WorldWideScience

Sample records for countries require urgent

  1. Fusion is urgent needed for the developing countries

    International Nuclear Information System (INIS)

    Li Jiangang

    2005-01-01

    Energy is a global problem, as it is central to economic development, climate and environment, and international stability and sustainability. Energy need is expected to double in 40 years and an even larger increase is needed to lift the world out of poverty. 80% of world's energy is generated by burning fossil fuels, which is driving climate change and generating pollution. China will grow up to be a moderate developed country in 2050. The coal-centred energy structure will remain until 2050. Annual Energy Consumption per person will increase from near 1 TCE to no less than 3 TCE ( at present time, US: 11.5 TCE; West Europe: 5.6 TCE; Japan: 5.1 TCE) Estimated Energy Demand: increasing from near 1B TCE to over 4B TCE within next 3-4 decades. To realize the long-term sustainable development, it is necessary for China to explore reliable ways and develop thousands of GW non- fossil fuel power. The fission energy is a transit solution. To build hundreds of GW Fission Nuclear Power Plants in China - social problems, safety and environmental concerns, technical difficulties should be solved in near future. It is crucial and urgent for China to realize the controlled Nuclear Fusion Energy for our long-term development in the future as early as possible. Fusion shows environmentally responsible and intrinsically safe, the supplies of fuel are essentially limitless. JET has produced 16MW of fusion power and shown that fusion can be mastered on earth. Fusion has a long and successful history of international collaboration with obvious benefits to all partners for peaceful purpose. ITER is a device for us to bring the Sun to earth for the first time in the history. A properly organised and funded fusion development programme could lead to a proto-type fusion power plant to generate electricity to the grid within about 30 years (ITER+IFMIF). For developing countries, such as China and India, fusion is one of the very few options for large-scale sustainable energy generation

  2. Newly Discovered Orangutan Species Requires Urgent Habitat Protection.

    Science.gov (United States)

    Sloan, Sean; Supriatna, Jatna; Campbell, Mason J; Alamgir, Mohammed; Laurance, William F

    2018-05-03

    Nater, et al.[1] recently identified a new orangutan species (Pongo tapanuliensis) in northern Sumatra, Indonesia-just the seventh described species of living great ape. The population of this critically-endangered species is perilously small, at only ∼800 individuals [1], ranking it among the planet's rarest fauna. We assert that P. tapanuliensis is highly vulnerable to extinction because its remaining habitat is small, fragmented, and poorly protected. While road incursions within its habitat are modest-road density is only one-eighth that of northern Sumatra-over one-fifth of its habitat is zoned for agricultural conversion or is comprised of mosaic agricultural and regrowth/degraded forest. Additionally, a further 8% will be affected by flooding and infrastructure development for a hydroelectric project. We recommend urgent steps to increase the chance that P. tapanuliensis will persist in the wild. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. A measure for provisional-and-urgent sanitary improvement in developing countries: septic-tank performance improvement.

    Science.gov (United States)

    Harada, H; Dong, N T; Matsui, S

    2008-01-01

    Although many cities have planed to develop sewerages in developing countries, sewerage establishment still requires huge investment and engineering efforts. Improvement of existing sanitation facilities may contribute the betterment of urban sanitation before sewerage establishment. The purpose of this study is to propose a measure to improve urban sanitation in areas where a sewerage development plan is proposed but has not been yet established, based on a case study in Hanoi, Vietnam. We found that 90.5% of human excreta flowed into septic tanks. However, 89.6% of septic tanks have never been desludged in the past and their performance was observed to be at a low level. The study also showed that if they introduce regular desludging with a frequency of once a year, they can eliminate 72.8% of COD loads from septic tanks. It was indicated that the performance can be dramatically recovered by regular desludging, which could contribute urban sanitation improvement in Hanoi. In conclusion, the performance recovery of septic tanks by regular desludging was proposed as a provisional-and-urgent measure for urban sanitation improvement, together with the septage treatment in sewage sludge treatment facilities, which should be established earlier than other facilities of sewage treatment systems. IWA Publishing 2008.

  4. The urgent requirement for new radioanalytical certified reference materials for nuclear safeguards, forensics, and consequence management

    International Nuclear Information System (INIS)

    Inn, K.G.W.; Martin Johnson, Jr.C.; Warren Oldham; Lav Tandon; Simon Jerome; Thomas Schaaff; Robert Jones; Daniel Mackney; Pam MacKill; Brett Palmer

    2013-01-01

    A multi-agency workshop was held from 25 to 27 August 2009, at the National Institute of Standards and Technology (NIST), to identify and prioritize the development of radioanalytical Certified Reference Materials (CRMs, generally provided by National Metrology Institutes; Standard Reference Materials, a CRM issued by NIST) for field and laboratory nuclear measurement methods to be used to assess the consequences of a domestic or international nuclear event. Without these CRMs, policy makers concerned with detecting proliferation and trafficking of nuclear materials, attribution and retribution following a nuclear event, and public health consequences of a nuclear event would have difficulty making decisions based on analytical data that would stand up to scientific, public, and judicial scrutiny. The workshop concentrated on three areas: post-incident Improvised Nuclear Device (IND) nuclear forensics, safeguard materials characterization, and consequence management for an IND or a Radiological Dispersion Device detonation scenario. The workshop identified specific CRM requirements to fulfill the needs for these three measurement communities. Of highest priority are: (1) isotope dilution mass spectrometry standards, specifically 233 U, 236 gNp, 244 Pu, and 243 Am, used for quantitative analysis of the respective elements that are in critically short supply and in urgent need of replenishment and certification; (2) CRMs that are urgently needed for post-detonation debris analysis of actinides and fission fragments, and (3) CRMs used for destructive and nondestructive analyses for safeguards measurements, and radioisotopes of interest in environmental matrices. (author)

  5. Reserve requirement systems in OECD countries

    OpenAIRE

    Yueh-Yun C. O’Brien

    2007-01-01

    This paper compares the reserve requirements of OECD countries. Reserve requirements are the minimum percentages or amounts of liabilities that depository institutions are required to keep in cash or as deposits with their central banks. To facilitate monetary policy implementation, twenty-four of the thirty OECD countries impose reserve requirements to influence their banking systems’ demand for liquidity. These include twelve OECD countries that are also members of the European Economic and...

  6. Projected uranium requirements of developing countries

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    The objective of this paper is to examine the uranium requirements of developing countries both in aggregate and individually. Although the cumulative uranium requirements of these countries are expected to account for less than eight percent of total requirements, the fact that many of these countries are expressing renewed interest in nuclear is, in itself, encouraging. The countries analyzed in this paper are Argentina, Brazil, Egypt, India, Israel, Mexico, Pakistan, South Africa, South Korea and Taiwan. For each country, the existing and planned nuclear capacity levels have been identified and capacity factors have been projected. For countries with no previous nuclear power, the world weighted average capacity factor for the specific reactor type is utilized. Other factors influencing nuclear power demand and operations of these developing countries will be discussed, and finally, uranium requirements based on a calculated optimal tails assay of .30 will be provided

  7. Sound insulation requirements in the Nordic countries

    DEFF Research Database (Denmark)

    Rasmussen, Birgit

    All Nordic countries have sound insulation requirements for housing and sound classification schemes originating from a common INSTA‐proposal in the mid 90’s, but unfortunately being increasingly diversified since then. The present situation impedes development and create barriers for trade and e...

  8. The longitudinal BMI pattern and body composition of patients with anorexia nervosa who require urgent hospitalization: A case control study.

    Science.gov (United States)

    Kawai, Keisuke; Yamashita, Sakino; Yamanaka, Takeharu; Gondo, Motoharu; Morita, Chihiro; Nozaki, Takehiro; Takakura, Shu; Hata, Tomokazu; Yamada, Yu; Matsubayashi, Sunao; Takii, Masato; Kubo, Chiharu; Sudo, Nobuyuki

    2011-12-05

    The prevention of serious physical complications in anorexia nervosa (AN) patients is important. The purpose of this study is to clarify which physical and social factors are related to the necessity for urgent hospitalization of anorexia nervosa (AN) patients in a long-term starvation state. We hypothesized that the change of longitudinal BMI, body composition and social background would be useful as an index of the necessity for urgent hospitalization. AN patients were classified into; urgent hospitalization, due to disturbance of consciousness or difficulty walking(n = 17); planned admission (n = 96); and outpatient treatment only groups (n = 136). The longitudinal BMI pattern and the clinical features of these groups were examined. In the hospitalization groups, comparison was done of body composition variation and the social background, including the educational level and advice from family members. After adjusting for age and duration of illness, the BMI of the urgent hospitalization group was lower than that of the other groups at one year before hospitalization (P < 0.01) and decreased more rapidly (P < 0.01). Urgent hospitalization was associated with the fat free mass (FFM) (P < 0.01). Between the groups, no considerable difference in social factors was found. The longitudinal pattern of BMI and FFM may be useful for understanding the severity in AN from the viewpoint of failure of the homeostasis system.

  9. The longitudinal BMI pattern and body composition of patients with anorexia nervosa who require urgent hospitalization: A case control study

    Directory of Open Access Journals (Sweden)

    Kawai Keisuke

    2011-12-01

    Full Text Available Abstract Background The prevention of serious physical complications in anorexia nervosa (AN patients is important. The purpose of this study is to clarify which physical and social factors are related to the necessity for urgent hospitalization of anorexia nervosa (AN patients in a long-term starvation state. We hypothesized that the change of longitudinal BMI, body composition and social background would be useful as an index of the necessity for urgent hospitalization. Methods AN patients were classified into; urgent hospitalization, due to disturbance of consciousness or difficulty walking(n = 17; planned admission (n = 96; and outpatient treatment only groups (n = 136. The longitudinal BMI pattern and the clinical features of these groups were examined. In the hospitalization groups, comparison was done of body composition variation and the social background, including the educational level and advice from family members. Results After adjusting for age and duration of illness, the BMI of the urgent hospitalization group was lower than that of the other groups at one year before hospitalization (P Conclusions The longitudinal pattern of BMI and FFM may be useful for understanding the severity in AN from the viewpoint of failure of the homeostasis system.

  10. Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening.

    Science.gov (United States)

    Marcellin, Patrick; Kutala, Blaise K

    2018-02-01

    CLDs represent an important, and certainly underestimated, global public health problem. CLDs are highly prevalent and silent, related to different, sometimes associated causes. The distribution of the causes of these diseases is slowly changing, and within the next decade, the proportion of virus-induced CLDs will certainly decrease significantly while the proportion of NASH will increase. There is an urgent need for effective global actions including education, prevention and early diagnosis to manage and treat CLDs, thus preventing cirrhosis-related morbidity and mortality. Our role is to increase the awareness of the public, healthcare professionals and public health authorities to encourage active policies for early management that will decrease the short- and long-term public health burden of these diseases. Because necroinflammation is the key mechanism in the progression of CLDs, it should be detected early. Thus, large-scale screening for CLDs is needed. ALT levels are an easy and inexpensive marker of liver necroinflammation and could be the first-line tool in this process. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Relationship between seasonal weather changes, risk of dehydration, and incidence of severe bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population

    Science.gov (United States)

    Palmisano, Pietro; Accogli, Michele; Zaccaria, Maria; Vergari, Alessandra; De Luca De Masi, Gabriele; Negro, Luca; De Blasi, Sergio

    2014-09-01

    There is little information on any seasonal variations or meteorological factors associated with symptomatic bradyarrhythmias requiring cardiac pacing. The aim of this single-center study was to investigate the seasonal distribution of the incidence of severe, life-threatening bradyarrhythmias requiring urgent temporary transvenous cardiac pacing in an elderly population. Consecutive patients who underwent urgent temporary transvenous cardiac pacing between 2007 and 2012 were enrolled. The baseline characteristics of the patients and some meteorological parameters, including the calculation the daily heat index (HI), were recorded. During the study period, 79 consecutive patients (mean age 82 ± 8 years, 41 % male) underwent urgent temporary transvenous cardiac pacing, mainly for third-degree atrioventricular block (79 %). The incidence of bradyarrhythmias was significantly higher in summer than in the other seasons ( P 90 °F for >3 h per day for at least 10 days ( P renal function impairment and hyperkalemia (all P < 0.05). This study showed an increased incidence of severe bradyarrhythmias in an elderly population during the hottest months of the year. In these months, in subjects characterized by increased susceptibility to dehydration, the risk of developing bradyarrhythmias was increased significantly.

  12. Perceived Requirements of MIS Curriculum Implementation in Bilingual Developing Countries

    Science.gov (United States)

    Kabeil, Magdy M.

    2005-01-01

    This paper addresses additional requirements associated with implementing a standard curriculum of Management Information Systems (MIS) in bilingual developing countries where both students and workplace users speak English as a second language. In such countries, MIS graduates are required to develop bilingual computer applications and to…

  13. Manpower requirements for nuclear power in developing countries

    International Nuclear Information System (INIS)

    Csik, B.J.

    1980-01-01

    It is recognized that each country has its individual unique characteristics and that there is no typical or average developing country. Common conditions represent exceptions, rather than the rule. Manpower requirements, however, are created by the tasks to be performed and activities to be carried out at each definite stage of a nuclear power project or programme. These tasks and activities, as well as the manpower requirements they create, are of a similar nature for any country, subject to the influence of prevailing local conditions. First, successive stages of the evolution of a nuclear power programme are defined. These are: pre-planning, planning, study and procurement, construction, operation of the first plant, confirmed and self-sufficient in implementing nuclear power projects. The developing countries are then classified according to the present stage of their evolution. Finally, the present and future manpower requirements of each country or group of countries are estimated. No attempt has been made to try to establish any precise data for any country in particular. The results obtained are global estimates, intended as indications of trends and of orders of magnitude. It is found that the developing world's present manpower requirements for nuclear power are of the order of 100,000 people, of which about 20,000 need specialized nuclear training. By the year 2000, for an installed nuclear capacity of 150 to 200 GW, overall manpower requirements should increase to more than 500,000 which would include 130,000 with specialized nuclear training. (author)

  14. MEDICAL SERVICE - URGENT CALLS

    CERN Multimedia

    Service Médical

    2000-01-01

    IN URGENT NEED OF A DOCTOR GENEVA: EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME: Open 24h/24h 748-49-50 AMG- Association Of Geneva Doctors: Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin 719-61-11 EMERGENCIES 719-61-11 CHILDREN'S EMERGENCIES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112   FRANCE: EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ...

  15. Urgent recommendation. Interim report

    International Nuclear Information System (INIS)

    Nakano, Masayuki

    2000-01-01

    The Investigation Committee for Critical Accident at Uranium Processing Plant was founded immediately after the accident to investigate the cause of the accident and to establish measures to prevent the similar accident. On September 30, 1999 around 10:35, the Japan's first criticality accident occurred at JCO Co. Ltd. Uranium processing plant (auxiliary conversion plant) located at Tokai-mura Ibaraki-ken. The criticality continued on and off for approximately 20 hours after the first instantaneous criticality. The accident led the recommendation of tentative evacuation and sheltering indoors for residents living in the neighborhood. The serious exposure to neutrons happened to three workers. The dominant effect is dose due to neutrons and gamma rays from the precipitation tank. When the accident took place, three workers dissolved sequentially about 2.4 kg uranium powder with 18.8 % enrichment in the 10-litter bucket with nitric acid. The procedure of homogenization of uranium nitrate was supposed to be controlled using the shape-limited narrow storage column. Actually, however, the thick and large precipitation tank was used. As a result, about 16.6 kg of uranium was fed into the tank, which presumably caused criticality. The first notification by JCO was delayed and the following communication was not smooth. This led to the delay of correct understanding of the situation and made the initial proper response difficult, then followed by insufficient communication between the nation, prefecture, and local authority. Urgent recommendations were made on the following items; (1) Safety measures to be taken at the accident site, (2) health cares for residents and others, (3) Comprehensive safety securing at nuclear operators such as Establishment of the effective audit system, Safety education for employees and Qualification and licensing system, Safety related documents, etc. (4) Reconstruction of the government's safety regulations such as How safety regulation

  16. Urgent recommendation. Interim report

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Masayuki [International Affairs and Safeguards Division, Atomic Energy Bureau, Science and Technology Agency, Tokyo (Japan)

    2000-12-01

    The Investigation Committee for Critical Accident at Uranium Processing Plant was founded immediately after the accident to investigate the cause of the accident and to establish measures to prevent the similar accident. On September 30, 1999 around 10:35, the Japan's first criticality accident occurred at JCO Co. Ltd. Uranium processing plant (auxiliary conversion plant) located at Tokai-mura Ibaraki-ken. The criticality continued on and off for approximately 20 hours after the first instantaneous criticality. The accident led the recommendation of tentative evacuation and sheltering indoors for residents living in the neighborhood. The serious exposure to neutrons happened to three workers. The dominant effect is dose due to neutrons and gamma rays from the precipitation tank. When the accident took place, three workers dissolved sequentially about 2.4 kg uranium powder with 18.8 % enrichment in the 10-litter bucket with nitric acid. The procedure of homogenization of uranium nitrate was supposed to be controlled using the shape-limited narrow storage column. Actually, however, the thick and large precipitation tank was used. As a result, about 16.6 kg of uranium was fed into the tank, which presumably caused criticality. The first notification by JCO was delayed and the following communication was not smooth. This led to the delay of correct understanding of the situation and made the initial proper response difficult, then followed by insufficient communication between the nation, prefecture, and local authority. Urgent recommendations were made on the following items; (1) Safety measures to be taken at the accident site, (2) health cares for residents and others, (3) Comprehensive safety securing at nuclear operators such as Establishment of the effective audit system, Safety education for employees and Qualification and licensing system, Safety related documents, etc. (4) Reconstruction of the government's safety regulations such as How safety

  17. Financial requirements of immunisation programmes in developing countries: a 2004-2014 perspective.

    Science.gov (United States)

    Peny, Jean-Michel; Gleizes, Olivier; Covilard, Jean-Pierre

    2005-08-31

    Vaccines are a key contributor to public health, especially in developing countries. Despite numerous demonstrations of the cost-effectiveness of immunisation, vaccines spending accounted for only 1.7% of the total pharmaceutical market in 2002, when UNICEF estimated that 34 million children were not reached by routine immunisation, most of them in developing countries. Several international organizations or initiatives, like the Global Alliance for Vaccines and Immunisation (GAVI), have defined a long-term goal of universal immunisation in developing countries. There is an urgent need to estimate the financial resources required to meet this goal. The objective of this study was to anticipate the funding needs for childhood immunisation in developing countries over the 2004-2014 period. The study scope includes all the 75 countries eligible for support from GAVI, and covers existing vaccines that are considered as a priority for GAVI (DTP (diphtheria, tetanus, pertussis), hepatitis B, Haemophilus influenzae type b (as a stand alone presentation or in combination with DTP) and yellow fever) as well as future vaccines (meningitis A and C, rotavirus, human papilloma virus (HPV), malaria, Streptococcus pneumoniae and tuberculosis) likely to be available within the 10-year period. We developed a methodology to estimate the number of doses required, based on disease prevalence and incidence, target populations, introduction dates of new vaccines, coverage dynamics and dosing regimen. The introduction price and price evolution of vaccines over time were modelled, taking into account the type of vaccine, the expected return on investment from vaccine manufacturers and the competitive landscape. Non-vaccine costs (capital costs and non-vaccine recurrent costs) were estimated based on the number of people immunised and number of doses dispensed, using available case studies as a reference. According to the optimal scenario that would consider the provision of all vaccines

  18. 77 FR 6815 - Agency Information Collection Activities: Country of Origin Marking Requirements for Containers...

    Science.gov (United States)

    2012-02-09

    ... Activities: Country of Origin Marking Requirements for Containers or Holders AGENCY: U.S. Customs and Border... information collection requirement concerning Country of Origin Marking Requirements for Containers or Holders...: Title: Country of Origin Marking Requirements for Containers or Holders. OMB Number: 1651-0057. Form...

  19. How urgent is urgent? Analysing urgent out-patient referrals to an adult psychiatric service.

    Science.gov (United States)

    Cubbin, S; Llewellyn-Jones, S; Donnelly, P

    2000-01-01

    It was noticed that over some years the number of referrals to the outpatient clinic (from various sources) which were marked 'urgent' had increased. We aimed to examine who makes these urgent referrals and the clinical factors associated with 'urgent' status. A sample of 201 referrals over a 26-month period was examined. Details of the referral requests were collected using a specially designed form. After each 'urgent' assessment, the referral was scored for appropriateness. This gave an indication of the agreement between referrer and clinic doctor as to what should constitute an ¤ urgent' referral. The majority of urgent referrals were from community psychiatric nurses, who, together with psychiatric social workers, make the most appropriate referrals. The more appropriate referrals clearly specified the clinical factors associated with urgent need for review. Patients regarded as suicidal were not associated with significantly higher appropriateness scores. Referrers should try and make 'urgent' outpatient requests as specific as possible: more clinical detail gives a clearer picture to the clinic doctor. Telephone consultations with general practitioners may help to ascertain a clearer picture of urgent requests if detail is lacking. Health professionals may all benefit from education in suicidal risk assessment. ( Int J Psych Clin Pract 2000; 4: 233 - 235).

  20. Developing countries` energy requirements; Besoins energetiques des pays en developpement

    Energy Technology Data Exchange (ETDEWEB)

    Arques, P. [Ecole Centrale Lyonnaise, 69 - Ecully (France)

    1995-03-01

    The amount of electric power and bacteriologically clean water produced in developing countries today is insufficient for the people`s needs. In order to develop successfully, these countries must necessarily achieve a threshold which, for the whole planet, will come to 1 000 000 MW of electricity. One way this can be done is by building several hundred power plants, with all the concomitant pollution problems. Another solution is Stirling motors, which use the power of sunlight to pump and pasteurize water and to generate electricity for one or more families, or for developmental home industries. (author). 4 refs., 6 figs.

  1. 77 FR 23490 - Agency Information Collection Activities: Country of Origin Marking Requirements for Containers...

    Science.gov (United States)

    2012-04-19

    ... Activities: Country of Origin Marking Requirements for Containers or Holders AGENCY: U.S. Customs and Border... of Origin Marking Requirements for Containers or Holders. This is a proposed extension of an... Requirements for Containers or Holders. [[Page 23491

  2. 14 CFR 61.93 - Solo cross-country flight requirements.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Solo cross-country flight requirements. 61... Solo cross-country flight requirements. (a) General. (1) Except as provided in paragraph (b) of this section, a student pilot must meet the requirements of this section before— (i) Conducting a solo cross...

  3. Required Market Risk Premium among countries in 2012

    Directory of Open Access Journals (Sweden)

    Pablo Fernandez

    2015-12-01

    This survey also links with the Equity Premium Puzzle. It may be explained by the fact that many market participants use historical data and advice from textbooks and finance professors. Consequently, ex-ante equity premia have been high, most market prices have been consistently undervalued, and the ex-post risk premia has been also high. Many investors use historical data and textbook prescriptions to estimate the required and the expected equity premium, the undervaluation and the high ex-post risk premium are self fulfilling prophecies.

  4. Quality assurance requirements for the reliability of nuclear power plants in developing countries

    International Nuclear Information System (INIS)

    Bhutta, S.M.

    1978-01-01

    Quality Assurance (QA) has not been taken very seriously in developing countries despite their having significant nuclear power programmes. This may affect plant reliability and demands that urgent and serious attention be given to the development and implementation of Quality Assurance programmes according to local conditions. Confusion has been created by the differences in definitions and interpretations of terminologies of Quality Assurance and Control. Problems have been aggravated by the lack of clearly defined responsibilities and accountabilities during the projects execution phases of site selection, data collection, design, equipment fabrication and construction, etc. Therefore, reliability of nuclear power plants in developing countries is relatively low. But whenever some programme of QA has been implemented it has helped to improve the plant performance. This is highlighted in this paper by the practical examples for the experience of Karachi Nuclear Power Plant whose forced outages have been reduced by over a half within a period of 3 years. In view of the benefits, a QA programme for Chashma Nuclear Power Project has also been initiated. In this paper urgency is emphasized for the establishment and implementation of a formal QA programme in the developing countries if the reactor suppliers and purchasers both want to ensure higher reliability of their plants. The best way that management can play its role effectively is by setting up a strong QA organization with local personnel, thus helping to attain self-reliance and higher reliability during plant operation. (author)

  5. Acoustic design of open-plan offices and comparison of requirements in the Nordic countries

    DEFF Research Database (Denmark)

    Petersen, Claus Møller; Rasmussen, Birgit

    2018-01-01

    In the Nordic countries, most office buildings include open-plan offices. However, to optimize working conditions, such spaces require special acoustic design to obtain reasonable sound attenuation between groups and satisfactory speech intelligibility internally in groups, although optimal worki...

  6. Institutional effectiveness of REDD+ MRV: Countries progress in implementing technical guidelines and good governance requirements

    NARCIS (Netherlands)

    Ochieng, R.M.; Visseren-Hamakers, Ingrid; Arts, B.; Brockhaus, M.; Herold, M.

    2016-01-01

    The UNFCCC requires REDD+ countries wishing to receive results-based payments to measure, report and verify (MRV) REDD+ impacts; and outlines technical guidelines and good governance requirements for MRV. This article examines institutional effectiveness of REDD+ MRV by assessing countries’ progress

  7. Anticipating urgent surgery in operating room departments

    NARCIS (Netherlands)

    van der Lans, M.; Hans, Elias W.; Hurink, Johann L.; Wullink, Gerhard; van Houdenhoven, M.; Kazemier, G.

    2005-01-01

    Operating Room (OR) departments need to create robust surgical schedules that anticipate urgent surgery, while minimizing urgent surgery waiting time and overtime, and maximizing utilization. We consider two levels of planning and control to anticipate urgent surgery. At the tactical level, we study

  8. THE IMPLEMENTATION OF EFFICIENT TRADE MATRIX AND GOLD RESERVE REQUIREMENT FOR COMMODITY TRADE AMONG ASEAN COUNTRIES

    Directory of Open Access Journals (Sweden)

    nurul anisak

    2017-06-01

    Full Text Available Objective - This study attempts to implement the efficient trade matrix among five selected ASEAN countries and its settlement by the gold reserve requirements through Multi-Bilateral Payments Arrangement (MBPA.Methods – The study is a qualitative research with analytic description. The purpose of this qualitative-descriptive study is to simulate the implementation of gold in the Multi-Bilateral Payment Arrangement among ASEAN countries using the current trade data.Results – This paper argues that the Southeast Asian countries can solve the problem through their internal coordination, particularly in terms of trade. One of the efforts is to reduce even eliminate the market risk by using the efficient payment arrangement.Conclusions – The study implied that the quantity amount of gold required to settle the trade balance will be reduced from the early gross payment. However, the ASEAN countries need to strengthen the cooperation among them through maximizing the trade relationship.

  9. URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  10. THE IMPLEMENTATION OF EFFICIENT TRADE MATRIX AND GOLD RESERVE REQUIREMENT FOR COMMODITY TRADE AMONG ASEAN COUNTRIES

    OpenAIRE

    nurul anisak

    2017-01-01

    Objective - This study attempts to implement the efficient trade matrix among five selected ASEAN countries and its settlement by the gold reserve requirements through Multi-Bilateral Payments Arrangement (MBPA).Methods – The study is a qualitative research with analytic description. The purpose of this qualitative-descriptive study is to simulate the implementation of gold in the Multi-Bilateral Payment Arrangement among ASEAN countries using the current trade data.Results – This paper argue...

  11. The role of advanced nuclear power technologies in developing countries: Criteria and design requirements

    International Nuclear Information System (INIS)

    1990-02-01

    The document includes the papers presented at the following two technical committee meetings organized by the IAEA: Technical Committee Meeting and Workshop on Criteria for the Introduction of Advanced Nuclear Power Technologies for Specific Applications in Developing Countries, Vienna, 27-30 June 1988 (14 papers) and Technical Committee Meeting and Workshop on Design Requirements for the Application of Advanced Concepts in Developing Countries, Vienna, 6-9 December 1988 (16 papers). A separate abstract was prepared for each of these papers

  12. MODERN REQUIREMENTS TO THE GENERAL EDUCATIONAL ESTABLISHMENTS LEADERS IN FOREIGN COUNTRIES (FOREIGN EXPERIENCE

    Directory of Open Access Journals (Sweden)

    I. Malitskaya

    2010-08-01

    Full Text Available As a result of ICT integration into the school educational and administrative process, ICT competence is being included in normative educational documents and standards. In the article it has been considered modern requirements to the school leaders in foreign countries (The USA, Lithuania, European countries, it is presented the National educational technological standards (NETS•A. Performance indicators for administrators developed by International society for technology in education ISTE, which is used for development of their own standards in different foreign countries.

  13. Urgent request on avian influenza

    DEFF Research Database (Denmark)

    More, Simon J.; Bicout, Dominique; Bøtner, Anette

    2016-01-01

    HPAI H5N8 is currently causing an epizootic in Europe, infecting many poultry holdings as well as captive and wild bird species in more than ten countries. Given the clear clinical manifestation, passive surveillance is considered the most effective means of detecting infected wild and domestic b...

  14. 76 FR 5250 - List of Countries Requiring Cooperation With an International Boycott

    Science.gov (United States)

    2011-01-28

    ... in, or cooperation with, an international boycott (within the meaning of section 999(b)(3) of the... DEPARTMENT OF THE TREASURY Office of the Secretary List of Countries Requiring Cooperation With an International Boycott In accordance with section 999(a)(3) of the Internal Revenue Code of 1986, the Department...

  15. Comparison and cost analysis of drinking water quality monitoring requirements versus practice in seven developing countries.

    Science.gov (United States)

    Crocker, Jonny; Bartram, Jamie

    2014-07-18

    Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country's ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states), Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries.

  16. Comparison and Cost Analysis of Drinking Water Quality Monitoring Requirements versus Practice in Seven Developing Countries

    Directory of Open Access Journals (Sweden)

    Jonny Crocker

    2014-07-01

    Full Text Available Drinking water quality monitoring programs aim to support provision of safe drinking water by informing water quality management. Little evidence or guidance exists on best monitoring practices for low resource settings. Lack of financial, human, and technological resources reduce a country’s ability to monitor water supply. Monitoring activities were characterized in Cambodia, Colombia, India (three states, Jordan, Peru, South Africa, and Uganda according to water sector responsibilities, monitoring approaches, and marginal cost. The seven study countries were selected to represent a range of low resource settings. The focus was on monitoring of microbiological parameters, such as E. coli, coliforms, and H2S-producing microorganisms. Data collection involved qualitative and quantitative methods. Across seven study countries, few distinct approaches to monitoring were observed, and in all but one country all monitoring relied on fixed laboratories for sample analysis. Compliance with monitoring requirements was highest for operational monitoring of large water supplies in urban areas. Sample transport and labor for sample collection and analysis together constitute approximately 75% of marginal costs, which exclude capital costs. There is potential for substantive optimization of monitoring programs by considering field-based testing and by fundamentally reconsidering monitoring approaches for non-piped supplies. This is the first study to look quantitatively at water quality monitoring practices in multiple developing countries.

  17. A Conceptual Model for Urgent Acquisition Programs

    Science.gov (United States)

    2017-04-06

    traditional acquisition to get things done quicker remaining a constant. “Recognizing this reality is the first step in building an acquisition system...an Operational Needs Statement or Joint Urgent Operational Needs Statement. Urgent acquisition policy focuses on getting capability to the field...typically funded for the equipping effort, which does not include funding for things like Service-wide production, training, or sustainment. In an AROC

  18. HESS Opinions "Urgent water challenges are not sufficiently researched"

    Directory of Open Access Journals (Sweden)

    L. P. Darvis

    2009-06-01

    Full Text Available In this opinion paper we submit that water experts conduct comparatively little research on the more urgent challenges facing the global community. Five specific biases are identified. First, research in the field of water and sanitation is heavily biased against sanitation. Second, research on food security is biased in favour of conventional irrigation and fails to address the problems and opportunities of rainfed agriculture. Third, insufficient water research is dedicated to developmental compared to environmental issues. Fourth, too little research is conducted on adaptation to climate change by developing countries. And finally, research on water governance has a fascination for conflict but too little eye for cooperation and meeting basic needs. This paper illustrates these biases with bibliometric indicators extracted from the ISI Web of Science. There is a stark mismatch between the global demand for knowledge and the supply of it. This mismatch is identified here as a problem that we water scientists must confront and resolve. We still lack a full understanding why this divergence between demand and supply occurs and persists; an understanding that is required to guide us towards aligning our research priorities to societal demands. The paper, however, makes some inferences. On the one hand, we should promote the global South to create its own research biases and allow it to develop alternative solutions. Simultaneously we would benefit from critical examination of our own research practice. Although this paper addresses a critical challenge it does not aim to be exhaustive or definitive. We merely identify the persistence of intransigent water problems as a valid research object in itself.

  19. Is Urgent Evoke a Digital Ba?

    DEFF Research Database (Denmark)

    Wichmand, Mette

    2018-01-01

    of such a platform, the World Bank’s online game Urgent Evoke, which has been designed with the pur- pose of engaging citizens in developing innovative solutions for sociopolitical problems like poverty. The analysis is based on Nonaka’s concept of Ba, which means “place” and is described as a platform for advancing...

  20. Urgent Aeromedical Evacuation Network Capacity Planning

    Science.gov (United States)

    2013-03-01

    What if AMC had one strategically positioned AC for the Urgent / Priority AE mission and the redistribution needs they encounter? This idea stems ...KtMI~rAFB _~...,_ Po~AFB ;------------~ Service Tirr~e Estimates I CO\\" CLl "SIO\\" • C-378 performs bestfrom a cost perspective • Contracted

  1. A data management system to enable urgent natural disaster computing

    Science.gov (United States)

    Leong, Siew Hoon; Kranzlmüller, Dieter; Frank, Anton

    2014-05-01

    Civil protection, in particular natural disaster management, is very important to most nations and civilians in the world. When disasters like flash floods, earthquakes and tsunamis are expected or have taken place, it is of utmost importance to make timely decisions for managing the affected areas and reduce casualties. Computer simulations can generate information and provide predictions to facilitate this decision making process. Getting the data to the required resources is a critical requirement to enable the timely computation of the predictions. An urgent data management system to support natural disaster computing is thus necessary to effectively carry out data activities within a stipulated deadline. Since the trigger of a natural disaster is usually unpredictable, it is not always possible to prepare required resources well in advance. As such, an urgent data management system for natural disaster computing has to be able to work with any type of resources. Additional requirements include the need to manage deadlines and huge volume of data, fault tolerance, reliable, flexibility to changes, ease of usage, etc. The proposed data management platform includes a service manager to provide a uniform and extensible interface for the supported data protocols, a configuration manager to check and retrieve configurations of available resources, a scheduler manager to ensure that the deadlines can be met, a fault tolerance manager to increase the reliability of the platform and a data manager to initiate and perform the data activities. These managers will enable the selection of the most appropriate resource, transfer protocol, etc. such that the hard deadline of an urgent computation can be met for a particular urgent activity, e.g. data staging or computation. We associated 2 types of deadlines [2] with an urgent computing system. Soft-hard deadline: Missing a soft-firm deadline will render the computation less useful resulting in a cost that can have severe

  2. [Towards universal nomenclature for urgent surgical care].

    Science.gov (United States)

    Liakhovs'kyĭ, V I; Dem'ianiuk, D H; Kravtsiv, M I; Borkunov, A L; Sapun, L V

    2013-06-01

    In a modern professional literature the diseases, which undoubtedly threaten the patient's health and life, are called an urgent, special, emergent, fixed-date, etc. Not rare these terms are used simultaneously. Such a plurality of names of a quite dangerous state causes sometimes in these conditions uncertainty to seek help of a specialists and loss of a time. Modern dictionaries of a foreign languages words, of a foreign languages words in Ukrainian language, medical, big explanatory dictionary of a modern Ukrainian language definitely explains, that these terms are synonyms. All of them mean unconditional, timing. And every expression may be used in this context. The above mentioned suggestions and thoughts do not promote a secure fixing in the citizens consciousness the undoubtedness, the disease consequences danger, a threat to health and life. To deposit this in their awareness it is possible not by amorphous depiction, but using a singular, brief, firm term - an urgent.

  3. Development of safety-related regulatory requirements for nuclear power in developing countries. Key issue paper no. 4

    International Nuclear Information System (INIS)

    Han, K.I.

    2000-01-01

    In implementing a national nuclear power program, balanced regulatory requirements are necessary to ensure nuclear safety and cost competitive nuclear power, and to help gain public acceptance. However, this is difficult due to the technology-intensive nature of the nuclear regulatory requirements, the need to reflect evolving technology and the need for cooperation among multidisciplinary technical groups. This paper suggests approaches to development of balanced nuclear regulatory requirements in developing countries related to nuclear power plant safety, radiation protection and radioactive waste management along with key technical regulatory issues. It does not deal with economic or market regulation of electric utilities using nuclear power. It suggests that national regulatory requirements be developed using IAEA safety recommendations as guidelines and safety requirements of the supplier country as a main reference after careful planning, manpower buildup and thorough study of international and supplier country's regulations. Regulation making is not recommended before experienced manpower has been accumulated. With an option that the supplier country's regulations may be used in the interim, the lack of complete national regulatory requirements should not deter introduction of nuclear power in developing countries. (author)

  4. Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients.

    Science.gov (United States)

    Owler, Brian K; Carmo, Kathryn A Browning; Bladwell, Wendy; Fa'asalele, T Arieta; Roxburgh, Jane; Kendrick, Tina; Berry, Andrew

    2015-09-01

    Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients' distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions. A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail. Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients. In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29-05:20 hours). The median distance traveled to reach a patient was 232 km (range 23-637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47-03:37 hours). The estimated median "time saved" was approximately 3:00 hours (IQR 1:44-3:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56-10:08 hours). Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions.

  5. Comparing Anesthesiology Residency Training Structure and Requirements in Seven Different Countries on Three Continents

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias V

    2017-01-01

    , and Switzerland as a way to better understand efforts to train anesthesiologists in different countries. Two physicians trained in each of the seven countries (convenience sample) were interviewed using a semi-structured approach. The interview was facilitated by use of a predetermined questionnaire that included...

  6. Finding the moral fiber: Why reform is urgently needed for a fair cotton trade

    OpenAIRE

    Pfeifer, K.; Kripke, G.; Alpert, E.

    2004-01-01

    Metadata only record US subsidies have led to depressed world cotton prices, which in turn have cost countries in Africa millions of dollars in lost export earnings. Oxfam estimates that sub-Saharan African countries lost $305 million due to US subsidies in crop year 2001. Because cotton is an important livelihood for millions of poor people, Oxfam believes action is urgently needed to reform the distortions in cotton trade that undermine the value of cotton to developing countries. The ce...

  7. A review of countries' pharmacist-patient communication legal requirements on prescription medications and alignment with practice: Comparison of Nordic countries.

    Science.gov (United States)

    Svensberg, Karin; Sporrong, Sofia Kälvemark; Björnsdottir, Ingunn

    2015-01-01

    Pharmacist-patient communication around prescription medications can optimize treatment outcomes. Society's expectations of pharmacist-patient communication around medications can be expressed in legislation, economic incentives, and authority control. In this study, the Nordic countries of Denmark, Finland, Iceland, Norway and Sweden provide the legislative examples and can be used as a platform to discuss how society's expectations, professional visions, and practice are aligning. The overall aim of this study was to describe society's expectations of pharmacist-patient communication around medications as expressed by the state in Nordic legislation, economic incentives and authority control. Additionally, this study describes how the states govern Nordic pharmacists in different pharmacy systems. A legal review was performed using online legislative databases. Regulating authorities were contacted to gather supplementary information. Thereafter, a qualitative document analysis was conducted. The Nordic countries regulate staff-patient communication by using broad laws. The legislation's main focus during dispensing is information on the use of medications, but also generic substitution and pricing. Pharmacies should have internal routines for this in place. Pharmacists' obligation to keep a journal on advice given during dispensing is ambiguously regulated. The economic incentives for communication on prescription medication during dispensing are included in the general pharmacy mark-up. Today's authority control focuses on the pharmacy management and appears to primarily evaluate structure indicators of communication, for example, if there is a routine method of counseling available. Various countries throughout the world differ in their requirements for pharmacy staff to communicate on the use of medicines during dispensing. The Nordic countries all require such communication, which aligns with professional visions. Regardless of the pharmacy system, the

  8. Guyana - How Do You Know Where to Get the Information You Need? Determining Ethics Approval Requirements in a Developing Country

    OpenAIRE

    Gloria Song

    2018-01-01

    Determining the process for obtaining local research ethics approval, or whether such a requirement even exists, may not always be straightforward in the context of some developing countries where such information may not be easily accessible to overseas researchers. How far do a researcher's ethical obligations extend in determining whether there is a requirement for local research ethics approval, and what form this would take (e.g., institutional or centralised ethics review)? In other wor...

  9. Challenges for the registration of vaccines in emerging countries: Differences in dossier requirements, application and evaluation processes.

    Science.gov (United States)

    Dellepiane, Nora; Pagliusi, Sonia

    2018-06-07

    The divergence of regulatory requirements and processes in developing and emerging countries contributes to hamper vaccines' registration, and therefore delay access to high-quality, safe and efficacious vaccines for their respective populations. This report focuses on providing insights on the heterogeneity of registration requirements in terms of numbering structure and overall content of dossiers for marketing authorisation applications for vaccines in different areas of the world. While it also illustrates the divergence of regulatory processes in general, as well as the need to avoid redundant reviews, it does not claim to provide a comprehensive view of all processes nor existing facilitating mechanisms, nor is it intended to touch upon the differences in assessments made by different regulatory authorities. This report describes the work analysed by regulatory experts from vaccine manufacturing companies during a meeting held in Geneva in May 2017, in identifying and quantifying differences in the requirements for vaccine registration in three aspects for comparison: the dossier numbering structure and contents, the application forms, and the evaluation procedures, in different countries and regions. The Module 1 of the Common Technical Document (CTD) of 10 countries were compared. Modules 2-5 of the CTDs of two regions and three countries were compared to the CTD of the US FDA. The application forms of eight countries were compared and the registration procedures of 134 importing countries were compared as well. The analysis indicates a high degree of divergence in numbering structure and content requirements. Possible interventions that would lead to significant improvements in registration efficiency include alignment in CTD numbering structure, a standardised model-application form, and better convergence of evaluation procedures. Copyright © 2018.

  10. Main features of licensing requirements for nuclear installations in several OECD member countries

    International Nuclear Information System (INIS)

    Reyners, P.

    1977-01-01

    The present paper contains a brief description of the main features of the above-mentioned six countries' licensing systems, namely the legal regime applicable, the appropriate licensing bodies, the general frame and scope of the respective national regimes, the involvement of the public and technical safety bodies as well as the inspection procedures. This description is supplemented by some introductory remarks. (orig.) [de

  11. Main features of licensing requirements for nuclear installations in several OECD member countries

    International Nuclear Information System (INIS)

    Reyners, P.

    1975-01-01

    The present paper contains a brief description of the main features of the above-mentioned six countries' licensing systems, namely the legal regime applicable, the appropriate licensing bodies, the general frame and scope of the respective national regimes, the involvement of the public and technical safety bodies as well as the inspection procedures. This description is supplemented by some introductory remarks. (orig.) [de

  12. Problems with biogas implementation in developing countries from the perspective of labor requirements

    NARCIS (Netherlands)

    Tucho, Gudina Terefe; Moll, Henri C.; Schoot Uiterkamp, Anton J.M.; Nonhebel, Sanderine

    2016-01-01

    Most households in rural developing countries depend on firewood from public forests or agricultural bio-wastes for cooking. Public forests, though, are declining due to an increasing population and inefficient use of wood. Use of agricultural wastes on the other hand involves loss of soil nutrients

  13. Energy performance requirements for new buildings in 11 countries from Central Europe. Exemplary comparison of three buildings

    Energy Technology Data Exchange (ETDEWEB)

    Loga, Tobias; Knissel, Jens; Diefenbach, Nikolaus

    2008-12-05

    The objective of the present comparison study is to show which energy efficiency require-ments have to be complied in different European countries when a new building is going to be constructed. For this purpose three Model Buildings were defined: a single-family house, a multi-family house and a school building. For each involved country (or region) the energy quality of the thermal envelope was determined which is necessary in order to just comply with the building code. Due to requirements on the overall energy performance the requested envelope quality usually depends also on the type of heat supply system or energy carrier. Therefore the systems were varied in a parameter study. The main result for each of the three Model Buildings is a comparison table which shows the heat transfer coefficient by transmission (a sort of mean U-value) for the different countries differenti-ated by supply system types. In a final step the primary energy demand according to the German regulation (EnEV 2007) was calculated for every envelope/system combination of the different countries. This allows a comparison of buildings with different supply systems. The study was performed by experts from 11 European member states: Germany, Austria, Czech Republic, Poland, Sweden, Denmark, UK, The Netherlands, Belgium, Luxembourg and France. (orig.)

