Karlsson

Full Text Available The case rate of Q fever in Europe has increased dramatically in recent years, mainly because of an epidemic in the Netherlands in 2009. Consequently, there is a need for more extensive genetic characterization of the disease agent Coxiella burnetii in order to better understand the epidemiology and spread of this disease. Genome reference data are essential for this purpose, but only thirteen genome sequences are currently available. Current methods for typing C. burnetii are criticized for having problems in comparing results across laboratories, require the use of genomic control DNA, and/or rely on markers in highly variable regions. We developed in this work a method for single nucleotide polymorphism (SNP typing of C. burnetii isolates and tissue samples based on new assays targeting ten phylogenetically stable synonymous canonical SNPs (canSNPs. These canSNPs represent previously known phylogenetic branches and were here identified from sequence comparisons of twenty-one C. burnetii genomes, eight of which were sequenced in this work. Importantly, synthetic control templates were developed, to make the method useful to laboratories lacking genomic control DNA. An analysis of twenty-one C. burnetii genomes confirmed that the species exhibits high sequence identity. Most of its SNPs (7,493/7,559 shared by >1 genome follow a clonal inheritance pattern and are therefore stable phylogenetic typing markers. The assays were validated using twenty-six genetically diverse C. burnetii isolates and three tissue samples from small ruminants infected during the epidemic in the Netherlands. Each sample was assigned to a clade. Synthetic controls (vector and PCR amplified gave identical results compared to the corresponding genomic controls and are viable alternatives to genomic DNA. The results from the described method indicate that it could be useful for cheap and rapid disease source tracking at non-specialized laboratories, which requires accurate

Isar-2 nuclear power station twenty-five years

International Nuclear Information System (INIS)

Fischer, Erwin; Luginger, Markus

2013-01-01

The Isar-2 nuclear power station (KKI 2) began commercial power operation on April 9, 1988. In these past 25 years the plant generated a total of approx. 285 billion kWh of electricity. The annual electricity production of KKI 2 of approx. 12 billion kWh corresponds to a share of approx. 15 % in the cumulated Bavarian electricity production. This amount of electricity, theoretically, could supply some 3 million three person households, or meet two thirds of the electricity requirement of the Bavarian industry, for one year. In its 25 years of power operation the Isar-2 nuclear power plant has recorded the highest annual gross electricity production of all nuclear power plants in the world nine times so far. A plant performance as impressive as this necessitates a plant availability far above the average. This, in turn, is based on short revision times and faultfree plant operation. However, high plant safety and availability must not be taken for granted, but are the result of responsible, safety-minded plant operation combined with continuous plant optimization and permanent execution of comprehensive checks, inspections, and maintenance measures. Besides plant technology also organization and administration were permanently advanced and adapted to changing requirements so as to safeguard reliable, safe, and non-polluting plant operation.

Clinico‑Electroencephalography Pattern and Determinant of 2‑year ...

African Journals Online (AJOL)

Annals of Medical and Health Sciences Research | Mar-Apr 2014 | Vol 4 | Issue 2 |. Address for .... had a positive history of febrile convulsion in childhood. Twenty eight (28/158 ..... Classification and Terminology of the International League.

Validity aspects in Chernobyl at twenty years of the accident

International Nuclear Information System (INIS)

Arredondo, C.

2006-01-01

inventory of rare gases of the core. The consequences of the accident have been studied during the twenty lapsed years since it happened. In this work the more recent discoveries on the effects in the health, the environment and economic that have been reported, as well as the current advances regarding the solution of the problems with the sarcophagus are commented. Other aspects little mentioned that consequences of the accident can be considered are discussed also, like they are the increment in the nuclear safety in the reactors in operation in the entire world and the termination of the cold war with the consequent dismantlement of a great one numbers of nuclear weapons. Finally it is remembered that the lessons learned in Chernobyl should never be forgotten. (Author)

Impact of the Antibiotic Stewardship Program on Prevention and Control of Surgical Site Infection during Peri-Operative Clean Surgery.

Science.gov (United States)

Liu, Juyuan; Li, Na; Hao, Jinjuan; Li, Yanming; Liu, Anlei; Wu, Yinghong; Cai, Meng

2018-04-01

Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention. During the pre-intervention stage (January 1, 2010 through December 31, 2011), comprehensive surveillance was performed to determine the SSI baseline data. In the second stage (January 1, 2012 through December 31, 2016), an infectious diseases physician and an infection control practitioner identified the surgical patients daily and followed up on the duration of antimicrobial prophylaxis. From January 1, 2010 to December 31, 2016, 41,426 patients underwent clean surgeries in a grade III, class A hospital. The rate of prophylactic antibiotic use in the 41,426 clean surgeries was reduced from 82.9% to 28.0% after the interventions. The rate of antibiotic agents administered within 120 minutes of the first incision increased from 20.8% to 85.1%. The rate at which prophylactic antimicrobial agents were discontinued in the first 24 hours after surgery increased from 22.1% to 60.4%. Appropriate antibiotic selection increased from 37.0% to 93.6%. Prophylactic antibiotic re-dosing increased from 3.8% to 64.8%. The SSI rate decreased from 0.7% to 0.5% (p < 0.05). The pathogen detection rate increased from 16.7% up to 41.8% after intervention. The intensity of antibiotic consumption reduced from 74.9 defined daily doses (DDDs) per 100 bed-days to 34.2 DDDs per 100 bed-days after the interventions. Long-term and continuous antibiotic stewardship programs have important effects on the prevention and control of SSI during clean surgery.

Esophageal Lichen Planus: Clinical and Radiographic Findings in Eight Patients.

Science.gov (United States)

Rauschecker, Andreas M; Levine, Marc S; Whitson, Matthew J; Tondon, Rashmi; Rubesin, Stephen E; Furth, Emma E; Metz, David C

2017-01-01

The purpose of this study is to present the clinical and radiographic findings of esophageal lichen planus. A search of computerized medical records identified 15 patients with pathologic findings of esophageal lichen planus on endoscopic biopsy specimens. Three other patients had presumed esophageal lichen planus, although no biopsy specimens were obtained. Twelve of these 18 patients (67%) had double-contrast esophagography performed at our institution; for eight of the 12 patients (67%), the studies revealed abnormalities in the esophagus. These eight patients constituted our study group. The barium esophagrams and medical records of these eight patients were reviewed to determine the clinical, radiographic, and endoscopic findings of esophageal lichen planus as well as the treatment and patient outcome. All eight patients were women (median age, 66.5 years), and all eight presented with dysphagia (mean duration, 3.2 years). Four patients had previous lichen planus that involved the skin (n = 1), the oral cavity (n = 2), or both (n = 1), and one patient later had lichen planus that involved the vagina. Five patients had a small-caliber esophagus with diffuse esophageal narrowing. The remaining three patients had segmental strictures in the cervical (n = 1), upper thoracic (n = 1), and distal thoracic (n = 1) esophagus. Esophageal lichen planus typically occurs in older women with longstanding dysphagia and often develops in the absence of extraesophageal disease. Barium esophagrams may reveal a small-caliber esophagus or, less commonly, segmental esophageal strictures. Greater awareness of the radiographic findings of esophageal lichen planus hopefully will lead to earlier diagnosis and better management of this condition.

Twenty Practices of an Entrepreneurial University

DEFF Research Database (Denmark)

Gjerding, Allan Næs; Wilderom, Celeste P.M.; Cameron, Shona P.B.

2006-01-01

studies twenty organisational practices against which a University's entrepreneurship can be measured. These twenty practices or factors in effect formed the basis for an entrepreneurship audit. During a series of interviews, the extent to which the universities are seen as entrepreneurial...

CMS rewards eight of its suppliers

CERN Multimedia

2002-01-01

At the third awards ceremony to honour its top suppliers, the CMS collaboration presented awards to eight firms. Seven of them are involved in the manufacture of the magnet. The winners of the third CMS suppliers' awards visit the assembly site for the detector. Unsurprisingly, the CMS magnet was once again in the limelight at the third awards ceremony in honour of the collaboration's top suppliers. 'Unsurprisingly', because this magnet, which must produce an intense field of 4 Tesla inside an enormous volume (12 metres in diameter and 13 metres in length) is the detector's key component. As a result, many firms are involved in its construction. The CMS suppliers' awards are an annual event aimed at rewarding the exceptional efforts of certain companies. Firms are only eligible once they have delivered at least 50% of their supplies. This year, the collaboration honoured eight firms at a ceremony held on Monday 4 March in the main auditorium. Seven of th...

Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

International Nuclear Information System (INIS)

Banaee, J.

2002-01-01

A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances

Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

Energy Technology Data Exchange (ETDEWEB)

Banaee, J.

2002-05-16

A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances.

Planning for Site Transition to Long-Term Stewardship: Identification of Requirements and Issues

Energy Technology Data Exchange (ETDEWEB)

Banaee, Jila

2002-08-01

A systematic methodology is presented and applied for the identification of requirements and issues pertaining to the planning for, and transition to, long term stewardship (LTS). The method has been applied to three of the twelve identified LTS functions. The results of the application of the methodology to contaminated and uncontaminated federal real property in those three functions are presented. The issues that could be seen as impediments to the implementation of LTS are also identified for the three areas under consideration. The identified requirements are significant and in some cases complex to implement. It is clear that early and careful planning is required in all circumstances.

Some Observations on Cultural Opposites in Contemporary China: Kunming and Beijing Twenty Years Later

Directory of Open Access Journals (Sweden)

Vesna Vučinić-Nešković

2016-02-01

Full Text Available This paper considers the cultural opposites observed in various segments of Chinese culture during the author's three stays in China over a period of twenty years. The first and second stay, in 1986 and 1989 respectively, coincided with the initial period of the implementation of modernization reforms in China, when their results were just beginning to be felt. The third stay was in 2009, towards the end of the third decade of reform implementation, at the time of an already developed marketoriented communism. The paper's main thesis is that most of the phenomena observed in present-day urban China can be assigned to opposite categories, namely Chinese-Western and traditional- contemporary. Cultural opposites have been observed in the sphere of tourism and the behavior of both Chinese and foreign visitors, in the use of Chinese and English in notices and signs in public places, and in the promotion of traditional and modern architecture. In addition, they have been noted in the presentation of arts and crafts and industrial products, in the manner of consumption of hot drinks, and in the combining of Chinese and foreign cuisine. They are also evident in a Beijing Opera performance adapted both to the modern Chinese and to foreigners, and in the traditional Chinese exercises and western dances performed in public parks. In conclusion, the paper suggests that the process of establishing connections between China and the West is being carried on in a moderate and controlled way. In the globalization process cultural opposites coexist and merge, imparting new features to Chinese culture.

From infancy to adolescence: fifteen years of continuous treatment with hydroxyurea in sickle cell anemia.

Science.gov (United States)

Hankins, Jane S; Aygun, Banu; Nottage, Kerri; Thornburg, Courtney; Smeltzer, Matthew P; Ware, Russell E; Wang, Winfred C

2014-12-01

Despite documented laboratory and clinical benefits of hydroxyurea for children with sickle cell anemia (SCA), the drug's long-term safety and efficacy remains poorly defined. The HUSOFT trial and extension study examined feasibility, toxicity, and hematological efficacy of hydroxyurea in infants with SCA. This report describes HUSOFT participants who have continued hydroxyurea therapy for 15 years. With IRB approval, medical records were reviewed for clinical, laboratory, and growth parameters. Twenty-eight infants enrolled in the original 2-year HUSOFT study received open-label liquid hydroxyurea at 20 mg/kg/day; 17 completed the extension study with dose escalation to 30 mg/kg/day. Eight of these 17 (6 girls and 2 boys, all HbSS) have continued on daily hydroxyurea for at least 15 years (median age at last follow-up 17.6 years) without interruption. All hematologic indices (Hb concentration, mean corpuscular volume (MCV), fetal hemoglobin) showed sustained effect after 15 years. The median maximum tolerated dose of hydroxyurea has decreased from 30 to 26 mg/kg/day (range 19.5-31.2); neutropenia [absolute neutrophil count (ANC)hydroxyurea therapy since infancy appears safe and efficacious in SCA.

Policy options to reduce consumer waste to zero: comparing product stewardship and extended producer responsibility for refrigerator waste.

Science.gov (United States)

Nicol, Scott; Thompson, Shirley

2007-06-01

Today, over-consumption, pollution and resource depletion threaten sustainability. Waste management policies frequently fail to reduce consumption, prevent pollution, conserve resources and foster sustainable products. However, waste policies are changing to focus on lifecycle impacts of products from the cradle to the grave by extending the responsibilities of stakeholders to post-consumer management. Product stewardship and extended producer responsibility are two policies in use, with radically different results when compared for one consumer product, refrigerators. North America has enacted product stewardship policies that fail to require producers to take physical or financial responsibility for recycling or for environmentally sound disposal, so that releases of ozone depleting substances routinely occur, which contribute to the expanding the ozone hole. Conversely, Europe's Waste Electrical and Electronic Equipment (WEEE) Directive requires extended producer responsibility, whereby producers collect and manage their own post-consumer waste products. WEEE has resulted in high recycling rates of greater than 85%, reduced emissions of ozone-depleting substances and other toxins, greener production methods, such as replacing greenhouse gas refrigerants with environmentally friendly hydrocarbons and more reuse of refrigerators in the EU in comparison with North America.

Toward an Understanding of Citywide Urban Environmental Governance: An Examination of Stewardship Networks in Baltimore and Seattle.

Science.gov (United States)

Romolini, Michele; Morgan Grove, J; Ventriss, Curtis L; Koliba, Christopher J; Krymkowski, Daniel H

2016-08-01

Efforts to create more sustainable cities are evident in the proliferation of sustainability policies in cities worldwide. It has become widely proposed that the success of these urban sustainability initiatives will require city agencies to partner with, and even cede authority to, organizations from other sectors and levels of government. Yet the resulting collaborative networks are often poorly understood, and the study of large whole networks has been a challenge for researchers. We believe that a better understanding of citywide environmental governance networks can inform evaluations of their effectiveness, thus contributing to improved environmental management. Through two citywide surveys in Baltimore and Seattle, we collected data on the attributes of environmental stewardship organizations and their network relationships. We applied missing data treatment approaches and conducted social network and comparative analyses to examine (a) the organizational composition of the network, and (b) how information and knowledge are shared throughout the network. Findings revealed similarities in the number of actors and their distribution across sectors, but considerable variation in the types and locations of environmental stewardship activities, and in the number and distribution of network ties in the networks of each city. We discuss the results and potential implications of network research for urban sustainability governance.

Twenty-Year Survey of Scientific Literacy and Attitudes Toward Science: Students’ Acceptance of Astrology and Pseudoscience

Science.gov (United States)

Sugarman, Hannah R.; Impey, C.; Buxner, S.; Antonellis, J.

2010-01-01

Our survey used to collect data during a twenty-year long investigation into the science literacy of undergraduates (see Impey et al., this meeting), contains several questions addressing how students conceptualize astrology, and other pseudoscientific ideas. This poster presents findings from the quantitative analysis of some of these question responses from almost 10,000 undergraduate students enrolled in introductory astronomy courses from 1989 to 2009. The results from our data reveal that a large majority of students (78%) and half of science majors (52%) consider astrology either "very” or "sort of” scientific. Students performed comparatively better on all other pseudoscientific questions, demonstrating that belief in astrology is pervasive and deeply entrenched. We compare our results to those obtained by the NSF Science Indicators series, and suggest possible reasons for the high susceptibility to belief in astrology. These findings call into question whether our education system is adequately preparing students to be scientifically literate adults. You can help! Stop by our poster and fill out a new survey that will give us important parallel information to help us continue to analyze our valuable data set. We acknowledge the NSF for funding under Award No. 0715517, a CCLI Phase III Grant for the Collaboration of Astronomy Teaching Scholars (CATS) Program.

International cyclotron conferences: twenty-five years of progress

International Nuclear Information System (INIS)

Martin, J.A.

1984-01-01

This brief introduction reviews a few of the highlights of the nine previous meetings to perhaps convey an appreciation of the time-scale of the significant achievements of past years and to leave the thought that the future is as filled with promise as was the past

Paleolithic nutrition: twenty-five years later.

