Infections that were once treatable have become more difficult to treat because of AR. AR is accelerated by inappropriate antibiotic use in people. Questions have been raised about whether agencies such as the Dept. of Health and Human Services (HHS) have adequately assessed the effects of antibiotic use and disposal on resistance in humans. This report: (1) describes fed. efforts to quantify the amount of antibiotics produced; (2) evaluates HHS's monitoring of antibiotic use and efforts to promote appropriate use; (3) examines HHS's monitoring of AR infections; and (4) describes fed. efforts to monitor antibiotic disposal and antibiotics in the environ. Charts and tables. This is a print on demand report.
Estimates the effect on Ryan White Comprehensive AIDS Resources Emergency Act (CARE Act) funding to urban areas (UA) if a certain stop-loss provision is enacted. Under the CARE Act, funding for UA is provided through three categories of grants: (1) formula grants that are awarded based on the case counts of people with HIV/AIDS in an UA; (2) supplemental grants that are awarded on a competitive basis based on an UA's demonstration of need; and (3) Minority AIDS Initiative grants, which are awarded to UA to address disparities in access, treatment, care, and health outcomes. This report developed an estimate of CARE Act funding with the stop-loss provision in, and also developed an estimate of such funding without that provision. Ill.
The Fed. Emerg. Mgmt. Agency (FEMA), awards grants to fire depts. and other org. for equipment, staffing, and other needs. As of July 2009, FEMA had received 25,000 and 22,000 applications for its FY '07 and '08 fire grant programs, respectively, and had awarded more than 5,000 grants in both years. This is a review of the application and award process for these grants, and addresses the: (1) extent to which FEMA has met statutory and program requirements for distributing the grant funds; (2) actions FEMA has taken to provide assistance to grant applicants and involve the fire service community in the process; and (3) extent to which FEMA has ensured that its grant process is accessible, clear, and consistent with requirements, incl. its grant guidance.
In the U.S., most nonprescription drugs are available over-the-counter in pharmacies and other stores. Experts have suggested that drug availability could be increased by establishing an additional class of nonprescription drugs that would be held behind the counter (BTC) but would require the intervention of a pharmacist before being dispensed; a similar class of drugs exists in many other countries. This is a report on: (1) arguments supporting and opposing a U.S. BTC drug class; (2) changes in drug availability in 5 countries and the impact of restricted nonprescription classes on availability; and (3) issues important to the establishment of a BTC drug class. The author studied 5 countries: Australia, Italy, the Netherlands, the U.K., and the U.S.
In Sept. 2000, the FDA approved the drug Mifeprex for use in terminating early term pregnancy. FDA approved the drug under a provision of its Subpart H regulations, allowing it to restrict the drug¿s distribution to assure its safe use. Critics argued that Mifeprex does not fit within the scope of Subpart H, which applies to drugs that treat serious or life-threatening illnesses. This report: (1) describes FDA¿s approval of Mifeprex, including the evidence considered and the restrictions placed on its distribution; (3) compares the Mifeprex approval process to the approval processes for other Subpart H restricted drugs; and (3) compares FDA¿s post-market oversight of Mifeprex to its oversight of other Subpart H restricted drugs. Illustrations.
Of the estimated 119 million visits to U.S. emergency depts. (ED) in 2006, over 40% were paid for by federally-supported programs -- Medicare, Medicaid, and the State Children's Health Insur. Program. There have been reports of crowded conditions in ED often associated with adverse effects on patient quality of care. In 2003, it was reported that most ED in metropolitan areas experienced some degree of crowding. For ex., two out of every three metropolitan hospitals reported going on ambulance diversion -- asking ambulances to bypass their ED and instead transport patients to other facilities. This report examined three indicators of ED crowding - -ambulance diversion, wait times, and patient boarding -- and factors that contribute to crowding. Illus.
The U.S. gov¿t. has a history of employing health surveillance to help limit malady, loss of life, and economic impact of diseases. Recent legislation and presidential directives have called for a robust and integrated biosurveillance capability; that is, the ability to provide early detection and situational awareness of potentially catastrophic biological events. The Implementing Recommendations of the 9/11 Commission Act directed a report on the state of biosurveillance and resource use in federal, state, local, and tribal governments. This report addresses: (1) federal efforts that support a national biosurveillance capability; and (2) the extent to which mechanisms are in place to guide the development of a national biosurveillance capability. Illustrations.
Amer. Samoa is the only populated U.S. insular area that does not have a fed. court. Congress has granted the local High Court fed. jurisdiction for certain fed. matters, such as specific areas of maritime law. This is a report on Amer. Samoa¿s system for addressing matters of fed. law and discusses: (1) the current system for adjudicating matters of fed. law in Amer. Samoa; (2) the reasons offered for or against changing the current system for adjudicating matters of fed. law in Amer. Samoa; (3) potential scenarios and issues associated with establishing a fed. court in Amer. Samoa or expanding the fed. jurisdiction of the local court; and (4) the potential cost elements and funding sources associated with implementing those different scenarios. Illus.
In early 2008, the FDA responded to a crisis involving the contamination of heparin, a medication used to prevent and treat blood clots, when the agency received multiple reports of adverse events involving severe allergic reactions. The crisis took place from January 2008 through May 2008, during which time FDA took several actions in its response to the crisis. This report reviewed FDA's management of the heparin crisis. This report examines: (1) how FDA prevented additional contaminated heparin from reaching U.S. consumers; (2) how FDA coordinated its response to the contaminated heparin crisis; and (3) FDA's monitoring and analysis of adverse events associated with heparin. Charts and tables. This is a print on demand report.
Among the efforts of the Dept. of Health and Human Services (HHS) to reduce the incidence of sexually transmitted diseases and unintended pregnancies, the agency provides funding to states and organizations that offer abstinence-until-marriage education. This testimony discusses efforts by: (1) HHS and the states to assess the scientific accuracy of materials used in abstinence-until-marriage education programs; and (2) HHS, the states, and researchers to asses the effectiveness of abstinence-until-marriage education programs. Also discusses a Public Health Service Act requirement regarding medically accurate information about condom effectiveness. Illustrations.
Since 2002, the Dept. of Homeland Security (DHS) has distributed over $19 billion in homeland security grants to enhance the nation¿s preparedness and response capabilities. FEMA is responsible for all preparedness efforts including allocating and managing these grants. This testimony examines: (1) the process and methods to allocate homeland security grants to state and local governments; (2) how DHS communicates with states and localities in making grant allocation decisions; (3) what challenges affect the expeditious spending of DHS grant funds by states and localities; and (4) the extent that DHS measured program outcomes as part of its efforts to monitor the expenditure of grant dollars. Includes recommendations. Charts and tables.