  14. Urgent tracheostomy: four-year experience in a tertiary hospital.

    Science.gov (United States)

    Costa, Liliana; Matos, Ricardo; Júlio, Sara; Vales, Fernando; Santos, Margarida

    2016-01-01

    Urgent airway management is one of the most important responsibilities of otolaryngologists, often requiring a multidisciplinary approach. Urgent surgical airway intervention is indicated when an acute airway obstruction occurs or there are intubation difficulties. In these situations, surgical tracheostomy becomes extremely important. We retrospectively studied the patients who underwent surgical tracheostomy from 2011 to 2014 by an otolaryngologist team at the operating theater of the emergency department of a tertiary hospital. Indications, complications and clinical evolution of the patients were reviewed. The study included 56 patients (44 men and 12 women) with a median age of 55 years. The procedure was performed under local anesthesia in 21.4% of the patients. Two (3.6%) patients were subjected to conversion from cricothyrostomy to tracheostomy. Head and neck neoplasm was indicated in 44.6% of the patients, deep neck infection in 19.6%, and bilateral vocal fold paralysis in 10.7%. Stridor was the most frequent signal (51.8%). Of the 56 patients, 15 were transferred to another hospital. Among the other 41 patients, 21 were decannulated (average time: 4 months), and none of them were cancer patients. Complications occurred in 5 (12.2%) patients: hemorrhage in 3, surgical wound infection in 1, and cervico-thoracic subcutaneous emphysema in 1. No death was related to the procedure. Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with difficult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.

  15. Planning and scheduling of semi-urgent surgeries

    NARCIS (Netherlands)

    Zonderland, Maartje Elisabeth; Boucherie, Richardus J.; Litvak, Nelli; Vleggeert-Lankamp, Carmen L.A.M.

    2010-01-01

    This paper investigates the trade-off between cancellations of elective surgeries due to semi-urgent surgeries, and unused operating room (OR) time due to excessive reservation of OR time for semi-urgent surgeries. Semi-urgent surgeries, to be performed soon but not necessarily today, pose an

  16. Current status of alcohol marketing policy--an urgent challenge for global governance.

    Science.gov (United States)

    Casswell, Sally

    2012-03-01

    To review research literature and available information on the extent and impacts of marketing, current policy response and the interests engaged in the policy debate in order to inform recommendations for policy change on alcohol marketing. Relevant literature, including systematic reviews and publicly available information (websites and participant observation) is reviewed and synthesized. Alcohol marketing has expanded markedly in the past 50 years and, while there remains uncertainty about the impact across the population, there is now clear evidence of its impact on the consumption of young people. Few countries have effective policy in place restricting alcohol marketing, and there is a lack of an international response to alcohol marketing which crosses national boundaries. The protection of alcohol marketing has been a major focus for vested interest groups and this has affected governmental response at national and international levels. There has been a lack of non-governmental organization engagement. The policy response to tobacco marketing provides a clear contrast to that of alcohol marketing policy and provides a model for alcohol marketing policy. The global exposure of young people to alcohol marketing requires an urgent policy response. The Framework Convention on Tobacco Control provides an appropriate model for global governance to control alcohol marketing. There are extant examples of national level legislation achieving comprehensive bans with France's Loi Evin providing a feasible model. Resources from philanthropic organizations to allow non-governmental organization engagement are urgently required, as is engagement by the governmental sector independent of commercial influence. © 2012 The Author, Addiction © 2012 Society for the Study of Addiction.

  17. IN URGENT NEED OF A DOCTOR

    CERN Multimedia

    Medical Service

    2001-01-01

    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 bvd.de la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  18. Access to care for patients with insulin-requiring diabetes in developing countries

    DEFF Research Database (Denmark)

    Beran, David; Yudkin, John S; de Courten, Maximilian

    2005-01-01

    The objective of this study was to assess the barriers to care for patients with insulin-requiring diabetes in Mozambique and Zambia.......The objective of this study was to assess the barriers to care for patients with insulin-requiring diabetes in Mozambique and Zambia....

  19. Atomic energy today: An urgent dilemma

    International Nuclear Information System (INIS)

    Coronado, G.

    1997-01-01

    This article compiles the trajectory of the nuclear energy, in different countries of the world, since 1939. It also makes reference to the nuclear accidents that have happened in the past. It contains information of other applications of the nuclear energy, such as: the atomic industry of energetic production and alternatives to the nuclear energy [es

  20. Urgent medical response in CBR incidents

    International Nuclear Information System (INIS)

    Castulik, P.; Slabotinsky, J.; Kralik, L.; Bradka, S.

    2009-01-01

    During CBR incidents with releases of hazardous materials (HazMat), there is extremely urgent aim of first rescuing responders to safe the life for as much as possible victims and reducing health consequences from the exposure of the HazMat. Highest priority of the response is to be applied, if victims are exposed with chemicals through their airways and/or mucous membranes. There is general approach in the emergency medical services (EMS) stated that the victims being in critical status have to receive emergency medical care on-site even prior the transportation to a medical facility. However, in a case of CBR events the EMS prefer to provide the First Aid for victims to be already decontaminated as mass casualties, e.g. by the firemen and transferred to a safe zone. This approach is to be time consuming and thus creating delays in medical care not in the favor of a victim's successful survival. In order to overcome this approach, there are needs for eminent ceasing of the victims exposure, protection of breathing tract/ventilation support and administration of antidotes, if available. All this have to be done in shortest time since HazMat incident/accident occurs. This presentation is focusing on emergency provisions for saving victims directly in contaminated environment through the assistance by responders, concentrating on search and rescue of victims, their emergency decontamination, breathing protection, clothing removal, ventilation support, antidote administration, fixing and bandage of trauma injuries prior transportation and/or mass decontamination. This experience is shared based on a field exercise with the EMS volunteers (Red Cross), fire brigade volunteers and university's students.(author)

  1. Urgent surgery for complicated colonic diverticula.

    Science.gov (United States)

    Funariu, Gheorghe; Binţinţan, Vasile; Seicean, Radu

    2006-03-01

    The AIM of this retrospective study was to evaluate the emergency surgical treatment of life-threatening complications of colonic diverticula. In the last 11 years, 22 of 101 patients with colonic diverticula (22.1%) underwent urgent surgery for acute complications: perforated gangrenous diverticulitis with generalized peritonitis (n=8) or pericolic abscess (n=8), acute bowel obstruction (n=4) and severe diverticular bleeding (n=2). In all patients with diffuse peritonitis or acute obstruction the indication for surgery was decided on clinical basis and the complicated diverticula were recognized only intra-operatively. Emergency surgical strategy differed according to the type of complication and the biologic condition of the patient: segmental colectomy and primary anastomosis for diverticular perforation (n=4), colonic stenosis (n=3) or diverticular bleeding (n=2); Hartmann resection with late reconnecting anastomosis in patients with diverticular perforation (n=5) or colonic obstruction (n=1); diverticulectomy with peritoneal drainage (n=2) and colostomy and drainage followed by secondary colectomy (n=5) for diverticular perforations in patients with poor general condition. Only one patient (4.5%) died post-operatively of multiple organ failure from generalized peritonitis. There was no anastomotic leakage in patients with primary anastomosis. Six patients (27.2%) developed wound infection. Hospital stay ranged between 11 and 60 days, significantly longer in cases with two-stage operations. Primary colectomy with immediate or delayed anastomosis is the best surgical procedure for acute divericular complications in patients with good biologic status. Two-stage operations such as colostomy and drainage coupled with late colectomy remain the viable alternative in patients with advanced disease and critical biologic condition.

  2. The greenhouse effect: is it urgent to wait?; Effet de serre est-il urgent d'attendre?

    Energy Technology Data Exchange (ETDEWEB)

    Zentelin, J.L. [Universite d' Evry Val d' Essonne, 91 - Evry (France)

    2005-01-01

    The greenhouse effect and the depletion of oil reserves are 2 urgent matters, one imminent and the other latent. The handling of these 2 related issues requires reconciling the advocates of precaution and the supporters of progress, technology and ethics. This is not at all easy, particularly as the delay in the climatic catastrophe tends to hide the issue. It appears that there are much more reasons to act than to wait: -) the climate thread is underestimated because of the slow evolution of the consequences of climatic change, -) the possible improvement of current technologies will have a low impact, -) technological breakthroughs are too rare to rely on them, -) the capacity of new technologies to take over is always underestimated, -) the changes in the way of consuming energy requires time to involve large part of the population, and -) international mechanisms lacks efficiency and adequacy. (A.C.)

  3. 29 CFR 516.14 - Country elevator employees exempt from overtime pay requirements under section 13(b)(14) of the Act.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Country elevator employees exempt from overtime pay....14 Country elevator employees exempt from overtime pay requirements under section 13(b)(14) of the... names and occupations of all persons employed in the country elevator, whether or not covered by the Act...

  4. Urgent reconstruction and re-equipping of coking plants

    Energy Technology Data Exchange (ETDEWEB)

    Kvitkin, I.A.; Martynenko, V.M.; Rozenfel' d, M.S.; Svyatogorov, A.A.; Shvartsman, I.G.

    1986-03-01

    This paper discusses the various options involved: complete or partial reconstruction of existing buildings and equipment or new construction with new equipment and new underground and surface communications. It explains that reconstruction work is divided into three phases: initial phase (clearance, dismantling, closing down coking batteries); basic phase (fitting heat-resistant materials, prestart-up assembly work); final phase (drying out, heating up, adjustments, start-up). A structured scheme for a typical initial phase is described and a method of calculating the durations of the various phases is discussed. Conclusion is that there is an urgent requirement for a document to be produced for the control of reconstruction work; it should contain standard durations and could serve as a standard for coking plant reconstruction work.

  5. 77 FR 42947 - Unexpected Urgent Refugee and Migration Needs

    Science.gov (United States)

    2012-07-20

    ... unexpected and urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of the Bureau of Population...

  6. Lower genital tract lesions requiring surgical intervention in girls: perspective from a developing country.

    Science.gov (United States)

    Ekenze, Sebastian O; Mbadiwe, Okezie M; Ezegwui, Hyginius U

    2009-10-01

    To determine the spectrum, outcome of treatment and the challenges of managing surgical lesions of lower genital tract in girls in a low-resource setting. Retrospective study of 87 girls aged 13-years and younger, with lower genital tract lesions managed between February 2002 and January 2007 at the University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Clinical charts were reviewed to determine the types, management, outcome of treatment and management difficulties. The median age at presentation was 1 year (range 2 days-13 years). Congenital lesions comprised 67.8% and acquired lesions 32.2%. The lesions included: masculinized external genitalia (24), vestibular fistula from anorectal malformation (23), post-circumcision labial fusion (12), post-circumcision vulval cyst (6), low vaginal malformations (6), labial adhesion (5), cloacal malformation (3), bifid clitoris (3) urethral prolapse (3), and acquired rectovaginal fistula (2). Seventy-eight (89.7%) had operative treatment. Procedure related complications occurred in 19 cases (24.4%) and consisted of surgical wound infection (13 cases), labial adhesion (4 cases) and urinary retention (2 cases). There was no mortality. Overall, 14 (16.1%) abandoned treatment at one stage or another. Challenges encountered in management were inadequate diagnostic facilities, poor multidisciplinary collaboration and poor patient follow up. There is a wide spectrum of lower genital lesion among girls in our setting. Treatment of these lesions may be challenging, but the outcome in most cases is good. High incidence of post-circumcision complications and poor treatment compliance may require more efforts at public enlightenment.

  7. The hydrogen economy urgently needs environmentally sustainable hydroelectricity

    International Nuclear Information System (INIS)

    Goodland, R.

    1995-01-01

    Only two sources of energy were said to have the capacity to bridge the transition to fully sustainable and renewable energy, namely natural gas and hydro. The argument was made that because of this advantage, both forms will have to be promoted fast, since the transition to sustainable energy is urgent. In so far as natural gas supplies are concerned, it was estimated that they will last for perhaps the next 50 years, whereas hydroelectric potential is practically unlimited. Developing nations could vastly accelerate their development, reduce poverty and approach sustainability by exporting hydro to industrial countries. Similarly, industrial nations switching from fossil fuels to hydrogen could move up the environmental ranking, and significantly help alleviating global pollution and climate risks. Environmental ranking of new energy sources, world reservoirs of hydroelectric power, environmental and social ranking of hydro sites, the environmental impacts of hydro projects, and the concept of environmental sustainability in hydro reservoirs, were summarized. Greater acceptance of the need for sustainable development by the hydro industry was urged, along with more care in selecting hydro development sites with sustainability as a prime objective. 23 refs., 6 figs

  8. Adolescent Literacy in Europe--An Urgent Call for Action

    Science.gov (United States)

    Sulkunen, Sari

    2013-01-01

    This article focuses on the literacy of the adolescents who, in most European countries, are about to leave or have recently left basic education with the assumption that they have the command of functional literacy as required in and for further studies, citizenship, work life and a fulfilling life as individuals. First, the overall performance…

  9. 76 FR 80907 - TRICARE Prime Urgent Care Demonstration Project

    Science.gov (United States)

    2011-12-27

    ... care including minor illness or injury for Active Duty Family Members enrolled in TRICARE Prime or.... Current data indicates that the ADFMs frequently need urgent care while traveling to new duty stations for... DEPARTMENT OF DEFENSE Office of the Secretary TRICARE Prime Urgent Care Demonstration Project...

  10. Funding for tuberculosis research—an urgent crisis of political will, human rights, and global solidarity

    Directory of Open Access Journals (Sweden)

    Mike Frick

    2017-03-01

    Full Text Available Tuberculosis (TB killed more people in 2015 than any other single infectious agent, but funding for research to develop better prevention, diagnosis, and treatment methods for TB declined to its lowest level in 7 years. TB research and development (R&D is woefully underfunded, a situation best viewed as a crisis of political will and a failure on the part of governments to see unmet innovation needs in the TB response as a human rights issue requiring immediate action. Over 60% of available money for TB R&D comes from public sources, and 67% of public money comes from a single country: the USA. The election of Donald Trump to the US presidency in November 2016 has introduced great uncertainty into the support that science generally, and TB research in particular, will receive in the coming years. Advocacy on the part of all actors—from civil society to TB-affected communities to scientists themselves—is urgently needed to increase US government support for TB research moving forward.

  11. Funding for tuberculosis research-an urgent crisis of political will, human rights, and global solidarity.

    Science.gov (United States)

    Frick, Mike

    2017-03-01

    Tuberculosis (TB) killed more people in 2015 than any other single infectious agent, but funding for research to develop better prevention, diagnosis, and treatment methods for TB declined to its lowest level in 7 years. TB research and development (R&D) is woefully underfunded, a situation best viewed as a crisis of political will and a failure on the part of governments to see unmet innovation needs in the TB response as a human rights issue requiring immediate action. Over 60% of available money for TB R&D comes from public sources, and 67% of public money comes from a single country: the USA. The election of Donald Trump to the US presidency in November 2016 has introduced great uncertainty into the support that science generally, and TB research in particular, will receive in the coming years. Advocacy on the part of all actors-from civil society to TB-affected communities to scientists themselves-is urgently needed to increase US government support for TB research moving forward. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  12. Health Economic Data Requirements and Availability in the European Union: Results of a Survey Among 10 European Countries.

    Science.gov (United States)

    Skoupá, Jana; Annemans, Lieven; Hájek, Petr

    2014-09-01

    To compare data requirements and their availability for health economic (HE) evaluations in five countries in Central/Eastern Europe (CEE) (Poland, the Czech Republic, Slovakia, Hungary, and Romania) and five countries in Western Europe (WE) (the United Kingdom, France, Germany, The Netherlands, and Sweden). A questionnaire was developed and distributed to market access personnel from Pfizer who were asked to complete the questionnaire either from their own knowledge or with support of external experts. The questionnaire focused on the obligation to conduct HE assessment for reimbursement submissions, local HE guidelines, applied discount rates for future costs and effects, willingness-to-pay thresholds, and available data sources. HE is mandatory in all CEE and three WE participating countries for reimbursement applications of innovative drugs. Usually, cost-effectiveness analysis and budget-impact analyses are required. The preferred outcome of cost-effectiveness analysis is quality-adjusted-life years. In Romania, France, and the Czech Republic, guidelines could not be identified at the time of the survey. The applicant usually prepares HE evaluations; in Sweden, the United Kingdom, The Netherlands, and Poland, unlocked models have to be presented for scrutiny. Discount rates vary from 1.5% to 5%, and, usually, is the same for costs and outcomes (except in The Netherlands and Poland). Only the United Kingdom, Poland, and Slovakia have an explicit willingness-to-pay threshold. In Poland, it is based on the gross domestic product per capita, and in Slovakia, it is based on multiples of average monthly salary. Differences were found on data availability. In WE, data can be acquired easier than in CEE. Health insurance funds do not provide their data unless they were published. Patient registries are either not available in CEE or difficult to access, so applicants mostly rely on retrospective medical chart data, hospital information systems, or expert panels. We

  13. A Multimeasurand ISO GUM Supplement is Urgent

    Directory of Open Access Journals (Sweden)

    V V Ezhela

    2007-10-01

    Full Text Available A critical overview of the current doubtful practice on presentation of correlated data in the physics literature and in the scientific and technological databases is presented. The simple rules to calculate the rounding thresholds to preserve the positive definiteness of the covariance and correlation matrices as well as the rounding thresholds for the components of the mean vector to keep them inside the "non-rounded" scatter region are formulated. Evidence that in the multivariate case there are severe limitations on the applicability of the linear differential law of uncertainty propagation is presented. The explicit relation of the number of input random variables I, the number of output variables D, and the order T of Taylor polynomials sufficient to preserve the self-consistent numerical presentation of the mean value of the vector function and its covariance matrix under nonlinear differential propagation procedure is obtained. It is stressed that the rounding thresholds for the safe rounding of correlated data impose the severe requirements on the storage and exchange formats of the correlated data that could not be met in the traditional publications on the paper but could be realized in the electronic media.

  14. Investment requirements in the oil industry of the independent oil exporting countries in the face of environmental challenges

    International Nuclear Information System (INIS)

    Rahmat, H.; Hamid, A.A.

    1992-01-01

    The oil industry has to operate under environmental constraints which involve commercial risks. Oil companies need to treat environmental management as an investment as well as an insurance problem, assessing risks and costs and deciding how to minimize them most cost effectively. Petroleum development in Malaysia is accelerating. In view of the high visibility of the industry and the wide publicity generated by a few incidents which have taken place outside Malaysia the national oil company, Petronas, is constantly vigilant in its efforts to preserve the environment. Oil producing countries like Malaysia will need to continue to set aside some of the revenue they obtain from the oil industry and use it for protecting the environment to ensure public acceptance and ultimately, orderly growth of their industry. Clearly they are less able to do so if their income is lessened through the interference with free trade among nations even if the purported reasons for the interference is the environment itself. Ultimately the environmental investment requirement in the oil industry of the independent and developing oil exporting countries is free trade without price distortions. The 1989 Langkawi Declaration on the Environment of the Commonwealth Heads of Government is appended to this article. (author)

  15. Mini-grid based off-grid electrification to enhance electricity access in developing countries: What policies may be required?

    International Nuclear Information System (INIS)

    Bhattacharyya, Subhes C.; Palit, Debajit

    2016-01-01

    With 1.2 billion people still lacking electricity access by 2013, electricity access remains a major global challenge. Although mini-grid based electrification has received attention in recent times, their full exploitation requires policy support covering a range of areas. Distilling the experience from a five year research project, OASYS South Asia, this paper presents the summary of research findings and shares the experience from four demonstration activities. It suggests that cost-effective universal electricity service remains a challenge and reaching the universal electrification target by 2030 will remain a challenge for the less developed countries. The financial, organisational and governance weaknesses hinder successful implementation of projects in many countries. The paper then provides 10 policy recommendations to promote mini-grids as a complementary route to grid extension to promote electricity access for successful outcomes. - Highlights: •The academic and action research activities undertaken through OASYS South Asia Project are reported. •Evidence produced through a multi-dimensional participatory framework supplemented by four demonstration projects. •Funding and regulatory challenges militate against universal electrification objectives by 2030. •Innovative business approaches linking local mini-grids and livelihood opportunities exist. •Enabling policies are suggested to exploit such options.

  16. Guyana - How Do You Know Where to Get the Information You Need? Determining Ethics Approval Requirements in a Developing Country

    Directory of Open Access Journals (Sweden)

    Gloria Song

    2018-02-01

    Full Text Available Determining the process for obtaining local research ethics approval, or whether such a requirement even exists, may not always be straightforward in the context of some developing countries where such information may not be easily accessible to overseas researchers. How far do a researcher's ethical obligations extend in determining whether there is a requirement for local research ethics approval, and what form this would take (e.g., institutional or centralised ethics review? In other words, how far should a researcher be expected to go in seeking out local ethics approval, especially where such information is not readily available? As part of this discussion, this case study describes the steps that I took as the principal researcher, before I was able to reasonably conclude that no national ethics approval requirement existed in Guyana for my particular research, which involved interviewing justice service providers about the implementation of Guyana's Domestic Violence Act. Drawing on this experience, I discuss various considerations that an international development researcher should bear in mind when planning and conducting research that seeks to meet leading international norms of research ethics.

  17. Present state of nuclear regulation organizations of main countries in the world. Importance of regulation staffs and requirements

    International Nuclear Information System (INIS)

    Nishida, Naoki

    2013-01-01

    After Fukushima accident, NRA (Nuclear Regulation Authority) was established in Japan as an independent organization from promotion. In order to perform effective and reliable nuclear regulation, it was important management organization such as nuclear regulation commission worked efficiently, and also requirements for nuclear regulation staffs engaged in actual regulatory works were of importance so as for appropriate decision making or judgments of management organization. Since regulation staffs needed professional expertise and technical judgment capabilities in wide areas including other than nuclear energy, various efforts had been done to get able regulation staffs in US, France and UK nuclear regulation organizations concerned, which became clarified after overseas investigation for this article. Since knowledge in nuclear industry could be used for effective regulation, mid-career recruitment had been employed in regulation organization of each country so as to take such knowledge and so it was important how to utilize industrial knowledge under appropriate conditions compatible with independence of regulation organization. (T. Tanaka)

  18. Quantitative comparison of measurements of urgent care service quality.

    Science.gov (United States)

    Qin, Hong; Prybutok, Victor; Prybutok, Gayle

    2016-01-01

    Service quality and patient satisfaction are essential to health care organization success. Parasuraman, Zeithaml, and Berry introduced SERVQUAL, a prominent service quality measure not yet applied to urgent care. We develop an instrument to measure perceived service quality and identify the determinants of patient satisfaction/ behavioral intentions. We examine the relationships among perceived service quality, patient satisfaction and behavioral intentions, and demonstrate that urgent care service quality is not equivalent using measures of perceptions only, differences of expectations minus perceptions, ratio of perceptions to expectations, and the log of the ratio. Perceptions provide the best measure of urgent care service quality.

  19. Requirements for effective technology transfer for engineering and project management. The views of the recipient country and the technology supplier

    International Nuclear Information System (INIS)

    Backhaus, K.W.

    1986-04-01

    Technology transfer in the area of engineering and project management for nuclear power plant projects is considered a rather complex and sophisticated matter. Therefore only within a long-term nuclear co-operation a meaningful transfer of such a multifaceted technology can reasonably be achieved. A long-term nuclear co-operation anticipates a nuclear power plant program consisting of a few nuclear power plants of a certain type and size in order to achieve the indispensable effect ''learning by doing''. The objectives of nuclear technology transfer may be in general or in particular; absorption of a foreign nuclear technology and its adaptation to the conditions and needs of the receiver's country; built-up of industrial infrastructure for planning, construction and operation of nuclear power plants; raising of the general industrial level and achieve a spin-off effect; creation of a basis for independent development of nuclear technology. The technology transfer on one side and the construction program of nuclear power plants on the other side cannot be practiced by two parallel but separated event, however, they form one unit. Contrary to the import of industrial equipment in terms of ''black box'', by means of a nuclear technology transfer the introduction of new dependencies will be prevented. The technology transfer can remarkably be facilitated by forming a joint venture engineering company in the recipient country. The required know-how potential within a certain time period determines the intensity of the technology transfer and consequently the man power to be involved. The realization of such technology transfer is demonstrated by means of practical examples. (author). 12 figs

  20. Urgent Safety Measures in Japan after Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Taniura, Wataru; Otani, Hiroyasu

    2012-01-01

    Due to tsunami triggered by the Great East Japan Earthquake, the operating and refueling reactor facilities at Fukushima Dai-ichi and Dai-ni Nuclear Power Plants caused a nuclear hazard. Given the fact, Japanese electric power companies voluntarily began to compile various urgent measures against tsunami. And then the Nuclear and Industrial Safety Agency (NISA) ordered the licensees to put into practice the voluntarily compiled urgent safety measures, in order to ensure the effectiveness of the means for recovering cooling functions along with avoiding the release of radioactive substances to the possible minimum, even if a huge tsunami following a severe earthquake hits nuclear power plants. The following describes the state and the effect of the urgent safety measures implemented for 44 reactors (under operation) and 1 reactor (under construction) in Japan and also describes the measures to be implemented by the licensees of reactor operation in the future.

  1. Predictors of Urgent Findings on Abdominopelvic CT in Patients with Crohn's Disease Presenting to the Emergency Department.

    Science.gov (United States)

    Jung, Yoon Suk; Park, Dong Il; Hong, Sung Noh; Kim, Eun Ran; Kim, Young Ho; Cheon, Jae Hee; Eun, Chang Soo; Han, Dong Soo; Lee, Chang Kyun; Kim, Jae Hak; Huh, Kyu Chan; Yoon, Soon Man; Song, Hyun Joo; Shin, Jeong Eun; Jeon, Seong Ran

    2015-04-01

    Patients with Crohn's disease (CD) are frequently exposed to diagnostic radiation, mainly as a result of abdominopelvic computed tomography (APCT) examinations. However, there are limited data on the impact of APCT on clinical management in this population. To investigate clinical predictors of urgent findings on APCT in patients with CD who presented to the emergency department (ED). A retrospective study was performed among patients with CD presenting to 11 EDs with a gastrointestinal complaint. The primary outcome, OPAN (obstruction, perforation, abscess, or non-CD-related urgent findings), included new or worsening CD-related urgent findings or non-CD-related urgent findings that required urgent or emergency treatment. Variables with P 100 beats/min (OR 2.33, 95 % CI 1.10-4.93), leukocyte count >10,000/mm(3) (OR 4.38, 95 % CI 2.10-9.13), and CRP >2.5 mg/dL (OR 3.11, 95 % CI 1.23-7.86) were identified as the independent predictors of OPAN, whereas biologic agent use (OR 0.37; 95 % CI 0.15-0.90) was identified as the negative predictor in patients with CD. Only 39 % of the APCTs performed in the ED among patients with CD showed urgent findings. Stricturing or penetrating disease, tachycardia, leukocytosis, and high CRP level were predictors of urgent CT findings, while biologic agent use was a negative predictor. To reduce unnecessary radiation exposure, the selection process for CD patients referred for APCT must be improved.

  2. Urgent Safety Measures in Japan after Great East Japan Earthquake

    International Nuclear Information System (INIS)

    Taniura, W.; Otani, H.

    2012-01-01

    Due to tsunami triggered by the Great East Japan Earthquake on March 11, 2011, the operating and refueling reactor facilities at Fukushima Dai-ichi and Dai-ni Nuclear Power Plants of Tokyo Electric Power Co. caused a nuclear hazard. Japanese electric power companies voluntarily began to compile various urgent measures against tsunami within the week the hazard was caused. As for the urgent safety measures of each licensee, it is clarified that effective measures have been appropriately implemented as a result of the inspection of the national government, the verification based on the guideline of the Japan Society of Maintenology and the stress test. (author)

  3. Use of a voice and video internet technology as an alternative to in-person urgent care clinic visits.

    Science.gov (United States)

    Brunett, Patrick H; DiPiero, Albert; Flores, Christine; Choi, Dongseok; Kum, Hayley; Girard, Donald E

    2015-06-01

    This study aimed to determine the feasibility of patient-initiated online Internet urgent care visits, and to describe patient characteristics, scope of care, provider adherence to protocols, and diagnostic and therapeutic utilization. A total of 456 unique patients were seen via Internet-based technology during the study period, generating 478 consecutive total patient visits. Of the 82 patients referred for an in-person evaluation, 75 patients (91.5%) reported to the clinic as instructed. None of the 82 patients recommended for in-person evaluation required an emergency department referral, hospital admission or urgent consultative referral. We conclude that real-time online primary and urgent care visits are feasible, safe and potentially beneficial in increasing convenient access to urgent and primary care. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. 77 FR 21389 - Unexpected Urgent Refugee and Migration Needs

    Science.gov (United States)

    2012-04-10

    ... April 3, 2012 Unexpected Urgent Refugee and Migration Needs Memorandum for the Secretary of State By the... 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as amended, (22 U.S.C... United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting unexpected and...

  5. Urgent water challenges are not sufficiently researched”

    NARCIS (Netherlands)

    Van der Zaag, P.; Gupta, J.; Darvis, L.P.

    2009-01-01

    In this opinion paper we submit that water experts conduct comparatively little research on the more urgent challenges facing the global community. Five specific biases are identified. First, research in the field of water and sanitation is heavily biased against sanitation. Second, research on food

  6. Actual Problems of Conclusion and Discharge of Urgent Labour Contracts

    Directory of Open Access Journals (Sweden)

    Shevelyova A. A.

    2013-05-01

    Full Text Available This article is devoted to the consideration of the questions connected with the conclusion and the termination of the urgent labour contract. The author, analyzing judicial practice, allocates the problems of separate regulation of the RF labour legislation enforcement.

  7. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    OpenAIRE

    Jenkins Hatice; Hossain Monir

    2017-01-01

    Providing small and medium enterprises (SMEs) with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analy...

  8. What drives energy consumption in developing countries? The experience of selected African countries

    International Nuclear Information System (INIS)

    Keho, Yaya

    2016-01-01

    This study investigates the drivers of energy consumption in Sub-Saharan African countries. It applies the bounds testing approach to cointegration to time series data at individual country levels over the period from 1970 to 2011. The study finds that energy consumption is cointegrated with real GDP per capita, industrial output, imports, foreign direct investment, credit to private sector, urbanization and population. Furthermore, the sign and magnitude of long-run estimates vary significantly for a single country and across countries depending on the energy consumption variable used. Overall, the findings confirm the leading role of economic growth, industrial output, population and urbanization. Economic growth, industrial output and population have positive effects on energy consumption in the majority of countries. Given the urgent need to address climate change, African countries should adopt policies to improve energy efficiency and accelerate transition toward renewable energy. The African Renewable Energy Initiative launched at the 21st session of the United Nations Conference of the Parties (COP21) is an opportunity for African countries to provide and maintain widespread access to reliable and affordable environmentally cleaner energy to meet the requirements of rapid economic growth and improved living standards. - Highlights: •Key drivers of energy use in 12 African countries are examined. •Economic growth, industrial GDP, population and urbanization play a leading role in explaining energy use. •Urbanization has a positive effect on energy use in six countries and a negative effect in four countries. •The results obtained have useful policy implications.

  9. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    Directory of Open Access Journals (Sweden)

    Jenkins Hatice

    2017-01-01

    Full Text Available Providing small and medium enterprises (SMEs with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analyzes how macroeconomic factors have contributed to increased commercial bank lending to SMEs in six emerging market countries: Turkey, Argentina, Brazil, Mexico, Chile, and Poland. Based on time series and panel data analysis, we find that a high GDP growth rate and increased competition in the banking sector have contributed to increased banking sector credit to SMEs. The findings also reveal that curbing the high inflation rate and reducing government domestic borrowing have significantly encouraged bank lending to the SME segment.

  10. Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series

    Directory of Open Access Journals (Sweden)

    Dincer Aktuerk

    2016-01-01

    Full Text Available Background: Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials and Methods: A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real-time monitoring of cerebral oxygenation with near-infrared spectroscopy (NIRS. The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery in any single institution will be small and hence there is a lack of large randomized studies. Results: This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8. In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO 2 , etc., were taken. Conclusion: The study shows good clinical outcome with the use of NIRS. This is our "work in progress," and we aim to conduct a larger study.

  11. Characterising non-urgent users of the emergency department (ED): A retrospective analysis of routine ED data.

    Science.gov (United States)

    O'Keeffe, Colin; Mason, Suzanne; Jacques, Richard; Nicholl, Jon

    2018-01-01

    The pressures of patient demand on emergency departments (EDs) continue to be reported worldwide, with an associated negative impact on ED crowding and waiting times. It has also been reported that a proportion of attendances to EDs in different international systems could be managed in settings such as primary care. This study used routine ED data to define, measure and profile non-urgent ED attendances that were suitable for management in alternative, non-emergency settings. We undertook a retrospective analysis of three years of Hospital Episode and Statistics Accident Emergency (HES A&E) data for one large region in England, United Kingdom (April 1st 2011 to March 31st 2014). Data was collected on all adult (>16 years) ED attendances from each of the 19 EDs in the region. A validated process based definition of non-urgent attendance was refined for this study and applied to the data. Using summary statistics non-urgent attenders were examined by variables hypothesised to influence them as follows: age at arrival, time of day and day of week and mode of arrival. Odds ratios were calculated to compare non-urgent attenders between groups. There were 3,667,601 first time attendances to EDs, of which 554,564 were defined as non-urgent (15.1%). Non-urgent attendances were significantly more likely to present out of hours than in hours (OR = 1.19, 95% CI: 1.18 to 1.20, Paged 16-44) compared to those aged 45-64 (odds ratio: 1.42, 95% CI: 1.41 to 1.43, Puse the ED to obtain healthcare that could be provided in a less urgent setting and also more likely to do this out of hours. Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours.

  12. Study on treatment of postpartum hemorrhage with urgent interventional embolization

    International Nuclear Information System (INIS)

    Xi Jiayuan; Ren Shuping; Lu Liang; Jiao Cunxian; Liu Yunxia; Yang Yu; Deng Gang; Li Jikang; Cao Xinhua; Mi Lan

    2002-01-01

    Objective: To evaluate urgent selective arterial embolization to treat massive postpartum hemorrhage. Methods: Twenty-seven patients with ages of 21-53 years undergoing severe postpartum hemorrhage, were due to central placental previa, uterine atony, birth canal trauma, placenta accretio, cervical pregnancy etc. All of the patients had lost a volume of blood about 1000 ml to 5000 ml while the hemorrhage could not be controlled with vaginal packing and administration of uterotonic drugs. Urgent hemostatic embolization was performed for them. After angiography, super selective catheterization was performed for bilateral anterior division of internal iliac branch of uterine arteries and embolized with Gelfoam particles. Results: Catheterization success rate was 96.3%. Angiography showed ectopic uterine artery in one case. Immediate block of hemorrhage took place in 22 cases and gradual hemostasis appeared in 4 cases, the efficacy rate was 96.3%. The one with ectopic uterine artery was operated upon to ablate the uterus. 11 patients with (bleeding) shock and 8 patients with DIC were all saved. Conclusions: Urgent arterial embolization is an ideal method for treating life-threatening postpartum hemorrhage. The procedure saves the maternal uterus and is also effective for postpartum DIC

  13. Global occupational health: current challenges and the need for urgent action.

    Science.gov (United States)

    Lucchini, Roberto G; London, Leslie

    2014-01-01

    Global occupational health and safety (OHS) is strictly linked to the dynamics of economic globalization. As the global market is increasing, the gap between developed and underdeveloped countries, occupational diseases, and injuries affect a vast number of workers worldwide. Global OHS issues also become local in developed countries due to many factors, including untrained migrant workers in the informal sector, construction, and agriculture. To identify the current status and challenges of global occupational health and safety and the needs for preventive action. Absence of OHS infrastructure amplifies the devastating consequences of infectious outbreaks like the Ebola pandemic and tuberculosis. Interventions in global OHS are urgently needed at various levels: 1. Increased governmental funding is needed for international organizations like the World Health Organization and the International Labor Organization to face the increasing demand for policies, guidance, and training. 2. Regulations to ban and control dangerous products are needed to avoid the transfer of hazardous production to developing countries. 3. The OHS community must address global OHS issues through advocacy, position papers, public statements, technical and ethical guidelines, and by encouraging access of OHS professionals from the developing countries to leadership positions in professional and academic societies. 4. Research, education, and training of OHS professionals, workers, unions and employers are needed to address global OHS issues and their local impact. 5. Consumers also can influence significantly the adoption of OHS practices by demanding the protection of workers who are producing he goods that are sold in the global market. Following the equation of maximized profits prompted by the inhibition of OHS is an old practice that has proven to cause significant costs to societies in the developed world. It is now an urgent priority to stop this process and promote a harmonized global

  14. Urgent Protection versus Chronic Need: Clarifying the Dual Mandate of Child Welfare Services across Canada

    Directory of Open Access Journals (Sweden)

    Nico Trocmé

    2014-08-01

    Full Text Available This study analyzed data from the 1998, 2003 and 2008 Canadian Incidence Study of reported child abuse and neglect (CIS and compared the profile of children who were reported for an urgent protection investigation versus any other investigation or assessment. As a proportion of all investigations, urgent protection cases have dropped from 28% of all investigations in 1998, to 19% in 2003, to 15% in 2008. Results from the CIS-2008 analysis revealed that 7% of cases involved neglect of a child under four, 4% of cases involved sexual abuse, 2% of cases involved physical abuse of a child under four and 1% of cases involved children who had sustained severe enough physical harm that medical treatment was required. The other 85% of cases of investigated maltreatment involved situations where concerns appear to focus less on immediate safety and more on the long-term effects of a range of family related problems. These findings underscore the importance of considering the dual mandate of child welfare mandates across Canada: intervening to assure the urgent protection and safety of the child versus intervening to promote the development and well-being of the child.

  15. Régimen constitucional del internamiento involuntario y urgente por trastorno mental = Constitucional framework on involuntary and urgent confinement due to mental disorder

    Directory of Open Access Journals (Sweden)

    Juan Francisco Sánchez Barrilao

    2013-05-01

    Full Text Available El presente trabajo aborda el régimen constitucional de los internamientos involuntarios y urgentes por trastorno mental como un supuesto de limitación de derechos fundamentales (especialmente, libertad personal; y, en particular, a la vista de la doctrina contenida en la Sentencia del Tribunal Constitucional 141/2012, dictada en resolución de un recurso de amparo al respecto. En tal sentido, se analiza el marco normativo de dichos internamientos (distinguiendo entre el estrictamente constitucional, el internacional y el meramente legal, su naturaleza (en relación al internamiento como tal, como respecto a la intervención judicial que ha de autorizarlo, sus concretas garantías (en especial, a la vista de la STC 141/2012, así como diversas cuestiones abiertas por la anterior Sentencia, no obstante, y que requieren de oportuna respuesta legal. The following piece of paper deals with the constitutional rule of the involuntary and urgent confinements due to mental disorder as restricting fundamental rights (especially, personal liberty according to the principles established in the judgement of the Spanish Constitutional Court 141/2012. Accordingly, the legal frameworkof a such confinements is analysed (making a distinction among constitutional, international and legal rules, its nature (ref. both confinements itself, as the role of judge who must authorize, its specific guarantees (in accordance with the judgement STC 141/2012, as well as a variety of issues requiring a timely legal response.

  16. Current positions in OECD member countries on competence profiles at present and requirements for the future: review of questionnaire responses

    International Nuclear Information System (INIS)

    Griffiths, J.S.

    2000-01-01

    The picture is mixed and very dependent on the state of the industry in the particular country. A key determinant is the social, political and economic views of the place of nuclear power generation within the energy policy. Where there is support at a political level or there are clearer financial incentives then the industry can develop and has the impetuous to maintain their capabilities and competence. If the industry position is not as strong the social pressures increase so that it is not viewed as a career. Recruitment and retention and maintaining competence becomes more difficult. Furthermore there are trends to move away from the traditional engineering and science degrees towards subjects which have a 'consumer vogue' and even more proven track records of employment. This in turn puts pressure on the availability of university level education at all levels. Hence if there are not well developed alternatives within a country and programmes of cooperation the very foundation of training and development is under threat. The problems have been recognised and there are a number of initiatives in place both in regulatory bodies, training establishments and the utilities. Recognition of the problem and transfer of good practices will help. Fundamentally there has to be the underpinning infrastructure to support education and training which in itself will allow for cross fertilization with the industry. It is clear that the problem is international and there has to be scope for international cooperation. (authors)

  17. Urgent Carotid Surgery: Is It Still out of Debate?

    Directory of Open Access Journals (Sweden)

    C. Battocchio

    2012-01-01

    Full Text Available Patients with symptomatic tight carotid stenosis have an increased short-time risk of stroke and an increased long-term risk of ischaemic vascular events compared with the general population. The aim of this study is to assess the safety, efficacy, and limitations of urgent CEA or CAS, in patients with carotid stenosis greater than 70% and clinically characterized by recurrent TIA or brain damage following a stroke (<2.5 cm. This study involved 28 patients divided into two groups. Group A consisted of sixteen patients who had undergone CEA, and group B consisted of twelve patients who had undergone CAS. Primary endpoints were mortality, neurological morbidity (by NIHSS and postoperative hemorrhagic cerebral conversion, at 30 days. Ten patients (62.5% of group A experienced an improvement in their initial neurological deficit while in 4 cases (26% the deficit remained stable. Two cases of neurologic mortality are presented. At 1 month, 9 patients (75% of group B experienced an improvement in their initial neurological deficit while 3 patients (25% had a neurological impairment. Urgent or deferred surgical or endovascular treatment have a satisfactory outcome considering the profile in very high-risk patient population. Otherwise in selected patients CEA seems to be preferred to CAS.

  18. A review of countries' pharmacist-patient communication legal requirements on prescription medications and alignment with practice

    DEFF Research Database (Denmark)

    Svensberg, Karin; Sporrong, Sofia Kälvemark; Björnsdottir, Ingunn

    2015-01-01

    BACKGROUND: Pharmacist-patient communication around prescription medications can optimize treatment outcomes. Society's expectations of pharmacist-patient communication around medications can be expressed in legislation, economic incentives, and authority control. In this study, the Nordic...... countries of Denmark, Finland, Iceland, Norway and Sweden provide the legislative examples and can be used as a platform to discuss how society's expectations, professional visions, and practice are aligning. OBJECTIVE: The overall aim of this study was to describe society's expectations of pharmacist......-patient communication around medications as expressed by the state in Nordic legislation, economic incentives and authority control. Additionally, this study describes how the states govern Nordic pharmacists in different pharmacy systems. METHOD: A legal review was performed using online legislative databases...

  19. The ED use and non-urgent visits of elderly patients

    Directory of Open Access Journals (Sweden)

    Umut Gulacti

    2016-12-01

    Full Text Available Objective: To evaluate the use of the emergency department (ED by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. Methods: This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. Results: A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001. While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001. For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001. The prevalence of upper respiratory tract infection (URTI was the highest within the elderly population (17.5%, CI: 17.1–17.9. The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%, and they were highest in the winter season (25.9% and in January (10.2%. The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. Conclusion: The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries. Keywords: Non-urgent, Prevalence, Visit, Main disease, Elderly patient, Emergency department

  20. Strengthening the capacity of SMEs and local authorities in developing countries to tackle environmental requirements in the supply chain

    Energy Technology Data Exchange (ETDEWEB)

    Sonnemann, G. [Div. of Technology, Industry and Economics (DTIE), United Nations Environment Programme (UNEP), Paris (France)

    2004-07-01

    UNEP DTIE, through its Life Cycle Initiative, proposes to join with industry to strengthen the capacity of the weakest economic actors in the global supply chains to tackle environmental requirements. Two particularly important target groups for this project are SMEs and local authorities. Although the SMEs are the immediate actors, they need appropriate political institutions to provide an enabling framework. Multinational companies are continuously increasing the environmental requirements that their suppliers have to meet in order to provide a green image for the final product reaching western markets. Some multinational companies have accompanied these requirements with information and training of suppliers. By joining with UNEP they will be able to expand the effectiveness of their outreach and also gain greater visibility for their environmental policies. For SMEs this project is an opportunity to develop environmental management expertise and thus position themselves as reliable suppliers to leading companies. (orig.)