Science.gov (United States)

Konner, Melvin; Eaton, S Boyd

2010-12-01

A quarter century has passed since the first publication of the evolutionary discordance hypothesis, according to which departures from the nutrition and activity patterns of our hunter-gatherer ancestors have contributed greatly and in specifically definable ways to the endemic chronic diseases of modern civilization. Refinements of the model have changed it in some respects, but anthropological evidence continues to indicate that ancestral human diets prevalent during our evolution were characterized by much lower levels of refined carbohydrates and sodium, much higher levels of fiber and protein, and comparable levels of fat (primarily unsaturated fat) and cholesterol. Physical activity levels were also much higher than current levels, resulting in higher energy throughput. We said at the outset that such evidence could only suggest testable hypotheses and that recommendations must ultimately rest on more conventional epidemiological, clinical, and laboratory studies. Such studies have multiplied and have supported many aspects of our model, to the extent that in some respects, official recommendations today have targets closer to those prevalent among hunter-gatherers than did comparable recommendations 25 years ago. Furthermore, doubts have been raised about the necessity for very low levels of protein, fat, and cholesterol intake common in official recommendations. Most impressively, randomized controlled trials have begun to confirm the value of hunter-gatherer diets in some high-risk groups, even as compared with routinely recommended diets. Much more research needs to be done, but the past quarter century has proven the interest and heuristic value, if not yet the ultimate validity, of the model.

Twenty-first century vaccines

Science.gov (United States)

Rappuoli, Rino

2011-01-01

In the twentieth century, vaccination has been possibly the greatest revolution in health. Together with hygiene and antibiotics, vaccination led to the elimination of many childhood infectious diseases and contributed to the increase in disability-free life expectancy that in Western societies rose from 50 to 78–85 years (Crimmins, E. M. & Finch, C. E. 2006 Proc. Natl Acad. Sci. USA 103, 498–503; Kirkwood, T. B. 2008 Nat. Med 10, 1177–1185). In the twenty-first century, vaccination will be expected to eliminate the remaining childhood infectious diseases, such as meningococcal meningitis, respiratory syncytial virus, group A streptococcus, and will address the health challenges of this century such as those associated with ageing, antibiotic resistance, emerging infectious diseases and poverty. However, for this to happen, we need to increase the public trust in vaccination so that vaccines can be perceived as the best insurance against most diseases across all ages. PMID:21893537

Twenty years of Triga Mark I reactor use

International Nuclear Information System (INIS)

Stasiulevicius, R.; Maretti Junior, F.

1981-01-01

This work is a report on the 20 years of activities of the Triga Mark I, research reactor located in Belo Horizonte, Brazil. It contains also a list of publications, details of operation and improvements introduced in the reactor as well as some perspectives for its future. (A.C.A.S.)

Next step in antibiotic stewardship: Pharmacist-provided penicillin allergy testing.

Science.gov (United States)

Gugkaeva, Z; Crago, J S; Yasnogorodsky, M

2017-08-01

Penicillin allergy limits therapeutic options for patients but often disappears over time, leaving patients erroneously labelled allergic and leading to the utilization of broad-spectrum and more expensive antibiotics. Penicillin allergy can be effectively assessed via skin testing. To improve patient access to penicillin allergy testing by implementing a pharmacist-provided service in a hospital setting. Beta-lactams remain a mainstream therapy for many infections due to their effectiveness, low side effects and affordability. Typically, patient access to penicillin allergy testing is limited by the availability of allergy specialists, who traditionally perform such testing. A pharmacist-provided penicillin allergy testing service was implemented at our hospital in 2015 and became a powerful antibiotic stewardship tool. Removing penicillin allergy from patient profiles significantly expanded therapeutic options, expedited discharges and reduced costs of care. Pharmacists can expand patient access to penicillin allergy testing. Pharmacist-provided penicillin allergy testing permitted optimized antibiotic treatment and expedited discharges. © 2017 John Wiley & Sons Ltd.

Progression of lumbar disc herniations over an eight-year period in a group of adult Danes from the general population

DEFF Research Database (Denmark)

Kjaer, Per; Tunset, Andreas; Boyle, Eleanor

2016-01-01

people (48 women and 58 men), were included. Over eight years, 65 % of the herniations remained unchanged, 17.5 % decreased, 12.5 % increased, and 5 % had a fluctuating pattern. Increased herniation size was associated with decreased dural sac area (β-0.25[-0.52;0.01]) and increased disc height (β 0...... might give the clinician a better understanding of the natural history and consequences of lumbar disc herniations. However, few longitudinal studies have investigated this process using reliable measures from magnetic resonance imaging (MRI). The objectives of this study were to examine changes...... with MRI-confirmed disc herniations at 41 or 45 years were included. Cross-sectional areas (mm(2)) of the LDH, dural sac and disc height were calculated from measurements performed on sagittal T2-weighted images using a previously validated method. Changes over time for the three MRI findings were defined...

Twenty years of immunocontraceptive research: lessons learned.

Science.gov (United States)

Miller, Lowell A; Fagerstone, Kathleen A; Eckery, Douglas C

2013-12-01

The National Wildlife Research Center (NWRC) began immunocontraception vaccine research by testing porcine zona pellucida (PZP) on white-tailed deer (Odocoileus virginianus). Early PZP research demonstrated that PZP induced infertility; however, increased length of the rut was observed in PZP-treated deer. An alternative vaccine using a keyhole limpet hemocyanin-gonadotropin-releasing hormone (KLH-GnRH) conjugate formulated with modified Freund's adjuvant was developed at NWRC. Suppression of GnRH has reduced reproduction in both sexes but is most effective in females. This vaccine was effective in preventing contraception in female deer for several years after a prime and boost. Due to adverse side effects of Freund's adjuvant, NWRC developed a new adjuvant called AdjuVac, a mineral oil/surfactant adjuvant with the addition of Mycobacterium avium as an immunostimulant. The price of KLH prompted a search for a more economical hemocyanin carrier protein for the GnRH peptide. Blue protein, derived from the mollusk Concholepas concholepas, proved to be a successful option. Formulation improvements resulted in a vaccine that can be effective as a single injection for multiple years, now called GonaCon. GonaCon is registered with the Environmental Protection Agency (EPA) for use in white-tailed deer in urban/suburban areas and for wild horses (Equus caballus) and burros (Equus asinus). Future GonaCon applications may include reducing reproduction to manage populations of other wildlife species, such as prairie dogs (Cynomys ludovicianus) in urban areas and suppressing reproduction to reduce the spread of venereal diseases such as brucellosis. Research is being conducted to develop a GnRH vaccine used in combination with the rabies vaccine to control population growth in free-roaming dogs, with the secondary effect of managing the spread of rabies. The EPA would regulate all these uses. Research is also ongoing on a GnRH vaccine to delay the onset of adrenocortical

Changes in Reef Fish Abundances Associated with the Introduction of Indo-Pacific Lionfish to the Florida Keys National Marine Sanctuary: a Twenty Year Time Series.

Science.gov (United States)

Hepner, M.; Muller-Karger, F. E.; Gittings, S.; Stallings, C.

2016-02-01

The Marine Biodiversity Observation Network (MBON) is a partnership between academic, private, and government researchers seeking to understand how marine biodiversity changes over long periods of time. In this context, a study of the multi-agency Reef Visual Census (RVC) data, collected over twenty years in the Florida Keys National Marine Sanctuary (FKNMS), was analyzed to measure possible changes in reef fish abundances as a result of possible predation by lionfish predation or due to related trophic cascading. Lionfish were first sighted in the FKNMS in January 2009, with abundances and frequency of occurrence increasing three to six fold throughout the sanctuary by 2011. Their high consumption rates of smaller fish, coupled with their rapidly increasing densities may be having a significant effect on coral reef fish communities. The study compares the natural variability in reef fish abundances from 1994-2009 in the FKNMS, 15 years prior to the first lionfish detected in the sanctuary, to changes in reef fish abundances 5 years after the invasion. The MBON project also aims to develop environmental DNA (eDNA) technology for conducting biodiversity assessments. eDNA is an emerging technique that seeks to quantify biodiversity in an area by obtaining genetic material directly from environmental samples (soil, sediment, water, etc.) without any obvious signs of biological source material. All marine organisms shed DNA into their surrounding habitat, leaving a "fingerprint." Similar to forensic science, the DNA can be collected from seawater and analyzed to determine what species were recently present. The MBON team is evaluating whether eDNA can be used to adequately monitor reef fish biodiversity in coral reef ecosystems. We will compare species detected in our samples to the taxonomic composition of reef fish communities at the sample site as recorded over the past twenty years in the Reef Visual Census data.

