Search

Abstract: The U.S. Department of Agriculture supports agricultural research by encouraging the formation of multidisciplinary and multi-institutional teams. Project teams focus on agricultural issues related to profitability and economic and environmental sustainability. Recently, a U.S. Department of Agriculture project to study the impact of equine management and feeding practices on the environment was approved. The project, “NE-1041: Environmental Impacts of Equine Operations,” is a Northeast regional project but includes research and extension faculty from across the country. The project team includes representatives from Alabama, Connecticut, Kentucky, Louisiana, Maryland, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, South Dakota, and Vermont. The goal of this project is to incorporate the best available data on horse management and feeding practices, manure storage and disposal, pasture and cropping management, soil and environmental quality, erosion control, and farm management practices to minimize negative impacts of equine operations on the environment. The specific objectives of the project are to assess existing data on environmental impacts of equine operations, identify gaps in current knowledge, conduct research when data are lacking or nonexistent, and incorporate existing and newly generated data into a systematic description of nutrient flow in soil, water, and air occurring on horse farms. Estimates will be made of pathogen transports and nitrogen (N)-, phosphorus (P)-, potassium (K)-, and energy (carbon)-loss potentials. In addition to identifying system-wide losses on equine farms, another goal of the project is to assist farmers and agricultural professionals in determining the value of equine management practices and other accepted best management practices. [Copyright &y& Elsevier]

Purpose. The results of a survey to characterize oncology drug shortages across the United States and the impact of shortages on clinical practice, patient safety, clinical trials, and health care costs are presented. Methods. A 34-item online survey was distributed to 1672 members of the Hematology/Oncology Pharmacy Association and other organizations to gather information on shortages of oncology drugs (i.e., all drugs essential in the care of cancer patients, including supportive care agents). Results. Two hundred forty-three completed responses, almost all from pharmacists (97%), were analyzed. Delays in chemotherapy administration or changes in treatment regimens due to drug shortages were reported by 93% of survey participants; 85% of respondents reported increased costs, and 10% reported reimbursement challenges related to drug shortages. At 34% of represented institutions, at least 1000 hours of additional labor annually was needed to manage shortages. Changes in therapy leading to near-miss errors were reported by 16% of participants, with 6% reporting one or more actual medication errors attributable to a drug shortage. The oncology medications most frequently reported to be in short supply during the preceding 12 months were fluorouracil, leucovorin, liposomal doxorubicin, and paclitaxel. The conduct of clinical trials was affected by drug shortages at 44% of represented institutions. Conclusion. A survey of U.S. oncology pharmacists indicated that oncology drug shortages occurred frequently in the first half of 2011. Shortages led to delays in chemotherapy and changes in therapy, complicated the conduct of clinical research, increased the risks of medication errors and adverse outcomes, and increased medication costs. [ABSTRACT FROM AUTHOR]