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Nuclear Materials Management and Safeguards System (NMMSS)
This paper describes the Nuclear Materials Management and Safeguards System (NMMSS) which is sponsored by the Department of Energy and the Nuclear Regulatory Commission. The system serves national security and program management interests, and international interests in the programs for the peaceful application of nuclear energy and non-proliferation of nuclear weapons. Within the scope of the NMMSS are found all nuclear materials applied and controlled under United States law and related international agreements, including U.S. nuclear materials production programs and US private nuclear industrial activities. In addition, its national and international scope enables it to provide services to other organizations such as the Arms Control and Disarmament Agency, the Department of State, and the US Congress
Multiple Family Group Therapy in a Drug and Alcohol Rehabilitation Centre: Residents' Experiences
Pregnant Managers and their Subordinates: The Effects of Gender Expectations on Hierarchical Relationships
Family therapy and the notion of accountability: With reference to trends in individual psychotherapy
Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup
Effect of Kidney Function on Drug Kinetics and Dosing in Neonates, Infants, and Children
Neonates, infants, and children differ from adults in many aspects, not just in age, weight, and body composition. Growth, maturation and environmental factors affect drug kinetics, response and dosing in pediatric patients. Almost 80% of drugs have not been studied in children, and dosing of these drugs is derived from adult doses by adjusting for body weight/size. As developmental and maturational changes are complex processes, such simplified methods may result in subtherapeutic effects or adverse events. Kidney function is impaired during the first 2 years of life as a result of normal growth and development. Reduced kidney function during childhood has an impact not only on renal clearance but also on absorption, distribution, metabolism and nonrenal clearance of drugs. 'Omics'-based technologies, such as proteomics and metabolomics, can be leveraged to uncover novel markers for kidney function during normal development, acute kidney injury, and chronic diseases. Pharmacometric modeling and simulation can be applied to simplify the design of pediatric investigations, characterize the effects of kidney function on drug exposure and response, and fine-tune dosing in pediatric patients, especially in those with impaired kidney function. One case study of amikacin dosing in neonates with reduced kidney function is presented. Collaborative efforts between clinicians and scientists in academia, industry, and regulatory agencies are required to evaluate new renal biomarkers, collect and share prospective pharmacokinetic, genetic and clinical data, build integrated pharmacometric models for key drugs, optimize and standardize dosing strategies, develop bedside decision tools, and enhance labels of drugs utilized in neonates, infants, and children