Antimicrobial stewardship activities: a survey of Queensland hospitals.

Science.gov (United States)

Avent, Minyon L; Hall, Lisa; Davis, Louise; Allen, Michelle; Roberts, Jason A; Unwin, Sean; McIntosh, Kylie A; Thursky, Karin; Buising, Kirsty; Paterson, David L

2014-11-01

In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. WHAT IS KNOWN ABOUT THE TOPIC?: The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare

Science and stewardship to protect and sustain wilderness values: Tenth World Wilderness Congress symposium; 2013, 4-10 October, Salamanca, Spain

Science.gov (United States)

Alan Watson; Stephen Carver; Zdenka Krenova; Brooke McBride

2015-01-01

The Tenth World Wilderness Congress (WILD10) met in Salamanca, Spain in 2013. The symposium on science and stewardship to protect and sustain wilderness values was the largest of multiple symposia held in conjunction with the Congress. This symposium was organized and sponsored by the Aldo Leopold Wilderness Research Institute, the Wildland Research Institute of the...

TPACK Updated to Measure Pre-Service Teachers' Twenty-First Century Skills

Science.gov (United States)

Valtonen, Teemu; Sointu, Erkko; Kukkonen, Jari; Kontkanen, Sini; Lambert, Matthew C.; Mäkitalo-Siegl, Kati

2017-01-01

Twenty-first century skills have attracted significant attention in recent years. Students of today and the future are expected to have the skills necessary for collaborating, problem solving, creative and innovative thinking, and the ability to take advantage of information and communication technology (ICT) applications. Teachers must be…

Urine culture guided antibiotic interventions: A pharmacist driven antimicrobial stewardship effort in the ED.

Science.gov (United States)

Zhang, Xi; Rowan, Nicole; Pflugeisen, Bethann Mangel; Alajbegovic, Sanjin

2017-04-01

Antibiotics are overprescribed for abnormal urine tests including asymptomatic bacteriuria (AB), contributing to rising antimicrobial resistance rates. Pharmacists reviewed urine cultures daily from emergency department (ED) encounters to assess antibiotic appropriateness. We studied antibiotic prescribing practices and assessed compliance to national guidelines, correlations with urine analysis (UA) components, and opportunities for antimicrobial stewardship in the ED. This quality improvement project (QIP) was a prospective cohort study at a community hospital ED, with data collected from finalized urine cultures resulting October 30, 2014 through January 5, 2015. Analyses were conducted using Chi-squared and Fisher Exact tests and stepwise multiple logistic regression. Urine cultures from 457 encounters were reviewed, of which 136 met the inclusion criteria as non-pregnant and asymptomatic for urinary tract infection (UTI). 43% of 136 patients were treated with antibiotics, for a total of 426 antibiotic days. Pharmacist interventions for these patients resulted in 122/426 (29%) of potential antibiotic days saved. Factors found to significantly increase the odds of antibiotic prescribing in asymptomatic patients included presence of leukocyte esterase (OR=4.5, 95% CI: 1.2-17.2; p=0.03) or nitrites (OR=10.8, 95% CI: 1.7-68.1; p=0.01) in the urine and age≥75 (OR=3.5, 95% CI: 1.2-9.6, p=0.02). Pharmacist intervention in discontinuing or modifying antibiotics for asymptomatic patients with urine cultures reduced unnecessary antibiotic exposure and was a first step in antimicrobial stewardship efforts in the ED. Future work includes limiting urine tests and subsequent antibiotic therapy for non-pregnant asymptomatic patients. Copyright © 2016 Elsevier Inc. All rights reserved.

Cryogenic air separation: the last twenty years

International Nuclear Information System (INIS)

Grenier, M.; Petit, P.

1986-01-01

In the last 20 years cryogenic air separation plant sizes have increased from 150 tons per day to 2800 tons per day. Progressively reversing heat exchangers have replaced regenerators. However, with this arrangement, the quantity of pure product output is limited to about 50% of the air input. With the appearance on the market of molecular sieve, another arrangement was developed, which allows one to produce a combined pure product flow equivalent to 85% of the air input. Recently, there has been a strong tendency for the reversing exchangers to be superseded by this arrangement. Due to the ever increasing cost of energy, optimization studies are today pushed much further than they used to be; as a consequence there have been major changes in the size of equipment, improvements in the machinery, and simultaneous developments in instrumentation

Capital in the Twenty-First Century

DEFF Research Database (Denmark)

Hansen, Per H.

2014-01-01

Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp......Review essay on: Capital in the Twenty-First Century. By Thomas Piketty . Translated by Arthur Goldhammer . Cambridge, Mass.: The Belknap Press of Harvard University Press, 2014. viii + 685 pp...

About Chernobyl - Twenty Years Later; Propos sur Tchernobyl

Energy Technology Data Exchange (ETDEWEB)

Tubiana, M

2006-07-01

The author discusses the reactor accident of Chernobyl, the information on its consequences so contradictory in the former USSR countries, the status of the effects observed, the forecasting concerning the onset of cancers in the coming years among the populations that were exposed to radiations, the public opinion facing the pessimists. He concludes on the lessons which can be drawn from Chernobyl. (A.L.B.)

Developing core elements and checklist items for global hospital antimicrobial stewardship programmes: a consensus approach.

Science.gov (United States)

Pulcini, C; Binda, F; Lamkang, A S; Trett, A; Charani, E; Goff, D A; Harbarth, S; Hinrichsen, S L; Levy-Hara, G; Mendelson, M; Nathwani, D; Gunturu, R; Singh, S; Srinivasan, A; Thamlikitkul, V; Thursky, K; Vlieghe, E; Wertheim, H; Zeng, M; Gandra, S; Laxminarayan, R

2018-04-03

With increasing global interest in hospital antimicrobial stewardship (AMS) programmes, there is a strong demand for core elements of AMS to be clearly defined on the basis of principles of effectiveness and affordability. To date, efforts to identify such core elements have been limited to Europe, Australia, and North America. The aim of this study was to develop a set of core elements and their related checklist items for AMS programmes that should be present in all hospitals worldwide, regardless of resource availability. A literature review was performed by searching Medline and relevant websites to retrieve a list of core elements and items that could have global relevance. These core elements and items were evaluated by an international group of AMS experts using a structured modified Delphi consensus procedure, using two-phased online in-depth questionnaires. The literature review identified seven core elements and their related 29 checklist items from 48 references. Fifteen experts from 13 countries in six continents participated in the consensus procedure. Ultimately, all seven core elements were retained, as well as 28 of the initial checklist items plus one that was newly suggested, all with ≥80% agreement; 20 elements and items were rephrased. This consensus on core elements for hospital AMS programmes is relevant to both high- and low-to-middle-income countries and could facilitate the development of national AMS stewardship guidelines and adoption by healthcare settings worldwide. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

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

Science.gov (United States)

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

2012-12-01

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

Place-Conscious Capacity-Building: A Systemic Model for the Revitalisation and Renewal of Rural Schools and Communities through University-Based Regional Stewardship

Science.gov (United States)

Johnson, Jerry; Thompson, Aaron; Naugle, Kim

2009-01-01

This paper sets forth a model of regional stewardship developed and implemented at a post-compulsory institution serving rural communities in central Appalachia, a region that is among the most impoverished in the United States. The model, termed place-conscious capacity-building, emphasises culturally-responsive methodologies and the strategic…

Femoral Component Revision with Use of Impaction Bone-Grafting and a Cemented Polished Stem: A Concise Follow-up, at Fifteen to Twenty Years, of a Previous Report*

NARCIS (Netherlands)

Te Stroet, M.A.; Gardeniers, J.W.M.; Verdonschot, N.J.; Rijnen, W.H.C.; Slooff, T.J.J.H.; Schreurs, B.W.