  1. [Budget impact analysis of idarucizumab for the management of patients treated with dabigatran in emergency / urgent situations in Italy

    Directory of Open Access Journals (Sweden)

    Andrea Belisari

    2016-06-01

    CONCLUSION: Idarucizumab for the management of patients treated with dabigatran in emergency / urgent situations has the potential for substantial savings, compared to treatments currently available. This preliminary assessment will require further confirmatory evidence when the product will become available in Italian healthcare setting. [Article in Italian

  2. The ED use and non-urgent visits of elderly patients.

    Science.gov (United States)

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-12-01

    To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p elderly age groups (p elderly population (17.5%, CI: 17.1-17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units. The proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

  3. Quality of emergency rooms and urgent care services: user satisfaction.

    Science.gov (United States)

    Lima, Cássio de Almeida; Santos, Bruna Tatiane Prates dos; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; Costa, Fernanda Marques da; Carneiro, Jair Almeida

    2015-01-01

    To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.

  4. Space nonweaponization. An urgent task for arms control

    International Nuclear Information System (INIS)

    Du Xiangwan; Pan Jusheng; Zhang Xinwei; Du Shuhua; Xu Changgen

    1990-05-01

    The authors attempt to expound the basic points of veiw and put forward a proposal on the space nonweaponization. The authors analyse the nature of space weaponry and its impact on arms race and point out that the space nonweaponization is an urgent task for arms control. The relations between prohibition of space and ASAT weapons, between prohibition of space weapons and reduction of nuclear weapons and between space weapon and nuclear test are all analysed. The inadequacy of the existing space treaties is made clear based on the evaluation. It is hoped that a verifiable treaty on the prohibition of space weapons should be made and international cooperation on peaceful use of outer space is necessary

  5. Projections of costs, financing, and additional resource requirements for low- and lower middle-income country immunization programs over the decade, 2011-2020.

    Science.gov (United States)

    Gandhi, Gian; Lydon, Patrick; Cornejo, Santiago; Brenzel, Logan; Wrobel, Sandra; Chang, Hugh

    2013-04-18

    The Decade of Vaccines Global Vaccine Action Plan has outlined a set of ambitious goals to broaden the impact and reach of immunization across the globe. A projections exercise has been undertaken to assess the costs, financing availability, and additional resource requirements to achieve these goals through the delivery of vaccines against 19 diseases across 94 low- and middle-income countries for the period 2011-2020. The exercise draws upon data from existing published and unpublished global forecasts, country immunization plans, and costing studies. A combination of an ingredients-based approach and use of approximations based on past spending has been used to generate vaccine and non-vaccine delivery costs for routine programs, as well as supplementary immunization activities (SIAs). Financing projections focused primarily on support from governments and the GAVI Alliance. Cost and financing projections are presented in constant 2010 US dollars (US$). Cumulative total costs for the decade are projected to be US$57.5 billion, with 85% for routine programs and the remaining 15% for SIAs. Delivery costs account for 54% of total cumulative costs, and vaccine costs make up the remainder. A conservative estimate of total financing for immunization programs is projected to be $34.3 billion over the decade, with country governments financing 65%. These projections imply a cumulative funding gap of $23.2 billion. About 57% of the total resources required to close the funding gap are needed just to maintain existing programs and scale up other currently available vaccines (i.e., before adding in the additional costs of vaccines still in development). Efforts to mobilize additional resources, manage program costs, and establish mutual accountability between countries and development partners will all be necessary to ensure the goals of the Decade of Vaccines are achieved. Establishing or building on existing mechanisms to more comprehensively track resources and

  6. Strengthening International Collaboration: Geosciences Research and Education in Developing Countries

    Science.gov (United States)

    Fucugauchi, J. U.

    2009-05-01

    Geophysical research increasingly requires global multidisciplinary approaches and global integration. Global warming, increasing CO2 levels and increased needs of mineral and energy resources emphasize impact of human activities. The planetary view of our Earth as a deeply complex interconnected system also emphasizes the need of international scientific cooperation. International collaboration presents an immense potential and is urgently needed for further development of geosciences research and education. In analyzing international collaboration a relevant aspect is the role of scientific societies. Societies organize meetings, publish journals and books and promote cooperation through academic exchange activities and can further assist communities in developing countries providing and facilitating access to scientific literature, attendance to international meetings, short and long-term stays and student and young researcher mobility. Developing countries present additional challenges resulting from limited economic resources and social and political problems. Most countries urgently require improved educational and research programs. Needed are in-depth analyses of infrastructure and human resources and identification of major problems and needs. Questions may include what are the major limitations and needs in research and postgraduate education in developing countries? what and how should international collaboration do? and what are the roles of individuals, academic institutions, funding agencies, scientific societies? Here we attempt to examine some of these questions with reference to case examples and AGU role. We focus on current situation, size and characteristics of research community, education programs, facilities, economic support, and then move to perspectives for potential development in an international context.

  7. Existing nuclear power plants and new safety requirements - an international survey. A description of the legal situation and of the regulatory practice in eight countries and in Germany

    International Nuclear Information System (INIS)

    Raetzke, C.; Micklinghoff, M.

    2006-01-01

    In our days, the question of whether existing nuclear power plants can be expected to comply with new standards is relevant for many reasons. The idea of writing this report was sparked by the fact that the German Federal Ministry of the Environment is planning a thorough revision of the regulations concerning nuclear safety. Since in Germany, according to the latest amendment to the Nuclear Act, a licence for a new plant cannot be granted, this project inevitably raises the basic question of whether the existing plants can be forced to comply with new safety regulation, if necessary by performing substantial backfitting. Aim of the enquiry is to find out how the question outlined above - new requirements for existing nuclear power plants - is dealt with in nine countries, namely Germany, Switzerland, France, Sweden, Finland, the United Kingdom, the USA, Spain and Belgium. In order to give a legible and qualified account, the authors have also investigated and depicted the general legislative and regulatory framework for nuclear of each country. Therefore, the book can also be read as a general introduction into the legal system and regulatory practice of these countries. (orig.)

  8. Patenting human stem cells: an urgent need for a clarification.

    Science.gov (United States)

    Byk, Christian

    2008-09-01

    Patenting human stem cells has become one of the most controversial issues of the bioethics field at the beginning of the XXIst century, at least in industrial countries. This article relates the story of the long legal adventure that preceded the ruling of the Warf case by the Enlarged board of appeal of the European Patent Office on 25th November 2008.

  9. Urgent need for warming experiments in tropical forests

    Science.gov (United States)

    Calaveri, Molly A.; Reed, Sasha C.; Smith, W. Kolby; Wood, Tana E.

    2015-01-01

    powerful and urgent way forward in order to improve our understanding of tropical forest responses to climate change.

  10. The urgent need to internalize CO2 emission costs

    International Nuclear Information System (INIS)

    Goodland, R.; El Serafy, S.

    1998-01-01

    Despite growing manifestations of global warming and the commitment of most nations to move towards reducing greenhouse gas (GHG) emissions, a simple device that can be effective in reducing GHG emissions continues to be overlooked or even rejected. This is to acknowledge the fact that carbon emissions inflict global costs that are not borne by emitters. This paper advocates that all activities emitting or saving carbon emissions should internalize the carbon cost inflicted or avoided by new projects involving CO 2 . Considering the current wide range of carbon cost estimates, the paper recommends that a two-stage approach be adopted. Firstly, incorporate carbon costs in project analysis only theoretically in order to differentiate objectively among alternative designs involving carbon emissions of varying degrees. Different estimates of the costs of a ton of carbon would be used in order to test the sensitivity of rates of return to alternative carbon costs. While this process would have the effect of screening the allocation of scarce investment funds among projects that affect global warming in different degrees, it should be viewed as only a first step. Secondly, we advocate a rigorous process of passing through estimated carbon costs to the ultimate users of the services of carbon-emitting projects and processes. It is this ultimate process that will secure the urgently needed transition from the current dependence on fossil fuels to more benign sources of energy that would reduce climate-change risks. Since the time available is limited, the paper points out the urgency of these proposals that are crucial for sustainability

  11. Urgent intra-arterial thrombolytic therapy for acute ischemic stroke

    International Nuclear Information System (INIS)

    Jin Zhengyu; Zhang Qing; Huang Yining; Cui Liying; Yang Ning; Liu Wei; Pan Jie; Gao Shan; Ye Jian; Xu Weihai; Liu Fangjian; Wang Leying; Chen Jun; Dai Jianping

    2002-01-01

    Objective: The authors report the results of urgent intra-arterial thrombolysis (IAT) in patients within 6 h of acute ischemic stroke onset. The purpose of the study was to observe the safety and efficacy of IAT and to analysis the predictive factors related to the outcome. Methods: 25 patients were treated by IAT using urokinase (UK) or recombinant Streptokinase (r-SK) in Union hospital. Primary neuroradiological assessment was performed with CT in all patients. Mechanical disruption of clot remnants was attempted after UK or r-SK was infused. Angiographic recanalization was classified according to Thrombolysis In Myocardial Infarction (TIMI) grades. Clinical outcome was classified as good for Modified Rankin Scale (MRS) scores of 0 to 3 and poor for MRS scores of 4 to 6. Results: There are 18(72%) of patients TIMI 0-1 and 7(28%) patients TIMI 2 before thrombolysis was performed. The rates of complete/partial recanalization just after infusion were 72%, minimal or no recanalization were 28%. 18(72%) of the 25 patients had good outcome, 7(28%) had poor outcome. Cerebral hemorrhage occurred in 4 of the 25 patients, all with poor outcome. Conclusion: Intra-arterial thrombolysis (IAT) is feasible and safe in the setting of acute stroke. Collateral circulation, recanalization and improvement by 4 or more points on NIHSSS within 24 hours were significantly associated with good outcome, there was significantly association between no recanalization and cerebral hemorrhage and death. The key to improve the effect of IAT was successful recanalization

  12. IAEA calls for urgent action on nuclear situation in Iraq

    International Nuclear Information System (INIS)

    2003-01-01

    Full text: The Director General of the International Atomic Energy Agency (IAEA), Dr. Mohamed ElBaradei, called on the United States and other Coalition authorities to allow IAEA experts to return to Iraq to address a possible radiological emergency there. 'I am deeply concerned by the almost daily reports of looting and destruction at nuclear sites and about the potential radiological safety and security implications of nuclear and radiological materials that may no longer be under control.' Such reports have described among other things yellow cake emptied on the ground from containers then taken for domestic use, and radioactive sources being stolen and removed from their shielding. 'We have a moral responsibility to establish the facts without delay and take urgent remedial action,' said Dr. ElBaradei. As hostilities in Iraq were coming to an end, Dr. ElBaradei wrote on 10 April to the US government bringing its attention to the need to secure the nuclear material stored at Tuwaitha - Iraq's nuclear research centre - and under IAEA seal since 1991. The IAEA also provided the United States with information about the nuclear material, radioactive sources, and nuclear waste in Iraq. The IAEA received oral assurances that physical protection of the site was in place; but following reports of looting there and at other sites, Dr. ElBaradei wrote again on 29 April, emphasizing the responsibility of the Coalition forces to maintain appropriate protection over the materials in question. This includes natural and low-enriched uranium, radioactive sources such as Cobalt 60 and Caesium 137, and nuclear waste. Dr. ElBaradei regrets that the IAEA has to date not received a response. He again urged that the Agency be allowed to send a safety and security team to Iraq so that a potentially serious humanitarian situation can be addressed without further delay. The IAEA has experienced international teams of radiation safety, nuclear security and emergency response specialists

  13. Characterising non-urgent users of the emergency department (ED: A retrospective analysis of routine ED data.

    Directory of Open Access Journals (Sweden)

    Colin O'Keeffe

    .12, 95% CI: 2.09 to 2.15, P<0.001.Younger adults are significantly more likely as older counterparts to use the ED to obtain healthcare that could be provided in a less urgent setting and also more likely to do this out of hours. Alternative services are required to manage non-urgent demand, currently being borne by the ED and the ambulance service, particularly in out of hours.

  14. Safety decommissioning regulations of radiochemical objects - the problem, requires urgent decision

    International Nuclear Information System (INIS)

    Rovnyj, S.I.; Arsent'eva, N.V.; Emel'yanov, N.M.; Kolesnikov, V.N.

    2001-01-01

    The necessity of planning and pursuance of the measures on decommissioning of radiochemical industry is discussed. Technological processes were stopped more than in 30 buildings and constructions of the PO Mayak. The characteristics of the technological buildings to be decommissioned were treated in the context of building peculiarities, function, character and level of contamination. An acceptable variant for reactor decommissioning invites development of the standard-legal aspects [ru

  15. China: a rich flora needed of urgent conservation

    OpenAIRE

    López-Pujol, Jordi; Zhao, A-Man

    2004-01-01

    [EN] China is one of the richest countries in plant biodiversity in the world. Besides to a rich flora, which contains about 33 000 vascular plants (being 30 000 of these angiosperms, 250 gymnosperms, and 2 600 pteridophytes), there is a extraordinary ecosystem diversity. In addition, China also contains a large pool of both wild and cultivated germplasm; one of the eight original centers of crop plants in the world was located there. China is also considered one of the main ce...

  16. The on-line European Community urgent radiological information exchange (ECURIE) information system

    International Nuclear Information System (INIS)

    De Cort, M.; Breitenbach, L.; De Vries, G.

    1998-01-01

    Immediately after the accident at the Chernobyl NPP, both the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) set up a system to meet the requirements for early warning and exchange of information. The Environment Institute of the CEC JRC-Ispra provides technical assistance for the European community Urgent Radiological Information Exchange system (ECURIE). By this system, Member State contact points can exchange information in a coded format. In order to facilitate the use and to assure the data quality, a Coding-Decoding Software (CDS) was developed in collaboration with the I.A.E.A. A new version, called CoDecS, is under development. An ECURIE data bank is under construction, which will automatically recognize and store incoming ECURIE messages. Further on, query and reporting software will be developed. The background objectives and the conceptual basis for the structure of the on-line information system is described. (author)

  17. China : a rich flora needed of urgent conservation

    OpenAIRE

    López-Pujol, Jordi

    2004-01-01

    China is one of the richest countries in plant biodiversity in the world. Besides to a rich flora, which contains about 33.000 vascular plants (being 30.000 of these angiosperms, 250 gymnosperms, and 2.600 pteridophytes), there is a extraordinary ecosystem diversity. In addition, China also contains a large pool of both wild and cultivated germplasm; one of the eight original centers of crop plants in the world was located there. China is also considered one of the main centers of origin and ...

  18. Expedited Systems Engineering for Rapid Capability and Urgent Needs

    Science.gov (United States)

    2012-12-31

    these areas. Different techniques for specification of software requirements (SysML), simulation models (Arena) and enterprise architecture ( BPMN ...were compared and the different concepts of each language were related to each other using DoDAF 2.0 as a framework. A prototype converter between BPMN ...2.0 XML and Arena was developed that allowed users to reuse BPMN models for event simulation. Motivation: Requirements management for software

  19. Home care robot for socially supporting the elderly: focus group studies in three European countries to screen user attitudes and requirements.

    Science.gov (United States)

    Zsiga, Katalin; Edelmayer, Georg; Rumeau, Pierre; Péter, Orsolya; Tóth, András; Fazekas, Gábor

    2013-12-01

    The growing number of elderly individuals presents new challenges for society. Many elderly individuals have physical or cognitive impairments and require support from caregivers. An attempt to overcome the limitations caused by the lack of human caregivers is the inclusion of assistive technology such as socially active robots. The Domeo-project of the Ambient Assisted Living Joint Programme of the European Union aims to develop a new companion robotic system that would allow assistance to the elderly. The requirements and attitude of the potential users and caregivers have been assessed in Austria, France and Hungary. The robot functions were demonstrated to the participants. Three focus groups were formed: potential end users, older caregivers and younger caregivers. The discussions were recorded and processed according to six aspects: (i) acceptability and privacy, (ii) pertinence of services, (iii) possible obstacles, (iv) motivation level to use the proposed services, (v) organizational issues and (vi) recommendations. Minor differences were observed between the countries, but there were considerable differences regarding the age of the participants. The younger caregivers want to be assured of the safety of their client and to receive immediate notification in case of an emergency. As for the elderly, the most important aspect is to gain a companion and a physical helper. Many of the recommendations can be taken into consideration during robot development, but some of them are not realistic at present.

  20. 78 FR 9569 - Unexpected Urgent Refugee and Migration Needs Relating to Syria

    Science.gov (United States)

    2013-02-08

    ... urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of the Bureau of Population, Refugees, and...

  1. 3 CFR - Unexpected Urgent Refugee and Migration Needs Related to Gaza

    Science.gov (United States)

    2010-01-01

    ... urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of Bureau of Population, Refugees, and...

  2. Globe report on energy in Central and Easter Europe and the CIS: An urgent need for international cooperation on energy efficiency improvement for sustainable development

    International Nuclear Information System (INIS)

    Laponche, B.; Baguenier, H.

    1998-01-01

    In comparison with European Union countries, the countries of Central and Eastern Europe as well as the Confederation of Independent States are characterized by a very high energy intensity i.e. ratio of energy consumption to gross domestic product. The paper deals with most important factors influencing this high energy intensity; variety of situations in different countries affecting the power supplies; an urgent need for energy efficiency policy and cooperation related to sustainable development; the necessary tools for energy efficiency implementation. Main energy data and global indicators are shown in the appendix

  3. Risks associated with managing asthma without a preventer: urgent healthcare, poor asthma control and over-the-counter reliever use in a cross-sectional population survey.

    Science.gov (United States)

    Reddel, Helen K; Ampon, Rosario D; Sawyer, Susan M; Peters, Matthew J

    2017-09-25

    Overuse of asthma relievers, particularly without anti-inflammatory preventers, increases asthma risks. This study aimed to identify how many reliever-only users have urgent healthcare, explore their attitudes and beliefs about asthma and its treatment, and investigate whether purchasing over-the-counter relievers was associated with worse asthma outcomes than by prescription. Cross-sectional population-based Internet survey in Australia. Of 2686 participants ≥16 years with current asthma randomly drawn from a web-based panel, 1038 (50.7% male) used only reliever medication. Urgent asthma-related healthcare; Asthma Control Test (ACT); patient attitudes about asthma and medications; reliever purchase (with/without prescription). Of 1038 reliever-only participants, 23.3% had required urgent healthcare for asthma in the previous year, and only 36.0% had a non-urgent asthma review. Those needing urgent healthcare were more likely than those without such events to be male (56.5% vs 49.0%, p=0.003) and current smokers (29.4% vs 23.3%, p=0.009). Only 30.6% had well-controlled asthma (ACT ≥20) compared with 71.0% of those with no urgent healthcare (pasthma symptoms (vs 5.5% of those without urgent healthcare). Those with urgent healthcare were more frustrated by their asthma and less happy with how they managed it, and they were less confident about their ability to manage worsening asthma, but just as likely as those without urgent healthcare to manage worsening asthma themselves rather than visit a doctor. Reliever-only users purchasing over-the-counter relievers were no more likely than those purchasing relievers by prescription to have uncontrolled asthma (35.9% vs 40.6%, p=0.23) but were less likely to have had a non-urgent asthma review. One-quarter of the reliever-only population had needed urgent asthma healthcare in the previous year, demonstrating the importance of identifying such patients. Their attitudes and beliefs suggest opportunities for targeting this

  4. Total hip arthroplasty for femoral neck fractures as an urgent procedure

    Directory of Open Access Journals (Sweden)

    Radoičić Dragan

    2017-01-01

    Full Text Available Background/Aim. Total hip arthroplasty (THA is one of the most widely accepted operative methods for femoral neck fracture (FNF in elderly. However, the data on the early THA for FNF are very limited. The aim of this study to determine if there were differences in postoperative complications and functional outcomes between an urgent and delayed THA following FNF. Methods. This prospective study included a total of 244 patients who had THA following FNF from January 2010 to January 2013. In the first group 41 FNF patients were treated with THA within less than 12 hours of admission. A total of 203 FNF patients were operated in delayed settings, of whom 162 required prolonged preoperative processing and comorbidities correction. The group II consisted of 41 FNF patients who were fit for the early surgery at admission, but the operation was delayed due to institution related reasons. Main outcome measurements included mortality, functional outcome assessement, cardiological and pulmonary complications, pressure ulcers, dislocations, infections, length of hospitalization and revisions. Results. There were no differences in terms of age, gender, type of implants, neither in mortality, nor complications. There were differences in hospital length of stay [t (51.72 = -10.25, p < 0.001]. The patients operated within less than 12 hours of admission, had significantly better scores at all three time points of functional outcome assessment: at discharge t (80 = 2.556, p < 0.012; one month t (80 = 4.731, p < 0.001; three months t (80 = 5.908, p < 0.001. Conclusion. THA for FNF as an urgent procedure is not a widely accepted concept. Our findings indicate that the early operative treatment, does not worsen clinical outcomes, and our results give an advantage to the policy of the early THA for FNF.

  5. Feasibility of Urgent-Start Peritoneal Dialysis in Older Patients with End-Stage Renal Disease: A Single-Center Experience.

    Science.gov (United States)

    Jin, Haijiao; Ni, Zhaohui; Mou, Shan; Lu, Renhua; Fang, Wei; Huang, Jiaying; Hu, Chunhua; Zhang, Haifen; Yan, Hao; Li, Zhenyuan; Yu, Zanzhe

    2018-01-01

    Patients with end-stage renal disease (ESRD) frequently require urgent-start dialysis. Recent evidence suggests that peritoneal dialysis (PD) might be a feasible alternative to hemodialysis (HD) in these patients, including in older patients. This retrospective study enrolled patients aged > 65 years with ESRD who underwent urgent dialysis without functional vascular access or PD catheter at a single center, from January 2011 to December 2014. Patients were grouped based on their dialysis modality (PD or HD). Patients unable to tolerate PD catheter insertion or wait for PD were excluded. Each patient was followed for at least 30 days after catheter insertion. Short-term (30-day) dialysis-related complications and patient survival were compared between the 2 groups. A total of 94 patients were enrolled, including 53 (56.4%) who underwent PD. The incidence of dialysis-related complications during the first 30 days was significantly lower in PD compared with HD patients (3 [5.7%] vs 10 [24.4%], p = 0.009). Logistic regression identified urgent-start HD as an independent risk factor for dialysis-related complications compared with urgent-start PD (odds ratio 4.760 [1.183 - 19.147], p = 0.028). The 6-, 12-, 24-, and 36-month survival rates in the PD and HD groups were 92.3% vs 94.6%, 82.4% vs 81.3%, 75.7% vs 74.2%, and 69.5% vs 60.6%, respectively, with no significant differences between the groups (log-rank = 0.011, p = 0.915). Urgent-start PD was associated with fewer short-term dialysis-related complications and similar survival to urgent-start HD in older patients with ESRD. Peritoneal dialysis may thus be a safe and effective dialysis modality for older ESRD patients requiring urgent dialysis. Copyright © 2018 International Society for Peritoneal Dialysis.

  6. A strategic-interaction analysis of an urgent appeal system and its outcomes for garment workers

    NARCIS (Netherlands)

    den Hond, F; Stolwijk, S.; Merk, J.

    2014-01-01

    Within the global garment industry the term "urgent appeal" is used to describe a request for action to Western activist groups for support in a specific case of labor rights violations. The urgent appeal system has become an important strategy for the transnational antisweatshop movement. It is

  7. The Urgent Need for Improved Climate Models and Predictions

    Science.gov (United States)

    Goddard, Lisa; Baethgen, Walter; Kirtman, Ben; Meehl, Gerald

    2009-09-01

    An investment over the next 10 years of the order of US$2 billion for developing improved climate models was recommended in a report (http://wcrp.wmo.int/documents/WCRP_WorldModellingSummit_Jan2009.pdf) from the May 2008 World Modelling Summit for Climate Prediction, held in Reading, United Kingdom, and presented by the World Climate Research Programme. The report indicated that “climate models will, as in the past, play an important, and perhaps central, role in guiding the trillion dollar decisions that the peoples, governments and industries of the world will be making to cope with the consequences of changing climate.” If trillions of dollars are going to be invested in making decisions related to climate impacts, an investment of $2 billion, which is less than 0.1% of that amount, to provide better climate information seems prudent. One example of investment in adaptation is the World Bank's Climate Investment Fund, which has drawn contributions of more than $6 billion for work on clean technologies and adaptation efforts in nine pilot countries and two pilot regions. This is just the beginning of expenditures on adaptation efforts by the World Bank and other mechanisms, focusing on only a small fraction of the nations of the world and primarily aimed at anticipated anthropogenic climate change. Moreover, decisions are being made now, all around the world—by individuals, companies, and governments—that affect people and their livelihoods today, not just 50 or more years in the future. Climate risk management, whether related to projects of the scope of the World Bank's or to the planning and decisions of municipalities, will be best guided by meaningful climate information derived from observations of the past and model predictions of the future.

  8. US and Russia face urgent decisions on weapons plutonium

    International Nuclear Information System (INIS)

    Hileman, B.

    1994-01-01

    Surplus plutonium poses a ''clear and present danger to national and international security,'' warns a National Academy of Sciences (NAS) study released in January, titled ''The Management and Disposition of Excess Weapons Plutonium.'' Over the past few years, many different methods of disposing of plutonium have been proposed. They range from shooting it into the Sun with missiles, to deep-seabed disposal, to fissioning it within a new generation of nuclear reactors. The NAS report rejects most of the methods suggested so far, but does recommend pursuing two of the options. One is to incorporate the plutonium in mixed-oxide fuel, a mixture of plutonium and uranium oxides, and use it to fuel commercial nuclear reactors. The other is to mix the plutonium with high-level waste and molten glass and mold the resulting material into large glass logs for eventual geologic disposal. Both are discussed here. The panel that wrote the NAS study is a standing committee called the Committee on International Security ampersand Arms Control. It suggests steps that should be taken now to guard supplies of plutonium removed from weapons. One step is bilateral US-Russian monitoring of warhead dismantlement. Others include setting up secure interim storage for the fissile materials and establishing an international monitoring system to verify the stockpiles and ensure that materials are not withdrawn for use in new weapons. The panel also urges Russia to stop producing fissile weapons materials and both countries to commit a very large fraction of their plutonium and highly enriched uranium from dismantled weapons to nonaggressive uses. The US and Russia have already made initial moves to accomplish these goals but have not fully implemented any of them

  9. The urgent need for quality improvement in Russia.

    Science.gov (United States)

    Ruevekamp, D

    1994-01-01

    Induced abortion became accepted as a legal method of family planning after the October Revolution of 1917 from which terminations were performed in state hospitals free of charge upon a woman's request. The procedure was made legal in response to then newly voiced egalitarian ideals and the increasing involvement of women in the labor market, as well as because of the rapidly deteriorating situation and post-Revolution period of famine. Administrators fully expected to reduce the incidence of abortion once living conditions improved. Little was done at the time to develop contraceptives. Stalin, however, in the 1920s and 1930s, lamented a falling birth rate in the face of manpower needed for labor and the military; abortion and contraceptives were banned, leading to post-abortion complications without really stimulating the birth rate. Abortion was relegalized in 1956, but the right to contraception was never fully restored. Seven million induced abortions were officially registered to have taken place in each of the last ten years in the former Soviet Union. A woman typically undergoes one abortion per year, or approximately twenty abortions during the childbearing period of her life. Lacking knowledge about contraception, contraceptives, and what many Western countries regard to be women's reproductive health rights, most Russian women, however, freely tolerate frequent repeated abortion as a normal method of fertility regulation. Lack of access to contraceptives along with the lack of domestic contraceptive method production facilities and lack of hard currency to secure quality supplies from abroad are contributing factors to this ongoing trend. Gynecologists also receive lucrative fees for illegal abortions and are unlikely to promote change. Plans to open twelve family planning centers in Moscow have been hampered by the inertia of bureaucracy, the lack of financial means, the lack of trained personnel, and people's suspicion of government bodies. Much needs

  10. Importance of good teamwork in urgent care services.

    Science.gov (United States)

    Meier, Curtis

    2014-11-01

    High quality, safe care for patients depends on effective teamwork, and where multi-professional teams work together there is higher patient satisfaction, increased staff innovation, less stress and more communication ( West 2013 ). Conversely, lapses in teamwork and poor communication can result in adverse events ranging from retained foreign objects to perinatal events and medication errors ( Peter and Pronovost 2013 ), and even the death of patients ( Resuscitation Council UK 2011 ). Teamwork requires a set of skills and behaviours that, once learned by clinicians, can save lives ( Peter and Pronovost 2013 ). This article refers to a case study to explore the topic of teamwork in a tertiary care emergency setting.

  11. Improving the transport of urgent specimens to an off-site laboratory using a novel sticker-tracker.

    Science.gov (United States)

    Sepahzad, Afsoon; Ejiofor, Florence; Giles, Susan; Klaber, Robert

    2013-01-01

    Obtaining results for urgent microbiology specimens in an efficient manner is imperative to ensure that patients receive appropriate antibiotic therapy. A previous audit carried out in the Paediatric department of a central teaching hospital and a number of clinical incidents, highlighted a delay in transport of specimens (exceeding eight hours) and 'missing' specimens. This results in empirical antibiotic treatment of infection, with delay in confirming microbiology result and unnecessary, distressing repeat investigation. As an initial step we sought staff opinion to further explore the problem. A sticker was designed for the microbiology specimen bag to assign accountability, track each step in the transport process and to raise awareness of the problem. The sticker required the member of staff responsible at each stage of the process to time, date and sign it, to allow tracking of potential delays. The new sticker tracking system was promoted and launched in the Paediatric department. Initial challenges included lack of awareness of the protocol and lack of pods for sending urgent specimens. The team met regularly and completed stickers were analysed weekly to identify on-going issues and to devise solutions. Consequently total transport time was reduced to an average of 69 minutes by September (within four hr target). Our intervention improved the efficiency and reliability of urgent specimen transport. This is likely to result in safer antibiotic use and avoid the need for repeat investigation. The system is now also used in the Neonatal department and has lead to the development of a new 'Central Specimens Reception'.

  12. Urgent problems of the radiobiology of the transplutonium elements

    International Nuclear Information System (INIS)

    Moskalev, Y.I.; Zalikin, G.A.

    1986-01-01

    The development of the atomic industry and nuclear energetics (the creation of new types of atomic reactors basedon fast neutrons, plutonium-producing reactors, and high-power thermonuclear reactors) requires the implementation of scientifically substantiated measures to prevent pollution of the environment by fission products, plutonium, and transplutonium elements, including Am 241, Cm 244, Bk 249, and Cf 252. This paper examines the influence of the level of absorption of actinides from the GI tract in both newborn and adult animals. A study is made of absorbed actinides contained in the meat of animals. The longterm effects of incorporation of compounds of Pu 239 into animals are discussed. The results of this experimental investigation of the metabolism and biological effects of various compounds of the transplutonium radionuclides were used as the basis of an estimation of the parameter of their metabolism in the human organism and the standardization of TPE

  13. Comparison of usefulness of each of five predictors of mortality and urgent transplantation in patients with advanced heart failure.

    Science.gov (United States)

    Sachdeva, Amit; Horwich, Tamara B; Fonarow, Gregg C

    2010-09-15

    B-type natriuretic peptide (BNP), peak oxygen consumption (VO(2)), blood urea nitrogen (BUN), systolic blood pressure (SBP), and pulmonary capillary wedge pressure are all established predictors of mortality or urgent transplantation in patients with advanced heart failure (HF). However, their comparative predictive ability in estimating prognosis has not been well studied. We analyzed 1,215 patients with advanced systolic HF referred to a university center from 1999 to 2009. BUN, BNP, VO(2), SBP, and pulmonary capillary wedge pressure were measured as a part of the initial evaluation. The patients were divided into groups according to the best cutoffs for predicting both 1- and 2-year mortality from the analysis of the receiver operating characteristic curves (BNP > or =579 pg/ml, peak VO(2) or =53 mg/dl, SBP or =21 mm Hg). During a 2-year follow-up, 234 patients (19%) died, and 208 (17%) required urgent transplantation. BNP (odds ratio 4.3, 95% confidence interval 3.3 to 5.5) and peak VO(2) (odds ratio 4.5, 95% confidence interval 2.6 to 7.8) were the strongest predictors for death or urgent transplantation. On multivariate analyses, BNP and peak VO(2) were the strongest predictors for both death or urgent transplantation and all-cause mortality. The c-statistic was 0.756 for BNP, 0.701 for VO(2), 0.659 for BUN, 0.638 for SBP, and 0.650 for pulmonary capillary wedge pressure. In conclusion, of the 5 established predictors of outcomes in advanced HF, BNP was the most robust discriminator of risk and thus could be useful, along with other more traditional prognostic variables, in patient counseling regarding prognosis and determining the timing for heart transplantation. Copyright 2010 Elsevier Inc. All rights reserved.

  14. Analysis of the impact of the Kyoto Protocol on the export revenues of OPEC member states and on the oil import requirements of non-Annex I countries

    NARCIS (Netherlands)

    Linden NH van der; Linde C van der; Lako P; Rooijen SNM van; Netherlands Energy Research; Netherlands Institute of International Relations; NOP

    2000-01-01

    The members of the Organisation of Petroleum Exporting Countries (OPEC) continue to voice their concerns about the adverse impact of the implementation of greenhouse gas emission reduction policies on the oil exporting countries. Referring to Article 4.8 of the UNFCCC, the OPEC is of the opinion

  15. Does peritoneal dialysis have a role in urgent-start end-stage kidney disease?

    Science.gov (United States)

    McQuillan, Rory F; Lok, Charmaine E

    2018-04-19

    Despite its many positive attributes, peritoneal dialysis remains underutilized, particularly in the United States. Urgent-start peritoneal dialysis (PD) has been proposed as a method of increasing PD prevalence. Urgent-start PD has been shown to be safe, feasible, and effective. However, urgent-start PD is also accompanied by several multidimensional challenges. This article is intended to equip the reader with a practical sense of whether an urgent-start PD program would be appropriate in his or her own clinical context and if appropriate, what factors would be necessary for such a program to flourish. As such, we summarize latent factors, which are necessary to consider before instituting an urgent-start PD. Then, using a series of clinical vignettes, highlight the component parts of a successful urgent-start PD program and the patient population who stand to benefit most from this strategy. The discussion is then balanced by presenting limitations to consider in the urgent-start PD approach. © 2018 Wiley Periodicals, Inc.

  16. Clinical outcome of acute nonvariceal upper gastrointestinal bleeding after hours: the role of urgent endoscopy.

    Science.gov (United States)

    Ahn, Dong-Won; Park, Young Soo; Lee, Sang Hyub; Shin, Cheol Min; Hwang, Jin-Hyeok; Kim, Jin-Wook; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho

    2016-05-01

    This study was performed to investigate the clinical role of urgent esophagogastroduodenoscopy (EGD) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) performed by experienced endoscopists after hours. A retrospective analysis was performed for consecutively collected data of patients with ANVUGIB between January 2009 and December 2010. A total of 158 patients visited the emergency unit for ANVUGIB after hours. Among them, 60 underwent urgent EGD (within 8 hours) and 98 underwent early EGD (8 to 24 hours) by experienced endoscopists. The frequencies of hemodynamic instability, fresh blood aspirate on the nasogastric tube, and high-risk endoscopic findings were significantly higher in the urgent EGD group. Primary hemostasis was achieved in all except two patients. There were nine cases of recurrent bleeding, and 30-day mortality occurred in three patients. There were no significant differences between the two groups in primary hemostasis, recurrent bleeding, and 30-day mortality. In a multiple linear regression analysis, urgent EGD significantly reduced the hospital stay compared with early EGD. In patients with a high clinical Rockall score (more than 3), urgent EGD tended to decrease the hospital stay, although this was not statistically significant (7.7 days vs. 12.0 days, p > 0.05). Urgent EGD after hours by experienced endoscopists had an excellent endoscopic success rate. However, clinical outcomes were not significantly different between the urgent and early EGD groups.

  17. Cation Exchange Capacity of Biochar: An urgent method modification

    Science.gov (United States)

    Munera, Jose; Martinsen, Vegard; Mulder, Jan; Tau Strand, Line; Cornelissen, Gerard

    2017-04-01

    A better understanding of the cation exchange capacity (CEC) values of biochar and its acid neutralizing capacity (ANC) is crucial when tailoring a single biochar for a particular soil and crop. Literature values for the CEC of biochar are surprisingly variable, commonly ranging from 5 to 50 cmol+/Kg even as high as 69 to 204 cmol+/Kg and often poorly reproducible, suggesting methodological problems. Ashes and very fine pores in biochar may complicate the analysis and thus compromise the results. Here, we modify and critically assess different steps in a common method for CEC determination in biochar and investigate how the measured CEC may be affected by slow cation diffusion from micro-pores. We modified the existing ammonium acetate (NH4-OAc) method (buffered at pH 7), based on displaced ammonium (NH4+) in potassium chloride (KCl) extracts after removing excess NH4-OAc with alcohol in batch mode. We used pigeon pea biochar (produced at 350 ˚C; particle size 0.5mm to 2mm) to develop the method and we tested its reproducibility in biochars with different ANC. The biochar sample (1.00g) was pH-adjusted to 7 after 2 days of equilibration, using hydrochloric acid (HCl), and washed with water until the conductivity of the water was modified method were highly reproducible and that 1 day shaking with NH4OAc and KCl is enough to saturate the exchange sites with NH4+ and subsequently with K+. The biochar to NH4OAc solution ratio did not affect the measured CEC. Three washings with at least 15 ml alcohol are required to remove excess NH4-OAc. We found the CEC of biochar with the displacement method from pigeon pea, corncob, rice husk and cacao shell to be 26.4(±0.3), 19.2(±0.5), 20.5(±0.4), 46.5±(0.2) cmol+/Kg, respectively. The selected batch experiment allows a large sample throughput, less laboratory equipment is needed and shaking ensures better contact between the extracting solution and the exchange sites.

  18. Idarucizumab in Three Patients Needing Urgent Surgical Intervention and One Case of Intravenous Thrombolysis in Ischaemic Stroke

    Directory of Open Access Journals (Sweden)

    Fredrik Andreas von Wowern

    2017-05-01

    Full Text Available Objective: To describe the benefits of reversal of the anticoagulation effects of dabigatran etexilate in patients requiring urgent surgery or thrombolysis for ischaemic stroke. Materials and methods: Four patients, treated with dabigatran etexilate and presenting with cholecystitis, tibial fracture, lower limb ischaemia and ischaemic stroke, respectively. Results: Administration of idarucizumab normalized bleeding parameters and provided safe conditions for surgery and, in one case, successful thrombolysis of an ischaemic stroke. Conclusion: The introduction of an effective reversal agent for dabigatran etexilate allows physicians perform surgery under conditions of normal coagulation and permits thrombolysis in patients with ischaemic stroke despite being treated with dabigatran etexilate.

  19. The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

    Science.gov (United States)

    Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

    2017-12-01

    We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

  20. The urgent neurological consultation in the population of the province of Ferrara, Italy.

    Science.gov (United States)

    Govoni, Vittorio; Della Coletta, Elena; Fallica, Elisa; Cesnik, Edward

    2018-05-01

    In the province of Ferrara, Italy, the urgent neurological consultation (UNC) cases in the population correspond to the resident outpatients who undergo a UNC in the ER of the university hospital of Ferrara (UHFe). Thanks to this health organization a retrospective survey identified 612 UNC cases (range of age 7-102 years, median 67,5 years) in the study period giving a period prevalence rate of 173 per 100,000 (95% CI 159.3-187.3) which increased with age (χ 2 for trend = 178.4 p  0.70). The prevalence rate decreased with the distance between the patients' residence and the UHFe (χ 2 for trend = 82.9, p < 0.001). The commonest clinical conditions requiring UNCs were acute cerebrovascular disorders (28%), headache (14%), and vertigo (9%). The hospital admission rate was 32.5% which increased with age (χ 2 for trend = 35.8, p < 0.001). The commonest discharge diagnoses of the admitted cases were ischemic stroke (57.3%), epilepsy (7%), TIA (6%), and intraparenchymal hemorrhage (5.5%). Acute cerebrovascular disease accounted for 69% of the discharge diagnoses. The survey showed that the UNCs' demand was higher than previous Italian data confirming that acute cerebrovascular disease is the most frequent acute neurological condition requiring attention in the ER. It also suggested that the UNCs could be poorly appropriate. These findings would require the healthcare administrators attention.

  1. Italy-Greece cooperation for transplantation of medically urgent Greek patients: is it an effective, efficient model?

    Science.gov (United States)

    Peritore, D; Pretagostini, R; Di Ciaccio, P; Fiaschetti, P; Gabbrielli, F; Oliveti, A; Stabile, D; Ricci, A; Vaia, F; Nanni Costa, A

    2012-09-01

    In 2005 the Italian National Transplant Centre (CNT) signed a cooperation agreement with the Hellenic Transplant Organization (HTO) fostering the transfer and transplantation of urgent Greek liver patients at Italian transplantation centers. So as to not reduce access to transplantation for Italian patients, the agreement provided compensation for organs allocated to Greek transplant recipients. The aim of this study was to analyze the flow of patients from Greece to Italy and the number of received livers to consider the possibility to extend this kind of agreement to other countries, so that this should not penalize Italian recipients. The agreement provides the possibility for Greek patients affected by acute disease to be transferred to Italian transplantation centers participating in the agreement. Until 2008 livers transplanted into Greek recipients were returned through a preferential offer of surplus Greek organs, whereas from 2009 an obligation of payback was introduced. During the reviewed period requests for transfer, transferred patients, and number of patients who later underwent transplantation in Italy were 56, 26, and 23, respectively. Livers offered by the Greek organization that were accepted, transferred, and transplanted in Italy have been 82, 50, and 44, respectively. According to our analysis, the cooperation has had as positive impact for both Greece, which has difficulties transplanting urgent recipient because of the low number of donors, and for Italy, which is not penalized by the use of an organ in a Greek recipients, but is also rewarded for helpfulness. Copyright © 2012 Elsevier Inc. All rights reserved.

  2. 75 FR 67015 - Unexpected Urgent Refugee And Migration Needs Resulting From Flooding InPakistan

    Science.gov (United States)

    2010-11-01

    ... September 3, 2010 Unexpected Urgent Refugee And Migration Needs Resulting From Flooding InPakistan... humanitarian needs resulting from recent devastating flooding in Pakistan. You are authorized and directed to...

  3. Household expenditure for dental care in low and middle income countries.

    Directory of Open Access Journals (Sweden)

    Mohd Masood

    Full Text Available This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries who participated in the WHO World Health Survey (WHS were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.

  4. Developing countries: small technology with big effects

    International Nuclear Information System (INIS)

    McRobie, G.; Carr, M.

    1978-01-01

    As far the poor countries of the world are concerned, during the past twenty years they have had access only to the technologies developed by the rich to suit the rich. It is now beyond question that some of the most daunting problems confronting the majority of the worlds populations stem directly from the kind of technology transferred to them under current aid and development programs. That the technology of the rich is generally inappropriate to meet the needs and resources of the poor countries is becoming more widley recognized both by aid-givers and aid-receivers. Yet it is this technology that continues to be almost exclusively and most powerfully promoted in the developing countries. To meet their needs a new technology must be discovered or devised: one that lies between the sickle and the combine harvester and is small, simple and cheap enough to harmonise withlocal human and material resources and lends itself to widespread reproduction with the minimum of outside help. What we now need most urgently is a new set of technologies, designed, by people who are informed by the need to develop capital-saving technologies capable of being decentralized to the maximum extend. The technology gap is not only wide, but the knowledge an resources required to fill is, although they exist in the industrialized countries, have not been mobilized to provide the right kind of knowledge and to make it available to those who need it. It was to do this that the Intermediate Technology Development Group was set up ten years ago. (orig.) 891 HP 892 EKI [de

  5. Urgent-Start Peritoneal Dialysis Complications: Prevalence and Risk Factors.

    Science.gov (United States)

    Xu, Damin; Liu, Tianjiao; Dong, Jie

    2017-07-01

    Mechanical complications are of particular concern in urgent-start peritoneal dialysis (PD) because of the shorter break-in period. However, risk factors have been reported inconsistently and data in urgent-start PD populations are limited. Observational cohort study. All patients treated with urgent-start PD, defined as PD therapy initiated within 1 week after catheter insertion, January 2003 to May 2013. Age, sex, abdominal surgery history, body mass index, hemoglobin level, albumin level, C-reactive protein level, break-in period (period between catheter insertion and PD therapy initiation), dialysate exchange volume, and use of overnight dwell. The presence of mechanical complications related to abdominal wall or catheter, including hernia, hydrothorax, hydrocele, subcutaneous leak, pericatheter leak, catheter malposition, omental wrap, and obstruction. 922 patients on urgent-start PD therapy were enrolled (mean age, 59.1±15.0 [SD] years). Prevalences of abdominal wall and catheter complications were 4.8% and 9.5%, respectively. The most common abdominal wall complication was hernia (55%), followed by hydrothorax (25%). On adjustment, male sex (HR, 5.41; 95% CI, 2.15-13.59; Pstart PD and conventional PD. Urgent-start PD is a safe and practicable approach. Male sex and history of abdominal surgery could contribute to the development of abdominal wall complications. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. The Lived Experiences of Persons Hospitalized for Construction of an Urgent Fecal Ostomy.