2012-01-01

We previously reported our results for thirty-three consecutive femoral component revisions with impaction bone-grafting, performed with the X-change femoral revision system and a cemented polished Exeter stem, at a minimum of eight years of follow-up. The present updated study shows the results

Year in review 2011

DEFF Research Database (Denmark)

Afshari, Arash; Pagani, Leonardo; Harbarth, Stephan

2012-01-01

ABSTRACT: There is an ever-growing importance for critical assessment of benefits and harms of various strategies with regards to antibiotic stewardship, infection control, molecular detection of pathogens and adequate treatment of multidrug-resistant organisms in ICUs. Ongoing financial constrai......ABSTRACT: There is an ever-growing importance for critical assessment of benefits and harms of various strategies with regards to antibiotic stewardship, infection control, molecular detection of pathogens and adequate treatment of multidrug-resistant organisms in ICUs. Ongoing financial...... constraints globally, changing demographics with an increasing and aging population and the slow introduction of new antibiotics make the utilisation of the best available evidence and goal-directed strategies essential in the ICU setting. This review will summarise findings from some of the recent major...

Twenty years later: The war did (not begin at Maksimir an anthropological analysis of the media narratives about a never ended football game

Directory of Open Access Journals (Sweden)

Đorđević Ivan

2012-01-01

Full Text Available The aim of this work is an analysis of the media narratives about the never ended football match between Dynamo Zagreb and Red Star Belgrade on May 13 1990. The article focuses on the media coverage twenty years after the incident in the context of the game's acquired mythic status, symbolically marking the beginning of the war in former Yugoslavia. The object of the analysis are Serbian and Croatian media with the aim of revealing the strategies of representing this event in the period of the normalization of the relations in the region. [Projekat Ministarstva nauke Republike Srbije, br. 177026: Cultural Heritage and Identity

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

The summer institute in clinical dental research methods: still going and growing after twenty years.

Science.gov (United States)

Derouen, Timothy A; Wiesenbach, Carol

2012-11-01

The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.S. states as well as forty-three countries outside the United States. The curriculum has expanded from the initial offering of biostatistics, clinical epidemiology, behavioral research methods, and ethics in clinical research to now include clinical trials, grantsmanship, data analysis, an elective in molecular biology, and a team project that provides participants with hands-on experience in research proposal development as members of an interdisciplinary team. Enrollment has doubled since the first year, yet exit evaluations of the program content have remained consistently high (rated as very good to excellent). One of the indicators of program quality is that at least 50 percent of recent participants indicated that they attended because the program was recommended by colleagues who had attended. There seems to be an ever-increasing pool of dental faculty members who are eager to learn more about clinical research methodology through the institute despite the intensive demands of full-time participation in a six-week program.

[Twenty-five years of screening eugenics in Spain].

Science.gov (United States)

Mérida Donoso, Salvador

2012-01-01

Over the past 25 years, the incidence of newborns with congenital defects in Spain has fallen by 56.7% primarily due to the practice of "fetal risk" abortion, after prenatal diagnosis. In some cases, such as people with Down syndrome, the strategy involves the removal of 80-90% of those affected in pregnancy. After presenting the techniques used today and statistical data, we will make a reflection about the ethical justification for prenatal diagnosis programs and practice of "eugenic" abortion.

Cerebral infarct eight months after primary Varicella-zoster virus infection

DEFF Research Database (Denmark)

Bjerrum, Maja Carsting; Nielsen, Jens Erik Klint; Nordling, Mette Maria

2013-01-01

Ischemic stroke is a recognised complication of Varicella-zoster virus (VZV) infections. We report on an otherwise healthy four-year-old boy who presented with acute neurological symptoms due to cerebral infarction eight months after primary VZV infection. Magnetic resonance imaging showed...

Hibernoma: MRI features in eight consecutive cases

International Nuclear Information System (INIS)

Lee, J.C.; Gupta, A.; Saifuddin, A.; Flanagan, A.; Skinner, J.A.; Briggs, T.W.R.; Cannon, S.R.

2006-01-01

Aim: To describe the preoperative magnetic resonance imaging findings of eight histologically-proven cases of hibernoma. Materials and methods: The site, size, and signal characteristics of eight consecutive hibernomas were retrospectively assessed on T1-weighted spin-echo and short T1 inversion recovery (STIR)/fat-saturated T2-weighted fast spin echo magnetic resonance images. Four patients also had gadolinium-enhanced fat-saturated T1-weighted spin echo imaging. Patient age and sex, and duration of symptoms were recorded. Results: Three female and five male patients with an average age 36 years (range 16-53 years) were included. Seven lesions occurred in the thigh, four in the anterior compartment and three in the posterior compartment. One lesion occurred superficial to the scapula. All cases demonstrated common magnetic resonance imaging findings of a well-defined, heterogeneous mass, slightly or clearly hypo-intense to subcutaneous fat on T1-weighted spin-echo images, with prominent thin low signal bands throughout the tumour. The lesions failed to fully suppress on STIR or fat-saturated T2-weighted images. Only one of the four contrast-enhanced studies demonstrated increased vascularity in the tumour. Conclusion: The MRI findings of a lesion that is diffusely slightly hypointense to surrounding subcutaneous fat, should prompt the operator to consider hibernoma in the differential diagnosis

Extended Producer Responsibility and Product Stewardship for Tobacco Product Waste.

Science.gov (United States)

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

2014-09-01

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

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases.

Science.gov (United States)

Drees, Marci; Gerber, Jeffrey S; Morgan, Daniel J; Lee, Grace M

2016-11-01

Administrative and surveillance data are used frequently in healthcare epidemiology and antimicrobial stewardship (HE&AS) research because of their wide availability and efficiency. However, data quality issues exist, requiring careful consideration and potential validation of data. This methods paper presents key considerations for using administrative and surveillance data in HE&AS, including types of data available and potential use, data limitations, and the importance of validation. After discussing these issues, we review examples of HE&AS research using administrative data with a focus on scenarios when their use may be advantageous. A checklist is provided to help aid study development in HE&AS using administrative data. Infect Control Hosp Epidemiol 2016;1-10.

Environmental Stewardship at the Savannah River Site: Generations of Success - 13212

Energy Technology Data Exchange (ETDEWEB)

Looney, Brian B.; Bergren, Christopher L.; Gaughan, Thomas F.; Aylward, Robert S.; Guevara, Karen C.; Whitaker, Wade C.; Hennessey, Brian T.; Mills, Gary L.; Blake, John I. [Savannah River Site, Aiken SC 29808, 773-42A (United States)

2013-07-01

Approximately sixty years ago, the Savannah River Site (SRS) was built to produce nuclear materials. SRS production operations impacted air, soil, groundwater, ecology, and the local environment. Throughout its history, SRS has addressed these contamination issues directly and has maintained a commitment to environmental stewardship. The Site boasts many environmental firsts. Notably, SRS was the first major Department of Energy (DOE) facility to perform a baseline ecological assessment. This pioneering effort, by Ruth Patrick and the Philadelphia Academy of Sciences, was performed during SRS planning and construction in the early 1950's. This unique early generation of work set the stage for subsequent efforts. Since that time, the scientists and engineers at SRS pro-actively identified environmental problems and developed and implemented effective and efficient environmental management and remediation solutions. This second generation, spanning the 1980's through the 2000's, is exemplified by numerous large and small cleanup actions to address metals and radionuclides, solvents and hydrocarbons, facility and area decommissioning, and ecological restoration. Recently, a third generation of environmental management was initiated as part of Enterprise SRS. This initiative to 'Develop and Deploy Next Generation Cleanup Technologies' formalizes and organizes the major technology matching, development, and implementation processes associated with historical SRS cleanup success as a resource to support future environmental management missions throughout DOE. The four elements of the current, third generation, effort relate to: 1) transition from active to passive cleanup, 2) in situ decommissioning of large nuclear facilities, 3) new long term monitoring paradigms, and 4) a major case study related to support for recovery and restoration of the Japanese Fukushima-Daiichi nuclear power plant and surrounding environment. (authors)

Risk factors for children's receptive vocabulary development from four to eight years in the longitudinal study of Australian children.