    Science.gov (United States)

    Herlufsen, Per; Brødsgaard, Anne

    The purpose of this study was to describe the lived experiences of hospital stays for patients undergoing urgent ostomy surgery. Qualitative, descriptive, phenomenological study. Six persons undergoing acute hospital admission and urgent ileostomy or colostomy surgery (either permanent or temporary) participated in the study. Participants were of Danish ethnicity and between the ages of 48 and 75 years. The research setting was the surgical department at a university hospital in the Capital Region of Denmark. Data collection and analyses were guided by a Reflective Lifeworld Research approach; this approach is based on phenomenological philosophy. Data were collected during in-depth interviews using a semistructured interview guide. Their average length was 50 minutes (range, 30-65 minutes). Interviews were digitally recorded and transcribed. Transcriptions were analyzed in 4 phases according to the principles of Reflective Lifeworld Research. The phenomenon we labeled "lived experiences of acute hospitalization with construction of an urgent unplanned fecal ostomy" comprised 4 constituents: (1) undergoing unexpected bodily changes, (2) partnership with professional caregivers, (3) experience of vulnerability, and (4) a lack of continuity. These constituents can be described as a number of challenges due to both hospitalization and ostomy creation. We found that individuals experience a number of challenges due to acute hospitalization and urgent construction of a fecal ostomy. These challenges are due to the unexpected bodily changes and interpersonal and organizational conditions. Nurses should be aware of not only the physical implications of urgent creation of a fecal ostomy but also the individual and psychological implications of this event.

  7. ABOUT THE FINANCIAL REPORTING ON THE CAPITAL MARKETS IN THE EUROPEAN UNION: REQUIREMENTS OF USING THE IFRS AND THE EQUIVALENCE OF THIRD COUNTRY ACCOUNTING STANDARDS

    Directory of Open Access Journals (Sweden)

    Aristita Rotila

    2013-12-01

    Full Text Available The need to build a single European market and to ensure the competitiveness of the community capital markets led to the involvement of European Union in the convergence process taking place on a global level in the realm of financial reporting. This paper is a study on financial reporting for the capital markets in the European Union by analyzing the accounting standards that need to be applied. Specifically, this paper highlights a number of issues concerning: the adoption of IAS / IFRS in the European Union and their compulsory aspect in preparing the consolidated financial statements for the companies listed on a regulated market; the requirement’s extension of using the IFRSs adopted in the European Union to the issuers of certain third countries involving a public offer of securities in European Union or performing transactions with securities on a community regulated market; the establish of a mechanism for the determination of equivalence of certain third country accounting standards with IFRSs in force at European level and, consequently, the possibility of using by some third country issuers, in preparing the consolidated financial statements submitted to the European markets, recognized national standards as equivalent to adopted IFRS.

  8. An audit of non-urgent general adult referrals to Stikland State Psychiatric Facility

    Directory of Open Access Journals (Sweden)

    J Ras

    2011-12-01

    Full Text Available Objectives. The national Department of Health strongly advocates the strengthening of primary health care systems, and recommendations for appropriate level of care referrals exist. Very few published data on the scope of current ambulatory specialised psychiatric hospital services in South Africa are currently available, making it difficult to assess whether these recommendations are being followed. As a starting point, an audit was conducted to obtain a profile of new non-urgent general adult patients seen at Stikland Hospital with a view to evaluating system needs and demands. Methods. The folders of 103 consecutively seen patients were selected for retrospective review. Patient demographic, referral and assessment information was entered into a single database. Descriptive statistics were compiled with reference to the above variables using SPSS. Results. Overall 58.3% of referrals were from the private sector. More than a third (36.7% of referral letters stated no clear reason for referral and 41.7% no psychiatric diagnosis, and 29.1% of patients were referred without psychotropic medication being started. On assessment 62.1% of patients were found to have a single Axis I diagnosis. Despite virtually no referral letters making any mention of them, substance use disorders (30.1%, personality traits/disorders (35.9% and co-morbid medical illness (36.7% were commonly found on assessment. Conclusions. A significant portion of the patients in our sample could have been managed at primary care level and were referred prematurely. The overall quality of referral letters was poor, and they lacked vital information required for appropriate pre-assessment decision making. Undergraduate training focusing on these skills should be intensified, and consideration should be given to incorporating aspects of our findings into primary health care updates.

  9. Energy problems in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Tasugi, Hirosaburo [Japan Industrial Tech. Association, Tokyo, Japan

    1989-06-20

    In order to rid the people's living of poverty in developing countries, first, the production of food has been planned to increase. And then, resource development and industrialization have been tried to improve with efforts. Because of such development and an increase in population, energy consumption has been increasing. Advanced countries have supported these countries in many ways, however, there is much difference in their assistance depend on various situations such as racial, religious, and political ones. Moreover, a gap between cities and farm villages has widen since infrastructure has not been fully equipped in developing countries. The electrification ratio is used as an index to show the degree of development in developing countries. It is low in the countries where development is lagging, particularly in farm villages. This gap is an urgent problem that faces developing countries. In order to cope with the actual conditions, advanced countries including Japan should be plan to reinforce their technological and economic assistance more suitable for farm villages. Furthermore, they should also improve the assistance system which includes a measure for environmental pollution control, considering the spot directly. 3 figs., 14 tabs.

  10. SCINTIGRAPHY IN URGENT CONDITIONS AND COMPLICATIONS OF ACUTE DISEASES AND TRAUMAS

    Directory of Open Access Journals (Sweden)

    N. Ye. Kudryashova

    2014-01-01

    Full Text Available ABSTRACT. The data generalized in the review characterize radionuclide method as a high informative technique in diagnosis of the row of acute diseases and traumas and complications of them. It was shown that each radionuclide technique decides the concrete clinical tests and has a strictly definite place in the diagnostic algorithm. Urgent radionuclide techniques give the important information for the choice of the treatment’s policy or operation’s volume in such acute diseases as tromboembolism, arterial occlusions, small bowel obstruction, acute cholecystitis and cholelithiasis, acute myocardial infarct, rhabdomyolysis, differentiation of acute urological and acute abdominal surgical diseases and so on. The main aim of the work of our radionuclide department is to perfect, modificate of urgent radionuclide techniques and to correct the place of them in urgent conditions’s diagnostic algorithm for increasing of the quality and the rapidity in diagnosis. 

  11. The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography.

    Science.gov (United States)

    Kaewlai, Rathachai; Greene, Reginald E; Asrani, Ashwin V; Abujudeh, Hani H

    2010-09-01

    The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P chest radiography of hospitalized patients. Published by Elsevier Inc.

  12. Developed-developing country partnerships: Benefits to developed countries?

    Directory of Open Access Journals (Sweden)

    Syed Shamsuzzoha B

    2012-06-01

    Full Text Available Abstract Developing countries can generate effective solutions for today’s global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed—this is perhaps the single most immediate need in planning for, and realizing, the full potential of international

  13. Developed-developing country partnerships: benefits to developed countries?

    Science.gov (United States)

    Syed, Shamsuzzoha B; Dadwal, Viva; Rutter, Paul; Storr, Julie; Hightower, Joyce D; Gooden, Rachel; Carlet, Jean; Bagheri Nejad, Sepideh; Kelley, Edward T; Donaldson, Liam; Pittet, Didier

    2012-06-18

    Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and

  14. Domestic and donor financing for tuberculosis care and control in low-income and middle-income countries: an analysis of trends, 2002-11, and requirements to meet 2015 targets.

    Science.gov (United States)

    Floyd, Katherine; Fitzpatrick, Christopher; Pantoja, Andrea; Raviglione, Mario

    2013-08-01

    Progress in tuberculosis control worldwide, including achievement of 2015 global targets, requires adequate financing sustained for many years. WHO began yearly monitoring of tuberculosis funding in 2002. We used data reported to WHO to analyse tuberculosis funding from governments and international donors (in real terms, constant 2011 US$) and associated progress in tuberculosis control in low-income and middle-income countries between 2002 and 2011. We then assessed funding needed to 2015 and how this funding could be mobilised. We included low-income and middle-income countries that reported data about financing for tuberculosis to WHO and had at least three observations between 2002 and 2011. When data were missing for specific country-year combinations, we imputed the missing data. We aggregated country-specific results for eight country groups defined according to income level, political and economic profile, geography, and tuberculosis burden. We compared absolute changes in total funding with those in the total number of patients successfully treated and did cross-country comparisons of cost per successfully treated patient relative to gross domestic product. We estimated funding needs for tuberculosis care and control for all low-income and middle-income countries to 2015, and compared these needs with domestic funding that could be mobilised. Total funding grew from $1·7 billion in 2002 to $4·4 billion in 2011. It was mostly spent on diagnosis and treatment of drug-susceptible tuberculosis. 43 million patients were successfully treated, usually for $100-500 per person in countries with high burdens of tuberculosis. Domestic funding rose from $1·5 billion to $3·9 billion per year, mostly in Brazil, Russia, India, China, and South Africa (BRICS), which collectively account for 45% of global cases, where national contributions accounted for more than 95% of yearly funding. Donor funding increased from $0·2 billion in 2002 to $0·5 billion in 2011, and

  15. Perceptions of psychosocial hazards, work-related stress and workplace priority risks in developing countries.

    Science.gov (United States)

    Kortum, Evelyn; Leka, Stavroula; Cox, Tom

    2011-01-01

    During the last few decades, major global developments in the world of work include an international trend to shift production to developing countries, with wide variations in working conditions and exposure to traditional and emerging occupational risks, such as psychosocial risks. The latter have rarely been addressed or explored in developing and economically-emerging country contexts while we find an abundant body of research from industrialized countries. The research presented, which is part of a larger study, explored the perception of multi-disciplinary experts from different regions, as defined by the World Health Organization (WHO), of the nature of psychosocial hazards, and work-related stress, as well as their views on workplace priorities that require urgent attention. Semi-structured interviews were conducted with 29 experts from developing countries which were subjected to thematic analysis. A two-tiered Delphi survey was completed by 74 experts in the first round with 53 of these experts completing the survey in the second round. Psychosocial hazards and work-related stress were mostly seen as interchangeable in terms of source and effect and all participants perceived them as concern to their workforce. Through the interviews and the Delphi surveys they allude to our contemporary understanding of psychosocial risks. Workplace risks of priority differed by region but primarily work-related stress, injury and accident prevention, and substance abuse and risk behaviors were reported to require urgent attention. The current lack of awareness and research in the area of psychosocial risks and work-related stress hampers action in developing countries. International experts should support the exchange of information and the development of interventions in workplaces in developing countries with a view to integrating these emerging risks into comprehensive occupational health and safety policy frameworks to make such approaches more effective.

  16. WEO-2006 Fact Sheet: Energy for Cooking in Developing Countries

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    Bringing modern energy to the world's poor is an urgent necessity. Although steady progress is made in expanding the use of modern household energy services in developing countries, in both scenarios many people still depend on traditional biomass in 2030. Action to encourage more efficient and sustainable use of traditional biomass and help people switch to modern cooking fuels and technologies is therefore urgent.

  17. Zambia mental health country profile.

    Science.gov (United States)

    Mayeya, John; Chazulwa, Roy; Mayeya, Petronella Ntambo; Mbewe, Edward; Magolo, Lonia Mwape; Kasisi, Friday; Bowa, Annel Chishimba

    2004-01-01

    traditionally the duty and responsibility of the extended family to look after the aged. Gender based violence (GBV) is another issue. Women, who are totally dependent on their spouses economically, are forced by circumstances to continue living in abusive relationships to the detriment of their mental well-being. In Zambia, the family is considered sacrosanct and the affairs of the family members, private. It is within this context that GBV is regarded as a family affair and therefore a private affair, yet spouse beating has led to depression and in some cases death. In terms of psychiatric services, there are close to 560 beds for psychiatric patients across the country. Common mental disorders found in Zambia are acute psychotic episodes, schizophrenia, affective disorders, alcohol related problems and organic brain syndromes. About 70-80% of people with mental health problems consult traditional health practitioners before they seek help from conventional health practitioners. Over time the number of frontline mental health workers and professional staff has been declining. This is due to the 'brain drain', retirement, death and low output from training institutions. For practicing psychiatrists, only one is available for the whole country. Other key mental health workers such as psychologists, social workers and occupational therapists are also in short supply. All in all, the mental health services situation in Zambia could be described as critical, requiring urgent attention.

  18. Non-urgent accident and emergency department use as a socially shared custom: a qualitative study.

    Science.gov (United States)

    Keizer Beache, Simone; Guell, Cornelia

    2016-01-01

    We explored attitudes of non-urgent accident and emergency department (AED) patients in the middle-income healthcare setting Saint Vincent and the Grenadines (SVG) in the Caribbean to understand how and why they decide to seek emergency care and resist using primary care facilities. In 2013, we conducted 12 semistructured interviews with a purposive sample of non-urgent AED users from a variety of social backgrounds. Verbatim transcripts were analysed with a grounded theory approach. In this study, we found, first, that participants automatically chose to visit the AED and described this as a locally shared custom. Second, the healthcare system in SVG reinforced this habitual use of the AED, for example, by health professionals routinely referring non-urgent cases to the AED. Third, there was also some deliberate use; patients took convenience and the systemic encouragement into account to determine that the AED was the most appropriate choice for healthcare. We conclude that the attitudes and habits of the Vincentian non-urgent patient are major determinants of their AED use and are intricately linked to local, socially shared practices of AED use. Findings show that health services research should reconsider rational choice behaviour models and further explore customs of health-seeking. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. 76 FR 53295 - Unexpected Urgent Refugee and Migration Needs Related to the Horn of Africa

    Science.gov (United States)

    2011-08-25

    ...-12 of August 8, 2011--Unexpected Urgent Refugee and Migration Needs Related to the Horn of Africa... Migration Needs Related to the Horn of Africa Memorandum for the Secretary of State By the authority vested... Department of State, related to the humanitarian crisis in the Horn of Africa. You are authorized and...

  20. 76 FR 14271 - Unexpected Urgent Refugee and Migration Needs Related to Libya

    Science.gov (United States)

    2011-03-16

    ... March 7, 2011 Unexpected Urgent Refugee and Migration Needs Related to Libya Memorandum for the... States, including section 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as... million from the United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting...

  1. 75 FR 67013 - Unexpected Urgent Refugee and Migration Needs Resulting from Violence in Kyrgyzstan

    Science.gov (United States)

    2010-11-01

    ... August 26, 2010 Unexpected Urgent Refugee and Migration Needs Resulting from Violence in Kyrgyzstan... laws of the United States, including section 2(c)(1) of the Migration and Refugee Assistance Act of... amount not to exceed $9.5 million from the United States Emergency Refugee and Migration Assistance Fund...

  2. If climate action becomes urgent: The importance of response times for various climate strategies

    NARCIS (Netherlands)

    van Vuuren, D.P.; Stehfest, E.

    2013-01-01

    Most deliberations on climate policy are based on a mitigation response that assumes a gradually increasing reduction over time. However, situations may occur where a more urgent response is needed. A key question for climate policy in general, but even more in the case a rapid response is needed,

  3. 75 FR 25271 - Office of Refugee Resettlement; Urgent Single Source Grant to Survivors of Torture International...

    Science.gov (United States)

    2010-05-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Office of Refugee Resettlement; Urgent Single Source Grant to Survivors of Torture International (SOTI) AGENCY: Office of Refugee... effects of torture. (2) Social and legal services for victims of torture. (3) Research and training for...

  4. Urgent surgical management for embolized occluder devices in childhood: single center experience

    Directory of Open Access Journals (Sweden)

    Gokaslan Gokhan

    2012-12-01

    Full Text Available Abstract Background In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods We retrospectively reviewed 9 patients (aged 2–15 years who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6, ventricular septal defect (n = 1, and patent ductus arteriosus (n = 2. Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

  5. 3 CFR - Unexpected Urgent Refugee and Migration Needs Related to the Continuing Conflict in Pakistan

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Unexpected Urgent Refugee and Migration Needs Related to the Continuing Conflict in Pakistan Presidential Documents Other Presidential Documents... to the Continuing Conflict in Pakistan Memorandum for the Secretary of State By the authority vested...

  6. Integration of HIV care into maternal health services: a crucial change required in improving quality of obstetric care in countries with high HIV prevalence.

    Science.gov (United States)

    Madzimbamuto, Farai D; Ray, Sunanda; Mogobe, Keitshokile D

    2013-06-10

    The failure to reduce preventable maternal deaths represents a violation of women's right to life, health, non-discrimination and equality. Maternal deaths result from weaknesses in health systems: inadequate financing of services, poor information systems, inefficient logistics management and most important, the lack of investment in the most valuable resource, the human resource of health workers. Inadequate senior leadership, poor communication and low staff morale are cited repeatedly in explaining low quality of healthcare. Vertical programmes undermine other service areas by creating competition for scarce skilled staff, separate reporting systems and duplication of training and tasks. Confidential enquiries and other quality-improvement activities have identified underlying causes of maternal deaths, but depend on the health system to respond with remedies. Instead of separate vertical programmes for management of HIV, tuberculosis, and reproductive health, integration of care and joint management of pregnancy and HIV would be more effective. Addressing health system failures that lead to each woman's death would have a wider impact on improving the quality of care provided in the health service as a whole. More could be achieved if existing resources were used more effectively. The challenge for African countries is how to get into practice interventions known from research to be effective in improving quality of care. Advocacy and commitment to saving women's lives are crucial elements for campaigns to influence governments and policy -makers to act on the findings of these enquiries. Health professional training curricula should be updated to include perspectives on patients' rights, communication skills, and integrated approaches, while using adult learning methods and problem-solving techniques. In countries with high rates of Human Immunodeficiency Virus (HIV), indirect causes of maternal deaths from HIV-associated infections now exceed direct causes

  7. Design and operation of ventilation in low energy residences – A survey on code requirements and building reality from six European countries and China

    DEFF Research Database (Denmark)

    del Carmen Bocanegra-Yanez, Maria; Rojas, Gabriel; Zukowska-Tejsen, Daria

    involved in the Annex. There were two main objectives, firstly, to describe and analyse a transition between actual requirements (national building codes and standards) and current practice. Secondly, to investigate current barriers and challenges regarding installation of mechanical ventilation......One of the key objectives of the IEA Annex 68 research programme entitled “Indoor Air Quality Design and Control in Low Energy Residential Buildings” is to provide a generic guideline for the design and operation of ventilation in residential buildings. Modern and refurnished domestic buildings...

  8. Mauritius country study

    Energy Technology Data Exchange (ETDEWEB)

    Manraj, D D [Central Statistical Office (Mauritius)

    1998-10-01

    Mauritius has no known oil, gas or coal reserves but is only endowed with limited renewable energy resources namely hydropower and bagasse. Bagasse represents about one third of the country`s energy requirements and meets almost all of the sugar industries energy demand. Projects identified for mitigation options are: Energy Sector - Renewable Sources (Solar, Wind, Biomass); Transport Sector - Fuel switching and Mass transit transport; Manufacturing Sector - Increase efficiency of energy use in the manufacturing process. (EG)

  9. 75 FR 34617 - Unexpected Urgent Refugee and Migration Needs Related to Somalia and Food Pipeline Breaks for...

    Science.gov (United States)

    2010-06-18

    ... unexpected and urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of the Bureau of Population...

  10. An audit of urgent referrals by the Procurator Fiscal to the Tayside Forensic Psychiatric Service.

    Science.gov (United States)

    White, T; Rutherford, H

    2005-10-01

    This study describes the demographic, offence and diagnostic characteristics of subjects referred by the Procurators Fiscal operating from three courts in Tayside, Scotland. A comparison is made of referrals made between 1988 to 1995 and 1997 to 1998. There was an increased rate of referral on an urgent basis over time, primarily involving patients already in contact with the psychiatric services, 37% of whom were detained and admitted to hospital. This urgent assessment ensured that mentally-disordered offenders were not remanded in custody simply for the preparation of a report, and it allowed an early assessment to be made regarding the suitability for diversion from prosecution. This outcome is compatible with guidelines issued by the Home Office in 1990 (Home Office, 1990).

  11. Impact on Quality When Pediatric Urgent Care Centers Are Staffed With Radiology Technologists.

    Science.gov (United States)

    Kan, J Herman; Orth, Robert C; Yen, Terry A; Schallert, Erica K; Zhang, Wei; Donnelly, Lane F

    2018-02-02

    The proliferation of pediatric urgent care centers has increased the need for diagnostic imaging support, but the impact of employing radiology technologists at these centers is not known. The purpose of this study was to evaluate radiographic impact and quality at urgent care centers with and without radiology technologists. A retrospective case-control study was conducted comparing 235 radiographic examinations (study) performed without and 83 examinations (control) performed with a radiology technologist at the authors' pediatric urgent care centers. Studies were evaluated for quality using a five-point, Likert-type scale (1 = poor, 5 = best) regarding field of view, presentation, and orthogonal view orientation. Studies were also evaluated for the incidence of positive results, need for repeat imaging, and discrepancies between initial study and follow-up. Imaging quality comparisons between study and control groups were statistically different for field of view (3.98 versus 4.29, P = .014), presentation (4.39 versus 4.51, P = .045), and orthogonal view orientation (4.45 versus 4.69, P = .033). The incidence of repeat imaging was similar (4.7% versus 2.4%, P = 0.526), as well as the discrepancy rates (3.4 versus 2.4%, P = 1.00). The incidence of abnormal radiographic findings for the study and control groups was similar (40.9% versus 34.9%, P = .363). Radiography is an important triage tool at pediatric urgent care centers. It is imperative to have optimal radiographic imaging for accurate diagnosis, and imaging quality is improved when radiology technologists are available. If not feasible or cost prohibitive, it is important that physicians be given training opportunities to bridge the quality gap when using radiographic equipment and exposing children to radiation. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  12. Estacionalidad e impacto del turismo en la atención urgente hospitalaria y primaria

    OpenAIRE

    Mateu Sbert, Josep

    2015-01-01

    Los servicios de urgencias médicas hospitalarios y de atención primaria son considerados claves en el funcionamiento del sistema sanitario. Modelizar el comportamiento temporal de las visitas urgentes es fundamental para planificar adecuadamente su demanda, especialmente en aquellas regiones donde se producen altas oscilaciones estacionales de población. El objetivo de esta tesis doctoral es estimar el impacto del turismo sobre las series de urgencias médicas de titularidad pública, tanto de ...

  13. THE COUNTRY BRAND AS A FORM OF THE STATE ADMINISTRATION

    Directory of Open Access Journals (Sweden)

    Serhii Romaniuk

    2017-11-01

    Full Text Available Resolving urgent social and economic problems in Ukraine requires a special approach, choosing large-scale integration instruments of government measures implementation that can reproduce and guide the development of the country in the right direction, which include territory branding. The subject of the study is a system of management of the set of brands of the national economy, its subjects, objects and public connections between them. The purpose of the article is to define the architecture of a national brand with appropriate levels of a hierarchy and justification of the impact vector of the management system of brands at each level of the hierarchy. Research methodology. During the research, systematic general principles of communication and development are used, which allowed disclosing the dialectic relationship between management methods at every level of the hierarchy. To achieve the goal, there are used: a synergetic approach to the integrated use of commercial, noncommercial brands and regional brands of the country; management approach to the country brand management process in specific market conditions; situational approach to the consideration of a brand as a tool for solving complex social, economic, environmental and political problems of the country. The object of the research is Ukraine. Conclusions of the research. The success of the establishment and functioning of a brand-oriented national economy and corresponding management system depends primarily on the joint efforts of government, private business and a wide public; the integrated approach to the management process organization, as well as consideration of the current situation in the country and its potential. Practical implications. The implementation of a brand-oriented model of the national economy is able to overcome the current socio-economic problems of the country, ensure its economic and political security, greatly improve the welfare of citizens through the

  14. Telemedicine for Developing Countries

    Science.gov (United States)

    Combi, Carlo; Pozzani, Gabriele

    2016-01-01

    Summary Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries. PMID:27803948

  15. Audit of radiology communication systems for critical, urgent, and unexpected significant findings.

    Science.gov (United States)

    Duncan, K A; Drinkwater, K J; Dugar, N; Howlett, D C

    2016-03-01

    To determine the compliance of UK radiology departments and trusts/healthcare organisations with National Patient Safety Agency and Royal College of Radiologist's published guidance on the communication of critical, urgent, and unexpected significant radiological findings. A questionnaire was sent to all UK radiology department audit leads asking for details of their current departmental policy regarding the issuing of alerts; use of automated electronic alert systems; methods of notification of clinicians of critical, urgent, and unexpected significant radiological findings; monitoring of results receipt; and examples of the more common types of serious pathologies for which alerts were issued. One hundred and fifty-four of 229 departments (67%) responded. Eighty-eight percent indicated that they had a policy in place for the communication of critical, urgent, and unexpected significant radiological findings. Only 34% had an automated electronic alert system in place and only 17% had a facility for service-wide electronic tracking of radiology reports. In only 11 departments with an electronic acknowledgement system was someone regularly monitoring the read rate. There is wide variation in practice across the UK with regard to the communication and monitoring of reports with many departments/trusts not fully compliant with published UK guidance. Despite the widespread use of electronic systems, only a minority of departments/trusts have and use electronic tracking to ensure reports have been read and acted upon. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  16. Effect of marital status on the outcome of patients undergoing elective or urgent coronary revascularization.

    Science.gov (United States)

    Barbash, Israel M; Gaglia, Michael A; Torguson, Rebecca; Minha, Sa'ar; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

    2013-10-01

    Marriage confers various health advantages in the general population. However, the added value of marriage among patients who undergo percutaneous coronary intervention (PCI) beyond the standard cardiovascular risk factors is not clear. This study aimed to assess the effects of marital status on outcomes of patients undergoing elective or urgent PCI. Clinical observational analysis of consecutive patients undergoing elective or urgent PCI from 1993 to 2011 was performed. Patients were stratified by marital status, comparing married to unmarried patients. Clinical outcome up to 12 months was obtained by telephone contact or office visit. A total of 11,216 patients were included in the present analysis; 55% were married and 45% unmarried. Significant differences in baseline characteristics were noted, including a lower prevalence of hypertension (86% vs 88%), diabetes (34% vs 38%), and smoking (19% vs 25%) among married vs unmarried patients, respectively (P married patients had a higher prevalence of hypercholesterolemia and family history of coronary artery disease. Early and late major adverse cardiac event rates were significantly lower for married vs unmarried patients up to 1 year (13.3% vs 8.2%, P Married status was independently associated with improved outcome in multivariable analysis (hazard ratio 0.7, 95% CI 0.6-0.9). Married patients who undergo urgent or elective PCI have superior short- and long-term outcomes up to 1 year when compared with unmarried patients. These benefits persist after adjustment for multiple traditional cardiovascular risk factors. © 2013.

  17. Impact of air pollution on the burden of chronic respiratory diseases in China: time for urgent action.

    Science.gov (United States)

    Guan, Wei-Jie; Zheng, Xue-Yan; Chung, Kian Fan; Zhong, Nan-Shan

    2016-10-15

    In China, where air pollution has become a major threat to public health, public awareness of the detrimental effects of air pollution on respiratory health is increasing-particularly in relation to haze days. Air pollutant emission levels in China remain substantially higher than are those in developed countries. Moreover, industry, traffic, and household biomass combustion have become major sources of air pollutant emissions, with substantial spatial and temporal variations. In this Review, we focus on the major constituents of air pollutants and their impacts on chronic respiratory diseases. We highlight targets for interventions and recommendations for pollution reduction through industrial upgrading, vehicle and fuel renovation, improvements in public transportation, lowering of personal exposure, mitigation of the direct effects of air pollution through healthy city development, intervention at population-based level (systematic health education, intensive and individualised intervention, pre-emptive measures, and rehabilitation), and improvement in air quality. The implementation of a national environmental protection policy has become urgent. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Syncope: Assessment of risk and an approach to evaluation in the emergency department and urgent care clinic

    Directory of Open Access Journals (Sweden)

    Baris Akdemir

    2015-03-01

    Full Text Available Syncope is among the most frequent forms of transient loss of consciousness (TLOC, and is characterized by a relatively brief and self-limited loss of consciousness that by definition is triggered by transient cerebral hypoperfusion. Most often, syncope is caused by a temporary drop of systemic arterial pressure below that required to maintain cerebral function, but brief enough not to cause permanent structural brain injury. Currently, approximately one-third of syncope/collapse patients seen in the emergency department (ED or urgent care clinic are admitted to hospital for evaluation. The primary objective of developing syncope/TLOC risk stratification schemes is to provide guidance regarding the immediate prognostic risk of syncope patients presenting to the ED or clinic; thereafter, based on that risk assessment physicians may be better equipped to determine which patients can be safely evaluated as outpatients, and which require hospital care. In general, the need for hospitalization is determined by several key issues: i the patient's immediate (usually considered 1 week to 1 month mortality risk and risk for physical injury (e.g., falls risk, ii the patient's ability to care for him/herself, and iii whether certain treatments inherently require in-hospital initiation (e.g., pacemaker implantation. However, at present no single risk assessment protocol appears to be satisfactory for universal application, and development of a consensus recommendation is an essential next step.

  19. Area Handbook Series. Albania: A Country Study

    Science.gov (United States)

    1992-04-01

    inadequa prenal cue, tbe proportion of preature births increse •d from 7 to 11 perent between 197 amd early 1992. Hospits lacked es- sen"h mecidmund erp...were urgently needed to deal with the multiplying number of privately owned cars. Albanian entrepreneurs also 151 Albania: A Country Study imported... entrepreneurs from the reta marketplace. At first, peasants began setting up road- side fruit and vegetables stands or carrying their produce to mar- kets in

  20. IAEA news: • Newcomer countries face common challenges in nuclear infrastructure development. • Safety and licensing requirements for small modular reactors: IAEA hosts first workshop for regulators. • IAEA reaches milestone in disposal of radioactive sources

    International Nuclear Information System (INIS)

    Kollar, Lenka; Dyck, Elisabeth; Dixit, Aabha; Gaspar, Miklos; Gil, Laura

    2016-01-01

    • Newcomer countries face common challenges in nuclear infrastructure development: Countries embarking on a nuclear power programme need to make sure that the development of their legal, regulatory and support infrastructure keeps pace with the construction of the power plant itself. This is the only way to ensure that the programme proceeds in a safe, secure and sustainable way, concluded participants of a workshop on nuclear power infrastructure development hosted at the IAEA last February. • Safety and licensing requirements for small modular reactors: IAEA hosts first workshop for regulators: A new generation of advanced, prefab nuclear power reactors called small modular reactors (SMRs) could be licensed and hit the market as early as 2020, and the IAEA is helping regulators prepare for their debut. In a series of workshops that began earlier this year, the IAEA is working closely with regulators on approaches to safety and licensing ahead of potential SMR deployment worldwide. • IAEA reaches milestone in disposal of radioactive sources: Successful tests of a promising technology for moving and storing low level radioactive sealed sources are paving the way for a new disposal method for dealing with small volumes of radioactive waste around the world. The method, which involves placing and covering sealed sources in a narrow hole a few hundred metres deep, would allow countries to safely and securely take charge of their own disused radioactive sources. The proof of concept for the technology was tested in Croatia late last year — without the use of actual radioactive material.

  1. Mapping health research capacity in 17 countries of the former Soviet Union and south-eastern Europe: an exploratory study.

    Science.gov (United States)

    Santoro, Alessio; Glonti, Ketevan; Bertollini, Roberto; Ricciardi, Walter; McKee, Martin

    2016-04-01

    Policies to improve health status, tackle disease and ensure equitable access to healthcare should be informed by evidence derived from high-quality research. However, health research capacity is unevenly distributed across countries, as revealed by mapping exercises that have been undertaken to provide a basis for concerted action to strengthen capacity. This study systematically describes capacity to undertake health research in the countries of the former Soviet Union and south-eastern Europe and identifies the elements required to create a national health research system. The mapping exercise comprised two elements: a survey of key informants in the respective countries and a bibliometric analysis of scientific publications in the field of public health. Our results confirm that health research remains a low priority in some countries of the WHO European Region. In these countries, most of the literature was produced by researchers outside the country, often to inform international donors. This study provides important information for countries seeking to initiate action to strengthen their research capacity. There is a need for a comprehensive strategy with sustained investment in training and career development of researchers. There is also a need to create new funding systems to provide financial support to those undertaking policy-relevant research. International collaboration and investment in mechanisms to bridge the gap between research and policy are urgently required. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  2. 77 FR 58404 - Announcing the Award of Two Urgent Single-Source Grants To Support Unaccompanied Alien Children...

    Science.gov (United States)

    2012-09-20

    ...] Announcing the Award of Two Urgent Single-Source Grants To Support Unaccompanied Alien Children Program...) announces the award of two urgent single-source grants from the Unaccompanied Alien Children's Program to... providing services under the Unaccompanied Alien Children's program. Award Grantee organization Location...

  3. Poor quality vital anti-malarials in Africa - an urgent neglected public health priority

    Directory of Open Access Journals (Sweden)

    Newton Paul N

    2011-12-01

    Full Text Available Abstract Background Plasmodium falciparum malaria remains a major public health problem. A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT at the correct dose. However, there are increasing reports of poor quality anti-malarials in Africa. Methods Seven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa. Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis and botanical investigations were performed. Results Counterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA containing paracetamol (acetaminophen, counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit or degraded artesunate and artesunate+amodiaquine in eight countries are described. Pollen analysis was consistent with manufacture of counterfeits in eastern Asia. These data do not allow estimation of the frequency of poor quality anti-malarials in Africa. Conclusions Criminals are producing diverse harmful anti-malarial counterfeits with important public health consequences. The presence of artesunate monotherapy, substandard and/or degraded and counterfeit medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance. With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure the quality of ACTs and removal of artemisinin monotherapies. The International Health Regulations may need to be invoked to counter these serious public health problems.

  4. Is food allergen analysis flawed? Health and supply chain risks and a proposed framework to address urgent analytical needs.

    Science.gov (United States)

    Walker, M J; Burns, D T; Elliott, C T; Gowland, M H; Mills, E N Clare

    2016-01-07

    Food allergy is an increasing problem for those affected, their families or carers, the food industry and for regulators. The food supply chain is highly vulnerable to fraud involving food allergens, risking fatalities and severe reputational damage to the food industry. Many facets are being pursued to ameliorate the difficulties including better food labelling and the concept of thresholds of elicitation of allergy symptoms as risk management tools. These efforts depend to a high degree on the ability reliably to detect and quantify food allergens; yet all current analytical approaches exhibit severe deficiencies that jeopardise accurate results being produced particularly in terms of the risks of false positive and false negative reporting. If we fail to realise the promise of current risk assessment and risk management of food allergens through lack of the ability to measure food allergens reproducibly and with traceability to an international unit of measurement, the analytical community will have failed a significant societal challenge. Three distinct but interrelated areas of analytical work are urgently needed to address the substantial gaps identified: (a) a coordinated international programme for the production of properly characterised clinically relevant reference materials and calibrants for food allergen analysis; (b) an international programme to widen the scope of proteomics and genomics bioinformatics for the genera containing the major allergens to address problems in ELISA, MS and DNA methods; (c) the initiation of a coordinated international programme leading to reference methods for allergen proteins that provide results traceable to the SI. This article describes in more detail food allergy, the risks of inapplicable or flawed allergen analyses with examples and a proposed framework, including clinically relevant incurred allergen concentrations, to address the currently unmet and urgently required analytical requirements. Support for the

  5. Rural energy and poverty in developing countries

    International Nuclear Information System (INIS)

    Fall, L.M.

    2000-01-01

    The study from which this article is drawn was carried out under the auspices of the World Energy Council, in collaboration with the FAO, and under the supervision of a steering committee made up of experts in which the author played an active role. The article begins with an in-depth analysis of the energy crisis in rural areas of developing countries and their economic implications, which contribute to increasing poverty among rural populations. It then assesses the limits and problems related to intervention and the solutions attempted in the past, with the aim of drawing lessons from the various experiments undertaken. From these, we see an edifying and worrying factor emerging as despite a great deal of well-intentioned effort, rural energy poverty still remains at an unacceptable level today in the so-called modern world of the third millennium. Indeed 2 billion people (accounting for a third of the world population and almost all living in developing countries) do not have access to modern forms of energy and still depend on firewood, leftovers from the harvest and animal waste in order to meet their energy needs. It therefore appears necessary and urgent if we intend to take up the challenge of meeting energy requirements in rural areas, to fundamentally change the attitudes and mentalities of decision-makers at a political and other levels (planners, consultants, donors etc). It also means changing direction in research to find solutions. The author then presents a range of 'solutions' advices and recommendations aimed at ensuring that future energy provision in rural areas is more stable and sustainable, enabling rural populations to live the decent life that they should be entitled to expect today. (author)

  6. "Why Is This Patient Being Sent Here?": Communication from Urgent Care to the Emergency Department.

    Science.gov (United States)

    Gardner, Rebekah; Choo, Esther K; Gravenstein, Stefan; Baier, Rosa R

    2016-03-01

    Despite patients' increasing use of urgent care centers (UCC), little is known about how urgent care clinicians communicate with the emergency department (ED). To assess ED clinicians' perceptions of the quality and consistency of communication when patients are referred from UCCs to EDs. Emergency medicine department chairs distributed a brief, electronic survey to a statewide sample of ED clinicians via e-mail. The survey included multiple-choice and free-text questions focused on types of communication desired and received from UCCs, types of test results available on transfer, and suggestions for improvement. Of 199 ED clinicians, 102 (51.3%) responded. More than four out of five respondents "somewhat" or "strongly agreed" that each of the following would be helpful: a telephone call, the reason for referral, specific concern, a copy of the chart, and UCC contact information. However, ED clinicians reported not consistently receiving these: only a fifth (21.6%) of clinicians reported receiving the specific concern for their last 5 patients transferred from a UCC, and 34.3% recalled receiving a copy of the chart. Overall, 54.9% reported receiving laboratory test results "often or almost always," 49.0% electrocardiograms, and 44.1% imaging reports. Qualitative analysis revealed several themes: incomplete data when patients are referred; barriers to discussion between ED and urgent care clinicians; and possible solutions to improve communication. Our findings highlight variation in communication from UCCs to EDs, indicating a need to improve communication standards and practices. We identify several potential ways to improve this clinical information hand-off. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Audit of radiology communication systems for critical, urgent, and unexpected significant findings

    International Nuclear Information System (INIS)

    Duncan, K.A.; Drinkwater, K.J.; Dugar, N.; Howlett, D.C.

    2016-01-01

    Aim: To determine the compliance of UK radiology departments and trusts/healthcare organisations with National Patient Safety Agency and Royal College of Radiologist's published guidance on the communication of critical, urgent, and unexpected significant radiological findings. Materials and methods: A questionnaire was sent to all UK radiology department audit leads asking for details of their current departmental policy regarding the issuing of alerts; use of automated electronic alert systems; methods of notification of clinicians of critical, urgent, and unexpected significant radiological findings; monitoring of results receipt; and examples of the more common types of serious pathologies for which alerts were issued. Results: One hundred and fifty-four of 229 departments (67%) responded. Eighty-eight percent indicated that they had a policy in place for the communication of critical, urgent, and unexpected significant radiological findings. Only 34% had an automated electronic alert system in place and only 17% had a facility for service-wide electronic tracking of radiology reports. In only 11 departments with an electronic acknowledgement system was someone regularly monitoring the read rate. Conclusion: There is wide variation in practice across the UK with regard to the communication and monitoring of reports with many departments/trusts not fully compliant with published UK guidance. Despite the widespread use of electronic systems, only a minority of departments/trusts have and use electronic tracking to ensure reports have been read and acted upon. - Highlights: • UK wide audit of communication of significant radiology results. • 88% of departments have a communication policy in place. • 34% of departments have an automated electronic alert system. • 17% of Trusts have facility for service wide electronic tracking of radiology reports.

  8. The ED use and non-urgent visits of elderly patients

    OpenAIRE

    Gulacti, Umut; Lok, Ugur; Celik, Murat; Aktas, Nurettin; Polat, Haci

    2016-01-01

    Objective: To evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits. Methods: This cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively. Results: A total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patien...

  9. [Are urgent imaging tests indicated in the management of acute pancreatitis?].

    Science.gov (United States)

    Fornell Pérez, R; Lozano Rodríguez, A

    2016-01-01

    Acute pancreatitis is a common emergency within abdominal disease. It is accepted that two of three conditions must be fulfilled for its diagnosis: characteristic clinical presentation, characteristic laboratory findings, and/or characteristic diagnostic imaging findings. The first two conditions are the most often used, probably for reasons of efficiency and frequency. Nevertheless, the need for imaging studies is sometimes a source of conflict. For this reason, we decided to review the current evidence regarding the indication of urgent imaging tests in the management of acute pancreatitis. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  10. El Mapa de la Incapacidad en España una necesidad urgente

    OpenAIRE

    Araceli López-Guillén García; José Manuel Vicente Pardo

    2015-01-01

    Resumen: Es urgente adaptar los sistemas de recogida de datos en incapacidad laboral para conseguir una mejor explotación epidemiológica de los mismos que facilite conocer la situación, análisis y planificación estratégica sobre incapacidad, creando con una base de datos mínimos básicos el Mapa de la Incapacidad en España permitiendo conocer las causas y el impacto de las situaciones de incapacidad laboral, practicar una gestión integral de recursos, prevenir las situaciones de incapacidad la...

  11. Recent progress of applying mesenchymal stem cells in therapy of urgent radiation damage

    International Nuclear Information System (INIS)

    Liu Jiangong; Guo Wanlong; Zhang Shuxian; Duan Zhikai

    2010-01-01

    At present, Cytokine therapy is the main strategy capable of preventing and reducing the acute radiation syndrome (ARS). With the problem of difficult match and severe graft versus host disease, haemopoietic stem cells can be used to find some effective approaches to treat acute radiation damage. Mesenchymal stem cells are of great therapeutic potential due to their particular characteristics including secretion of hematopoietic cytokine, reconstruction hemopoietic microenvironment, poor-immunogenicity, ease of reception ectogenic gene transfection and expression. This paper is to summarize the studies of biological characteristics of MSC and its application prospects in urgent radiation damage. (authors)

  12. CDM Country Guides

    International Nuclear Information System (INIS)

    2005-01-01

    Under the Integrated Capacity Strengthening for the Clean Development Mechanism (ICS-CDM) programme, IGES presents the CDM Country Guides, a series of manuals on CDM project development for Cambodia, China, India, Indonesia, the Philippines, and Thailand. These guidebooks aim at facilitating CDM project developments in Asia by providing essential information to both project developers and potential investors. Chapter 1, Introduction, is a summary of issues that developers and investors in CDM projects should be aware of. Includes tips for readers to effectively use the guidebook to find specific information. Chapter 2, Country Profile, comprises a profile that provides a broad picture of the country, including social, economic, and political information, as well as an overview of the country's energy situation, which is important for project development and investment. Chapter 3, The CDM Project Cycle, gives an explanation of the general CDM project cycle, which includes identifying a project, issuance of carbon credits, requirements, and stakeholders for each process. Chapter 4, Possible CDM Projects in the Country, is an overview of the country's potential resources and sectoral or project type categories that hold potential for CDM projects. Chapter 5, Government Authorities, gives a comprehensive picture of the CDM-related institutional framework and its inter-organisational relationships. Chapter 6, CDM Project Approval Procedures and Requirements Steps, informs about obtaining project approval and its requirements (e.g., country-specific provisions on additionality, sustainable development criteria, and environmental impact assessment) in the host country. Chapter 7, Laws and Regulations, is an overview of basic investment-related laws, environmental and property law, and sector-specific regulations relevant to CDM project activities. Chapter 8, Fiscal and Financing Issues, gives practical information on the financial market in the host country (both

  13. Experts disconnected by media and politicians. Accurate and trustworthy information by experts - an urgent mission

    International Nuclear Information System (INIS)

    Ehdwall, Hans; Rising, Agneta

    1999-01-01

    Sweden was one of the first countries outside the Soviet Union to be affected in 1986 by fall-out from the Chernobyl accident, which created an acute demand for correct information about reactor safety and effects of ionising radiation. A precursor to the Swedish Nuclear Training and Safety Centre, KSU, assumed in 1986 an important role in informing the general public, by using established press channels, by issuing newsletters, booklets and videotapes, and by sending mobile measuring units to the contaminated regions in Sweden. What started as an acute effort, has since then continued as a permanent activity, as the Chernobyl accident re-opened the nuclear issue as a subject of political controversy in Sweden. As on previous occasions in the debate about nuclear power, the arguments in the public and political debate were largely of scientific or technical nature, and very often grossly erroneous. Such technical false conceptions have often found their way to leading decisions-makers in politics and mass media. Corrections and refutations of this kind often require considerable expert knowledge, a scientific aitude but also a pedagogic interest. Often time-consuming research into particular issues is needed. The traditional information departments at the utilities are not very well equipped to handle such situations. The Analysis Group on nuclear power, attached to KSU, has therefore, on behalf of the utilities, been given the responsibility to generate factual information on nuclear power issues that might arise in the media or in the political and public debate. The communication mandate of the Analysis Group covers nuclear safety, the effects of ionising radiation, and comparative risk assessments. It does not include economy, energy requirements, nuclear waste or utility policy issues. Within its mandate the Analysis Group has a freedom to operate with independence and on its own merits

  14. Urgent embolization for the treatment of serious epistaxis in nasopharyngeal carcinoma after radiotherapy

    International Nuclear Information System (INIS)

    Zhu Jun; Ni Caifang; Liu Yizhi; Jing Yonghai; Zhu Xiaoli; Zou Jianwei

    2009-01-01

    Objective: To discuss the clinical effect and safety of urgent embolization with arterial catheterization in the treatment of serious epistaxis in patients with nasopharyngeal carcinoma after radiotherapy. Methods: Fifteen patients with nasopharyngeal carcinoma occurred serious epistaxis after radiotherapy. Because of failure to respond to the treatment of nasal packing and medication, embolization of the bleeding arteries with gelfoam or steel coils was carried out within 1-4 hours after the bleeding. The target arteries were judged by the internal and external carotid angiographic findings. Results: The embolization procedure was successfully completed, in all of 15 patients within 1.5 hours with the technical successful rate of 100%. The bleeding ceased in all 15 patients with the effective rate of 100%. Mild facial palsy occurred in 2 cases, and facial pain of the affected side in one case. All above symptoms were relived and disappeared in about one week after the procedure, leaving no serious complications. Conclusion: Urgent arterial embolization is an effective, safe and simple method for controlling the serious epistaxis in nasopharyngeal carcinoma after radiotherapy. (authors)

  15. Single port laparoscopic colorectal surgery in debilitated patients and in the urgent setting.

    LENUS (Irish Health Repository)

    Moftah, M

    2012-09-01

    Single port laparoscopy is a relatively new niche in the expanding spectrum of minimal access surgery for colorectal disease. To date the published experience has predominantly focused on planned operations for neoplasia in the elective setting. It seems probable however that the benefits of minimal abdominal wounding will be greatest among those patients with the highest risk of impaired wound healing. Combining this with the impression of improved cosmesis suggests that (the mostly young) patients with inflammatory bowel disease needing urgent operation are the most likely to appreciate and benefit from the extraoperative effort. The extension of single port surgery to the acute setting and for debilitated individuals is therefore a likely next step advance in broadening the category of patients for whom it represents a real benefit and ultimately aid in focusing by selection the subgroups for whom this technique is best suited and most appropriate. We describe here our approach (including routine use of a surgical glove port) to patients presenting for urgent colorectal operation for benign disease. As provision of specialized approaches regardless of timing or mode of presentation is a defining component of any specialty service, this concept will soon be more fully elucidated and established.

  16. Urgent Biophilia: Human-Nature Interactions and Biological Attractions in Disaster Resilience

    Directory of Open Access Journals (Sweden)

    Keith G. Tidball

    2012-06-01

    Full Text Available This contribution builds upon contemporary work on principles of biological attraction as well as earlier work on biophilia while synthesizing literatures on restorative environments, community-based ecological restoration, and both community and social-ecological disaster resilience. It suggests that when humans, faced with a disaster, as individuals and as communities and populations, seek engagement with nature to further their efforts to summon and demonstrate resilience in the face of a crisis, they exemplify an urgent biophilia. This urgent biophilia represents an important set of human-nature interactions in SES characterized by hazard, disaster, or vulnerability, often appearing in the 'backloop' of the adaptive cycle. The relationships that human-nature interactions have to other components within interdependent systems at many different scales may be one critical source of resilience in disaster and related contexts. In other words, the affinity we humans have for the rest of nature, the process of remembering that attraction, and the urge to express it through creation of restorative environments, which may also restore or increase ecological function, may confer resilience across multiple scales. In making this argument, the paper also represents a novel contribution to further theorizing alternatives to anthropocentric understandings of human-nature relations, and strongly makes the case for humans as part of, not separate from, ecosystems.

  17. Urgent Coronary Artery Bypass Surgery in a Patient with Postinfarction Angina and Active Myelomonocytic Leukaemia

    Directory of Open Access Journals (Sweden)

    Samuel Anthony Galea

    2016-11-01

    Full Text Available Chronic myelomonocytic leukaemia (CMML is a myelodysplastic/myeloproliferative neoplasm affecting the production and differentiation of the monocyte cell lineage. Cardiac surgery in the context of CMML poses challenges that are not routinely encountered. This is the first reported case in the literature of a patient with active CMML undergoing urgent on-pump coronary artery bypass grafting. A 68-year-old Caucasian man with a history of hypertension, hyperlipidaemia, hypothyroidism, and hypercholesterolaemia, who had been diagnosed by the haematologists with CMML a few months earlier but had remained untreated, underwent urgent surgical coronary revascularisation because of postinfarction angina following a non-ST elevation myocardial infarction associated with troponin I rise. The patient had fulminant postoperative myelomonocytic leukaemoid reaction, with a clinical picture of severe systemic inflammatory response syndrome and multiple organ dysfunction syndrome. This led to extensive vasodilation and heart failure that resulted in the death of the patient. Various authors have suggested different techniques and treatment options, each attempting to mitigate the effect of the postoperative inflammatory response. However, this is a high-risk endeavour with a myriad of inflammatory signals mobilised into action because of the surgical insult. Off-pump surgery or preoperative pharmacological attenuation of CMML activity might have dampened this response and resulted in a positive outcome for the patient.

  18. Bullying Victimization (Being Bullied) Among Adolescents Referred for Urgent Psychiatric Consultation: Prevalence and Association With Suicidality.

    Science.gov (United States)

    Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne

    2015-10-01

    To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen's University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment.

  19. Urgent Living-Donor Liver Transplantation in a Patient With Concurrent Active Tuberculosis: A Case Report.

    Science.gov (United States)

    Jung, B-H; Park, J-I; Lee, S-G

    2018-04-01

    Although active tuberculosis (TB) is considered a contraindication for liver transplantation (LT), this is the only treatment in patients with liver failure and concurrent active TB. We report a case with successful urgent living-donor LT for irreversible liver failure in the presence of active TB. A 48-year-old man, with a history of decompensated alcoholic liver cirrhosis, was presented with stupor. At admission, his consciousness had deteriorated to semi-coma, and his renal function also rapidly deteriorated to hepatorenal syndrome. A preoperative computed tomography scan of the chest revealed several small cavitary lesions in both upper lobes, and acid-fast bacillus stain from his sputum was graded 2+. Adenosine deaminase levels from ascites were elevated, suggesting TB peritonitis. A first-line anti-TB drug regimen was started immediately (rifampin, isoniazid, levofloxacin, and amikacin). An urgent living-donor LT was performed 2 days later. After LT, the regimen was changed to second-line anti-TB drugs (amikacin, levofloxacin, cycloserine, and pyridoxine). The sputum acid-fast bacillus stain tested negative on postoperative day 10. His liver function remained well preserved, even after the reversion to first-line anti-TB treatment. The patient recovered without any anti-TB medication-related complications and was discharged. LT can be prudently performed as a life-saving option, particularly for patients with liver failure and concurrent active TB. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Impact of Marijuana Legalization in Colorado on Adolescent Emergency and Urgent Care Visits.

    Science.gov (United States)

    Wang, George Sam; Davies, Sara Deakyne; Halmo, Laurie Seidel; Sass, Amy; Mistry, Rakesh D

    2018-03-30

    Approximately 6%-8% of U.S. adolescents are daily/past-month users of marijuana. However, survey data may not reliably reflect the impact of legalization on adolescents. The objective was to evaluate the impact of marijuana legalization on adolescent emergency department and urgent cares visits to a children's hospital in Colorado, a state that has allowed both medical and recreational marijuana. Retrospective review of marijuana-related visits by International Classification of Diseases codes and urine drug screens, from 2005 through 2015, for patients ≥ 13 and marijuana-related visits were identified. Behavioral health evaluation was obtained for 2,813 (67%); a psychiatric diagnosis was made for the majority (71%) of these visits. Coingestants were common; the most common was ethanol (12%). Marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 in 2015. (p = marijuana use, our data demonstrate a significant increase in adolescent marijuana-associated emergency department and urgent cares visits in Colorado. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Components of Hospital Perioperative Infrastructure Can Overcome the Weekend Effect in Urgent General Surgery Procedures.

    Science.gov (United States)

    Kothari, Anai N; Zapf, Matthew A C; Blackwell, Robert H; Markossian, Talar; Chang, Victor; Mi, Zhiyong; Gupta, Gopal N; Kuo, Paul C

    2015-10-01

    We hypothesized that perioperative hospital resources could overcome the "weekend effect" (WE) in patients undergoing emergent/urgent surgeries. The WE is the observation that surgeon-independent patient outcomes are worse on the weekend compared with weekdays. The WE is often explained by differences in staffing and resources resulting in variation in care between the week and weekend. Emergent/urgent surgeries were identified using the Healthcare Cost and Utilization Project State Inpatient Database (Florida) from 2007 to 2011 and linked to the American Hospital Association (AHA) Annual Survey Database to determine hospital level characteristics. Extended median length of stay (LOS) on the weekend compared with the weekdays (after controlling for hospital, year, and procedure type) was selected as a surrogate for WE. Included were 126,666 patients at 166 hospitals. A total of 17 hospitals overcame the WE during the study period. Logistic regression, controlling for patient characteristics, identified full adoption of electronic medical records (OR 4.74), home health program (OR 2.37), pain management program [odds ratio (OR) 1.48)], increased registered nurse-to-bed ratio (OR 1.44), and inpatient physical rehabilitation (OR 1.03) as resources that were predictors for overcoming the WE. The prevalence of these factors in hospitals exhibiting the WE for all 5 years of the study period were compared with those hospitals that overcame the WE (P surgery procedures. Improved hospital perioperative infrastructure represents an important target for overcoming disparities in surgical care.

  2. Use of the emergency department for less-urgent care among type 2 diabetics under a disease management program

    Directory of Open Access Journals (Sweden)

    Myers Leann

    2009-12-01

    Full Text Available Abstract Background This study analyzed the likelihood of less-urgent emergency department (ED visits among type 2 diabetic patients receiving care under a diabetes disease management (DM program offered by the Louisiana State University Health Care Services Division (LSU HCSD. Methods All ED and outpatient clinic visits made by 6,412 type 2 diabetic patients from 1999 to 2006 were extracted from the LSU HCSD Disease Management (DM Evaluation Database. Patient ED visits were classified as either urgent or less-urgent, and the likelihood of a less-urgent ED visit was compared with outpatient clinic visits using the Generalized Estimating Equation methodology for binary response to time-dependent variables. Results Patients who adhered to regular clinic visit schedules dictated by the DM program were less likely to use the ED for less urgent care with odds ratio of 0.1585. Insured patients had 1.13 to 1.70 greater odds of a less-urgent ED visit than those who were uninsured. Patients with better-managed glycated hemoglobin (A1c or HbA1c levels were 82 times less likely to use less-urgent ED visits. Furthermore, being older, Caucasian, or a longer participant in the DM program had a modestly lower likelihood of less-urgent ED visits. The patient's Charlson Comorbidity Index (CCI, gender, prior hospitalization, and the admitting facility showed no effect. Conclusion Patients adhering to the DM visit guidelines were less likely to use the ED for less-urgent problems. Maintaining normal A1c levels for their diabetes also has the positive impact to reduce less-urgent ED usages. It suggests that successful DM programs may reduce inappropriate ED use. In contrast to expectations, uninsured patients were less likely to use the ED for less-urgent care. Patients in the DM program with Medicaid coverage were 1.3 times more likely to seek care in the ED for non-emergencies while commercially insured patients were nearly 1.7 times more likely to do so. Further

  3. Integrating community children’s nursing in urgent and emergency care: a qualitative comparison of two teams in North West England

    Directory of Open Access Journals (Sweden)

    Kyle Richard G

    2012-07-01

    Full Text Available Abstract Background Despite the policy principle that “children are best cared for at home whenever possible” children continue to have high rates of emergency department (ED attendance and emergency hospital admission. Community Children’s Nursing Teams (CCNTs can care for acutely ill children at home but their potential to provide an alternative to ED attendance and hospitalisation depends on effective integration with other services in the urgent care system, such as EDs and Observation and Assessment Units (OAUs. Although challenges of integrating CCNTs have been identified, there has been no comparative assessment of the factors that facilitate or hinder integration of care of acutely ill children by CCNTs with the urgent care system. The aim of this study was to identify enablers and barriers to integration of CCNTs with urgent and emergency care. Methods Comparative case studies were conducted of two CCNTs serving Primary Care Trusts in North West England. Twenty-two health professionals including CCNT managers and staff; paediatricians; nurses; children’s ward, ED and OAU staff; commissioners of children’s services; GPs and primary care staff were interviewed between June 2009 and February 2010. Qualitative data were analysed thematically using the Framework approach. Results Barriers to integration included paediatricians’ perceived lack of ownership of the CCNT, poor communication between consultants and community children’s nurses (CCNs, and weak personal relationships. This prevented early referral to the CCNT as an alternative to hospital care. Enablers of integration included co-location and rotation of CCNs through urgent care settings including OAUs and EDs. This enabled nurses to develop skills, make decisions about referral to home care and gain the confidence of referring clinicians. Conclusions Integration of CCNTs at multiple points in the urgent care system is required in order to provide an alternative to

  4. ANITA (Advanced Network for Isotope and TArget laboratories) - The urgent need for a European target preparation network

    Science.gov (United States)

    Schumann, Dorothea; Sibbens, Goedele; Stolarz, Anna; Eberhardt, Klaus; Lommel, Bettina; Stodel, Christelle

    2018-05-01

    A wide number of research fields in the nuclear sector requires high-quality and well-characterized samples and targets. Currently, only a few laboratories own or have access to the equipment allowing fulfilling such demands. Coordination of activities and sharing resources is therefore mandatory to meet the increasing needs. This very urgent issue has now been addressed by six European target laboratories with an initiative called ANITA (Advanced Network for Isotope and TArget laboratories). The global aim of ANITA is to establish an overarching research infrastructure service for isotope and target production and develop a tight cooperation between the target laboratories in Europe in order to transfer the knowledge and improve the production techniques of well-characterized samples and targets. Moreover, the interaction of the target producers with the users shall be encouraged and intensified to deliver tailor-made targets best-suited to the envisaged experiments. For the realization of this ambitious goal, efforts within the European Commission and strong support by the target-using communities will be necessary. In particular, an appropriate funding instrument has to be found and applied, enabling ANITA to develop from an initiative employed by the interested parties to a real coordination platform.

  5. Outcomes of urgent carotid endarterectomy for stable and unstable acute neurologic deficits.

    Science.gov (United States)

    Barbetta, Iacopo; Carmo, Michele; Mercandalli, Giulio; Lattuada, Patrizia; Mazzaccaro, Daniela; Settembrini, Alberto M; Dallatana, Raffaello; Settembrini, Piergiorgio G

    2014-02-01

    The aim of the study was to assess the outcomes of carotid endarterectomy (CEA) performed in an urgent setting on acutely symptomatic patients selected through a very simple protocol. From January 2002 to January 2012, 193 symptomatic patients underwent CEA. Of these, 90 presented with acute symptoms, and after a congruous carotid stenosis was identified, underwent urgent operations (group 1): 27 patients had transient ischemic attack (group 1A), 52 patients had mild to moderate stroke (group 1B), and 11 patients had stroke in evolution (group 1C). The remaining 103 patients with a nonrecent neurologic deficit were treated by elective surgery in the same period (group 2). End points were 30-day neurologic morbidity and mortality. The median delay of urgent CEA (U-CEA) from deficit onset was 48 hours (interquartile range, 13-117 hours). Groups 1 and 2 were comparable in demographics. Acute patients showed a higher rate of stroke at presentation (70% vs 37%; P = .001) and of history of coronary artery disease (30% vs 13.5%; P = .007). Acute patients sustained six postoperative strokes (6.6%). Neurologic outcomes were correlated to clinical presentation: no strokes occurred in group 1A patients, and 5.8% group 1B patients and 27.3% group 1C patients had postoperative stroke (P two thromboembolic strokes. Elective patients sustained four postoperative strokes (3.9%), with one death (0.9%) as a consequence of hyperperfusion cerebral edema. U-CEAs performed ≤48 hours from symptom onset had a lower postoperative stroke rate than those performed >48 hours (4.4% vs 8.8%; P = .3). Among patients presenting with a stroke (group 1B), the National Institutes of Health Stroke Scale (NIHSS) assessment at discharge showed improvement in 79% (although only 25% had ≥4 points in reduction), stability in 17%, and deterioration in 4%. Patients with moderate stroke were slightly better in NIHSS improvement than those with mild stroke (median NIHSS variation at discharge, -3 vs -1; P

  6. Patient Reasons for Non-Urgent Utilization of the Dwight David Eisenhower Army Medical Center Emergency Department

    National Research Council Canada - National Science Library

    Sizemore, Charles J

    2004-01-01

    .... A review of the present body of literature revealed common themes why non-urgent patients typically present at emergency departments, the impacts to hospitals, and possible initiatives that could be...

  7. Radioimmunoassay of hormones for clinical trials of fertility regulating agents in developing countries

    International Nuclear Information System (INIS)

    1975-01-01

    The need for accurate hormonal assay is emphasized, and becomes more urgent as hormones, in addition to their conventional medical use are being increasinly used for family planning purposes, particularly in developing countries. Readily available facilities and laboratories for the assay of hormone strength are therefore required, and also for the standardization of methods and techniques for such assays. Radioimmunology appears and excellent tool for this. Analytical techniques in actual use and techniques of potential future use are considered. Techniques for assessing hormone strength, potenty and doses are outlined. Criteria are developed, required for establishing a calibration and standardization laboratory for hormone strength. These criteria include a discussion of the necessary staff, location of such a facility and the material and equipment needed. Help from consultants, staff training, and the growth in sample analysis and corresponding financial aspects are discussed. Finally, the problems are reviewed of creating national laboratories which can be developed as services available for certain geographical regions

  8. Design Methodology of a Sensor Network Architecture Supporting Urgent Information and Its Evaluation

    Science.gov (United States)

    Kawai, Tetsuya; Wakamiya, Naoki; Murata, Masayuki

    Wireless sensor networks are expected to become an important social infrastructure which helps our life to be safe, secure, and comfortable. In this paper, we propose design methodology of an architecture for fast and reliable transmission of urgent information in wireless sensor networks. In this methodology, instead of establishing single complicated monolithic mechanism, several simple and fully-distributed control mechanisms which function in different spatial and temporal levels are incorporated on each node. These mechanisms work autonomously and independently responding to the surrounding situation. We also show an example of a network architecture designed following the methodology. We evaluated the performance of the architecture by extensive simulation and practical experiments and our claim was supported by the results of these experiments.

  9. Occupational stressors among nurses working in urgent and emergency care units

    Directory of Open Access Journals (Sweden)

    Denyson Santana PEREIRA

    Full Text Available The study aimed to assess occupational stressors among nurses working in urgent and emergency care facilities. It is a descriptive research developed in two public hospitals of different complexity degrees, with 49 nurses. Data were collected from June to September 2011. The Bianchi's Stress Scale, which is composed of six domains: Relationship, Unit functioning, Staff management, Nursing care, Unit coordination, and Work conditions was used to assess occupational stressors based on the regular activities performed by nurses. Data were analyzed by using descriptive statistics and Mann Whitney-U test. For the nurses working in the high complexity healthcare facility - hospital A the most stressful domain was Nursing care, while for those professionals working in the medium complexity healthcare facility - hospital B, Staff management was the most stressful domain. The nurses from hospital A perceived care-related activities as more stressful, while for those in hospital B administrative activities were considered more stressful.

  10. Urgent X-ray examination of new-born babies. 1. Oesophagus-stomach

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W; Poplavski, K [Vienna Univ. (Austria). Kinderklinik

    1981-01-01

    This paper provides the paediatrician using radiology and his assistants with exact and easily-understood instructions as to how to carry out an urgent X-ray examination of the oesophagus and the stomach. As far as an X-ray examination for the diagnosis of an atresia of the oesophagus, an oesophago-tracheo fistula and a pylorusstenosis, are concerned, fluoroscopy is in the first instance unnecessary, provided that an exact sequence of steps is kept to. Only in cases of long-term check-ups after oesophagus operations and oesophago-tracheo fistulas that are difficult to prove fluoroscopy is necessary. By carrying out the examinations suggested here, a correct diagnosis can be reached soon and exposure of the child to radiations kept to a minimum.

  11. Chemical Pesticides and Human Health: The Urgent Need for a New Concept in Agriculture.

    Science.gov (United States)

    Nicolopoulou-Stamati, Polyxeni; Maipas, Sotirios; Kotampasi, Chrysanthi; Stamatis, Panagiotis; Hens, Luc

    2016-01-01

    The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs, and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production, which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.

  12. Chemical pesticides and human health: The urgent need for a new concept in agriculture

    Directory of Open Access Journals (Sweden)

    Polyxeni Nicolopoulou-Stamati

    2016-07-01

    Full Text Available The industrialization of the agricultural sector has increased the chemical burden on natural ecosystems. Pesticides are agrochemicals used in agricultural lands, public health programs and urban green areas in order to protect plants and humans from various diseases. However, due to their known ability to cause a large number of negative health and environmental effects, their side effects can be an important environmental health risk factor. The urgent need for a more sustainable and ecological approach has produced many innovative ideas, among them agriculture reforms and food production implementing sustainable practice evolving to food sovereignty. It is more obvious than ever that the society needs the implementation of a new agricultural concept regarding food production which is safer for man and the environment, and to this end, steps such as the declaration of Nyéléni have been taken.

  13. Servant leadership: An urgent style for the current political leadership in South Africa

    Directory of Open Access Journals (Sweden)

    Mookgo S. Kgatle

    2018-05-01

    Full Text Available The aspects of the political leadership in South Africa discussed in this article include, among others, abuse of power, corruption and lack of public accountability. In response to these aspects, the article demonstrates that servant leadership is an urgent style for the current state of political leadership in South Africa. The article discusses key aspects of the current political leadership in South Africa as a point of departure. The article also discusses the theological foundation and key principles of servant leadership in order to apply them to the current state of political leadership in South Africa Intradisciplinary and/or interdisciplinary implications: Servant leadership principles as outlined from a theological point of view are applied to the aspects of political leadership in South Africa.

  14. The carcinogenic effects of aspartame: The urgent need for regulatory re-evaluation.

    Science.gov (United States)

    Soffritti, Morando; Padovani, Michela; Tibaldi, Eva; Falcioni, Laura; Manservisi, Fabiana; Belpoggi, Fiorella

    2014-04-01

    Aspartame (APM) is an artificial sweetener used since the 1980s, now present in >6,000 products, including over 500 pharmaceuticals. Since its discovery in 1965, and its first approval by the US Food and Drugs Administration (FDA) in 1981, the safety of APM, and in particular its carcinogenicity potential, has been controversial. The present commentary reviews the adequacy of the design and conduct of carcinogenicity bioassays on rodents submitted by G.D. Searle, in the 1970s, to the FDA for market approval. We also review how experimental and epidemiological data on the carcinogenic risks of APM, that became available in 2005 motivated the European Commission (EC) to call the European Food and Safety Authority (EFSA) for urgent re-examination of the available scientific documentation (including the Searle studies). The EC has further requested that, if the results of the evaluation should suggest carcinogenicity, major changes must be made to the current APM specific regulations. Taken together, the studies performed by G.D. Searle in the 1970s and other chronic bioassays do not provide adequate scientific support for APM safety. In contrast, recent results of life-span carcinogenicity bioassays on rats and mice published in peer-reviewed journals, and a prospective epidemiological study, provide consistent evidence of APM's carcinogenic potential. On the basis of the evidence of the potential carcinogenic effects of APM herein reported, a re-evaluation of the current position of international regulatory agencies must be considered an urgent matter of public health. © 2014 Wiley Periodicals, Inc.

  15. COUNTRY IMAGE VS. COUNTRY BRAND: DIFFERENCES AND SIMILARITIES

    Directory of Open Access Journals (Sweden)

    Denisa Adriana COTÎRLEA

    2015-08-01

    Full Text Available This article was written in order to provide an overview regarding the differences and similarities regarding two congruent, yet different concepts: country brand and country image. The geopolitical context and, implicitly, the current global context require a redefinition – or a more complex circumscription – of the “country image” and “country branding” concepts. In this paper, the author aimed to highlight the characteristics and particularities of the approached concepts in order to shape a framework of the context within these two operate; a brief analysis of the literature is presented, trying to emphasize the slight difference between the approached concepts

  16. Mauritius country study

    International Nuclear Information System (INIS)

    Manraj, D.D.

    1998-01-01

    Mauritius has no known oil, gas or coal reserves but is only endowed with limited renewable energy resources namely hydropower and bagasse. Bagasse represents about one third of the country's energy requirements and meets almost all of the sugar industries energy demand. Projects identified for mitigation options are: Energy Sector - Renewable Sources (Solar, Wind, Biomass); Transport Sector - Fuel switching and Mass transit transport; Manufacturing Sector - Increase efficiency of energy use in the manufacturing process. (EG)

  17. Coal in sub-Saharan-African countries undergoing desertification

    Science.gov (United States)

    Weaver, J.N.; Brownfield, M.E.; Bergin, M.J.

    1990-01-01

    Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub

  18. The development of the world's population as a factor determining future energy requirements

    International Nuclear Information System (INIS)

    Vossebrecker, H.; Henssen, H.

    1988-01-01

    Urgently desired economic developments improving the conditions of living in the developing countries and, in the long term, introducing a stabilization of the world's population, result in a considerable rise in world energy requirement. This, in turn, causes conflicts and raises major ecological dangers because of the accelerated depletion of fossil sources of energy it entails. The severity of the CO 2 problem emerges clearly only when seen in connection with the population growth of the developing countries. Undoubtedly, therefore, the fossil sources of energy will have to give up their present leading role in world energy supply because of the intolerable environmental pollution they produce and because of the dwindling oil and gas reserves. The only hope remaining for the present is the possibility of nuclear power and renewable energies pointly being able to meet requirements, while all economically reasonable conservation potentials are being exploited. (orig./UA) [de

  19. Practical Secondary Education: Planning for Cost-Effectiveness in Less Developed Countries.

    Science.gov (United States)

    Chisman, Dennis

    Public pressure for expansion of secondary and higher education has forced governments of several developing countries to urgently seek ways to meet this demand. Many of these countries have been hard hit by debt and high world interest rates. At their 1984 conference, Commonwealth Ministers of Education requested the Secretariat to examine ways…

  20. Archival Education in Scandinavian Countries

    Directory of Open Access Journals (Sweden)

    Muhammet Hanefi Kutluoğlu

    2008-03-01

    Full Text Available Every country has responsibilities to provide the necessary personnel needed for their archival inheritance by education. Education can be shaped through tradition, historical inheritance and scientifi c necessities by defi ning the right educational method. Scandinavian countries have determined different education models based on their tradition, historical inheritance and requirements. In this article we focused on the formation of archival tradition, application of archival education in Scandinavian countries and the infl uence of the developments taking place in Europe on these countries. The relation between the archival education in European and Scandinavian countries is evaluated through a comparative method, and similarities to other countries are also evaluated. Finally, the present situation of archival education and the measures needed in this fi eld are taken into consideration.

  1. Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

    Science.gov (United States)

    Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

    2014-06-01

    This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

  2. Communication of urgent public health messages to urban populations: lessons from the Massachusetts water main break.

    Science.gov (United States)

    Wang, C Jason; Little, Alison A; Holliman, Jaime Bruce; Ng, Chun Y; Barrero-Castillero, Alejandra; Fu, Chong Min; Zuckerman, Barry; Bauchner, Howard

    2011-10-01

    To study when and how an urgent public health message about a boil-water order reached an urban population after the Massachusetts water main break. In-person surveys were conducted in waiting areas of clinics and emergency departments at a large urban safety net hospital within 1 week of the event. Of 533 respondents, 97% were aware of the order; 34% of those who lived in affected cities or towns were potentially exposed to contaminated water. Among those who were aware, 98% took action. Respondents first received the message through word of mouth (33%), television (25%), cellular telephone calls (20%), landline calls (10%), and other modes of communication (12%). In multivariate analyses, foreign-born respondents and those who lived outside the city of Boston had a higher risk of exposure to contaminated water. New modes (eg, cellular telephones) were used more commonly by females and younger individuals (ages 18 to 34). Individuals who did not speak English at home were more likely to receive the message through their personal networks. Given the increasing prevalence of cellular telephone use, public officials should encourage residents to register landline and cellular telephone for emergency alerts and must develop creative ways to reach immigrants and non-English-speaking groups quickly via personal networks.

  3. Improving efficiency and saving money in an otolaryngology urgent referral clinic.

    Science.gov (United States)

    Ibrahim, Nader; Virk, Jagdeep; George, Jason; Elmiyeh, Behrad; Singh, Arvind

    2015-06-16

    A closed loop audit of the ear nose and throat (ENT) urgent referral clinic at a London hospital was conducted assessing the number of patients reviewed, referral source, appropriateness of referral, presenting complaint and assigned follow-up appointments. Data was sourced from clinic letters and the patient appointment system over a 3-mo period. The initial cycle analysed 490 patients and the subsequent cycle 396. The initial audit yielded clinically relevant and cost effective recommendations which were implemented, and the audit cycle was subsequently repeated. The re-audit demonstrated decreased clinic numbers from an average 9.8 to 7.2 patients per clinic, in keeping with ENT United Kingdom guidelines. A 21% decrease in patient follow-up and 13% decrease in inappropriate referrals was achieved. Direct bookings into outpatient clinics decreased by 8%, due to correct referral pathway utilisation. Comparisons of all data sets were found to show statistical significance P saving of £32490 in a period of 3 mo (£590 per clinic). We demonstrated that simple guidelines, supervision and consultant-led education which are non-labour intensive can have a significant impact on service provision and cost.

  4. Research and increase of expertise in arachno-entomology are urgently needed.

    Science.gov (United States)

    Mehlhorn, Heinz; Al-Rasheid, Khaled A S; Al-Quraishy, Saleh; Abdel-Ghaffar, Fathy

    2012-01-01

    Considering the contents of international journals of parasitology dealing with broader topics inside this field show that rather a few papers appear with studies in the discipline of arachno-entomology. In the journals Journal of Parasitology, Parasitology Research and Trends in Parasitology, the relations of published papers on protozoology, helminthology and arachno-entomology showed that in all three journals, papers on protozoans were the most common, while those on helminths of any kind reached the second place being rather as common as the protozoan papers in Parasitology Research and in the Journal of Parasitology. In Trends of Parasitology, however, the papers on helminths reached only about 25% of the numbers published on protozoan topics. But in all three journals-and this is important-the papers on arachno-entomological themes were scarce reaching less than the half of the protozoan papers in Parasitology Research, and only about 15% in the Journal of Parasitology and in the Trends of Parasitology. These disproportions between the three great subdivisions of targets in the focus of parasitological research are dangerous, since this lack exists already for several decades and thus led to a backlog of unsolved increasing problems that are caused by ticks, mites, insects and/or parasitic crustaceans especially in times of intensive globalization and global warming. Studies on the biology, vectorship, invasion and spreading of wanted vectors and on the control of pests and parasites belonging to the field of arachno-entomology are urgently needed.

  5. Parents were accurate proxy reporters of urgent pediatric asthma health services: a retrospective agreement analysis.

    Science.gov (United States)

    Ungar, Wendy J; Davidson-Grimwood, Sara R; Cousins, Martha

    2007-11-01

    To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and hospitalizations in 545 asthmatic children recruited from sites in the greater Toronto area was conducted. Health services use data were extracted from the Ontario Health Insurance Plan and Canadian Institute for Health Information databases for each child for the interval coinciding with the proxy report for each health service type. Agreement between administrative data and respondent reports (n=545) was substantial for hospitalizations in the past year (kappa=0.80 [0.74, 0.86]), moderate for ED visits in the past year (kappa=0.60 [0.53, 0.67]), and slight for physician visits (kappa=0.13 [0.00, 0.27]) in the past 6 months. Income, parent's education, and child quality-of-life symptom scores did not affect agreement. Agreement for ED visits was significantly higher (Pasthma attack in the past 6 months (kappa=0.61 [0.54, 0.68]) compared to children who did not (kappa=0.25 [0.00, 0.59]). Parents of asthmatic children are reliable reporters of their child's respiratory-related urgent health services utilization.

  6. Environmental Assessment of Urgent-Relief Acceptance of Foreign Research Reactor Spent Nuclear Fuel

    International Nuclear Information System (INIS)

    1994-04-01

    The Department of Energy has completed the Environmental Assessment (EA) of Urgent-Relief Acceptance of Foreign Research Reactor Spent Nuclear Fuel and issued a Finding of No Significant Impact (FONSI) for the proposed action. The EA and FONSI are enclosed for your information. The Department has decided to accept a limited number of spent nuclear fuel elements (409 elements) containing uranium that was enriched in the United States from eight research reactors in Austria, Denmark, Germany, Greece, the Netherlands, Sweden, and Switzerland. This action is necessary to maintain the viability of a major US nuclear weapons nonproliferation program to limit or eliminate the use of highly enriched uranium in civil programs. The purpose of the EA is to maintain the cooperation of the foreign research reactor operators with the nonproliferation program while a more extensive Environmental Impact Statement (EIS) is prepared on a proposed broader policy involving the acceptance of up to 15,000 foreign research reactor spent fuel elements over a 10 to 15 year period. Based on an evaluation of transport by commercial container liner or chartered vessel, five eastern seaboard ports, and truck and train modes of transporting the spent fuel overland to the Savannah River Sits, the Department has concluded that no significant impact would result from any combination of port and made of transport. In addition, no significant impacts were found from interim storage of spent fuel at the Savannah River Site

  7. Accidents involving Brazilian indigenous treated at urgent and emergency services of the Unified Health System.

    Science.gov (United States)

    Souza, Edinilsa Ramos de; Njaine, Kathie; Mascarenhas, Márcio Dênis Medeiros; Oliveira, Maria Conceição de

    2016-12-01

    Abstract We analyzed the accidents with Brazilian indigenous treated at urgent and emergency services of the Unified Health System (SUS). Data were obtained from the 2014 Viva Survey, which included 86 services from 24 capitals and the Federal District. The demographic profile of the indigenous, the event and the attendance were characterized. Most of the attended people were male in the 20-39 years age group. Falls and traffic accidents were the main reasons for attendance. Alcohol use was informed by 5.6% of the attended people, a figure that increases to 19.1% in traffic accidents, 26.1% among drivers and 22.8% among motorcyclists. There was a statistical difference between genders in relation to age, disability, place of occurrence of the event, work-related event and victim's condition in the traffic accident. We emphasize the importance of providing visibility to accidents with indigenous and engage them in the prevention of such events. Data reliability depends on the adequate completion in indigenous health information systems.

  8. Environmental Assessment of Urgent-Relief Acceptance of Foreign Research Reactor Spent Nuclear Fuel

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    The Department of Energy has completed the Environmental Assessment (EA) of Urgent-Relief Acceptance of Foreign Research Reactor Spent Nuclear Fuel and issued a Finding of No Significant Impact (FONSI) for the proposed action. The EA and FONSI are enclosed for your information. The Department has decided to accept a limited number of spent nuclear fuel elements (409 elements) containing uranium that was enriched in the United States from eight research reactors in Austria, Denmark, Germany, Greece, the Netherlands, Sweden, and Switzerland. This action is necessary to maintain the viability of a major US nuclear weapons nonproliferation program to limit or eliminate the use of highly enriched uranium in civil programs. The purpose of the EA is to maintain the cooperation of the foreign research reactor operators with the nonproliferation program while a more extensive Environmental Impact Statement (EIS) is prepared on a proposed broader policy involving the acceptance of up to 15,000 foreign research reactor spent fuel elements over a 10 to 15 year period. Based on an evaluation of transport by commercial container liner or chartered vessel, five eastern seaboard ports, and truck and train modes of transporting the spent fuel overland to the Savannah River Sits, the Department has concluded that no significant impact would result from any combination of port and made of transport. In addition, no significant impacts were found from interim storage of spent fuel at the Savannah River Site.

  9. Health literacy in the urgent care setting: What factors impact consumer comprehension of health information?

    Science.gov (United States)

    Alberti, Traci L; Morris, Nancy J

    2017-05-01

    An increasing number of Americans are using urgent care (UC) clinics due to: improved health insurance coverage, the need to decrease cost, primary care offices with limited appointment availability, and a desire for convenient care. Patients are treated by providers they may not know for episodic illness or injuries while in pain or not feeling well. Treatment instructions and follow-up directions are provided quickly. To examine health literacy in the adult UC population and identify patient characteristics associated with health literacy risk. As part of a larger cross-sectional study, UC patients seen between October 2013 and January 2014 completed a demographic questionnaire and the Newest Vital Sign. Descriptive, nonparametric analyses, and a multinomial logistic regression were done to assess health literacy, associated and predictive factors. A total of 57.5% of 285 participants had adequate health literacy. The likelihood of limited health literacy was associated with increased age (p literacy is common in a suburban UC setting, increasing the risk that consumers may not understand vital health information. Clear provider communication and confirmation of comprehension of discharge instructions for self-management is essential to optimize outcomes for UC patients. ©2017 American Association of Nurse Practitioners.

  10. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services.

    Science.gov (United States)

    Mascarenhas, Márcio Dênis Medeiros; Souto, Rayone Moreira Costa Veloso; Malta, Deborah Carvalho; Silva, Marta Maria Alves da; Lima, Cheila Marina de; Montenegro, Marli de Mesquita Silva

    2016-12-01

    Injuries resulting from motorcycle road traffic accidents are an important public health issue in Brazil. This study aimed to describe the characteristics of motorcyclists involved in traffic accidents attended in public urgent and emergency services in the state capitals and the Federal District. This is a cross-sectional study based on data from the Violence and Accident Surveillance System (VIVA Survey) in 2014. Data were analyzed according to sociodemographic, event and attendance characteristics. Proportional differences between genders were analyzed by chi-square test (Rao-Scott) with 5% significance level. Motorcyclist-related attendances (n = 9,673) reported a prevalence of men (gender ratio = 3.2), young people aged 20-39 years (65.7%), black / brown (73.6%), paid work (76.4%). Helmet use was reported by 79.1% of the victims, 13.3% had consumed alcohol in the six hours prior to the accident, 41.4% of the events were related to the victim's work. Accidents were more frequent on weekends, in the morning and late afternoon. These characteristics can support the development of public accident prevention policies and health promotion.

  11. Trans fatty acid content in Serbian margarines: Urgent need for legislative changes and consumer information.

    Science.gov (United States)

    Vučić, Vesna; Arsić, Aleksandra; Petrović, Snježana; Milanović, Sandra; Gurinović, Mirjana; Glibetić, Maria

    2015-10-15

    This study examined the fatty acid (FA) composition of 13 (7 soft and 6 hard) Serbian margarines. Significantly higher amounts of trans fatty acids (TFA) were found in hard margarines (up to 28.84% of total FA), than in soft ones (0.17-6.89%). Saturated FA (SFA) were present with 22.76-51.17%. Oleic acid ranged from 26.78% to 43.78%. The proportion of polyunsaturated FA (PUFA) was 22.15-49.29% in soft margarines, but only 8.02-15.28% in hard margarines, probably due to the hydrogenisation process. The atherogenic and thrombogenic indexes (AI and TI, respectively) in soft margarines were relatively low (AI 0.23-0.63 and TI 0.44-0.97), but in hard margarines AI and particularly TI were high (1.03-1.67 and 1.96-3.04, respectively). These findings suggest that FA composition of Serbian margarines should be improved by replacing atherogenic TFA and SFA with beneficial ones, in order to avoid adverse effects on health. Therefore legislative changes and consumer information are urgently needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. DEVELOPING COUNTRIES. TRANSITION ECONOMIES

    Directory of Open Access Journals (Sweden)

    Dumitru FILIPEANU

    2016-05-01

    Full Text Available According to the modern theories of economic development – the take-off, backwardness, convergence and balanced growth hypothesis - the new industrialized states from Asia seem to have noticed the advantages of backwardness from which low income countries benefited, namely the possibility to take advantage of the latest technological discoveries of advanced countries, thus achieving a faster growth than the latter which operated closer to the technological border. The assimilation of appropriate technologies, however, required the efficient mobilization and allocation of resources and the improvement of human and physical capital. While the Western countries were confronted with crises generated by inflationary shocks and movements of speculative capital, the relative isolation of countries whose economy was planned by the world economy sheltered them until 1990, unemployment being practically non-existent. Asia's exceptional economic success is not only due to borrowing Western practices, but also to the fact that Asian societies maintained certain traditional features of their own culture - such as a strong work ethic - and integrated them in the modern business environment.

  13. Urgent Optic Nerve Decompression via an Endoscopic Endonasal Transsphenoidal Approach for Craniopharyngioma in a 12-Month-Old Infant: A Case Report.

    Science.gov (United States)

    Shibata, Teishiki; Tanikawa, Motoki; Sakata, Tomohiro; Mase, Mitsuhito

    2018-01-01

    Craniopharyngiomas are benign tumors and account for approximately 5.6-13% of all intracranial tumors in children. Diagnosis of pediatric craniopharyngioma is often delayed until the tumor becomes relatively large and manifests severe visual and/or endocrine disturbance. Endoscopic endonasal approaches have recently been introduced to surgery for craniopharyngioma. These techniques, however, have rarely been utilized in patients affected with craniopharyngioma as young as 1 year old. This report documents a 12-month-old male infant with sellar craniopharyngioma who presented with acute total vision loss. To increase the chances of visual recovery, an endoscopic endonasal optic nerve decompression was performed as an urgent procedure. After decompression, which resulted in improvement of his visual disturbance, gross total resection of the tumor was undertaken through an anterior interhemispheric approach at a later date. Tumor mass reduction through an endoscopic endonasal transsphenoidal approach followed by secondary radical total resection under craniotomy was considered to be useful in cases such as this when urgent optic nerve decompression is required. © 2018 S. Karger AG, Basel.

  14. The former USSR: an energy balance in urgent need of improvement

    International Nuclear Information System (INIS)

    Provost, H.

    1993-01-01

    The energy balance of the former USSR is a decisive factor in the economies of the countries now remaining. This balance is facing a crunch due to excessive consumption of liquid hydrocarbons, combined with a downswing in production since 1988. There is a pressing need to open up the petroleum industries to Western technologies and partnerships. 1 fig., 4 tabs

  15. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy

    OpenAIRE

    Barbadoro, Pamela; Di Tondo, Elena; Menditto, Vincenzo Giannicola; Pennacchietti, Lucia; Regnicoli, Februa; Di Stanislao, Francesco; D?Errico, Marcello Mario; Prospero, Emilia

    2015-01-01

    Objective The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED) for non-urgent visits. Methods The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use. Results Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32?6.47) of re-admissions have be...

  16. Mapping ergonomics application to improve SMEs working condition in industrially developing countries: a critical review.