Directory of Open Access Journals (Sweden)

Catherine L Taylor

Full Text Available Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a risk factor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4-8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC. Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB, low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4-8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children

Risk factors for children's receptive vocabulary development from four to eight years in the longitudinal study of Australian children.

Science.gov (United States)

Taylor, Catherine L; Christensen, Daniel; Lawrence, David; Mitrou, Francis; Zubrick, Stephen R

2013-01-01

Receptive vocabulary develops rapidly in early childhood and builds the foundation for language acquisition and literacy. Variation in receptive vocabulary ability is associated with variation in children's school achievement, and low receptive vocabulary ability is a risk factor for under-achievement at school. In this study, bivariate and multivariate growth curve modelling was used to estimate trajectories of receptive vocabulary development in relation to a wide range of candidate child, maternal and family level influences on receptive vocabulary development from 4-8 years. The study sample comprised 4332 children from the first nationally representative Longitudinal Study of Australian Children (LSAC). Predictors were modeled as risk variables with the lowest level of risk as the reference category. In the multivariate model, risks for receptive vocabulary delay at 4 years, in order of magnitude, were: Maternal Non- English Speaking Background (NESB), low school readiness, child not read to at home, four or more siblings, low family income, low birthweight, low maternal education, maternal mental health distress, low maternal parenting consistency, and high child temperament reactivity. None of these risks were associated with a lower rate of growth from 4-8 years. Instead, maternal NESB, low school readiness and maternal mental health distress were associated with a higher rate of growth, although not sufficient to close the receptive vocabulary gap for children with and without these risks at 8 years. Socio-economic area disadvantage, was not a risk for low receptive vocabulary ability at 4 years but was the only risk associated with a lower rate of growth in receptive vocabulary ability. At 8 years, the gap between children with and without socio-economic area disadvantage was equivalent to eight months of receptive vocabulary growth. These results are consistent with other studies that have shown that social gradients in children's developmental outcomes

Preimplantation genetic diagnosis for cystic fibrosis: the Montpellier center's 10-year experience.

Science.gov (United States)

Girardet, A; Ishmukhametova, A; Willems, M; Coubes, C; Hamamah, S; Anahory, T; Des Georges, M; Claustres, M

2015-02-01

This study provides an overview of 10 years of experience of preimplantation genetic diagnosis (PGD) for cystic fibrosis (CF) in our center. Owing to the high allelic heterogeneity of CF transmembrane conductance regulator (CFTR) mutations in south of France, we have set up a powerful universal test based on haplotyping eight short tandem repeats (STR) markers together with the major mutation p.Phe508del. Of 142 couples requesting PGD for CF, 76 have been so far enrolled in the genetic work-up, and 53 had 114 PGD cycles performed. Twenty-nine cycles were canceled upon in vitro fertilization (IVF) treatment because of hyper- or hypostimulation. Of the remaining 85 cycles, a total of 493 embryos were biopsied and a genetic diagnosis was obtained in 463 (93.9%), of which 262 (without or with a single CF-causing mutation) were transferable. Twenty-eight clinical pregnancies were established, yielding a pregnancy rate per transfer of 30.8% in the group of seven couples with one member affected with CF, and 38.3% in the group of couples whose both members are carriers of a CF-causing mutation [including six couples with congenital bilateral absence of the vas deferens (CBAVD)]. So far, 25 children were born free of CF and no misdiagnosis was recorded. Our test is applicable to 98% of couples at risk of transmitting CF. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Report on a Six-Year versus Eight-Year Textbook Adoption Cycle and Prepaid Freight.

Science.gov (United States)

Texas Education Agency, Austin.

This report, submitted to the 71st Texas Legislature in fulfillment of the mandates contained in House Concurrent Resolution 84, summarizes a study of the feasibility of an 8-year cycle for the adoption of certain textbooks and considers the feasibility of contracting with textbook publishers on a freight prepaid basis. First, 6-year versus 8-year…

What's to Be Done About Laboratory Quality? Process Indicators, Laboratory Stewardship, the Outcomes Problem, Risk Assessment, and Economic Value: Responding to Contemporary Global Challenges.

Science.gov (United States)

Meier, Frederick A; Badrick, Tony C; Sikaris, Kenneth A

2018-02-17

For 50 years, structure, process, and outcomes measures have assessed health care quality. For clinical laboratories, structural quality has generally been assessed by inspection. For assessing process, quality indicators (QIs), statistical monitors of steps in the clinical laboratory total testing, have proliferated across the globe. Connections between structural and process laboratory measures and patient outcomes, however, have rarely been demonstrated. To inform further development of clinical laboratory quality systems, we conducted a selective but worldwide review of publications on clinical laboratory quality assessment. Some QIs, like seven generic College of American Pathologists Q-Tracks monitors, have demonstrated significant process improvement; other measures have uncovered critical opportunities to improve test selection and result management. The College of Pathologists of Australasia Key Indicator Monitoring and Management System has deployed risk calculations, introduced from failure mode effects analysis, as surrogate measures for outcomes. Showing economic value from clinical laboratory testing quality is a challenge. Clinical laboratories should converge on fewer (7-14) rather than more (21-35) process monitors; monitors should cover all steps of the testing process under laboratory control and include especially high-risk specimen-quality QIs. Clinical laboratory stewardship, the combination of education interventions among clinician test orderers and report consumers with revision of test order formats and result reporting schemes, improves test ordering, but improving result reception is more difficult. Risk calculation reorders the importance of quality monitors by balancing three probabilities: defect frequency, weight of potential harm, and detection difficulty. The triple approach of (1) a more focused suite of generic consensus quality indicators, (2) more active clinical laboratory testing stewardship, and (3) integration of formal

The role of point-of-care tests in antibiotic stewardship for urinary tract infections in a resource-limited setting on the Thailand-Myanmar border.

Science.gov (United States)

Chalmers, Lauren; Cross, Jessica; Chu, Cindy S; Phyo, Aung Pyae; Trip, Margreet; Ling, Clare; Carrara, Verena; Watthanaworawit, Wanitda; Keereecharoen, Lily; Hanboonkunupakarn, Borimas; Nosten, François; McGready, Rose

2015-10-01

Published literature from resource-limited settings is infrequent, although urinary tract infections (UTI) are a common cause of outpatient presentation and antibiotic use. Point-of-care test (POCT) interpretation relates to antibiotic use and antibiotic resistance. We aimed to assess the diagnostic accuracy of POCT and their role in UTI antibiotic stewardship. One-year retrospective analysis in three clinics on the Thailand-Myanmar border of non-pregnant adults presenting with urinary symptoms. POCT (urine dipstick and microscopy) were compared to culture with significant growth classified as pure growth of a single organism >10(5)  CFU/ml. In 247 patients, 82.6% female, the most common symptoms were dysuria (81.2%), suprapubic pain (67.8%) and urinary frequency (53.7%). After excluding contaminated samples, UTI was diagnosed in 52.4% (97/185); 71.1% (69/97) had a significant growth on culture, and >80% of these were Escherichia coli (20.9% produced extended-spectrum β-lactamase (ESBL)). Positive urine dipstick (leucocyte esterase ≥1 and/or nitrate positive) compared against positive microscopy (white blood cell >10/HPF, bacteria ≥1/HPF, epithelial cells sensitivity (99% vs. 57%) but a lower specificity (47% vs. 89%), respectively. Combined POCT resulted in the best sensitivity (98%) and specificity (81%). Nearly one in ten patients received an antimicrobial to which the organism was not fully sensitive. One rapid, cost-effective POCT was too inaccurate to be used alone by healthcare workers, impeding antibiotic stewardship in a high ESBL setting. Appropriate prescribing is improved with concurrent use and concordant results of urine dipstick and microscopy. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

'Twenty-five years after Chernobyl accident: Safety for the future'. 2011 National report of Ukraine

International Nuclear Information System (INIS)

Imanaka, Tetsuji; Shindo, Mahito

2016-02-01

This is the Japanese translation of the Ukrainian National Report 'Twenty-five Years after Chernobyl Accident: Safety for the Future', published by the Ministry of Ukraine of Emergencies in 2011 (in Ukrainian and English). This Japanese translation is published as an outcome of the KAKENHI research project on liquidations of Nuclear Disasters in the World (headed by Tetsuji Imanaka), in which Shindo participates, and as a KUR report of the Research Reactor Institute at Kyoto University. The objective of publishing this Japanese translation is to provide basic information on how to overcome the consequences of a large-scale Nuclear Disaster for the wide range of public, including decision-makers and administrative staff. By doing so, this publication aims at invigorating discussions over measures to be applied for overcoming the consequences of the TEPCO Nuclear Disaster (started in 11th March 2011 at Fukushima), and at forming proper schemes to minimise the consequences on current and future generations. The original text of this translation tightly summarised the whole picture of the Chernobyl Nuclear Disaster, which had been the only large-scale Nuclear Disaster until 11th March 2011. More importantly, it describes all sorts of measures and schemes taken in Ukraine from 1986 to 2011 in order to overcome the consequences of the Chernobyl Nuclear Disaster, in a quite well structured manner. In other words, from the contents of this text, Japanese readers are able to learn a lot about the very problems currently facing with. Therefore, I wish many Japanese readers will read this text, and utilise the knowledge written here effectively to overcome the consequences of the TEPCO Nuclear Disaster. (J.P.N.)

Community-Based Prescribing for Impetigo in Remote Australia: An Opportunity for Antimicrobial Stewardship.

Science.gov (United States)

Oliver, Stefanie Jane; Cush, James; Ward, Jeanette E

2017-01-01

To support antibiotic prescribing for both hospital and community-based health professionals working in remote North Western Australia, a multidisciplinary Antimicrobial Stewardship (AMS) Committee was established in 2013. This Committee is usually focused on hospital-based prescribing. A troubling increase in sulfamethoxazole/trimethoprim resistance in Staphylococcus aureus antibiograms from 9 to 18% over 1 year prompted a shift in gaze to community prescribing. Finding a paucity of relevant research, we first investigated contextual factors influencing local prescribing. We also designed a systematic survey of experts with experience relevant to our setting using a structured response survey (12 questions) to better understand specific AMS risks. Using these findings, recommendations were formulated for the AMS Committee. Prescribing recommendations in a regional Skin Infections Protocol had previously been altered in December 2014. From 15 experts, we received 9 comprehensive responses (60%) about AMS risks in community prescribing. If feasible, prescribing audits also would have been valuable. Ten recommendations regarding specific antibiotic recommendations were submitted to the AMS Committee. As AMS Committees in Australia usually focus on hospital-based prescribing, novel methods such as external expert opinion could inform deliberations about community-based prescribing. Our approach meant that this AMS Committee was able to intervene in the 2017 organizational review of the regional Skin Infections Protocol used by prescribers likely unaware of AMS risks. This experience demonstrates the value of incorporating AMS principles in community-based prescribing in context of a remote setting.

Science and stewardship to protect and sustain wilderness values: Seventh World Wilderness Congress symposium; 2001 November 2-8; Port Elizabeth, South Africa

Science.gov (United States)

Alan Watson; Janet Sproull

2003-01-01

The Seventh World Wilderness Congress met in Port Elizabeth, South Africa, in 2001. The symposium on science and stewardship to protect and sustain wilderness values was one of several symposia held in conjunction with the Congress. The papers contained in this proceedings were presented at this symposium and cover seven topics: state-of-knowledge on protected areas...

The Stewardship Science Academic Alliance: A Model of Education for Fundamental and Applied Low-energy Nuclear Science

Energy Technology Data Exchange (ETDEWEB)

Cizewski, J.A., E-mail: cizewski@rutgers.edu

2014-06-15

The Stewardship Science Academic Alliances (SSAA) were inaugurated in 2002 by the National Nuclear Security Administration of the U. S. Department of Energy. The purpose is to enhance connections between NNSA laboratories and the activities of university scientists and their students in research areas important to NNSA, including low-energy nuclear science. This paper highlights some of the ways that the SSAA fosters education and training of graduate students and postdoctoral scholars in low-energy nuclear science, preparing them for careers in fundamental and applied research and development.

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

Science.gov (United States)

Daniel, Michelle

2012-01-01

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

Production and processing asymmetries in the acquisition of tense morphology by sequential bilingual children

DEFF Research Database (Denmark)

Chondrogianni, Vicky; Marinis, Theodoros

2011-01-01

This study investigates the production and online processing of English tense morphemes by sequential bilingual (L2) Turkish-speaking children with more than three years of exposure to English. Thirty-nine six- to nine-year-old L2 children and twenty-eight typically developing age-matched monolin......This study investigates the production and online processing of English tense morphemes by sequential bilingual (L2) Turkish-speaking children with more than three years of exposure to English. Thirty-nine six- to nine-year-old L2 children and twenty-eight typically developing age...

Twenty-Five Years Later: A Librarian Looks Back...and Ahead

Science.gov (United States)

York, Sherry

2007-01-01

In this article, the author thinks about the changes that have taken place in school libraries during the past 25 years that she has shared with Linworth Publishing. She remembers the first copy of "The Book Report" that arrived in the mail as a sample. As a high school librarian with several years experience, she found this new magazine an…

The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

OpenAIRE

Sartelli, M.; Labricciosa, F.M.; Barbadoro, P.; Pagani, L.; Ansaloni, L.; Brink, A.J.; Carlet, J.; Khanna, A.; Chichom-Mefire, A.; Coccolini, F.; Saverio, S. Di; May, A.K.; Viale, P.; Watkins, R.R.; Scudeller, L.

2017-01-01

BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial steward...

Radiation protection training: twenty year experience in Hungary

International Nuclear Information System (INIS)

Pellet, Sandor; Kanyar, Bela; Zagyvay, Peter; Solymosi, Jozsef; Bujtas, Tibor; Feher, Istvan; Giczi, Ferenc; Deme, Sandor; Uray, Istvan

2008-01-01

In Hungary, radiation protection training for radiation workers has been introduced in very early, just following the publication of the ICRP recommendation No. 26. Before that, in some of the institutions, radiation protection training was recommended for technicians and medical doctors working in nuclear medicine, X-ray diagnostic radiology and radiation therapy, as well as in some of industrial applications, but not on regular way. Since 1988, radiation protection training regulated by the Ministry of Health and required for all of the workers in radiation workplaces licensed by the authority the State Public Health and Medical Officers Service (SPHAMOS). Decree No. 16/2000. (VI. 8.) EuM of the Minister of Health on the enforcement of Clauses of the Nuclear Law 116/1996 regulates the radiation protection training of Radiation Workers (RW). Annex 4 of Decree sees radiation protection training and in-service training: Persons performing conducted work in the field of the use of the nuclear energy and any other work within legal relationship shall be educated in training and in-service training at an interval of 5 years. Three levels of the training introduced; basic, extended and comprehensive, based on radiation risk related to the given job. Several institutions are involved in performing radiation protection training, such universities, scientific institutions, Regional Radiological Health Centers (RRHC) of SPHAMOS, private enterprises etc. All training course material is subject to accreditation. Most of the faculties of the universities involved in training of natural sciences and engineering provide subjects on the fundamentals of dosimetry, radiobiology and radiation protection within the courses of physics, biophysics, chemistry, biology, ecology etc. These courses take 5-10 contact hours per week on average. The members of the Hungarian Committee of EUTERP Platform summarize their broad experience collected in the past 20 year. (author)

Twenty-five-year experience with the Björk-Shiley convexoconcave heart valve: a continuing clinical concern.