    Science.gov (United States)

    Hermawati, Setia; Lawson, Glyn; Sutarto, Auditya Purwandini

    2014-01-01

    In industrially developing countries (IDC), small and medium enterprises (SMEs) account for the highest proprotion of employment. Unfortunately, the working conditions in SMEs are often very poor and expose employees to a potentially wide range of health and safety risks. This paper presents a comprehensive review of 161 articles related to ergonomics application in SMEs, using Indonesia as a case study. The aim of this paper is to investigate the extent of ergonomics application and identify areas that can be improved to promote effective ergonomics for SMEs in IDC. The most urgent issue found is the need for adopting participatory approach in contrast to the commonly implemented top-down approach. Some good practices in ergonomics application were also revealed from the review, e.g. a multidisciplinary approach, unsophisticated and low-cost solutions, and recognising the importance of productivity. The review also found that more work is still required to achieve appropriate cross-cultural adaptation of ergonomics application.

  17. Performance of two strategies for urgent ANCA and anti-GBM analysis in vasculitis.

    Science.gov (United States)

    de Joode, Anoek A E; Roozendaal, Caroline; van der Leij, Marcel J; Bungener, Laura B; Sanders, Jan Stephan F; Stegeman, Coen A

    2014-02-01

    In anti-neutrophil cytoplasmic antibodies (ANCA) associated small vessel vasculitis (AAV), rapid testing for ANCA and anti-glomerular basement membrane (GBM) antibodies may be beneficial for therapeutic purpose. We analysed the diagnostic performance of two rapid ANCA and anti-GBM test methods in 260 patients with suspected AAV. Between January 2004 and November 2010, we analysed 260 samples by qualitative Dotblot (Biomedical Diagnostics); retrospective analysis followed with directly coated highly sensitive automated Phadia ELiA and ELiA anti-GBM. Results were related to the final clinical diagnosis and compared with routine capture ELISA. Seventy-four patients had a final diagnosis of AAV (n=62) or anti-GBM disease (n=12). Both Dotblot and ELiA detected all 12 cases of anti-GBM disease; 2 false positive results were found. Dotblot detected ANCA in 56 of 62 AAV patients (sensitivity 90%, NPV 97%), and showed 5 false positives (specificity 97%, PPV 90%). The Phadia ELiA anti-PR3(s) or anti-MPO(s) was positive in 57 of 62 AAV patients (sensitivity 92%, NPV 97%), and had 5 false positives (specificity 97%, PPV 88%). Routine capture ELISA was equally accurate (sensitivity 94%, specificity 97%, PPV 88%, NPV 98%). The Dotblot and Phadia ELiA on anti-GBM, anti-PR3(s) and anti-MPO(s) performed excellently; results were almost identical to routine ELISA. When suspicion of AAV or anti-GBM disease is high and diagnosis is urgently needed, both tests are very powerful for rapid serological diagnosis. Further studies have to confirm the test performances in samples routinely presented for ANCA testing and in follow-up of positive patients. Copyright © 2013 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  18. El Mapa de la Incapacidad en España una necesidad urgente

    Directory of Open Access Journals (Sweden)

    Araceli López-Guillén García

    2015-09-01

    Full Text Available Resumen: Es urgente adaptar los sistemas de recogida de datos en incapacidad laboral para conseguir una mejor explotación epidemiológica de los mismos que facilite conocer la situación, análisis y planificación estratégica sobre incapacidad, creando con una base de datos mínimos básicos el Mapa de la Incapacidad en España permitiendo conocer las causas y el impacto de las situaciones de incapacidad laboral, practicar una gestión integral de recursos, prevenir las situaciones de incapacidad laboral, potenciar los mecanismos de detección de la enfermedad y los aspectos preventivos de la salud laboral, mejorar la gestión sanitaria que precisa y la protección socio laboral. Conclusiones: Proponemos la base mínima de datos para la elaborar el Mapa de Incapacidad. Conociendo el impacto incapacitante de la pérdida de salud en la población trabajadora se procederá a una mejor gestión y adecuación de recursos atencionales, promocionales, preventivos, reintegradores, y prestacionales en torno a la incapacidad temporal y permanente. Conocer nuestra población "incapacitada (por enfermedad" es fundamental para cualquier análisis sobre impacto y necesidades de protección social, para contrastarla con la población activa, la población en formación o inactiva previa a la edad laboral, y la población inactiva jubilada.

  19. Blowhole colostomy for the urgent management of distal large bowel obstruction.

    Science.gov (United States)

    Kasten, Kevin R; Midura, Emily F; Davis, Bradley R; Rafferty, Janice F; Paquette, Ian M

    2014-05-01

    Complete obstruction of the distal colon or rectum often presents as a surgical emergency. This study evaluated the efficacy of blowhole colostomy versus transverse loop colostomy for the emergent management of distal large intestinal obstruction. Retrospective chart review of all colostomy procedures (CPT 44320) performed for complete distal large bowel obstruction during the past 6 y in a university hospital practice was undertaken. Blowhole was compared with loop colostomy with a primary endpoint of successful colonic decompression. One hundred forty-one patients underwent colostomy creation during the study period. Of these, 61 were completed for acute obstruction of the distal colon or rectum (19 blowhole versus 42 loop colostomy). No differences between study groups were seen in age, gender, body mass index, malnutrition, American Society of Anesthesiology class, time to liquid or regular diet, 30-d or inhospital mortality, or rates of complications. Patients undergoing blowhole colostomy had significantly higher cecal diameters at diagnosis (9.14 versus 7.31 cm, P = 0.0035). Operative time was shorter in blowhole procedures (43 versus 51 min, P = 0.017). Postoperative length of stay was significantly shorter for blowhole colostomy (6 versus 8 d, P = 0.014). The primary endpoint of successful colonic decompression was met in all colostomy patients. Diverting blowhole colostomy is a safe, quick, and effective procedure for the urgent management of distal colonic obstruction associated with obstipation and massive distention. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  1. Child and Adolescent Emergency and Urgent Mental Health Delivery Through Telepsychiatry: 12-Month Prospective Study.

    Science.gov (United States)

    Roberts, Nasreen; Hu, Tina; Axas, Nicholas; Repetti, Leanne

    2017-10-01

    The significant gap between children and adolescents presenting for emergency mental healthcare and the shortage of child and adolescent psychiatrists constitutes a major barrier to timely access for psychiatric assessment for rural and remote areas. Unlike remote areas, urban emergency departments have in-house psychiatric consultation. Telepsychiatry may be a solution to ensure the same service for remote areas. However, there is a paucity of studies on the use of telepsychiatry for child and adolescent emergency consults. Thus, the aim of our study was to (1) assess patient satisfaction with telepsychiatry and (2) compare clinical characteristics and outcome of telepsychiatry with face-to-face emergency child and adolescent assessments. This is a prospective study of telepsychiatry emergency assessments of children and adolescents referred by emergency physicians. The comparison group was age- and gender-matched patients seen for face-to-face urgent assessments. Data were gathered on demographic and clinical variables. Telepsychiatry satisfaction was assessed using a questionnaire. Descriptive statistics and chi-square tests were used to assess group differences for each variable. Logistic regression was used to assess impact of the variables on outcome after the consult. A p value <0.05 was used to determine statistical significance. Sixty (n = 60) assessments were conducted through telepsychiatry in 12 months. Among the telepsychiatry group, Aboriginal patients were over-represented (50% vs. 6.7%, p < 0.001), a higher proportion received a diagnosis of adjustment disorder (22% vs. 8.3%, p = 0.004) or no diagnosis (27% vs. 6.7%, p = 0.004) compared with controls. There was no statistically significant difference between groups on other clinical variables. Patients reported a high degree of satisfaction with telepsychiatry. Telepsychiatry is acceptable to patients and families for safe emergency assessment and follow-up, reducing unnecessary travel

  2. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    Directory of Open Access Journals (Sweden)

    Kangolle Alfred CT

    2010-10-01

    Full Text Available Abstract Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1 Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2 Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3 Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1 Capacity building in oncology health services research, policy and planning relevant to developing countries. (2 Development of high-quality health data sources. (3 More oncology-related economic evaluations in developing countries. (4 Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and

  3. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

    Science.gov (United States)

    Hanna, Timothy P; Kangolle, Alfred C T

    2010-10-13

    Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political

  4. Healthcare worker exposure to Middle East respiratory syndrome coronavirus (MERS-CoV: Revision of screening strategies urgently needed

    Directory of Open Access Journals (Sweden)

    Hala Amer

    2018-06-01

    Conclusions: The data obtained in this study support the widespread testing of all close contacts of MERS-CoV cases, regardless of the significance of the contact or presence or absence of symptoms. In addition, urgent careful review of guidance regarding the return of asymptomatic MERS-CoV-positive HCWs under investigation to active duty is needed.

  5. 76 FR 35719 - Unexpected Urgent Refugee and Migration Needs Related to Libya and C[ocirc]te d'Ivoire

    Science.gov (United States)

    2011-06-20

    ... June 8, 2011 Unexpected Urgent Refugee and Migration Needs Related to Libya and C[ocirc]te d'Ivoire... laws of the United States, including section 2(c)(1) of the Migration and Refugee Assistance Act of... amount not to exceed $15 million from the United States Emergency Refugee and Migration Assistance Fund...

  6. 76 FR 53913 - Award of an Urgent Single-Source Grant to Survivors of Torture International (SOTI) in San Diego...

    Science.gov (United States)

    2011-08-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Refugee Resettlement Award of an Urgent Single... Refugee Resettlement, ACF, HHS. ACTION: Notice; correction. CFDA Number: 93.604. SUMMARY: The Office of Refugee Resettlement, ACF, HHS published a document in the Federal Register of August 16, 2011 (76 FR...

  7. Emergency Department Referrals for Adolescent Urgent Psychiatric Consultation: Comparison of Clinical Characteristics of Repeat-presentations and Single-presentation.

    Science.gov (United States)

    Roberts, Nasreen; Nesdole, Robert; Hu, Tina

    2018-01-01

    a) to examine the demographic and clinical characteristics of repeat-presentations to an adolescent urgent psychiatric clinic, and b) to compare them with single-time presentation. This 18-month retrospective study compared repeat-presenters to age and gender matched single-time presenters. Demographic variables included age gender and ethnicity. Clinical variables included reason for referral, family history, diagnosis, recommendations and compliance. Data were analyzed using descriptive statistics, McNemar's Chi-square tests for matched pairs, and conditional logistic regression. Of 624 assessments 24% (N=151) were repeat-presentations. Compared with single-presentation, repeat-presentation group had a higher proportion of Aboriginal youth (X2 (1) = 108.28 p presentation group had higher odds of past hospital admission (OR: 3.50, p presentations for urgent psychiatric consultation constitute a quarter of referrals to the urgent psychiatric clinic. Identifying and addressing factors that contribute to repeat-presentations may, assist in improving treatment compliance by ensuring focused interventions and service delivery for these youth. In turn, this will improve access to the limited urgent services for other youth.

  8. Country profiles: Belgium

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    Within months, Belgium will have to import practically all of its energy requirements; coal production will stop in 1992. Though nuclear will continue to provide the bulk of the country's power supply, government policy has shifted away from reliance on the atom for electricity generation towards natural gas. With no oil reserves of its own, keeping demand under check has been a priority for governments down the years. The actual level of oil imports runs well above consumption since the refining sector supplies products for the European market. Belgium's own petrol station businesses face considerable rationalisation, with average throughput well below EC levels. (author)

  9. Variation in Quality of Urgent Health Care Provided During Commercial Virtual Visits.

    Science.gov (United States)

    Schoenfeld, Adam J; Davies, Jason M; Marafino, Ben J; Dean, Mitzi; DeJong, Colette; Bardach, Naomi S; Kazi, Dhruv S; Boscardin, W John; Lin, Grace A; Duseja, Reena; Mei, Y John; Mehrotra, Ateev; Dudley, R Adams

    2016-05-01

    Commercial virtual visits are an increasingly popular model of health care for the management of common acute illnesses. In commercial virtual visits, patients access a website to be connected synchronously-via videoconference, telephone, or webchat-to a physician with whom they have no prior relationship. To date, whether the care delivered through those websites is similar or quality varies among the sites has not been assessed. To assess the variation in the quality of urgent health care among virtual visit companies. This audit study used 67 trained standardized patients who presented to commercial virtual visit companies with the following 6 common acute illnesses: ankle pain, streptococcal pharyngitis, viral pharyngitis, acute rhinosinusitis, low back pain, and recurrent female urinary tract infection. The 8 commercial virtual visit websites with the highest web traffic were selected for audit, for a total of 599 visits. Data were collected from May 1, 2013, to July 30, 2014, and analyzed from July 1, 2014, to September 1, 2015. Completeness of histories and physical examinations, the correct diagnosis (vs an incorrect or no diagnosis), and adherence to guidelines of key management decisions. Sixty-seven standardized patients completed 599 commercial virtual visits during the study period. Histories and physical examinations were complete in 417 visits (69.6%; 95% CI, 67.7%-71.6%); diagnoses were correctly named in 458 visits (76.5%; 95% CI, 72.9%-79.9%), and key management decisions were adherent to guidelines in 325 visits (54.3%; 95% CI, 50.2%-58.3%). Rates of guideline-adherent care ranged from 206 visits (34.4%) to 396 visits (66.1%) across the 8 websites. Variation across websites was significantly greater for viral pharyngitis and acute rhinosinusitis (adjusted rates, 12.8% to 82.1%) than for streptococcal pharyngitis and low back pain (adjusted rates, 74.6% to 96.5%) or ankle pain and recurrent urinary tract infection (adjusted rates, 3.4% to 40

  10. The urgent matter of online pro-eating disorder content and children: clinical practice.

    Science.gov (United States)

    Custers, Kathleen

    2015-04-01

    During the last decade, much concern has been expressed about online pro-eating disorder communities (e.g., pro-anorexia websites and blogs) which encourage their users to engage in disordered eating behavior. The aim of the current paper is to reemphasize the importance of pro-eating disorder communities in light of the recent changes in the media landscape. With the increase of social networking sites, pro-anorexia messages have transplanted to more volatile and constantly changing media, such as Snapchat, Twitter, Facebook, Instagram, Pinterest, and many others. Most parents, educators, and health professionals are unaware of the sheer scope and nature of such pro-anorexia messages in these new contexts. The current paper will provide a review of pro-eating disorder websites, overview the effects of such websites on young people's health, examine the emergence of these messages on social media platforms, and highlight a number of guidelines for clinicians and parents. The dissemination of online pro-eating disorder content to different types of social networking sites is becoming an urgent issue. • Existing research on pro-eating disorder websites examines the prevalence and the content of these websites, and the effects of pro-eating disorder content on both clinical (eating disordered individuals) and non-clinical samples (non-eating disordered individuals). • The scope and nature of such anorexia messages is unknown to most adults, and many people (including parents and medical professionals) are insufficiently aware of the ease with which young people access, navigate, and use a wide range of online platforms. • Pro-anorexia messages are no longer limited to websites that can be easily monitored, but instead have been transplanted to more volatile and constantly changing media such as Snapchat, Twitter, Facebook, Pinterest, and Tumblr which makes pro-eating disorder content much more easily accessible. • This paper wants to emphasize the implications

  11. Emergency Department Non-Urgent Visits and Hospital Readmissions Are Associated with Different Socio-Economic Variables in Italy.

    Directory of Open Access Journals (Sweden)

    Pamela Barbadoro

    Full Text Available The aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED for non-urgent visits.The study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use.Among the 416,698 sampled admissions, 6.39% (95% CI, 6.32-6.47 of re-admissions have been registered; the distribution shows a high frequency of events in the age 65-84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37-52.57. The regression model has shown the significant role played by age, type of structure (geriatric acute care, and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38-15.27 of the total number of respondents to the questionnaire (N = 504. The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3-7.8 p = 0.008, while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30-0.90.In the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization.

  12. Obesity and the metabolic syndrome in developing countries: focus on South Asians.

    Science.gov (United States)

    Misra, Anoop; Bhardwaj, Swati

    2014-01-01

    With improvement in the economic situation, an increasing prevalence of obesity and the metabolic syndrome is seen in developing countries in South Asia. Particularly vulnerable population groups include women and children, and intra-country and inter-country migrants. The main causes are increasing urbanization, nutrition transition, reduced physical activity, and genetic predisposition. Some evidence suggests that widely prevalent perinatal undernutrition and childhood 'catch-up' obesity may play a role in adult-onset metabolic syndrome and type 2 diabetes. Data show that atherogenic dyslipidemia, glucose intolerance, thrombotic tendency, subclinical inflammation, and endothelial dysfunction are higher in South Asians than white Caucasians. Many of these manifestations are more severe even at an early age in South Asians than white Caucasians. Metabolic and cardiovascular risks in South Asians are also heightened by their higher body fat, truncal subcutaneous fat, intra-abdominal fat, and ectopic fat deposition (liver fat, muscle fat, etc.). Further, cardiovascular risk cluster manifests at a lower level of adiposity and abdominal obesity. The cutoffs of body mass index and waist circumference for defining obesity and abdominal obesity, respectively, have been lowered for Asians, and same has been endorsed for South Asians in the UK. The economic cost of obesity and related diseases in developing countries, having meager health budget, is enormous. Increasing awareness of these noncommunicable diseases and how to prevent them should be focus of population-wide prevention strategies in South Asian developing countries. Community intervention programs focusing on increased physical activity and healthier food options for schoolchildren are urgently required. Data from such a major intervention program conducted by us on adolescent urban schoolchildren in north India (project MARG) have shown encouraging results and could serve as a model for initiating such

  13. Photovoltaic marketing in developing countries

    International Nuclear Information System (INIS)

    Muntasser, M.A.; Bara, M.F.; Quadri, H.A.; El-Tarabelsi, R.; La-azebi, I.F.

    2000-01-01

    Photovoltaic (PV) insolation-harnessing is acknowledged as the most practical economic solution to meet the requirements of one hundred million people without electricity in the developing countries. Industrialised countries in particular, have been active in utilising such technologies because they can afford the current peak watt prices of US $3-15 for such systems. The market in those countries will soon be close to saturation and attention by suppliers will have to be shifted to the already established larger market in less developed countries (LDCs). PV marketing in these developing countries, i.e. ability to penetrate the potential market, is facing tremendous hurdles. This paper reviews the present status and future directions of the PV market in developing countries as well as discusses the current technical, social, financial or geopolitical barriers and constraints, which are in line with the trends in the world. The paper concludes by making a global policy package proposal, in terms of an appeal on the global community concerned with PV to propagate proposal, in terms of an appeal on the global community concerned with PV to propagate this proposal more convincingly, perhaps to emanate from an internationally recognised 'forum', like a PV conference and exhibition, with cooperation and participation of PV manufacturers, suppliers, industrialised countries, NGOs, financial institutions and developing countries. (Author)

  14. Cyclotrons in developing countries

    International Nuclear Information System (INIS)

    Vera Ruiz, Hernan

    2004-01-01

    Cyclotron accelerators are prolific sources of charged particle for the production of radionuclides and have become an essential tool in the practice of modern nuclear medicine by providing reliable radiotracers for SPECT and PET studies. In a recent survey conducted by the IAEA in 2001, the growth in the number of cyclotron facilities installed in laboratories and hospitals in developed as well as developing countries was recorded. This trend, which started in the late 70's, continues in the present time also and all indications are that it will continue in the next five to ten years. The reasons for this growth are several: technology involved has become more user or 'hospital friendly', third party reimbursement for several clinical studies based on F-18 PET radiopharmaceuticals at least in some of the advanced countries started in 1998 and above all, the clear irrefutable and demonstrable conclusion of the positive cost/benefit outcomes of PET studies in the field of oncology to a lesser degree, thus far, for cardiology and neurology. It is however recognizable that the overall financial cost of the technology, which comprises the premises to house the facility, the cyclotron accelerator, the corresponding radiochemistry and quality control equipment and the PET cameras can be nevertheless an expensive proposition that requires careful advance planning. This fact is even more relevant when the facility is planned for installation in a developing country, which, frequently, in addition to having a lack of sufficient financial resources, do have shortage of qualified human resources to efficiently run the facility. In spite of the above, it is fact that more and more public as well as private organizations in the developing countries are setting up cyclotron/PET programmes or are seriously considering the installation of such a facility

  15. Malnutrition in older adults - urgent need for action: a plea for improving the nutritional situation of older adults.

    Science.gov (United States)

    Volkert, Dorothee

    2013-01-01

    During the past decades, malnutrition has attracted increasing scientific attention and is by now regarded as a true geriatric syndrome characterized by multifactorial causality, identified by symptoms and accompanied by frailty, disability and poor outcome. This viewpoint summarizes our present knowledge and the usual current handling of malnutrition in older people and highlights the urgent need for action in this field. Age-related changes in the complex system of appetite regulation, resulting in the so-called anorexia of aging, predispose older adults to a decrease in food intake which may lead to malnutrition, if additional risk factors like health or social problems occur. Consequently, malnutrition is widespread in the older population, notably in those who are institutionalized. Despite the fact that effective interventions are available, prevention and treatment of malnutrition do not currently receive appropriate attention. As an important first step towards better awareness, screening for malnutrition should become a mandatory integral part of the comprehensive geriatric assessment. Furthermore, practical local guidelines should be implemented in all geriatric hospital wards and nursing homes in order to improve nutritional care in the daily routine. Important to note is that reasonable nutritional management is not possible without qualified staff in adequate numbers allowing appropriate individual nutritional care. Regarding future research, studies at the cellular, metabolic and clinical levels and the linking of information from different research approaches are required to better understand the transition from good nutritional health and independence of old people to malnutrition, functional impairment and poor health. In parallel to well-designed observational and intervention studies, standardized documentation of nutritional information in daily routine would enable the uniform collection of data for research as well as for political decisions

  16. Market prospects of modular HTR in EEC countries

    International Nuclear Information System (INIS)

    Albisu, F.; Garribba, S.F.; Lefevre, J.C.; Leuchs, D.; Vivante, C.

    1991-01-01

    The energy outlook for the early 21st century is very uncertain. Low-cost oil and natural gas reserves will become seriously depleted and nonfossil energy resources may be urgently required because of environmental reasons. In this framework, small- and medium-size nuclear reactors (SMSNRs), particularly the Modular High-Temperature Reactor (HTR) would allow extension of uses of nuclear energy while being adopted to produce power and/or steam or heat, where heat can be at low or high temperature. For policy making and planning purposes it is meaningful to appraise the market potential of Modular HTR during the next 20 or 30 years. The paper presents the outcomes of country studies on the subject conducted for a sample of EC Member nations, including France, Federal Republic of Germany, Italy, and Spain. Among the goals of the studies are the definition of market segments, and identification of the principal obstacles which will affect future adoption of SMSNRs. Opportunities offered by the different contexts and energy end-uses seem promising. Numerous difficulties and constraints emerge, however, some of which might be eased by actions that national governments or more often the European Community may wish to take. (author)

  17. Market prospects of modular HTR in EEC countries

    International Nuclear Information System (INIS)

    Albisu, F.; Garribba, S.F.; Lefevre, J.C.; Leuchs, D.; Vivante, C.

    1992-01-01

    The energy outlook for the early 21st century is very uncertain. Low-cost oil and natural gas reserves will become seriously depleted and non-fossil energy resources may be urgently required because of environmental reasons. In this framework, the European Economic Community should be able to rely upon nuclear energy as an economic, safe and readily deployable resource for its future. Small and medium-size nuclear reactors (SMSNRs), particularly modular high-temperature reactor (HTR) would allow extension of uses of nuclear energy while being adopted to produce power and/or steam or heat, where heat can be at low or high temperature. For policy making and planning purposes it appears meaningful to appraise the market potential of modular HTR during the next twenty or thirty years. Thus the paper presents the outcomes of country studies on the subject conducted for a sample of Member nations to the European Economic Community including France, Federal Republic of Germany, Italy and Spain. Amongst the goals of the studies are definition of market segments, identification of the principal obstacles which would affect future adoption of SMSNRs. Opportunities offered by the different contexts and energy end-uses seem promising. Numerous difficulties and constraints emerge however, some of which might be eased by actions that national governments or more often the European Economic Community, may wish to take. (orig.)

  18. Energy Policies of IEA Countries: Hungary 2006 Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    Hungary has arrived at an important moment in its energy policy. The Hungarian government has improved energy policies in a number of areas. Still, significant challenges remain. To prepare the country for the full liberalisation of the EU electricity and gas market by July 2007, further steps in market reform are urgently required. At this point in time, there is no clarity about the system under which the market should operate after its full opening. Subsidies are another problem. Even though substantial progress has been made in reforming payments to gas consumers, the overall level of subsidies to producers and consumers of energy needs to be reviewed. This analysis makes recommendations to tackle these concerns and also discusses the potential contribution of energy efficiency to increasing energy security and economic competitiveness. The gas dispute between Russia and Ukraine in January 2006 focused global attention on consumer nations' vulnerability to supply disruptions. The Hungarian government has since placed greater emphasis on diversification of suppliers and has supported the development of new routes to bring gas into Europe. Hungary has dramatically improved its energy efficiency during the last 15 years. Nevertheless, enhanced efficiency, particularly in the field of gas use will continue to play a key role for securing future national energy supplies. This review has identified significant room for progress particularly in the gas-to-power sector, where old power stations need to be replaced, and in the residential sector, where improved thermal performance of Hungarian housing could bring impressive results.

  19. Energy Policies of IEA Countries: Hungary 2006 Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    Hungary has arrived at an important moment in its energy policy. The Hungarian government has improved energy policies in a number of areas. Still, significant challenges remain. To prepare the country for the full liberalisation of the EU electricity and gas market by July 2007, further steps in market reform are urgently required. At this point in time, there is no clarity about the system under which the market should operate after its full opening. Subsidies are another problem. Even though substantial progress has been made in reforming payments to gas consumers, the overall level of subsidies to producers and consumers of energy needs to be reviewed. This analysis makes recommendations to tackle these concerns and also discusses the potential contribution of energy efficiency to increasing energy security and economic competitiveness. The gas dispute between Russia and Ukraine in January 2006 focused global attention on consumer nations' vulnerability to supply disruptions. The Hungarian government has since placed greater emphasis on diversification of suppliers and has supported the development of new routes to bring gas into Europe. Hungary has dramatically improved its energy efficiency during the last 15 years. Nevertheless, enhanced efficiency, particularly in the field of gas use will continue to play a key role for securing future national energy supplies. This review has identified significant room for progress particularly in the gas-to-power sector, where old power stations need to be replaced, and in the residential sector, where improved thermal performance of Hungarian housing could bring impressive results.

  20. The Double Burden of Malnutrition in Countries Passing through the Economic Transition.

    Science.gov (United States)

    Prentice, Andrew M

    2018-01-01

    Undernutrition in both its acute and chronic forms (wasting and stunting) is strongly inversely correlated with the wealth of nations. Consequently, as many low- and middle-income countries (LMICs) achieve economic advancement and pass through the so-called "nutrition transition," their rates of undernutrition decline. Many countries successfully achieved the Millennium Development Goal of halving undernutrition and whole continents have been transformed in recent decades. The exception is Africa where the slower rates of decline in the prevalence of undernutrition has been overtaken by population growth so that the absolute number of stunted children is rising. In many regions, economic transition is causing a rapid increase in the number of overweight and obese people. The rapidity of this rise is such that many nations bear the simultaneous burdens of under- and overnutrition; termed the "double burden" of malnutrition. This double burden, accompanied as it is by the unfinished agenda of high levels of infectious diseases, is crippling the health systems of many LMICs and thus requires urgent attention. Although the prognosis looks threatening for many poor countries, they have the advantage of being able to learn from the mistakes made by other nations that have passed through the transition before them. Concerted action across many arms of government would achieve huge future dividends in health and wealth for any nations that can grasp the challenge. © 2018 S. Karger AG, Basel.

  1. The Chennai floods of 2015: urgent need for ethical disaster management guidelines.

    Science.gov (United States)

    Mariaselvam, Suresh; Gopichandran, Vijayaprasad

    2016-01-01

    India has suffered several natural disasters in recent years. The super cyclone of Orissa in 1999 and the tsunami on the southeastern coast in 2004, both led to major developments in disaster management abilities in the country. Almost a decade after the last major disaster that hit south India, the recent floods in Chennai in 2015 brought to the fore a whole set of ethical considerations. There were issues of inequity in the relief and response activities, conflicts and lack of coordination between the government and non-government relief and response, more emphasis on short-term relief activities rather than rehabilitation and reconstruction, and lack of crisis standards of care in medical services. This paper highlights these ethical issues and the need for ethical guidelines and an ethical oversight mechanism for disaster management and response.

  2. Urgent Problems in Learning the Public Administration (on the Example of Georgia

    Directory of Open Access Journals (Sweden)

    Shota Dogonadze

    2011-12-01

    Full Text Available Public management can and should be taught. Former Soviet Republics, including Georgia are facing this acute problem. Some attention is directed to management training, but public management stays in the background, although it is evident that major political and economic problems of Georgia and other countries of so-called “fledging democracies” arise due to the government theory neglect. The article considers development of administrative way of thinking starting from political doctrine to managerial approach, prospects for public management principles development, existing educational models. The epoch of classic universities is passing; with the help of textbooks students can only make courseworks. That’s why the use of innovative methods is necessary for students training.

  3. [Aging and health in Sub-Saharan Africa: an urgent agenda for international cooperation].

    Science.gov (United States)

    Telles, José Luiz; Borges, Ana Paula Abreu

    2013-12-01

    The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.

  4. Realities given in Colombia: an urgent call to the psychology of liberation

    Directory of Open Access Journals (Sweden)

    Daniela Barrera Machado

    2017-06-01

    Full Text Available The socio-political crisis that Colombia has been going through for decades has made psychology an enormous task, namely: to think about the role it plays in the midst of these realities given in the country and in the contribution it has made and could make for its transformation. Starting from the proposals of Ignacio Martín-Baró and Edgar Barrero Cuellar, this article tries to reflect on the psychology that Colombia needs, a psychology of the liberation that makes a decided commitment by a critical perspective and emancipating; Which implies transcending its authoritarian epistemology, constructing theory from and for the people and deploying a transformative praxis that takes on three important tasks: to recover the historical memory, to deideologize the common sense and to promote the popular virtues.

  5. Prevention of parent to child transmission of HIV: Urgent need to be addressed

    Directory of Open Access Journals (Sweden)

    Dhrubajyoti J Debnath

    2013-01-01

    Full Text Available Context: An estimated 430,000 children were newly infected with HIV in 2008, over 90% of them through mother-to-child transmission (MTCT. Without intervention, the risk of MTCT ranges from 20% to 45% as per the World Health Organization (WHO. Aim: To find the uptake of Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT services during pregnancy. Setting and Design: Cross-sectional study. Materials and Methods: Ethical approval and informed consent was taken. Uptake of PPTCT services by the mother was obtained in 222 pregnancies. This was compared with the HIV status of children born to them. Statistical Analysis Used: Percentages. Results: In 25.7% pregnancies, the mothers were tested for HIV. One child was born was to a mother who had tested HIV negative in pregnancy. In 50% of the mother-child pairs, both mother and child received PPTCT. Where both the mother and child received PPTCT, only 13.3% children born were HIV positive as against 40% children who were HIV positive where neither mother nor the child had received PPTCT. Conclusion: Uptake of PPTCT services was low. In countries like India where the chances of parent to child transmission of HIV are likely to be more than in developed countries due to breastfeeding practices, the uptake of PPTCT services should be maximized to decrease the burden of pediatric HIV because even a single pediatric HIV infection counts. All the pregnant women need to be voluntarily tested twice for HIV in pregnancy, in which the second test for HIV may be in late pregnancy.

  6. A Parallel World for the World Bank: A Case Study of Urgent: Evoke, An Educational Alternate Reality Game

    Directory of Open Access Journals (Sweden)

    David I. Waddington

    2013-01-01

    Full Text Available In 2010, the World Bank launched Urgent: Evoke, an alternate reality game. Conceived in response to the demands of African universities, the game was designed to promote the World Bank Institute’s vision of positive global change through social innovation, and made substantial use of Web 2.0 tools such as blogs, personal profiles, and social networks. This article offers a case study of Urgent: Evoke, divided into four sections: first, the potential to use video games as citizenship education tools is discussed; second, the unique game genre (alternate reality games into which Evoke falls is explained and some possible uses of this genre in higher education are examined; third, the functioning of the Evoke game world is explained; and fourth, the results of the Evoke educational project are assessed. The case study concludes with some commentary on Evoke’s ideological message, which those less sympathetic to capitalism may view as problematic.

  7. Glaucoma in developing countries

    Directory of Open Access Journals (Sweden)

    Ravi Thomas

    2012-01-01

    Full Text Available Objective: To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries. Materials and Methods: Extrapolation of existing data and experience in eye care delivery and teaching models in an unequally developed country (India are used to make recommendations. Results: Parameters like population attributable risk percentage indicate that glaucoma is a public health problem but lack of simple diagnostic techniques and therapeutic interventions are barriers to any effective plan. Case detection rather than population-based screening is the recommended strategy for detection. Population awareness of the disease is low and most patients attending eye clinics do not receive a routine comprehensive eye examination that is required to detect glaucoma (and other potentially blinding eye diseases. Such a routine is not taught or practiced by the majority of training institutions either. Angle closure can be detected clinically and relatively simple interventions (including well performed cataract surgery can prevent blindness from this condition. The strategy for open angle glaucoma should focus on those with established functional loss. Outcomes of this proposed strategy are not yet available. Conclusions: Glaucoma cannot be managed in isolation. The objective should be to detect and manage all potential causes of blindness and prevention of blindness from glaucoma should be integrated into existing programs. The original pyramidal model of eye care delivery incorporates this principle and provides an initial starting point. The routine of comprehensive eye examination in every clinic and its teaching (and use in residency programs is mandatory for the detection and management of potentially preventable blinding pathology from any cause, including glaucoma. Programs for detection of glaucoma should not be initiated unless adequate facilities for diagnosis and surgical intervention are in place and

  8. An Analysis of Methodologies and Best Practices for Rapidly Acquiring Technologies to Meet Urgent Warfighter Needs

    Science.gov (United States)

    2008-03-01

    projects are a very small and unique subset of the typical acquisition and S& T programs and require a unique culture, operating environment, and...ll f th th t I’ l l 3 i t b t th ’ d b d I d ’ t k if it’ b h t i t ti l d b f l h t i i o em a ve seen are eve n program managemen , u ere s...Abstract The rapidly changing global security environment that today’s military operates within requires an ever increasing ability to quickly

  9. The Financial and Economic Crisis and Developing Countries

    Directory of Open Access Journals (Sweden)

    Bruno Gurtner

    2010-03-01

    Full Text Available Developing countries were hit hard by the financial and economic crisis, although the impact was somewhat delayed. Every country had different challenges to master. The closer the developing countries are interconnected with the world economy, the crasser the effects. And the incipient recovery that is becoming noticeable is, for the time being, restricted to only a few countries and regions.The crisis was transmitted primarily by trade and financial flows forcing millions back into poverty. Attainment of the Millennium Development Goals is seriously jeopardised in many countries. Many developing countries did not and do not have the resources to stimulate the economy and protect their socially disadvantaged populations to the same extent as the industrialised countries. However, many countries have made considerable efforts to mitigate the effects. Developing countries have also increased their cooperation with one another and are urgently demanding a greater voice in global economic affairs.The industrialised countries are for the most part more concerned with their own problems. Their readiness to provide more extensive aid is limited. They are under pressure from the international institutions to relax their previous dominance in favour of the increasingly strong emerging countries. A shift in power and influence that was already noticeable before the financial crisis is deepening.

  10. Healthcare waste management practice in the West Black Sea Region, Turkey: A comparative analysis with the developed and developing countries.

    Science.gov (United States)

    Ciplak, Nesli; Kaskun, Songul

    2015-12-01

    The need for proper healthcare waste management has been a crucial issue in many developing countries as it is in Turkey. The regulation regarding healthcare wastes in Turkey was updated in 2005 in accordance with the European Union (EU) waste directives, but it still falls behind meeting the requirements of current waste treatment technologies. Therefore, this study aims to reveal deficiencies, inconsistencies, and improper applications of healthcare waste management in the western part of the Turkish Black Sea Region. In this study, it was revealed that nearly 1 million people live in the region, resulting in 5 million hospital admissions annually. All the healthcare waste produced (1000 tons yr(-1)) is treated in an autoclave plant. However, treating some categories of healthcare wastes in autoclave units mismatches with the EU waste regulations, as alternative treatment technologies are not technically able to treat all types of healthcare wastes. A proper waste management system, therefore, requires an internal segregation scheme to divert these wastes from the main healthcare waste stream. The existing malpractice in the region could cause serious health problems if no measure is taken urgently. It is expected that healthcare waste management in the region and then all across Turkey will be improved with the significant deficiencies and inconsistencies pointed out in this research. In developed countries, specific rules and regulations have already been implemented along with the recommendations for handling of healthcare waste. However, in Turkey, these wastes are treated in autoclave units, which mismatches with the European Union waste regulations, as alternative treatment technologies are not technically capable to treat all types of healthcare wastes. The existing malpractice could cause serious health problems if no measure is taken urgently. The authors demonstrated the existing status of Turkish waste management and revealed deficiencies

  11. Affective Load and Engagement in Second Life: Experiencing Urgent, Persistent, and Long-Term Information Needs

    Science.gov (United States)

    Nahl, Diane

    2010-01-01

    New users of virtual environments face a steep learning curve, requiring persistence and determination to overcome challenges experienced while acclimatizing to the demands of avatar-mediated behavior. Concurrent structured self-reports can be used to monitor the personal affective and cognitive struggles involved in virtual world adaptation to…

  12. Some aspects of RF radiation safety guidelines on urgent protective measures in case of radiation emergency at NPP

    International Nuclear Information System (INIS)

    Bulgakov, V.G.; Klepikova, N.V.; Shershakov, V.M.; Ivanov, E.A.

    2003-01-01

    emergency. Besides, specific activities of radionuclides in foods are also used as criteria; requirements regarding intervention measures depend on whether the predicted dose can bring about deterministic effects. In the case of high doses leading to deterministic effects protection measures are mandatory. If deterministic effects cannot be excluded, then protection measures should be justifiable and optimized. One of the key concepts of emergency response activities is the intervention level. In NRB-99 the intervention level is defined as radiation factor level which when exceeded requires protection measures. The NRB-99 lays down dose levels the excess of which can lead to clinical effects. These are consistent with the IAEA guidelines. The criteria of NRB-99 for shelter and evacuation am different from those of ICRP as far as measurement units are concerned. In NRB-99 doses averted through sheltering and evacuation are proposed to be calculated as absorbed dose, rather than effective dose. The NRB-99 requires prediction of doses averted by sheltering, evacuation and iodine prophylaxis in the first 10 days after a radiation accident. This suggests that a protection measure can be as long as 10 days. The NRB-99 contains no recommendation with regard to consideration of exposure pathways. Also, in the NRB-99 there is no mentioning of population groups for which averted dose should be calculated. The IAEA recommendations specify that averted dose should apply to a population mean value, rather than most exposed persons (critical groups). However, predicted doses for critical groups should be estimated given exposure levels require urgent Intervention (i. e. leading to clinical effects). Method for express assessment of possible intervention areas in the early phase of emergency at a nuclear power plant. The presentation discusses a method for preparing quickly recommendations an emergency measures to protect the personnel and the public in case of emergency at a NPP with V

  13. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  14. Initial Experience of a Primary Urgent Care Clinic Curriculum and Subspecialty Lectureship Series Implementation in a Los Angeles County Hospital.

    Science.gov (United States)

    Agrawal, Harsh; Martinez, Anna; Volkmann, Elizabeth R; Melamed, Oleg; Wali, Soma

    2017-05-01

    Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning. The Olive View-UCLA Medical Center internal medicine residency program has a total of 74 residents, which includes postgraduate year-1 (PGY-1) to PGY-4, with PGY-4 being combined internal medicine-pediatrics or emergency medicine-internal medicine residents. We used core curriculum topics as provided by the Accreditation Council for Graduate Medical Education to design the curriculum. We sent e-mails to the stakeholders whom we identified as the residents and the attending physicians working in urgent care, inquiring after topics they wanted to discuss during the rotation. Using these responses we compiled a list of all of the topics that could be discussed and reviewed during the rotation. These topics were broken down into short 10- to 15-minute-long lectures. During the lectures, we provided a retrospective post- then prequestionnaire to the residents for evaluation of the program and the lectures. A benefit of the post-then-pre design is that participants answer the postquestions and the prequestions together after the lecture, thereby reducing the possibility of response shift bias. Of the 74 residents in the program, 25 responded; the response rate was approximately 33%. Regarding content, 92% (23) said it was appropriate, 4% (1) said it was too low a level, and 4% (1) did not respond. Overall, 36% (9) said the lecture was

  15. Learning from mistakes: errors in approaches to melanoma and the urgent need for updated national guidelines.

    Science.gov (United States)

    Simionescu, Olga; Blum, Andreas; Grigore, Mariana; Costache, Mariana; Avram, Alina; Testori, Alessandro

    2016-09-01

    The tracking and identification of errors in the detection and follow-up of melanoma are important because there is huge potential to increase awareness about the most vulnerable aspects of diagnosis and treatment, and to improve both from the perspective of healthcare economics. The present study was designed to identify where errors occur and to propose a minimum set of rules for the routine guidance of any specialist in melanoma management. This report describes the evaluation of a unique series of 33 cases in which errors applying to many steps in the diagnosis and treatment of melanoma were detected. Cases were collected at two centers in Romania, one public and one private, as part of a process of obtaining patient-requested second opinions. A total of 166 errors were identified across the 33 patients, most of which were treatment errors. The errors fell into six categories: clinical diagnostic errors (36 errors among 30 patients); primary surgical errors (31 errors among 16 patients); pathology errors (24 errors among 17 patients); sentinel lymph node biopsy errors (13 errors among 13 patients); staging errors (17 errors among 13 patients); and treatment or management errors (45 errors among 33 patients). Based on the present results, we propose that in countries lacking national guidelines, clinicians should adhere to international evidence-based guidelines for the diagnosis and treatment of melanoma. © 2015 The International Society of Dermatology.

  16. Country programming mission. Namibia

    International Nuclear Information System (INIS)

    1991-01-01

    In response to a request from the Government of Namibia conveyed in a letter dated 29 November 1990 IAEA provided a multi-disciplinary Programming Mission which visited Namibia from 15 - 19 July 1991. The terms of reference of the Mission were: 1. To assess the possibilities and benefits of nuclear energy applications in Namibia's development; 2. To advise on the infrastructure required for nuclear energy projects; 3. To assist in the formulation of project proposals which could be submitted for Agency assistance. This report is based on the findings of the Mission and falls into 3 sections with 8 appendices. The first section is a country profile providing background information, the second section deals with sectorial needs and institutional review of the sectors of agriculture including animal production, life sciences (nuclear medicine and radiotherapy) and radiation protection. The third section includes possible future technical co-operation activities

  17. URGENT ISSUES OF ORGANIZATION OF AUDIT ACTIVITY IN UKRAINE AND DIRECTIONS FOR THEIR SOLUTIONS

    Directory of Open Access Journals (Sweden)

    Maryna Shendryhorenko

    2018-01-01

    Full Text Available In conditions of economic uncertainty and competition, the importance of objective economic control increases both from owners and supervisors. Reliable financial reporting provides the possibility of making conscious economic decisions, warns of operations associated with increased risk. The opinion of the auditor increases the trust in the financial activity of the company and the general loyalty to business by the stakeholders – owners, investors, potential customers, suppliers, authorities. Therefore, the issue of the exclusion of the corruption component between the audit firm and the client company during the organization and conduct of the audit is a topical issue in many countries of the world, including Ukraine. The purpose of the paper is to substantiate the theoretical principles and practical recommendations for the organization of audit activity and overcoming corruption in the economic sphere in Ukraine. Methodology. The methodological basis of research is general scientific and special methods of knowledge. To determine the current state of audit in Ukraine, quantitative changes in the dynamics of audit firms and certified auditors, applied methods of synthesis, comparison, grouping. For isolating problems that arise in the market of audit services, methods of specificity and abstraction are used. The method of analysis was the basis for determining the main factors of corruption in the audit sector and its impact on the dynamics of Ukraine’s economic development. The dialectical method, synthesis, and abstraction have been used to formulate proposals for improving the order, in which services are provided in the audit field. A tabular method was used to reflect the systematic results of the consolidation and grouping of indexes of corruption perception index in Ukraine in 2013–2017. The graphical method was used to visually reproduce the dynamics of the change in the perceptions of corruption in Ukraine, the USA and Poland

  18. Marine litter plastics and microplastics and their toxic chemicals components: the need for urgent preventive measures.