Science.gov (United States)

Blot, William J; Ibrahim, Michel A; Ivey, Tom D; Acheson, Donald E; Brookmeyer, Ron; Weyman, Arthur; Defauw, Joseph; Smith, J Kermit; Harrison, Donald

2005-05-31

The first Björk-Shiley convexoconcave (BSCC) prosthetic heart valves were implanted in 1978. The 25th anniversary provided a stimulus to summarize the research data relevant to BSCC valve fracture, patient management, and current clinical options. Published and unpublished data on the risks of BSCC valve fracture and replacement were compiled, and strategies for identifying candidates for prophylactic valve reoperation were summarized. By December 2003, outlet strut fractures (OSFs), often with fatal outcomes, had been reported in 633 BSCC valves (0.7% of 86,000 valves implanted). Fractures still continue to occur, but average rates of OSFs in 60 degrees valves are now valve characteristics, especially valve angle and size, with weaker effects associated with other manufacturing variables. OSF risks are mildly lower among women than men but decline sharply with advancing age. The risks of valve replacement typically greatly exceed those of OSF. By comparing individualized estimated risks of OSF versus valve replacement, guidelines have been developed to identify the small percentage of BSCC patients (mostly younger men) who would be expected to have a gain in life expectancy should reoperative surgery be performed. Twenty-five years after the initial BSCC valve implants, fractures continue to occur. Continued monitoring of BSCC patients is needed to track and quantify risks and enable periodic updating of guidelines for patients and their physicians.

Eight years of bioethics

OpenAIRE

Moreno-Exebio, Luis

2012-01-01

Este trabajo presenta la experiencia que significó el paso por el Programa Internacional de Formación en Ética de la investigación biomédica y psicosocial del Centro Interdisciplinario de Estudios en Bioética de la Universidad de Chile (2003–2004) y algunas reflexiones respecto de la integración de lo aprendido en mi posterior labor en comités de ética y programas académicos de ética de investigación. Asimismo, en la elaboración de regulaciones que permitan una mejor evaluación ética y cientí...

Impact of an antimicrobial stewardship intervention on appropriateness of prescribing for community-acquired pneumonia in an Australian regional hospital.

Science.gov (United States)

Bond, Stuart E; Boutlis, Craig S; Yeo, Wilfred W; Miyakis, Spiros

2017-05-01

Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP. © 2017 Royal Australasian College of Physicians.

Nuclear Materials Stewardship Within the DOE Environmental Management Program

International Nuclear Information System (INIS)

Bilyeu, J. D.; Kiess, T. E.; Gates, M. L.

2002-01-01

The Department of Energy (DOE) Environmental Management (EM) Program has made significant progress in planning disposition of its excess nuclear materials and has recently completed several noteworthy studies. Since establishment in 1997, the EM Nuclear Material Stewardship Program has developed disposition plans for excess nuclear materials to support facility deactivation. All nuclear materials have been removed from the Miamisburg Environmental Management Project (Mound), and disposition planning is nearing completion for the Fernald Environmental Management Project and the Rocky Flats Environmental Technology Site. Only a few issues remain for materials at the Hanford and Idaho sites. Recent trade studies include the Savannah River Site Canyons Nuclear Materials Identification Study, a Cesium/Strontium Management Alternatives Trade Study, a Liquid Technical Standards Trade Study, an Irradiated Beryllium Reflectors with Tritium study, a Special Performance Assessment Required Trade Study, a Neutron Source Trade Study, and development of discard criteria for uranium. A Small Sites Workshop was also held. Potential and planned future activities include updating the Plutonium-239 storage study, developing additional packaging standards, developing a Nuclear Material Disposition Handbook, determining how to recover or dispose of Pu-244 and U-233, and working with additional sites to define disposition plans for their nuclear materials

The Effect of an Eight-Week Period of Aerobic Exercise on Plasma Concentration of Ghrelin and Growth Hormone in Young Women

Directory of Open Access Journals (Sweden)

Rashidlamir

2011-12-01

Full Text Available Introduction: Ghrelin is a peptide which is secreted from human stomach. It has an important role in the secretion of growth hormone, energy balance, obesity, food intake behavior, and some cardiovascular functions. The purpose of this study was to assess the effects of an eight-week of aerobic exercise on plasma concentration of ghrelin and GH in non-athletic young women. Methods: Twenty young non-athletic women with mean age of 22±2/1 years and mean BMI of 21±1/07 Kg/m2 voluntarily entered the study and they were randomly divided into control and experimental groups. Experimental group conducted an aerobic exercise program three sessions each week and 60 minutes in each session with 70-80% of maximum heart rate for 8 weeks. Control group didn’t exercise. Blood samples were taken 48 hours before the first and after the last session of exercise. Plasma concentrations of ghrelin and growth hormone were measured by ELISA and radioimmunoassay methods, respectively. Data was analyzed by independent samples T test and Pearson correlation test by SPSS(version16. Results: The eight-week period of aerobic exercise caused a significant increase in plasma concentration of ghrelin and a significant decrease in plasma concentration of GH. Conclusion: It can be concluded from the study that exercise-induced increase in plasma ghrelin in response to negative energy balance didn’t stimulate GH secretion, so other mechanisms may be effective in this regard.

Planning for the Transition to Long-Term Stewardship at Three U.S. Department of Energy-Chicago Operations Office Facilities

International Nuclear Information System (INIS)

Moos, L. P.; Ditmars, J. D.; Heston, S. L.; Granzen, G. A.; Holzemer, M. J.; Bennett, D. B.

2003-01-01

This paper describes a pilot study that resulted in the generation of draft planning documents for the upcoming transition from remediation construction to long-term stewardship at three national laboratories managed by the U.S. Department of Energy (DOE)-Chicago Operations Office (CH). The remediation construction work at these facilities is being completed under the DOE's Office of Environmental Management (EM) Program. Once the remediation is complete, the responsibility for long-term stewardship (LTS) of the closed waste sites is expected to be transferred to the DOE organization responsible for managing each of the three facilities (i.e., the site landlord). To prepare for this transfer, an extensive planning effort is required. This pilot study utilized the DOE guidance in effect at the time to (1) develop a series of documents identifying applicable requirements that the LTS Programs will need to satisfy, issues that need to be resolved before the transfer can proceed, and criteria to be used to determine when active remediation is complete and a given site is ready for transfer to the LTS Program; (2) examine alternate structures for possible LTS Programs; and (3) develop draft LTS Implementation Plans. This advanced planning effort yielded a number of observations and lessons learned that are applicable to any facility approaching the end of its remediation construction phase

Twenty years of punishment (and democracy) in South Africa

African Journals Online (AJOL)

in 2004, South Africa has the highest incarceration rate in Africa and one of the highest in the world.2 In. 2013, the number of people serving life imprisonment stood at 11 000, as opposed to 400 in 1994.3. Democratisation has thus brought with it a dramatic increase in long-term prison sentences, ranging from seven years ...

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-06-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Honeyman, Bruce D.

2006-06-01

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

Effects of Group 1 versus Group 2 carbapenems on the susceptibility of Acinetobacter baumannii to carbapenems: a before and after intervention study of carbapenem-use stewardship.

Science.gov (United States)

Yoon, Young Kyung; Yang, Kyung Sook; Lee, Seung Eun; Kim, Hyun Jeong; Sohn, Jang Wook; Kim, Min Ja

2014-01-01

Antimicrobial stewardship programs have been proposed for reducing bacterial resistance in the hospital environment. The purpose of this study was to investigate the impact of a carbapenem-use stewardship program on the susceptibility of Acinetobacter baumannii to Group 2 carbapenems. A before and after intervention study was conducted at a university hospital from September 2008 to February 2013. Three study periods were defined: Phase I, pre-intervention (months 1-18); Phase II, a postintervention period during which ertapenem use was mandated but carbapenem use was not restricted (months 19-36); and Phase III, a postintervention period during which Group 2 carbapenem use was restricted (months 37-54). During the study period, intervention resulted in diminished consumption of Group 2 carbapenems (antimicrobial use density (AUD): 21.3±6.0 in Phase I, 18.8±6.0 in Phase II, 16.1±4.4 in Phase III; P = 0.028) and increased consumption of ertapenem (AUD: 2.7±1.7 in Phase I, 7.2±4.5 in Phase II, 9.1±5.3 in Phase III; Pcarbapenem during the previous one month was positively and significantly associated with a subsequent increase in the proportion of carbapenem-resistant A. baumannii (CRAB) (P = 0.031). Implementing a carbapenem-use stewardship program featuring the preferential use of ertapenem for treating appropriate indications of infection resulted in reduced use of Group 2 carbapenems and had a positive impact on the susceptibility of A. baumannii to carbapenems. This approach could be integrated into CRAB-control strategies in hospitals.