    Science.gov (United States)

    Gallo, Frederic; Fossi, Cristina; Weber, Roland; Santillo, David; Sousa, Joao; Ingram, Imogen; Nadal, Angel; Romano, Dolores

    2018-01-01

    Persistent plastics, with an estimated lifetime for degradation of hundreds of years in marine conditions, can break up into micro- and nanoplastics over shorter timescales, thus facilitating their uptake by marine biota throughout the food chain. These polymers may contain chemical additives and contaminants, including some known endocrine disruptors that may be harmful at extremely low concentrations for marine biota, thus posing potential risks to marine ecosystems, biodiversity and food availability. Although there is still need to carry out focused scientific research to fill the knowledge gaps about the impacts of plastic litter in the marine environment (Wagner et al. in Environ Sci Eur 26:9, 2014), the food chain and human health, existing scientific evidence and concerns are already sufficient to support actions by the scientific, industry, policy and civil society communities to curb the ongoing flow of plastics and the toxic chemicals they contain into the marine environment. Without immediate strong preventive measures, the environmental impacts and the economic costs are set only to become worse, even in the short term. Continued increases in plastic production and consumption, combined with wasteful uses, inefficient waste collection infrastructures and insufficient waste management facilities, especially in developing countries, mean that even achieving already established objectives for reductions in marine litter remains a huge challenge, and one unlikely to be met without a fundamental rethink of the ways in which we consume plastics. This document was prepared by a working group of Regional Centres of the Stockholm and Basel Conventions and related colleagues intended to be a background document for discussion in the 2017 Conference of the Parties (COP) of the Basel Convention on hazardous wastes and the Stockholm Convention on persistent organic pollutants (POPs). The COP finally approved that the issue of plastic waste could be dealt by its

  19. Pharmacovigilance activities in ASEAN countries.

    Science.gov (United States)

    Suwankesawong, Wimon; Dhippayom, Teerapon; Tan-Koi, Wei-Chuen; Kongkaew, Chuenjid

    2016-09-01

    This study aimed to explore the current landscape and identify challenges of pharmacovigilance (PV) among Association of Southeast Asian Nations (ASEAN) countries. This cross-sectional survey collected data from May 2014 to December 2015. Questionnaires seeking to collect information on resources, processes, roles and responsibility, and functions of PV systems were sent to relevant persons in the ASEAN countries. Functions of PV centers were measured using the minimum World Health Organization requirements for a functional national PV system. Performances of PV centers were measured by the following: (1) the indicators related to the average number of individual case safety reports (ICSR); (2) presence of signal detection activities and subsequent action; and (3) contribution to the global vigilance database. Cambodia, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam completed the survey. PV systems in four surveyed countries (Indonesia, Malaysia, Singapore, and Thailand) achieved all aspects of the World Health Organization minimum requirement for a functional national PV system; the remaining countries were deemed to have unclear communication strategies and/or no official advisory committee. Average numbers of recent ICSR national returns ranged from 7 to 3817 reports/year/million population; three countries (Malaysia, Singapore, and Thailand) demonstrated good performance in reporting system and reported signal detection activities and subsequent actions. All participating countries had submitted ICSRs to the Uppsala Monitoring Center during the survey period (2013-2015). Four participating countries had functional PV systems. PV capacity, functionality, and legislative framework varied depending on local healthcare ecosystem networks. Implementing effective communication strategies and/or technical assistance from the advisory committee are needed to strengthen PV in ASEAN. Copyright © 2016 John Wiley & Sons, Ltd. Copyright

  20. [Urgent surgical treatment of gastric volvulus related to upside-down stomach syndrome].

    Science.gov (United States)

    Hána, L; Kasalický, M; Koblihová, E; Suchánek, Š; Horažďovský, P; Ryska, M

    2015-12-01

    Upside-down stomach syndrome is a rare type of a large paraoesophageal hiatal hernia, which requires an immediate surgical treatment in case of incarceration. The authors present a case report of a 53-year-old male patient with gastric volvulus related to the upside-down stomach syndrome. Surgical treatment was complicated by an injury to distal oesophagus, which was successfully treated using a self-expandable metallic stent among other methods. Despite the complicated postoperative course with a necessity of reoperation, insertion of an oesophageal stent, thoracotomy for a mediastinal abscess and secondary healing of the laparotomy, the patient was discharged in a good condition with healed oesophageal perforation and laparotomy after 52 days.

  1. Building country image process

    Directory of Open Access Journals (Sweden)

    Zubović Jovan

    2005-01-01

    Full Text Available The same branding principles are used for countries as they are used for the products, only the methods are different. Countries are competing among themselves in tourism, foreign investments and exports. Country turnover is at the level that the country's reputation is. The countries that begin as unknown or with a bad image will have limits in operations or they will be marginalized. As a result they will be at the bottom of the international influence scale. On the other hand, countries with a good image, like Germany (despite two world wars will have their products covered with a special "aura".

  2. Urgent thoracotomy for penetrating chest trauma: analysis of 158 patients of a single center.

    Science.gov (United States)

    Onat, Serdar; Ulku, Refik; Avci, Alper; Ates, Gungor; Ozcelik, Cemal

    2011-09-01

    Penetrating injuries to the chest present a frequent and challenging problem, but the majority of these injuries can be managed non-\\operatively. The aim of this study was to describe the incidence of penetrating chest trauma and the ultimate techniques used for operative management, as well as the diagnosis, complications, morbidity and mortality. A retrospective 9-year review of patients who underwent an operative procedure following penetrating chest trauma was performed. The mechanism of injury, gender, age, physiological and outcome parameters, including injury severity score (ISS), chest abbreviated injury scale (AIS) score, lung injury scale score, concomitant injuries, time from admission to operating room, transfusion requirement, indications for thoracotomy, intra-operative findings, operative procedures, length of hospital stay (LOS) and rate of mortality were recorded. A total of 1123 patients who were admitted with penetrating thoracic trauma were investigated. Of these, 158 patients (93 stabbings, 65 gunshots) underwent a thoracotomy within 24 h after the penetrating trauma. There were 146 (92.4%) male and 12 (7.6%) female patients, and their mean age was 25.72 9.33 (range, 15–54) years. The mean LOS was 10.65 8.30 (range, 5–65) days. Patients admitted after a gunshot had a significantly longer LOS than those admitted with a stab wound (gunshot, 13.53 9.92 days; stab wound, 8.76 6.42 days, p chest AIS score (p chest requiring a thoracotomy are uncommon, and lung-sparing techniques have become the most frequently used procedures for lung injuries. The presence of associated abdominal injuries increased the mortality five-fold. Factors that affected mortality were ISS, chest AIS score, SBP, ongoing chest output, blood transfusion volume, diaphragmatic injury and associated abdominal injury.

  3. Urgent and Compelling Need for Coastal and Inland Aquatic Ecosystem Research Using Space-Based Sensors

    Science.gov (United States)

    Otis, D. B.; Muller-Karger, F. E.; Hestir, E.; Turpie, K. R.; Roberts, D. A.; Frouin, R.; Goodman, J.; Schaeffer, B. A.; Franz, B. A.; Humm, D. C.

    2016-12-01

    Coastal and inland waters and associated aquatic habitats, including wetlands, mangroves, submerged grasses, and coral reefs, are some of the most productive and diverse ecosystems on the planet. They provide services critical to human health, safety, and prosperity. Yet, they are highly vulnerable to changes in climate and other anthropogenic pressures. With a global population of over seven billion people and climbing, and a warming atmosphere driven by carbon dioxide now in excess of 400 ppb, these services are at risk of rapidly diminishing globally. We know little about how these ecosystems function. We need to characterize short-term changes in the functional biodiversity and biogeochemical cycles of these coastal and wetland ecosystems, from canopy to benthos, and trace these changes to their underlying environmental influences. This requires an observation-based approach that covers coastal and inland aquatic ecosystems in a repeated, synoptic manner. Space-borne sensing systems can provide this capability, supported by coordinated in situ calibration and product validation activities. The design requires high temporal resolution (weekly or better), medium spatial resolution (30 m pixels at nadir to complement Landsat-class sensors), and highly sensitive, ocean-color radiometric quality, high resolution spectroscopy with Visible and Short-Wave IR bands (order of 10 nm or better) to assess both atmospheric correction parameters and land vegetation composition. The strategy needs to include sunglint avoidance schemes, and methods to maximize signal to noise ratios and temporal coverage of aquatic areas. We describe such a system, and urge the U.S. to implement such an observing strategy in the short-term and sustain it for the benefit of humankind.

  4. Role of enhanced multi-detector-row computed tomography before urgent endoscopy in acute upper gastrointestinal bleeding.

    Science.gov (United States)

    Miyaoka, Youichi; Amano, Yuji; Ueno, Sayaka; Izumi, Daisuke; Mikami, Hironobu; Yazaki, Tomotaka; Okimoto, Eiko; Sonoyama, Takayuki; Ito, Satoko; Fujishiro, Hirofumi; Kohge, Naruaki; Imaoka, Tomonori

    2014-04-01

    Multi-detector-row computed tomography (MDCT) has been reported to be a potentially useful modality for detection of the bleeding origin in patients with acute upper massive gastrointestinal (GI) bleeding. The purpose of this study is to investigate the efficacy of MDCT as a routine method for detecting the origin of acute upper GI bleeding prior to urgent endoscopy. Five hundred seventy-seven patients with acute upper GI bleeding (514 nonvariceal patients, 63 variceal patients) who underwent urgent upper GI endoscopy were retrospectively analyzed. Patients were divided into three groups: enhanced MDCT, unenhanced MDCT, and no MDCT before endoscopy. The diagnostic accuracy of MDCT for detection of the bleeding origin was evaluated, and the average procedure times needed to endoscopically identify the bleeding origin were compared between groups. Diagnostic accuracy among endoscopists was 55.3% and 14.7% for the enhanced MDCT and unenhanced MDCT groups, respectively. Among nonvariceal patients, accuracy was 50.2% in the enhanced MDCT group, which was significantly better than that in the unenhanced MDCT group (16.5%). In variceal patients, accuracy was significantly better in the enhanced MDCT group (96.4%) than in the unenhanced MDCT group (0.0%). These accuracies were similar to those achieved by expert radiologists. The average procedure time to endoscopic detection of the bleeding origin in the enhanced MDCT group was significantly faster than that in the unenhanced MDCT and no-MDCT groups. Enhanced MDCT preceding urgent endoscopy may be an effective modality for the detection of bleeding origin in patients with acute upper GI bleeding. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  5. Modelling energy systems for developing countries

    International Nuclear Information System (INIS)

    Urban, F.; Benders, R.M.J.; Moll, H.C.

    2007-01-01

    Developing countries' energy use is rapidly increasing, which affects global climate change and global and regional energy settings. Energy models are helpful for exploring the future of developing and industrialised countries. However, energy systems of developing countries differ from those of industrialised countries, which has consequences for energy modelling. New requirements need to be met by present-day energy models to adequately explore the future of developing countries' energy systems. This paper aims to assess if the main characteristics of developing countries are adequately incorporated in present-day energy models. We first discuss these main characteristics, focusing particularly on developing Asia, and then present a model comparison of 12 selected energy models to test their suitability for developing countries. We conclude that many models are biased towards industrialised countries, neglecting main characteristics of developing countries, e.g. the informal economy, supply shortages, poor performance of the power sector, structural economic change, electrification, traditional bio-fuels, urban-rural divide. To more adequately address the energy systems of developing countries, energy models have to be adjusted and new models have to be built. We therefore indicate how to improve energy models for increasing their suitability for developing countries and give advice on modelling techniques and data requirements

  6. A prospective study to assess the value of MMP-9 in improving the appropriateness of urgent referrals for colorectal cancer

    Directory of Open Access Journals (Sweden)

    Hobbs Richard FD

    2006-10-01

    Full Text Available Abstract Background Bowel cancer is common and is a major cause of death. Most people with bowel symptoms who meet the criteria for urgent referral to secondary care will not be found to have bowel cancer, and some people who are found to have cancer will have been referred routinely rather than urgently. If general practitioners could better identify people who were likely to have bowel cancer or conditions that may lead to bowel cancer, the pressure on hospital clinics may be reduced, enabling these patients to be seen more quickly. Increased levels of an enzyme called matrix metalloproteinase 9 (MMP-9 have been found to be associated with such conditions, and this can be measured from a blood sample. This study aims to find out whether measuring MMP-9 levels could improve the appropriateness of urgent referrals for patients with bowel symptoms. Methods People aged 18 years or older referred to a colorectal clinic will be asked to complete a questionnaire about symptoms, recent injuries or chronic illnesses (these can increase the level of matrix metalloproteinases and family history of bowel cancer. A blood sample will be taken from people who consent to take part to assess MMP-9 levels, and the results of examination at the clinic and/or investigations arising from the clinic visit will be collected from hospital records. The accuracy of MMP-9 will be assessed by comparing the MMP-9 level with the resulting diagnosis. The combination of factors (e.g. symptoms and MMP-9 level that best predict a diagnosis of malignancy (invasive disease or polyps will be determined. Discussion Although guidelines are in place to facilitate referrals to colorectal clinics, symptoms alone do not adequately distinguish people with malignancy from people with benign conditions. This study will establish whether MMP-9 could assist this process. If this were the case, measurement of MMP-9 levels could be used by general practitioners to assist in the identification

  7. Wire-guided (Seldinger technique intubation through a face mask in urgent, difficult and grossly distorted airways

    Directory of Open Access Journals (Sweden)

    Jake M Heier

    2012-01-01

    Full Text Available We report two cases of successful urgent intubation using a Seldinger technique for airway management through an anesthesia facemask, while maintaining ventilation in patients with difficult airways and grossly distorted airway anatomy. In both cases, conventional airway management techniques were predicted to be difficult or impossible, and a high likelihood for a surgical airway was present. This technique was chosen as it allows tracheal tube placement through the nares during spontaneous ventilation with the airway stented open and oxygen delivery with either continuous positive airway pressure and/or pressure support ventilation. This unhurried technique may allow intubation when other techniques are unsuitable, while maintaining control of the airway.

  8. The first safe country

    Directory of Open Access Journals (Sweden)

    Raffaela Puggioni

    2012-06-01

    Full Text Available The Dublin II Regulation makes the first safe country of refuge solelyresponsible for refugees and asylum seekers. In the case of Italy, thefirst responsible country has not been acting responsibly.

  9. Alcohol and other drug problems in Australia: the urgent need for nurse education.

    Science.gov (United States)

    de Crespigny, C

    1996-07-01

    The economic, social and health costs associated with alcohol and other drug use, including medicines, impact on the Australian community profoundly. Many Australians use alcohol and other drugs (AODs) on a regular basis and a significant number experience problems at some time. There are about 25,000 drug-related deaths annually, the majority of which are related to alcohol and tobacco use. Many young people die or are injured as a direct result of alcohol intoxication, accidental overdose and related problems, and significant numbers of elderly people are hospitalised, permanently incapacitated or suffer avoidable trauma through adverse drug reactions and side-effects of medications. It is estimated that at least 25 per cent of acute hospital beds hold patients with alcohol-related problems directly associated with the medical diagnosis, and there are comparable numbers of people needing social and other forms of assistance at some time. Despite the preventative nature of many AOD problems and the call for harm reduction, timely intervention and support for the thousands of Australians attending hospitals, community health and mental health services, nurses are yet to effectively assist the community in preventing and responding to the range of AOD problems. Nursing policy, guidelines and clinical expertise are required to assist the community in addressing this issue. Undergraduate, postgraduate and continuing education have a vital role to play in providing the profession with the knowledge, skills and research base to meet this challenge.

  10. The urgent need for clinical, diagnostic, and operational research for management of Buruli ulcer in Africa.

    Science.gov (United States)

    O'Brien, Daniel P; Comte, Eric; Serafini, Micaela; Ehounou, Geneviève; Antierens, Annick; Vuagnat, Hubert; Christinet, Vanessa; Hamani, Mitima D; du Cros, Philipp

    2014-05-01

    Despite great advances in the diagnosis and treatment of Buruli ulcer, it is one of the least studied major neglected tropical diseases. In Africa, major constraints in the management of Buruli ulcer relate to diagnosis and treatment, and accessibility, feasibility, and delivery of services. In this Personal View, we outline key areas for clinical, diagnostic, and operational research on this disease in Africa and propose a research agenda that aims to advance the management of Buruli ulcer in Africa. A model of care is needed to increase early case detection, to diagnose the disease accurately, to simplify and improve treatment, to reduce side-effects of treatment, to deal with populations with HIV and tuberculosis appropriately, to decentralise care, and to scale up coverage in populations at risk. This approach will require commitment and support to strategically implement research by national Buruli ulcer programmes and international technical and donor organisations, combined with adaptations in programme design and advocacy. A critical next step is to build consensus for a research agenda with WHO and relevant groups experienced in Buruli ulcer care or related diseases, and we call on on them to help to turn this agenda into reality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. A New U.S. Water Policy: Long Overdue and Urgently Needed

    Science.gov (United States)

    Gleick, P.

    2008-12-01

    The United States has no consistent, integrated national or international water policy in place, and has not conducted a review of its water institutions or priorities since 1970. This talk will summarize the state of US water policy and make recommendations for the new administration. As we enter the 21st century, pressures on United States and international water resources are growing and conflicts among water users are worsening. International attention to these problems is increasing and the US - intentionally or not - plays a vital and irreplaceable role. Even in the US, where basic human needs for water are largely (though not completely) satisfied, controversy continues over the proper role of expensive dams, failure to adequately fund infrastructure maintenance and expansion, the different roles of public and private corporations, and local communities in managing water. And new challenges are arising, as climate change and extreme events seem to worsen, new water quality threats materialize, and financial constraints grow. Arguments among western states over allocations of shared rivers are rising, as are tensions between cities and farmers over water rights. The US and Mexico have unresolved disagreements over the Colorado and Rio Grande/Rio Bravo rivers, and our Canadian neighbors are concerned about proposals to divert Great Lakes or Canadian water. Bottled water is raising new issues about equity, cost, environmental impacts, and the role of the private sector. Some of the new ideas, new policies, and new efforts that will be required to address these issues in the coming decade will be presented here.

  12. Radiotherapy in small countries.

    Science.gov (United States)

    Barton, Michael B; Zubizarreta, Eduardo H; Polo Rubio, J Alfredo

    2017-10-01

    To examine the availability of radiotherapy in small countries. A small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model. There were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries. There are no radiotherapy services in any LMIC islands. Copyright © 2017. Published by Elsevier Ltd.

  13. EU Outer Borders and Radiation - An Urgent Need for Standardization, New Detector Technologies and Education Harmonization

    International Nuclear Information System (INIS)

    Prlic, Ivica; Suric Mihic, Marija; Kosmina, Domagoj; Shaw, Peter; Hajdinjak, Mladen; Cerovac, Zdravko; Bozina, Zeljko

    2014-01-01

    It appears that new IAEA transport regulations are s tarting to bite - as now there is a definite requirement for assessments of all relevant radio-nuclides in n on-equilibrium mixes': It is heard that several shipments that were either delayed significantly or rejected all together in ports in the EU. Things like synthetic rutile, zirconia, copper concentrates, and so on... Devise a NORM Passport for NORM shipments : including a text description of the material and photographs, radionuclide content plus some radiological data (dose rates, gamma spectrum and maybe also something on trigger levels for border monitoring alarms). Produce a guidance booklet for border control authorities. The two suggestions are connected, and Ii is suggested that they form a single project of how to equip the EU border contort facilities. Denial of shipment due to border alarms is an issue that affects industry- that is why it is hoped that they would be interested in being involved. Clearly it is needed to address world-wide transport (i.e. because that's where most of the NORM comes from). The whole EU outer border customs protocol is th be added to above mentioned monitoring of NORM. The new radiation technologies are used to fulfill the security issues (like stowaways, smuggling, ilicit trafficking etc..). All above mentioned forces us to standardize the customs protocols, to upgrade the education of involved workers and fo harmonize the issue throughout the EU. Croatia is a front point in the moment because of the very long and 'soft' outer EU border. (authors)

  14. Convenience, quality and choice: Patient and service-provider perspectives for treating primary care complaints in urgent care settings.

    Science.gov (United States)

    Sturgeon, David

    2017-11-01

    To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers. A comparative case study approach was adopted and between October 2014 and May 2015 the researcher was embedded as a participant observer as part of the emergency nurse practitioner team at two, nurse-led, MIUs (site A and B). During this time, 40 patients, 17 service-providers and 1 senior manager were interviewed. Patients and service-providers at both sites identified convenience and quality of care as the principle reasons patients presented for primary healthcare services at MIUs rather than their GP practice. Service-providers were aware that by providing treatment, they established a precedent and a sense of expectation for future care. Patients are acting rationally and predictably in response to healthcare policy promises regarding choice, expectation created by service-providers, and local demographic factors. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  15. Reducing maternal mortality in Nigeria: the need for urgent changes in financing for maternal health in the Nigerian health system.

    Science.gov (United States)

    Ebeigbe, P N

    2013-06-01

    Nigeria's maternal mortality indices are among the worst in the world. Various approaches aimed at combatting the persistently high maternal mortality rates in the past have been ineffective. The objective of this article was to evaluate the fairness and equitability of financing for maternal health in the Nigerian health system. A review of the performance of the Nigerian Health system with regards to financing for maternal healthcare and comparison with other health systems utilising internationally accepted criteria was done. Household out-of -pocket payment was found to be the largest source of health care financing in the Nigerian health system contributing as much as 65.6 % of total health expenditure. This is in sharp contrast to the performance of more effective health systems like that in South Africa where health care is free for pregnant and breast feeding mothers. The result is that South Africa reports less than a tenth of total maternal mortalities reported from Nigeria annually. The current Nigeria health financing system is not equitable and appears to encourage maternal mortalities since it does not cater for the most vulnerable. There is an urgent need for a review of financing of maternal health in Nigeria to achieve universal access to maternal health care. An urgent overhaul of the currently under performing National Health Insurance scheme or adoption of the simpler system based on funding from taxation with universal access for health care including maternal care and services free at the point of access is suggested.

  16. REACH MUSC: A telemedicine facilitated network for urgent stroke: initial experience

    Directory of Open Access Journals (Sweden)

    Robert J. Adams

    2012-03-01

    Full Text Available REACH MUSC provides stroke consults via the internet in South Carolina. From May 2008 to April 2011 231 patients were treated with intravenous (IV thrombolysis and 369 were transferred to Medical University of South Carolina (MUSC including 42 for intra-arterial revascularization (with or without IV tPA. Medical outcomes and hemorrhage rates, reported elsewhere, were good (Lazaridis et al. 2011, in press. Here we report operational features of REACH MUSC which covers 15 sites with 2,482 beds and 471,875 Emergency Department (ED visits per year. Eight Academic Faculty from MUSC worked with 165 different physicians and 325 different nurses in the conduct of 1085 consults. For the 231 who received tissue plasminogen activator (tPA, time milestones were: Onset to Door: 62 min (mean, 50 (median; Door to REACH Consult: 43 and 33, Consult Request to Consult Start: was 9 and 7 minutes, Consult Start to tPA Decision: 31 and 25 minutes; Decision to Infusion: 20 and 14 minutes, and total Door to Needle: 98 and 87 minutes. The comparable times for the 854 not receiving tPA were: Onset to Door: 140 and 75 minutes; Door to REACH Consult: 61 and 41 minutes; Consult Request to Consult Start 9 and 7 minutes, Consult Start to tPA Decision 27 and 23 minutes. While the consultants respond to consult requests in < 10 minutes, there is a long delay between arrival and Consult request. Tracking of operations indicates if we target shortening Door to Call time and time from tPA decision to start of drug infusion we may be able to improve Door to Needle times to target of < 60 minutes. The large number of individuals involved in the care of these patients, most of whom had no training in REACH usage,will require novel approaches to staff education in ED based operations where turnover is high. Despite these challenges this robust system delivered tPA safely and in a high fraction of patients evaluated using the REACH MUSC system.

  17. Nuclear power for developing countries

    International Nuclear Information System (INIS)

    Kendall, J.; Kupitz, J.; Rogner, H. H.

    2000-01-01

    Nuclear power is a proven technology which currently makes a large contribution to the electricity supply in a number of countries and, to a much less extent, to heat supply in some countries. Nuclear power is economically competitive with fossil fuels for base load electricity generation in many countries, and is one of the commercially proven energy supply options that could be expanded in the future to reduce environmental burdens, especially greenhouse gas emissions, from the electricity sector. Over the past five decades, nearly ten thousand reactor-years of operating experience have been accumulated with current nuclear power plants. Building upon this background of success and applying lessons learned from the experience of operating plants, new generations of nuclear power plants have been, or are being developed. Improvements incorporated into these advance designs include features that will allow operators more time to perform equipment protection and safety actions in response to equipment failures and other off normal operating conditions, and that will reduce and simplify the actions required. Great attention is also paid to making new plants simpler to operate, inspect, maintain and repair, thus increasing their overall cost efficiency and their compatibility with the infrastructure of developing countries. The paper provides a discussion of future world energy supply and demand projections, current status and prospects for nuclear power, a short summary of advanced reactor concepts and non-electrical applications of nuclear energy for developing countries, and a review of the role of the IAEA. (author)

  18. Conservative approach versus urgent appendectomy in surgical management of acute appendicitis with abscess or phlegmon Resultados del tratamiento conservador inicial y de la cirugía urgente en la apendicitis aguda evolucionada

    Directory of Open Access Journals (Sweden)

    J. M. Aranda-Narváez

    2010-11-01

    Full Text Available Background: Surgical management of acute appendicitis with appendiceal abscess or phlegmon remains controversial. We studied the results of initial conservative treatment (antibiotics and percutaneous drainage if necessary, with or without interval appendectomy compared with immediate surgery. Methods: We undertook an observational, retrospective cohort study of patients with a clinical and radiological diagnosis of acute appendicitis with an abscess or phlegmon, treated in our hospital between January 1997 and March 2009. Patients younger than 14, with severe sepsis or with diffuse peritonitis were excluded. A study group of 15 patients with acute appendicitis complicated with an abscess or phlegmon underwent conservative treatment. A control group was composed of the other patients, who all underwent urgent appendectomy, matched for age and later randomized 1:1. The infectious risk stratification was established with the National Nosocomial Infections Surveillance System (NNIS index. Dependent variables were hospital stay and surgical site infection. Analysis was with SPSS, with p Introducción: Existe controversia acerca del tratamiento idóneo de la apendicitis aguda evolucionada en forma de absceso o flemón. Realizamos un estudio para la evaluación de resultados del tratamiento conservador inicial (antibiótico y drenaje percutáneo si se precisa, con/sin apendicectomía diferida y del tratamiento quirúrgico urgente. Método: Estudio observacional analítico de cohortes retrospectivas. Criterios de inclusión: pacientes con diagnóstico clínico y radiológico de apendicitis aguda evolucionada en forma de absceso o flemón, tratados en nuestro hospital entre enero 1997 y marzo 2009, excluyendo pacientes pediátricos, con sepsis grave o peritonitis difusa. En 15 pacientes con apendicitis complicada con absceso o flemón (cohorte de estudio se indicó tratamiento conservador inicial. El grupo control se obtuvo del resto de pacientes (en

  19. Pesticide Applicator Certification in Indian Country

    Science.gov (United States)

    This website provides information about the EPA Plan for the Federal Certification of Applicators of Restricted Use Pesticides within Indian Country, including plan requirements, how to become certified, how to register for training, and who is certified.

  20. Evidence-Based Practice Standard Care for Acute Pain Management in Adults With Sickle Cell Disease in an Urgent Care Center.

    Science.gov (United States)

    Kim, Sunghee; Brathwaite, Ron; Kim, Ook

    Vaso-occlusive episodes (VOEs) with sickle cell disease (SCD) require opioid treatment. Despite evidence to support rapid pain management within 30 minutes, care for these patients does not consistently meet this benchmark. This quality improvement study sought to decrease the first analgesic administration time, increase patient satisfaction, and expedite patient flow. A prospective pre-/postevaluation design was used to evaluate outcomes with patients 18 years or older with VOEs in an urgent care (UC) center after implementation of evidence-based practice standard care (EBPSC). A pre- and postevaluation survey of SCD patients' satisfaction with care and analogous surveys of the UC team to assess awareness of EBPSC were used. A retrospective review of the electronic medical records of patients with VOEs compared mean waiting time from triage to the first analgesic administration and the mean length of stay (LOS) over 6 months. Implementing EBPSC decreased the mean time of the first analgesic administration (P = .001), significantly increased patient satisfaction (P = .002), and decreased the mean LOS (P = .010). Implementing EBPSC is a crucial step for improving the management of VOEs and creating a positive patient experience. The intervention enhances the quality of care for the SCD population in a UC center.

  1. Foreign bodies in upper gastrointestinal tract and urgent endoscopic interventions – review of a ten-year period

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2005-07-01

    Full Text Available Background: Foreign bodies in the upper digestive tube are rarely the cause of an urgent condition in gastroenterology. They usually enter the digestive tube during nutrition or by mistake. However, certain groups of the population such as convicts or psychiatric patients tend to swallow them intentionally. The authors aim was to assess the percentage of patients in which urgent endoscopic investigation revealed true foreign bodies in the upper digestive tube, to evaluate the success of endoscopic procedures and the resolution of eventual complications.Patients and methods: The study includes patients in which urgent endoscopic investigations of the upper digestive tract were performed in a 10-year period (1 January 1994 to 31 December 2003.Results: Altogether 6416 patients were investigated, mean age 59.3 years, SD ± 17.2 years, range 1–106 years, 2452 females and 3964 males. In 51 patients, 0.8% of all subjects, foreign bodies were detected in the esophagus or stomach. In these patients a total of 65 endoscopic investigations were performed, in 94% the foreign bodies were removed endoscopically (48/51 patients, in three cases the endoscopic procedures were not successful. Among the foreign bodies removed were various metal or plastic objects: coins, keys, screws, hooks, batteries, razor blades, needles, parts of kitchen, toilet or writing utensils, lighters, buttons, toys, a toothbrush as well as impacted pieces of bone. In the patients with successful endoscopic removal of the objects, no significant complications were noted. In 3 patients (3/48, 6.3% only mild hemorrhages from the region of the esophagogastric junction were observed.Conclusions: The technological development of endoscopic instruments made it possible to carry out different therapeutic procedures. The method has proved successful in removing foreign bodies from the upper digestive tube. Various factors affect the success of the procedure, the more important being adequate

  2. Imbalances in the knowledge about infant mental health in rich and poor countries: too little progress in bridging the gap.

    Science.gov (United States)

    Tomlinson, Mark; Bornstein, Marc H; Marlow, Marguerite; Swartz, Leslie

    2014-01-01

    The vast majority of infants are born in poor countries, but most of our knowledge about infants and children has emerged from high-income countries. In 2003, M. Tomlinson and L. Swartz conducted a survey of articles on infancy between 1996 and 2001 from major international journals, reporting that a meager 5% of articles emanated from parts of the world other than North America, Europe, or Australasia. In this article, we conducted a similar review of articles on infancy published between 2002 and 2012 to assess whether the status of cross-national research has changed in the subsequent decade. Results indicate that despite slight improvements in research output from the rest of world, only 2.3% of articles published in 11 years included data from low- and middle-income countries--where 90% of the world's infants live. These discrepancies are indicative of the progress still needed to bridge the so-called 10/90 gap (S. Saxena, G. Paraje, P. Sharan, G. Karam, & R. Sadana,) in infant mental health research. Cross-national collaboration is urgently required to ensure expansion of research production in low-resource settings. © 2014 Michigan Association for Infant Mental Health.

  3. Perspective of patients, patients' families, and healthcare providers towards designing and delivering hospice care services in a middle income Country.

    Science.gov (United States)

    Azami-Aghdash, Saber; Ghojazadeh, Morteza; Aghaei, Mir Hossein; Naghavi-Behzad, Mohammad; Asgarlo, Zoleikha

    2015-01-01

    In view of the recent surge in chronic disease rates and elderly population in the developing countries, there is an urgent felt need for palliative and hospice care services. The present study investigates the views and attitudes of patients and their families, physicians, nurses, healthcare administrators, and insurers regarding designing and delivering hospice care service in a middle income country. In this qualitative study, the required data was collected using semi structured interviews and was analyzed using thematic analysis. Totally 65 participants from hospitals and Tabriz University of Medical Sciences were selected purposively to achieve data saturation. Analyzing the data, five main themes (barriers, facilitators, strategies, attitudes, and service provider) were extracted. Barriers included financial issues, cultural-religious beliefs, patient and family-related obstacles, and barriers related to healthcare system. Facilitators included family-related issues, cultural-religious beliefs, as well as facilitators associated with patients, healthcare status, and benefits of hospice service. Most participants (79%) had positive attitude towards hospice care service. Participant suggested 10 ways to design and deliver effective and efficient hospice care service. They thought the presence of physicians, nurses, and psychologists and other specialists and clergy were necessary in the hospice care team. Due to lack of experience in hospice care in developing countries, research for identifying probable barriers and appropriate management for reducing unsuccessfulness in designing and delivering hospice care service seems necessary. Input from the facilitators and their suggested solutions can be useful in planning the policy for hospice care system.

  4. De l’urgente nécessité de réformer la gouvernance globale Reframing Global Governance : Apocalypse Soon or Reform !

    Directory of Open Access Journals (Sweden)

    David Held

    2011-03-01

    Full Text Available Le réchauffement climatique, la pauvreté ou la menace d’une catastrophe nucléaire comptent parmi les défis majeurs auxquels l’humanité se doit de faire face collectivement en ce début de 21e siècle. Malgré la gravité et l’urgence de la situation, les moyens dont nous disposons pour résoudre de tels problèmes demeurent limités et incomplets. Il est dès lors non seulement essentiel mais aussi urgent de penser comment faire face à de tels enjeux globaux. Les solutions passent par des mécanismes de gouvernance globale et se doivent de répondre aux exigences de solidarité, de démocratie, de justice sociale et d’efficacité politique. Il s’agit notamment d’assurer à chaque personne la possibilité d’influencer les conditions sociales qui façonnent sa vie. Il est donc encore possible d’agir sur le cours des choses, mais si aucune réponse n’est rapidement apportée à ces défis majeurs, le futur de l’humanité risque d’être compromis.Global warming, poverty and the threat of nuclear catastrophe are among the major challenges humanity has to face collectively in this early 21st century. In spite of the seriousness and the urgency of the situation, the means at our disposal to solve such problems remain limited and incomplete. It is therefore not only essential but also urgent to think about how to face these growing global challenges. It requires new mechanisms of global governance and taking steps toward solidarity, democracy, justice and policy effectiveness. Among these key issues is the need to ensure the possibility for each person to influence the social conditions that shape his or her life. Thus, there is still hope that the vital task of reframing global governance may be pursued with an increasing sense of urgency. If this does not happen, the very future of humanity is at risk.

  5. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison.

    Science.gov (United States)

    Rothwell, Peter M; Giles, Matthew F; Chandratheva, Arvind; Marquardt, Lars; Geraghty, Olivia; Redgrave, Jessica N E; Lovelock, Caroline E; Binney, Lucy E; Bull, Linda M; Cuthbertson, Fiona C; Welch, Sarah J V; Bosch, Shelley; Alexander, Faye C; Carasco-Alexander, Faye; Silver, Louise E; Gutnikov, Sergei A; Mehta, Ziyah

    2007-10-20

    The risk of recurrent stroke is up to 10% in the week after a transient ischaemic attack (TIA) or minor stroke. Modelling studies suggest that urgent use of existing preventive treatments could reduce the risk by 80-90%, but in the absence of evidence many health-care systems make little provision. Our aim was to determine the effect of more rapid treatment after TIA and minor stroke in patients who are not admitted direct to hospital. We did a prospective before (phase 1: April 1, 2002, to Sept 30, 2004) versus after (phase 2: Oct 1, 2004, to March 31, 2007) study of the effect on process of care and outcome of more urgent assessment and immediate treatment in clinic, rather than subsequent initiation in primary care, in all patients with TIA or minor stroke not admitted direct to hospital. The study was nested within a rigorous population-based incidence study of all TIA and stroke (Oxford Vascular Study; OXVASC), such that case ascertainment, investigation, and follow-up were complete and identical in both periods. The primary outcome was the risk of stroke within 90 days of first seeking medical attention, with independent blinded (to study period) audit of all events. Of the 1278 patients in OXVASC who presented with TIA or stroke (634 in phase 1 and 644 in phase 2), 607 were referred or presented direct to hospital, 620 were referred for outpatient assessment, and 51 were not referred to secondary care. 95% (n=591) of all outpatient referrals were to the study clinic. Baseline characteristics and delays in seeking medical attention were similar in both periods, but median delay to assessment in the study clinic fell from 3 (IQR 2-5) days in phase 1 to less than 1 (0-3) day in phase 2 (prisk of recurrent stroke in the patients referred to the study clinic was 10.3% (32/310 patients) in phase 1 and 2.1% (6/281 patients) in phase 2 (adjusted hazard ratio 0.20, 95% CI 0.08-0.49; p=0.0001); there was no significant change in risk in patients treated elsewhere. The

  6. Country risk analysis

    International Nuclear Information System (INIS)

    David, A.

    1992-01-01

    This paper reports that the oil industry has been an internationally based industry that has been heavily dependent on outside financing sources. Historically, financing came from investment houses that, in most cases, participated in the projects as equity investors. However, investment companies can no longer satisfy the capital requirements of the current high level of exploration and development activities. The current trend is to involve commercial banks on a purely lending basis. Commercial banks, by their nature, are risk averse. In the case of oil and gas exploration and production they are asked to take not only technical risk and price risk but geopolitical risk as well. Methods have been developed by commercial banks to reduce technical and price risks to point which enables them to be comfortable with a loan. However, geopolitical risks are more difficult to assess. The risk associated with many countries are the nationalization of the investment, new tax restrictions, restriction of currency movements, and/or revisions to the production sharing agreements

  7. ERISA failures and the erosion of workers' rights: the urgent need to protect private & public workers' pension and benefits.

    Science.gov (United States)

    Allen, James P; Bales, Richard A

    On March 11, 2011, Governor Scott Walker of Wisconsin signed into law a bill that eliminated most collective bargaining rights for the state's public-sector workers. Many other cash-strapped states followed Wisconsin's lead and introduced or enacted similar restraints on the rights of their workers. Thousands of public workers, whose only means of protecting their rights rested in their ability to collectively bargain, suddenly found their retirement benefits in jeopardy. This truth highlighted the lack of protections for public worker benefits similar to those of the private sector. However, the Employee Retirement Income Security Act, enacted for that purpose, has failed to secure these benefits. This article seeks to provide a broad overview of the crisis facing the pension and benefits system in the United States and offers some possible solutions. More importantly, the goal is to spur discourse on the urgent need to protect the benefits of all workers, public and private.

  8. [Anaesthetic management of patients in the third trimester of pregnancy undergoing urgent laparoscopic surgery. Experience in a general hospital].

    Science.gov (United States)

    López-Collada Estrada, María; Olvera Martínez, Rosalba

    2016-01-01

    Laparoscopic surgery is well accepted as a safe technique when performed on a third trimester pregnant woman. The aim is to describe the anaesthetic management of a group of patients undergoing this type of surgery. An analysis was made of records of 6 patients in their third trimester of pregnancy and who underwent urgent laparoscopic surgery from 2011 to 2013. The study included 6 patients, with a diagnosis of acute cholecystitis in 4 of them. The other 2 patients had acute appendicitis, both of who presented threatened preterm labour. The most frequent indications for laparoscopic surgery during the last trimester of birth were found to be acute cholecystitis and acute appendicitis. Acute appendicitis is related to an elevated risk of presenting threatened preterm labour. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  9. Duty of care or a matter of conduct -- can a doctor refuse a person in need of urgent medical attention?

    Science.gov (United States)

    Dean, Jessica; Mahar, Patrick; Loh, Erwin; Ludlow, Karinne

    2013-10-01

    Medical practitioners may have their particular skills called upon outside a direct professional context. The responsibilities of medical practitioners outside their defined scope of clinical practice may not be clear to all clinicians. To consider the possible legal consequences of a doctor refusing to assist a person in need of urgent medical attention both in terms of medical negligence and professional misconduct. Where an established clinical relationship does not exist, and a doctor does not wish to render aid, three particular scenarios may arise. A doctor may actively deny being a doctor, passively avoid identifying themselves as a doctor or acknowledge being a doctor, but refuse to render assistance. Aside from any ethical issues, how a doctor chooses to act and represent themselves may lead to different legal ramifications. There exists significant variation in state provisions relating to legal obligations to render aid, which may benefit from review and revision at a national level.

  10. Country Presentation Uganda

    International Nuclear Information System (INIS)

    Oriada, R.; Byakagaba, A.; Kiza, M.; Magembe, M.

    2010-01-01

    Like Many African countries, Uganda is not Immune to the problem of illicit trafficking of Nuclear and Radioactive materials. This has been worsened by the porosity of the Ugandan Borders. There is control on the few Entry points and much of the border line does not have adequate control on what enters and leaves the country. Uganda is also used as a transit route with the neighboring countries like Sudan, Democratic Republic of Congo, Kenya,Tanzania.

  11. Extended training to prepare GPs for future workforce needs: a qualitative investigation of a 1-year fellowship in urgent care.

    Science.gov (United States)

    Dale, Jeremy; Russell, Rachel; Harkness, Frances; Wilkie, Veronica; Aiello, Matthew

    2017-09-01

    It has been argued that UK general practice specialist training should be extended to better prepare GPs for the challenges facing 21st-century health care. Evidence is needed to inform how this should occur. To investigate the experience of recently trained GPs undertaking a 1-year full-time fellowship programme designed to provide advanced skills training in urgent care, integrated care, leadership, and academic practice; and its impact on subsequent career development. Semi-structured interviews conducted longitudinally over 2 years augmented by observational data in the West Midlands, England. Participants were interviewed on at least three occasions: twice while undertaking the fellowship, and at least once post-completion. Participants' clinical and academic activities were observed. Data were analysed using a framework approach. Seven GPs participated in the pilot scheme. The fellowship was highly rated and felt to be balanced in terms of the opportunities for skill development, academic advancement, and confidence building. GPs experienced enhanced employability on completing the scheme, and at follow-up were working in a variety of primary care/urgent care interface clinical and leadership roles. Participants believed it was making general practice a more attractive career option for newly qualified doctors. The 1-year fellowship provides a defined framework for training GPs to work in an enhanced manner across organisational interfaces with the skills to support service improvement and integration. It appears to be well suited to preparing GPs for portfolio roles, but its wider applicability and impact on NHS service delivery needs further investigation. © British Journal of General Practice 2017.

  12. Comparison of Open and Closed Hand Fractures and the Effect of Urgent Operative Intervention.

    Science.gov (United States)

    Minhas, Shobhit V; Catalano, Louis W

    2018-06-13

    To establish and compare the incidence of 30-day postoperative infection in surgically managed open and closed metacarpal and phalangeal fractures, and to determine whether open fractures treated urgently had a lower incidence of postoperative infection. We conducted a retrospective analysis of patient demographics, comorbidities, and 30-day infection rates of patients undergoing operative fixation of metacarpal, proximal, or middle phalanx fractures from 2008 to 2015 using the American College of Surgeons' National Surgical Quality Improvement Program database. A total of 3,506 patients were identified and patient variables and infection incidence were compared between open and closed injuries, as well as open injuries managed within 1 day of admission and those treated on an elective basis or treated more than 1 day after admission. Bivariate analysis was used to determine independent risk factors for postoperative infection. Although 34.2% of open hand fractures were taken urgently to the operating room, the diagnosis of open fractures along with nonurgent surgical treatment for open fractures was associated with a low incidence of postoperative infection. In addition, smoking was a risk factor for postoperative infection although anatomic location (phalanx vs metacarpal) was not. Patients undergoing surgery for metacarpal or proximal/middle phalangeal fractures are not at greater risk for infection based on the diagnosis of open fracture alone. In addition, patients with open fractures who are taken to the operating room more than 1 day from presentation did not have a higher incidence of infection. Smoking is associated with increased 30-day infection rates after surgery, and surgeons should identify these patients for preoperative risk stratification, counseling, and postoperative wound monitoring. Prognostic II. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  13. Urgent endoscopic retrograde cholangiopancreatography is not superior to early ERCP in acute biliary pancreatitis with biliary obstruction without cholangitis.

    Science.gov (United States)

    Lee, Hee Seung; Chung, Moon Jae; Park, Jeong Youp; Bang, Seungmin; Park, Seung Woo; Song, Si Young; Chung, Jae Bock

    2018-01-01

    Acute pancreatitis is a common diagnosis worldwide, with gallstone disease being the most prevalent cause (50%). The American College of Gastroenterology recommends urgent endoscopic retrograde cholangiopancreatography (ERCP) (within 24 h) for patients with biliary pancreatitis accompanied by cholangitis. Most international guidelines recommend that ERCP be performed within 72 h in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, but the optimal timing for endoscopy is controversial. We investigated the optimal timing for ERCP in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, and whether performing endoscopy within 24 h is superior to performing it after 24 h. We analyzed the clinical data of 505 patients with newly diagnosed acute pancreatitis, from January 1, 2005 to December 31, 2014. We divided the patients into two groups according to the timing of ERCP: pancreatitis and a bile duct obstruction without cholangitis. The mean age of the patients was 55 years (range: 26-90 years). Bile duct stones and biliary sludge were identified on endoscopy in 45 (61.6%) and 11 (15.0%) patients, respectively. The timing of ERCP within 72 h was not associated with ERCP-related complications (P = 0.113), and the total length of hospital stay was not different between urgent and early ERCP (5.9 vs. 5.7 days, P = 0.174). No significant differences were found in total length of hospitalization or procedural-related complications, in patients with biliary pancreatitis and a bile duct obstruction without cholangitis, according to the timing of ERCP (< 24 h vs. 24-72 h).

  14. Predictive Factors of One-Year Mortality in a Cohort of Patients Undergoing Urgent-Start Hemodialysis.

    Directory of Open Access Journals (Sweden)

    Luciene P Magalhães

    Full Text Available Chronic kidney disease (CKD affects 10-15% of adult population worldwide. Incident patients on hemodialysis, mainly those on urgent-start dialysis at the emergency room, have a high mortality risk, which may reflect the absence of nephrology care. A lack of data exists regarding the influence of baseline factors on the mortality of these patients. The aim of this study was to evaluate the clinical and laboratory characteristics of this population and identify risk factors that contribute to their mortality.We studied 424 patients who were admitted to our service between 01/2006 and 12/2012 and were followed for 1 year. We analyzed vascular access, risk factors linked to cardiovascular disease (CVD and mineral and bone disease associated with CKD (CKD-MBD, and clinical events that occurred during the follow-up period. Factors that influenced patient survival were evaluated by Cox regression analysis.The patient mean age was 50 ± 18 years, and 58.7% of them were male. Hypertension was the main cause of primary CKD (31.8%. Major risk factors were smoking (19.6%, dyslipidemia (48.8%, and CVD (41%. Upon admission, most patients had no vascular access for hemodialysis (89.4%. Biochemical results showed that most patients were anemic with high C-reactive protein levels, hypocalcemia, hyperphosphatemia, elevated parathyroid hormone and decreased 25-hydroxy vitamin D. At the end of one year, 60 patients died (14.1%. These patients were significantly older, had a lower percentage of arteriovenous fistula in one year, and low levels of 25-hydroxy vitamin D.The combined evaluation of clinical and biochemical parameters and risk factors revealed that the mortality in urgent-start dialysis is associated with older age and low levels of vitamin D deficiency. A lack of a permanent hemodialysis access after one year was also a risk factor for mortality in this population.

  15. RADIOLOGY IN URGENT MEDICINE

    Directory of Open Access Journals (Sweden)

    Article Editorial

    2017-01-01

    Full Text Available Интервью с директором Научно-образовательного клинического центра Гибридных технологий лучевой медицины, заведующим кафедрой лучевой диагностики и лучевой терапии Первого МГМУ им. И.М. Сеченова, руководителем отдела томографии Института клинической кардиологии им. А.Л. Мясникова, главным консультантом Главного медицинского управления УД Президента РФ, академиком РАН Сергеем Константиновичем Терновым.

  16. Councils of Urgent Studies

    Science.gov (United States)

    Cellarius, Richard A.; Platt, John

    1972-01-01

    Discusses the role of national or international coordinating councils in focusing research on solutions of major human problems. Presents a taxonomy of 25 areas under the major heading: Physical Technology and Engineering; Biotechnology; Behavior and Personal Relations; National Social Structures; World Structure; and Channels of Effectiveness.…

  17. Nuclear energy in transition countries

    International Nuclear Information System (INIS)

    Knapp, V.

    2000-01-01

    Transition countries, respectively the countries that have in the year's 89/90 broken with the communist political and economy system are passing through difficult years. From their traditional markets within the closely interconnected socialist economy system, which has disintegrated, they have to reorient themselves to new, often saturated and sophisticated markets. To integrate into Europe as equal partners, rather then remain poor relatives, they must reduce this development gap in a reasonable time, not longer than 15 years. Slower pace would not give acceptable perspective to their young people and they would look for it elsewhere, thereby reducing creative forces for progress. Examples of economic development show that sustained growth of GDP is impossible without similar industrial growth, which, in turn, requires corresponding increase of energy use. In the same time these countries are the parts of densely populated European region and are subject to emission restriction of effluents with local or global effects. It is difficult to see how these countries could attain their development goals, whilst respecting their Kyoto obligations, without supplying increased energy demand from nuclear sources. (author)

  18. Day Care: Other Countries.

    Science.gov (United States)

    Hjartarson, Freida; And Others

    This collection of 5 bilingual papers on day care programs in foreign countries (China, the Soviet Union, and 3 Scandinavian countries) is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Paper I considers day care services in…

  19. Country Profiles, Malaysia.

    Science.gov (United States)

    Marzuki, Ariffin Bin; Peng, J. Y.

    A profile of Malaysia is sketched in this paper. Emphasis is placed on the nature, scope, and accomplishments of population activities in the country. Topics and sub-topics include: location and description of the country; population (size, growth patterns, age structure, urban/rural distribution, ethnic and religious composition, migration,…

  20. Serbia : Systematic Country Diagnostic

    OpenAIRE

    World Bank Group

    2015-01-01

    This Systematic Country Diagnostic (SCD) aims to identify the major constraints on and opportunities for sustaining poverty reduction and shared prosperity in Serbia. The SCD serves as the analytic foundation on which the World Bank Group and the Government of Serbia will define a new Country Partnership Framework for FY2016 to FY2020. It is based on the best possible analysis, drawing on ...

  1. Álcool, direção automotiva e o Programa Vida Urgente na visão de jovens voluntários Vida Urgente Program, alcohol and driving: young volunteers' view

    Directory of Open Access Journals (Sweden)

    Andréa dos Santos Nascimento

    2011-08-01

    Full Text Available O objetivo deste estudo é analisar as representações sociais dos jovens voluntários do Programa Vida Urgente, do Espírito Santo, acerca do trabalho por eles realizado. Foram realizadas 20 entrevistas com roteiro semiestruturado objetivando conhecer a opinião sobre os efeitos da própria atuação e a visão que possuem do programa. Para tanto foram entrevistados jovens de ambos os sexos, com idades entre 15 e 26 anos, posteriormente divididos em dois grupos com base no critério de tempo de atuação nas ações do Programa: G1 - 06 a 12 meses e G2 - acima de 12 meses. Por meio da análise de conteúdo, verificou-se que a afinidade com a proposta do trabalho voluntário e a valorização do discurso da conscientização são alguns dos motivos para o ingresso no Programa. Os entrevistados informaram ter identificado maior receptividade no público-alvo, o que é percebido por eles como uma mudança positiva no comportamento dos motoristas abordados.This study's goal is to analyze the social representations of the young volunteers of Vida Urgente Program of Espírito Santo about the work developed by them. 20 interviews were carried out using a semi-structured questionnaire with the objective to know the opinion about the effects of their performance and the vision they possess about the program. For such, 20 participants of both sexes with ages from 15 to 26 years were interviewed, subsequently divided into two groups according to the time of participation in the Program: G1 - 06 to 12 months and G2 - above 12 months. Using content analysis, it was verified that the affinity with the program's proposal of volunteer work and valorization of the speech of awareness are some of the reasons to enter the program. The respondents informed having identified larger receptivity from the target-public, which is perceived by them as a positive change on approached drivers.

  2. Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

    Science.gov (United States)

    Naganuma, Toshihide; Takemoto, Yoshiaki

    2017-01-01

    We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

  3. The burden of non communicable diseases in developing countries

    Directory of Open Access Journals (Sweden)

    Boutayeb Abdesslam

    2005-01-01

    Full Text Available Abstract Background By the dawn of the third millennium, non communicable diseases are sweeping the entire globe, with an increasing trend in developing countries where, the transition imposes more constraints to deal with the double burden of infective and non-infective diseases in a poor environment characterised by ill-health systems. By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. Many of the non communicable diseases can be prevented by tackling associated risk factors. Methods Data from national registries and international organisms are collected, compared and analyzed. The focus is made on the growing burden of non communicable diseases in developing countries. Results Among non communicable diseases, special attention is devoted to cardiovascular diseases, diabetes, cancer and chronic pulmonary diseases. Their burden is affecting countries worldwide but with a growing trend in developing countries. Preventive strategies must take into account the growing trend of risk factors correlated to these diseases. Conclusion Non communicable diseases are more and more prevalent in developing countries where they double the burden of infective diseases. If the present trend is maintained, the health systems in low-and middle-income countries will be unable to support the burden of disease. Prominent causes for heart disease, diabetes, cancer and pulmonary diseases can be prevented but urgent (preventive actions are needed and efficient strategies should deal seriously with risk factors like smoking, alcohol, physical inactivity and western diet.

  4. ERAWATCH Country Reports 2012

    DEFF Research Database (Denmark)

    Grimpe, Christoph

    between the national priorities and the structural challenges, highlighting the latest developments, their dynamics and impact in the overall national context. They further analyse and assess the ability of the policy mix in place to consistently and efficiently tackle these challenges. These reports were......This analytical country report is one of a series of annual ERAWATCH reports produced for EU Member States and Countries Associated to the Seventh Framework Programme for Research of the European Union (FP7). The main objective of the ERAWATCH Annual Country Reports is to characterise and assess...... the performance of national research systems and related policies in a structured manner that is comparable across countries. The Country Report 2012 builds on and updates the 2011 edition. The report identifies the structural challenges of the national research and innovation system and assesses the match...

  5. Country branding: an imperative for developing countries | Akotia ...

    African Journals Online (AJOL)

    Clarifying what a country brand and country branding encompasses, this paper examines the competitive advantage a country brand engenders for developing countries. Furthermore, emphasising country branding as a social construction, this paper argues that for developing countries entrenched in the poverty cycle there ...

  6. Perceptions of urgency: defining the gap between what physicians and nurses perceive to be an urgent issue.

    Science.gov (United States)

    Quan, S D; Morra, D; Lau, F Y; Coke, W; Wong, B M; Wu, R C; Rossos, P G

    2013-05-01

    and context, not clinical condition. Most disagreement occurred when nurses used urgent messaging for time sensitive but not clinically urgent issues in an effort to expedite the resolution of their issue by the physicians. These results indicate the need for clinical communication systems to incorporate decision support around both clinical prioritization and expected response time in their design. Effective interprofessional communication is essential to the provision of safe, quality-based healthcare; these results highlight some of the sociotechnical aspects of health information technology implementation that must be considered. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Emerging nuclear security issues for transit countries

    International Nuclear Information System (INIS)

    Gabulov, I.A.

    2003-01-01

    Full text: Tragic events of September eleventh have made nuclear terrorism dangers more evident. In the light of increased terrorism preventing the spread of nuclear and nuclear related items as well as radioactive materials that can be used for production so-called 'dirty bomb'is an urgent global claim. Nuclear Security issues cover multiple aspects of the security and first of all the threat from nuclear terrorism, detection and protection of illicit trafficking of nuclear materials and other radioactive sources, legal shipment of such type materials as well as nuclear related dual use items. In the face of emerging threats the prevention of proliferation by the development of effective national system of nuclear export controls is hugely important for transit countries like Azerbaijan with underdeveloped export controls and strategic locations along trade and smuggling routes between nuclear suppliers States and countries attempting to develop nuclear weapons or any nuclear explosive devices. Thus, in the face of increasing international threat from nuclear terrorism the role and place of Azerbaijan Republic in the struggle against terrorism increases. In this context it is very important to establish effective national capabilities for detection and prevention of illicit trafficking of radioactive and nuclear materials as well as nuclear related dual use items across Azerbaijan's borders. One of the ways for enhancing and strengthening existing activities in this field is carrying out joint actions between scientists and enforcement officials in order to improve knowledge of the front-line customs and border guard inspectors concerning multiple aspects of Nuclear Security

  8. Sustainable energy issues in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Munasinghe, M [Environmental Policy Division, The World Bank, Washington D.C. (US)

    1991-07-01

    Increased energy use is a vital pre-requisite for economic development, and less developing countries (LDCs) are struggeling to meet energy needs at acceptable costs. LDC decision-makers share the worldwide environmental concerns, but also face other urgent issues like poverty. The industrialised countries can afford to substitute environmental protection for further material growth, but the LDCs will need concessional funding to participate in addressing global environmental problems. Global financing issues may be analysed and resolved through tradeoffs among several criteria including affordability/additionality, fairness/equity, and economic efficiency. The short-term LDC response to sustainable energy issues will be limited mainly to conventional technologies in efficiency improvements, conservation and resource development. The industrialised nations should provide financial resources to LDCs and develop the technology to be used in the 21st century. Pilot international funds like the Global Environmental Facility and the Ozone Fund will help LDCs participate in the effort to solve global environmental issues. (author) 16 refs.

  9. European countries in transition

    International Nuclear Information System (INIS)

    Gautier, Celia; Pescia, Dimitri; Ferreira, Francisco; Antunes, Rita; Claustre, Raphael; Priesner, Goerg C.; Pidous, Blandine; Dufour, Manon; Zuloaga, Francisco

    2014-01-01

    From the Atlantic Ocean to the Baltic Sea, from Portugal to Poland through UK, Germany or Austria, energy transition is in progress everywhere in Europe, but at different rhythms and in various conditions from one country to the other. How does the European framework promote the energy transition at the local and regional scales? What advantages the most advanced countries are relying on? How do citizens and local projects take over slow or retrograde governmental policies? This dossier gives some elements of answer through an overview of some energy policy scenarios under implementation in some European countries (Germany, Portugal, Denmark, Austria, UK, Spain)

  10. Decreasing delays in urgent and expedited surgery in a university teaching hospital through audit and communication between peri-operative and surgical directorates.

    Science.gov (United States)

    Cosgrove, J F; Gaughan, M; Snowden, C P; Lees, T

    2008-06-01

    National Confidential Enquiry into Patient Outcome and Death guidelines for urgent surgery recommend a fully staffed emergency operating theatre and restriction of 'after-midnight' operating to immediate life-, limb- or organ-threatening conditions. Audit performed in our institution demonstrated significant decreases in waiting times for urgent surgery and an increased seniority of medical care associated with overnight pre-operative assessment of patients by anaesthetic trainees. Nevertheless, urgent cases continued to be delayed unnecessarily. A classification of delays was developed from existing guidelines and their incidence was audited. The results were disseminated to involved directorates. A repeat of the audit demonstrated a significant decrease in delays (p = 0.001), a significant increase in the availability of surgeons (p = 0.001) and a significant decrease in the median waiting time for urgent surgery compared to the first audit cycle and a previous standard (p auditing delays and disseminating the results of the audit significantly decreases delays and median waiting times for urgent surgery because of improved surgical availability.

  11. Public opinion: Country comparisons

    Science.gov (United States)

    Hopkins, Debbie

    2015-11-01

    Climate change awareness, risk perception and policy support vary between and within countries. National-scale comparisons can help to explain this variability and be used to develop targeted interventions.

  12. Investment in Developing Countries

    Science.gov (United States)

    Motooka, Takeshi

    1973-01-01

    The fundamental problems of investment in rural education in the present developing countries are analyzed. Needs of rural education are outlined and financial considerations related to investment in the improvement of rural educational programs are discussed. (SM)

  13. Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

    Science.gov (United States)

    Moseley, Tanya W.; Stanley, Ashley; Wei, Wei; Parikh, Jay R.

    2018-01-01

    Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers. PMID:29473859

  14. Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses.

    Science.gov (United States)

    Moseley, Tanya W; Stanley, Ashley; Wei, Wei; Parikh, Jay R

    2018-02-23

    Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers.

  15. Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

    Directory of Open Access Journals (Sweden)

    Tanya W. Moseley

    2018-02-01

    Full Text Available Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers.

  16. [Experience in the treatment of patients with STEMI in the frame of urgent PCI Project in Medimurje County].

    Science.gov (United States)

    Hranilović, Rudolf

    2009-02-01

    In 2004, the mortality rate of cardiovascular disease in Medimurje County was 53%, with coronary heart disease accounting for 18.2% of cases. The need of organizing a County team for health was recognized. Five health priorities were acknowledged with coronary heart disease on the top of the list. In 2005, Medimurje County was among the first regions outside Zagreb that had launched the Project of urgent percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. Internal medicine physicians from the County Hospital received thorough education and printed materials on the issue were distributed to primary care physicians. A media campaign for the general population of the Medimurje County was also prepared. During the first 2 years of the project, the average pain-to-needle time in our patients was less than 4 hours. From the beginning of the project till July 2007, more than 100 patients with STEMI were treated with emergency PCI. There still are issues that have remained unsolved (how to reduce the pain-to-door and door-to-needle time, managing patients in cardiogenic shock, NSTEMI-patients, and presentation of patients with multivessel disease to cardiac surgeons). It is important to carry on with the intensive media campaign as well as with further education of patients, physicians and other health personnel.

  17. Obesity in African-American Women--The Time Bomb is Ticking: An Urgent Call for Change.

    Science.gov (United States)

    Fowler, Barbara A

    2015-12-01

    The "time bomb is ticking" because there is an obesity crisis associated with higher rates of chronic diseases such as stroke, hypertension, type 2 diabetes, and some forms of cancer in African-American women compared to White women. African-American women incur higher medical costs from hospitalizations, decreased productivity in the work setting, lost wages, the needfor medical benefits and pharmacy-associated costs, and more time away from family than White women. Numerous factors, such as the socio-cultural context of eating, acceptance of a larger weight status, the emotionally liberating effects offood, and preference for highfat and high caloric, sugary-content, and sodium-laden food influences the obesity crisis in African-American women. The interplay of poverty and lower socioeconomic status, residential segregation, health literacy, availability of fast foods and scarce produce in local convenience food marts, physical inactivity, and conflicting messages from social media public service announcements (PSAs) and ads in national magazines affect the obesity crisis in African-American women. There is an urgent call for sustainable, community-driven health policy initiatives that improve access to healthy foods in lower-income, minority communities. Furthermore, African-American women are challenged to modify their health behaviors by preparing healthy meals for themselves and theirfamilies, and by engaging in physical activity.

  18. Stroke acute management with urgent risk-factor assessment and improvement (SAMURAI) rt-PA registry. General results and subanalyses

    International Nuclear Information System (INIS)

    Toyoda, Kazunori; Koga, Masatoshi; Shiokawa, Yoshiaki

    2010-01-01

    Stroke Acute Management with Urgent Risk-factor Assessment and Improvement [SAMURAI] rt-PA Registry is a multicenter retrospective observational study from 10 Japanese stroke centers. A total of 600 patients (223 women, 72±12 years old) treated with intravenous alteplase (0.6 mg/kg) were studied. Symptomatic intracerebral hemorrhage within 36 hours with ≥4 point-increase from the baseline National Institutes of Health (NIH) Stroke Scale score developed in 8 patients (1.3%, 95% confidence interval (CI) 0.7-2.6%). At 3 months, 199 patients (33.2%, 29.5-37.0%) had a modified Rankin Scale (mRS) score ≤1. Analysis of 399 patients with a premorbid mRS score ≤1 who met the criteria of the European license (≤80 years old, an initial NIHSS score ≤24, etc.) showed that 40.6% (35.9-45.5%) had a 3-month mRS ≤1. In the subanalyses from this registry, early ischemic change on diffusion-weighted imaging assessed by the Alberta Stroke Programme Early CT Score, as well as reduced estimated glomerular filtration rate, was associated with early intracerebral hemorrhage and 3-month outcomes of patients. (author)

  19. Stroke acute management with urgent risk-factor assessment and improvement (SAMURAI) rt-PA registry. General results and subanalyses

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Kazunori; Koga, Masatoshi [National Cerebral and Cardiovascular Center, Suita, Osaka (Japan); Shiokawa, Yoshiaki [Kyorin Univ., School of Medicine, Mitaka, Tokyo (Japan)

    2010-11-15

    Stroke Acute Management with Urgent Risk-factor Assessment and Improvement [SAMURAI] rt-PA Registry is a multicenter retrospective observational study from 10 Japanese stroke centers. A total of 600 patients (223 women, 72{+-}12 years old) treated with intravenous alteplase (0.6 mg/kg) were studied. Symptomatic intracerebral hemorrhage within 36 hours with {>=}4 point-increase from the baseline National Institutes of Health (NIH) Stroke Scale score developed in 8 patients (1.3%, 95% confidence interval (CI) 0.7-2.6%). At 3 months, 199 patients (33.2%, 29.5-37.0%) had a modified Rankin Scale (mRS) score {<=}1. Analysis of 399 patients with a premorbid mRS score {<=}1 who met the criteria of the European license ({<=}80 years old, an initial NIHSS score {<=}24, etc.) showed that 40.6% (35.9-45.5%) had a 3-month mRS {<=}1. In the subanalyses from this registry, early ischemic change on diffusion-weighted imaging assessed by the Alberta Stroke Programme Early CT Score, as well as reduced estimated glomerular filtration rate, was associated with early intracerebral hemorrhage and 3-month outcomes of patients. (author)

  20. Inequality in OECD countries.

    Science.gov (United States)

    Thévenot, Celine

    2017-08-01

    This article recalls the state of play of inequality levels and trends in OECD countries, with a special focus on Nordic countries. It sheds light on explaining the drivers of the rise in inequality and its economic consequences. It addresses in particular the issue of redistribution through taxes and transfers. It concludes with an overview of policy packages that should be considered to address the issue of rising inequalities.

  1. Causal chains, policy trade offs and sustainability: Analysing land (mis)use in seven countries in the South

    NARCIS (Netherlands)

    Nesheim, I.; Reidsma, P.; Bezlepkina, I.; Verburg, R.W.; Abdeladhim, M.A.; Bursztyn, M.; Chen, L.; Cissé, Y.; Feng, S.; Gicheru, P.; König, H.J.; Novira, N.; Purushothaman, S.; Rodrigues-Filho, S.; Sghaier, M.

    2014-01-01

    The need to enhance sustainable development of land use is more urgent than ever; specifically in developing countries where poverty and land degradation are often interlinked. To promote a common understanding of land use problems by experts, stakeholders and decision makers, it is essential to

  2. Building Health Promotion Capacity in Developing Countries: Strategies from 60 Years of Experience in the United States

    Science.gov (United States)

    Howze, Elizabeth H.; Auld, M. Elaine; Woodhouse, Lynn D.; Gershick, Jessica; Livingood, William C.

    2009-01-01

    The Galway Consensus Conference articulated key definitions, principles, values, and core domains of practice as the foundation for the diffusion of health promotion across the globe. The conference occurred in the context of an urgent need for large numbers of trained health workers in developing countries, which face multiple severe threats to…

  3. Obesity and the metabolic syndrome in developing countries.

    Science.gov (United States)

    Misra, Anoop; Khurana, Lokesh

    2008-11-01

    Prevalence of obesity and the metabolic syndrome is rapidly increasing in developing countries, leading to increased morbidity and mortality due to type 2 diabetes mellitus (T2DM) and cardiovascular disease. Literature search was carried out using the terms obesity, insulin resistance, the metabolic syndrome, diabetes, dyslipidemia, nutrition, physical activity, and developing countries, from PubMed from 1966 to June 2008 and from web sites and published documents of the World Health Organization and Food and Agricultural Organization. With improvement in economic situation in developing countries, increasing prevalence of obesity and the metabolic syndrome is seen in adults and particularly in children. The main causes are increasing urbanization, nutrition transition, and reduced physical activity. Furthermore, aggressive community nutrition intervention programs for undernourished children may increase obesity. Some evidence suggests that widely prevalent perinatal undernutrition and childhood catch-up obesity may play a role in adult-onset metabolic syndrome and T2DM. The economic cost of obesity and related diseases in developing countries, having meager health budgets is enormous. To prevent increasing morbidity and mortality due to obesity-related T2DM and cardiovascular disease in developing countries, there is an urgent need to initiate large-scale community intervention programs focusing on increased physical activity and healthier food options, particularly for children. International health agencies and respective government should intensively focus on primordial and primary prevention programs for obesity and the metabolic syndrome in developing countries.

  4. Energy in developing countries: prospects and problems

    International Nuclear Information System (INIS)

    Baum, V.

    1977-01-01

    This paper analyses requirements for primary energy and electric power in the developing countries in the light of projections of population and economic growth. It evaluates the availability of indigenous energy resources and focuses on input requirements (capital, technology, trained personnel) for accelerated energy development; it reviews possible supplies for such inputs from domestic sources, transnational corporations, multilateral institutions, and through co-operation among the developing countries themselves and between the developing and the developed countries. The paper analyses the findings of the United Nations study ''The Future of the World Economy. A Study on the Impact of the Prospective Economic Issues and Policies on the International Development Strategy'' as far as they relate to energy and the developing countries in the light of the objectives of the Declaration on the Establishment of a New International Economic Order

  5. The RADCAT-3 system for closing the loop on important non-urgent radiology findings: a multidisciplinary system-wide approach.

    Science.gov (United States)

    Dibble, Elizabeth H; Swenson, David W; Cobb, Cynthia; Paul, Timothy J; Karn, Andrew E; Portelli, David C; Movson, Jonathan S

    2017-04-01

    The goal of this project was to create a system that was easy for radiologists to use and that could reliably identify, communicate, and track communication of important but non-urgent radiology findings to providers and patients. Prior to 2012, our workflow for communicating important non-urgent diagnostic imaging results was cumbersome, rarely used by our radiologists, and resulted in delays in report turnaround time. In 2012, we developed a new system to communicate important non-urgent findings (the RADiology CATegorization 3 (RADCAT-3) system) that was easy for radiologists to use and documented communication of results in the electronic medical record. To evaluate the performance of the new system, we reviewed our radiology reports before (June 2011-June 2012) and after (June 2012-June 2014) the implementation of the new system to compare utilization by the radiologists and success in communicating these findings. During the 12 months prior to implementation, 250 radiology reports (0.06 % of all reports) entered our workflow for communicating important non-urgent findings. One-hundred percent were successfully communicated. During the 24 months after implementation, 13,158 radiology reports (1.4 % of all reports) entered our new RADCAT-3 workflow (3995 (0.8 % of all reports) during year 1 and 9163 (1.9 % of all reports) during year 2). 99.7 % of those reports were successfully communicated. We created a reliable system to ensure communication of important but non-urgent findings with providers and/or patients and to document that communication in the electronic medical record. The rapid adoption of the new system by radiologists suggests that they found it easy to use and had confidence in its integrity. This system has the potential to improve patient care by improving the likelihood of appropriate follow-up for important non-urgent findings that could become life threatening.

  6. Country nuclear power profiles

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    The preparation of Country Nuclear Power Profiles was initiated within the framework of the IAEA`s programme for nuclear power plant performance assessment and feedback. It responded to a need for a database and a technical document containing a description of the energy and economic situation and the primary organizations involved in nuclear power in IAEA Member States. The task was included in the IAEA`s programmes for 1993/1994 and 1995/1996. In March 1993, the IAEA organized a Technical Committee meeting to discuss the establishment of country data ``profiles``, to define the information to be included in the profiles and to review the information already available in the IAEA. Two expert meetings were convened in November 1994 to provide guidance to the IAEA on the establishment of the country nuclear profiles, on the structure and content of the profiles, and on the preparation of the publication and the electronic database. In June 1995, an Advisory Group meeting provided the IAEA with comprehensive guidance on the establishment and dissemination of an information package on industrial and organizational aspects of nuclear power to be included in the profiles. The group of experts recommended that the profiles focus on the overall economic, energy and electricity situation in the country and on its nuclear power industrial structure and organizational framework. In its first release, the compilation would cover all countries with operating power plants by the end of 1995. It was also recommended to further promote information exchange on the lessons learned from the countries engaged in nuclear programmes. For the preparation of this publication, the IAEA received contributions from the 29 countries operating nuclear power plants and Italy. A database has been implemented and the profiles are supporting programmatic needs within the IAEA; it is expected that the database will be publicly accessible in the future. Refs, figs, tabs.

  7. Country nuclear power profiles

    International Nuclear Information System (INIS)

    1998-03-01

    The preparation of Country Nuclear Power Profiles was initiated within the framework of the IAEA's programme for nuclear power plant performance assessment and feedback. It responded to a need for a database and a technical document containing a description of the energy and economic situation and the primary organizations involved in nuclear power in IAEA Member States. The task was included in the IAEA's programmes for 1993/1994 and 1995/1996. In March 1993, the IAEA organized a Technical Committee meeting to discuss the establishment of country data ''profiles'', to define the information to be included in the profiles and to review the information already available in the IAEA. Two expert meetings were convened in November 1994 to provide guidance to the IAEA on the establishment of the country nuclear profiles, on the structure and content of the profiles, and on the preparation of the publication and the electronic database. In June 1995, an Advisory Group meeting provided the IAEA with comprehensive guidance on the establishment and dissemination of an information package on industrial and organizational aspects of nuclear power to be included in the profiles. The group of experts recommended that the profiles focus on the overall economic, energy and electricity situation in the country and on its nuclear power industrial structure and organizational framework. In its first release, the compilation would cover all countries with operating power plants by the end of 1995. It was also recommended to further promote information exchange on the lessons learned from the countries engaged in nuclear programmes. For the preparation of this publication, the IAEA received contributions from the 29 countries operating nuclear power plants and Italy. A database has been implemented and the profiles are supporting programmatic needs within the IAEA; it is expected that the database will be publicly accessible in the future

  8. 76 FR 50744 - Notice To Announce the Award of an Urgent Single-Source Grant to Survivors of Torture...

    Science.gov (United States)

    2011-08-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Refugee Resettlement Notice To Announce the... AGENCY: Office of Refugee Resettlement, ACF, HHS. ACTION: The Office of Refugee Resettlement announces..., twenty-eight percent of the country's asylum-seekers came to California for resettlement. In 2010, a...

  9. Palliative radiotherapy in developing countries

    International Nuclear Information System (INIS)

    Allen, B.J.

    2010-01-01

    Full text: The International Agency for Research on Cancer predicts that cancer incidence in developing countries will increase dramatically in the first two decades of this millennium. Already some 80% of cancer patients in developing countries present with incurable disease. [n many cases pain is a severe problem and palliation is needed to improve quality of life as well as extending survival. This paper will consider the physical and clinical aspects of palliative radiotherapy (PRT), choice of radiation modality, alternative approaches to imaging and therapy and cost-benefit considerations. The potential benefits of a dedicated palliative centre include lower cost and therefore more centres, enabling more patients access to regional palliative care. Whilst there is an obvious need for palliative radiotherapy, simple curative treatments could also be managed. C060 radiotherapy has important advantages in developing countries, because of the higher initial cost of a linear accelerator, as well as the need for reliable power supply and the level of skill required by linac technicians and physicists. The beam characteristics of both C060 units and low energy linacs are compared and both are found to be acceptable for palliation. The concept of telemedicine is also discussed, using mobile phones and internet communication to allow rural clinics to receive support from specialists based in the cities, to send images for remote diagnosis and remote dose planning for radiotherapy. (author)

  10. Short- and Long-Term Stroke Risk after Urgent Management of Transient Ischaemic Attack: The Bologna TIA Clinical Pathway.

    Science.gov (United States)

    Guarino, Maria; Rondelli, Francesca; Favaretto, Elisabetta; Stracciari, Andrea; Filippini, Massimo; Rinaldi, Rita; Zele, Ivana; Sartori, Michelangelo; Faggioli, Gianluca; Mondini, Susanna; Donti, Andrea; Strocchi, Enrico; Degli Esposti, Daniela; Muscari, Antonio; Veronesi, Maddalena; D'Addato, Sergio; Spinardi, Luca; Faccioli, Luca; Pastore Trossello, Marco; Cirignotta, Fabio

    2015-01-01

    Rapid management can reduce the short stroke risk after transient ischaemic attack (TIA), but the long-term effect is still little known. We evaluated 3-year vascular outcomes in patients with TIA after urgent care. We prospectively enrolled all consecutive patients with TIA diagnosed by a vascular neurologist and referred to our emergency department (ED). Expedited assessment and best secondary prevention was within 24 h. Endpoints were stroke within 90 days, and stroke, myocardial infarction, and vascular death at 12, 24 and 36 months. Between August 2010 and July 2013, we evaluated 686 patients with suspected TIA; 433 (63%) patients had confirmed TIA. Stroke at 90 days was 2.07% (95% confidence interval (CI), 1.1-3.9) compared with the ABCD2-predicted risk of 9.1%. The long-term stroke risk was 2.6% (95% CI, 1.1-4.2), 3.7% (95% CI, 1.6-5.9) and 4.4% (95% CI, 1.9-6.8) at 12, 24 and 36 months, respectively. The composite outcome of stroke, myocardial infarction, and vascular death was 3.5% (95% CI, 1.7-5.1), 4.9% (95% CI, 2.5-7.4), and 5.6% (95% CI, 2.8-8.3) at 12, 24, and 36 months, respectively. TIA expedited management driven by vascular neurologists was associated with a marked reduction in the expected early stroke risk and low long-term risk of stroke and other vascular events. © 2015 S. Karger AG, Basel.

  11. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health

    Science.gov (United States)

    Holt, Kathryn E.; Wertheim, Heiman; Zadoks, Ruth N.; Baker, Stephen; Whitehouse, Chris A.; Dance, David; Jenney, Adam; Connor, Thomas R.; Hsu, Li Yang; Severin, Juliëtte; Brisse, Sylvain; Cao, Hanwei; Wilksch, Jonathan; Gorrie, Claire; Schultz, Mark B.; Edwards, David J.; Nguyen, Kinh Van; Nguyen, Trung Vu; Dao, Trinh Tuyet; Mensink, Martijn; Minh, Vien Le; Nhu, Nguyen Thi Khanh; Schultsz, Constance; Kuntaman, Kuntaman; Newton, Paul N.; Moore, Catrin E.; Strugnell, Richard A.; Thomson, Nicholas R.

    2015-01-01

    Klebsiella pneumoniae is now recognized as an urgent threat to human health because of the emergence of multidrug-resistant strains associated with hospital outbreaks and hypervirulent strains associated with severe community-acquired infections. K. pneumoniae is ubiquitous in the environment and can colonize and infect both plants and animals. However, little is known about the population structure of K. pneumoniae, so it is difficult to recognize or understand the emergence of clinically important clones within this highly genetically diverse species. Here we present a detailed genomic framework for K. pneumoniae based on whole-genome sequencing of more than 300 human and animal isolates spanning four continents. Our data provide genome-wide support for the splitting of K. pneumoniae into three distinct species, KpI (K. pneumoniae), KpII (K. quasipneumoniae), and KpIII (K. variicola). Further, for K. pneumoniae (KpI), the entity most frequently associated with human infection, we show the existence of >150 deeply branching lineages including numerous multidrug-resistant or hypervirulent clones. We show K. pneumoniae has a large accessory genome approaching 30,000 protein-coding genes, including a number of virulence functions that are significantly associated with invasive community-acquired disease in humans. In our dataset, antimicrobial resistance genes were common among human carriage isolates and hospital-acquired infections, which generally lacked the genes associated with invasive disease. The convergence of virulence and resistance genes potentially could lead to the emergence of untreatable invasive K. pneumoniae infections; our data provide the whole-genome framework against which to track the emergence of such threats. PMID:26100894

  12. HIS priorities in developing countries.

    Science.gov (United States)

    Amado Espinosa, L

    1995-04-01

    Looking for a solution to fulfill the requirements that the new global economical system demands, developing countries face a reality of poor communications infrastructure, a delay in applying information technology to the organizations, and a semi-closed political system avoiding the necessary reforms. HIS technology has been developed more for transactional purposes on mini and mainframe platforms. Administrative modules are the most frequently observed and physicians are now requiring more support for their activities. The second information systems generation will take advantage of PC technology, client-server models and telecommunications to achieve integration. International organizations, academic and industrial, public and private, will play a major role to transfer technology and to develop this area.

  13. [AIDS, developing countries and ethnopsychiatry].

    Science.gov (United States)

    Ehrhardt, N; Defourny, J; Bertrand, J

    1995-04-01

    This work briefly assesses the history of the AIDS epidemic in different geographic regions and examines factors that render developing countries particularly vulnerable. It reviews the three main techniques of traditional therapeutic systems and examines their implications for psychiatric treatment of AIDS patients from developing countries. Young age structures, low rates of condom usage, women's lack of education and of sexual bargaining power, and the deficiencies of health and educational facilities are among factors that increase risks of HIV in developing countries. Health education geared to specific audiences should encourage condom use and other preventive measures. Among factors to encourage condom use, group decision making appears to be of greatest potential influence on behavior in sub-Saharan Africa and among African immigrants to Europe. To encourage preventive measures and to understand reactions of non-Western populations to HIV, it is desirable to understand the deeper meanings of their cultures and of traditional therapies. It is difficult and misguided to pose a diagnosis according to the criteria of Western psychiatry. Western psychiatry has been proven incompetent in its attempts to treat members of traditional societies, whether immigrants or in their countries of origin. And attempts to integrate traditional healing into a western medical system have not been successful. Traditional systems accomplish therapeutic goals by three major techniques, possession, shamanism, and clairvoyance, or their numerous variants. It is recommended that group sessions be held with immigrants requiring treatment, in which the principal therapist is assisted by translators, who help create a space for the patient intermediate between the two cultures, where the therapies can coexist without conflict.

  14. Nuclear Safety Culture Assessment for a Newcomer Country: Case Study of Jordan

    International Nuclear Information System (INIS)

    Khasawneh, Khalid; Park, Yun Woon

    2016-01-01

    For countries initiating or considering to start their nuclear power programs; developing a successful safety culture is of a great challenge, owing to lack of experience and the sensitive nature of the nuclear industry in general. The Jordanian case was chosen since Jordan is in the early stages of its nuclear program and the establishment of an effective safety culture is crucial to guarantee the safe operation of its future nuclear facilities. It also should be noted that Fukushima accident has adversely affected the progress of the Jordanian nuclear program driven by the negative public opinion. The government shifts the policies toward enhancing the nuclear safety by enforcing the communication between the engaged parties and openness and transparency with public. In the wake of Fukushima accident the Jordanian government reassured the appropriate siting criteria and siting review, the leadership and the organizations commitment to nuclear safety by adopting advanced reactor technology, the consideration of modern operator accident mitigation strategies and the increased and close cooperation with IAEA and adherence to evolving international safety standards. The progress in the Jordanian nuclear power project in order to satisfy the IAEA requirements was quantified and ranked. A good progress was shown in some aspects, for example in the multicultural and multi-national elements and the establishment of an independent and effective regulatory body. However, some elements, concerning the understanding of the safety culture, management system of the regulatory body and the cultural assessment was not satisfied and an urgent need to focus on and enhance those aspects are required by the Jordanian government. Some elements, for example the leadership, communication and competence, have partial fulfillment of the IAEA requirements. However enhancing those aspects is required in the short and the mid-term in order to guarantee a well-established nuclear power

  15. Nuclear Safety Culture Assessment for a Newcomer Country: Case Study of Jordan

    Energy Technology Data Exchange (ETDEWEB)

    Khasawneh, Khalid; Park, Yun Woon [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    For countries initiating or considering to start their nuclear power programs; developing a successful safety culture is of a great challenge, owing to lack of experience and the sensitive nature of the nuclear industry in general. The Jordanian case was chosen since Jordan is in the early stages of its nuclear program and the establishment of an effective safety culture is crucial to guarantee the safe operation of its future nuclear facilities. It also should be noted that Fukushima accident has adversely affected the progress of the Jordanian nuclear program driven by the negative public opinion. The government shifts the policies toward enhancing the nuclear safety by enforcing the communication between the engaged parties and openness and transparency with public. In the wake of Fukushima accident the Jordanian government reassured the appropriate siting criteria and siting review, the leadership and the organizations commitment to nuclear safety by adopting advanced reactor technology, the consideration of modern operator accident mitigation strategies and the increased and close cooperation with IAEA and adherence to evolving international safety standards. The progress in the Jordanian nuclear power project in order to satisfy the IAEA requirements was quantified and ranked. A good progress was shown in some aspects, for example in the multicultural and multi-national elements and the establishment of an independent and effective regulatory body. However, some elements, concerning the understanding of the safety culture, management system of the regulatory body and the cultural assessment was not satisfied and an urgent need to focus on and enhance those aspects are required by the Jordanian government. Some elements, for example the leadership, communication and competence, have partial fulfillment of the IAEA requirements. However enhancing those aspects is required in the short and the mid-term in order to guarantee a well-established nuclear power

  16. Country report: a methodology

    International Nuclear Information System (INIS)

    Colin, A.

    2013-01-01

    This paper describes a methodology which could be applicable to establish a country report. In the framework of nuclear non proliferation appraisal and IAEA safeguards implementation, it is important to be able to assess the potential existence of undeclared nuclear materials and activities as undeclared facilities in the country under review. In our views a country report should aim at providing detailed information on nuclear related activities for each country examined taken 'as a whole' such as nuclear development, scientific and technical capabilities, etc. In order to study a specific country, we need to know if there is already an operating nuclear civil programme or not. In the first case, we have to check carefully if it could divert nuclear material, if there are misused declared facilities or if they operate undeclared facilities and conduct undeclared activities aiming at manufacturing nuclear weapon. In the second case, we should pay attention to the development of a nuclear civil project. A country report is based on a wide span of information (most of the time coming from open sources but sometimes coming also from confidential or private ones). Therefore, it is important to carefully check the nature and the credibility (reliability?) of these sources through cross-check examination. Eventually, it is necessary to merge information from different sources and apply an expertise filter. We have at our disposal a lot of performing tools to help us to assess, understand and evaluate the situation (cartography, imagery, bibliometry, etc.). These tools allow us to offer the best conclusions as far as possible. The paper is followed by the slides of the presentation. (author)

  17. National adaptation funding: ways forward for the poorest countries

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Amjad; Jallow, Bubu; Konate, Mama; Muyungi, Richard; Reazudding, Mohammed

    2009-04-15

    Rising sea levels, shifting rainfall and other impacts of climate change present a huge risk to some of the world's poorest countries. Faced with such challenges, many LDCs or Least Developed Countries have found themselves juggling the need to adapt to climate impacts with other essential concerns. In 2001, LDCs began to develop National Adaptation Programmes of Action or NAPAs to identify their most urgent and immediate adaptation needs. Since then, 39 of them have gone through this rigorous process, but only a handful of the projects they identified have been submitted for funding. Even fewer have been accepted for implementation. To avoid wasting the massive investment in NAPAs so far, it is key for richer nations to give NAPAs the fiscal and institutional support they need.

  18. Unexpected plateauing of childhood obesity rates in developed countries.

    Science.gov (United States)

    Wabitsch, Martin; Moss, Anja; Kromeyer-Hauschild, Katrin

    2014-01-31

    Surveys performed in the past 10 to 15 years show a yet unexplained stabilization or decline in prevalence rates of childhood obesity in developed countries. The projected continuous increase in obesity prevalence throughout future decades seems not to occur at present. Apparently, saturation has been reached, which might be related to societal adjustments. Hence, we postulate a cumulative effect of public health programs for obesity prevention resulting, for example, in an increase in physical activity, and a decline in television viewing and in the consumption of sugar-sweetened soft drinks by children. Effective public health programs are urgently needed for developing countries, where obesity rates in children still continued to increase during the past decade.

  19. Problems and Approaches for Blood Transfusion in the Developing Countries.

    Science.gov (United States)

    Roberts, David J; Field, Stephen; Delaney, Meghan; Bates, Imelda

    2016-04-01

    A safe supply of blood and the knowledge, skill, and resources for the appropriate use of blood are essential for medical services. Many problems are faced in the development of transfusion services in low- or medium-income countries (LMICs). Unfortunately, in many countries, providing safe blood is made more difficult by a lack of blood donors and the high frequency of transfusion-transmissible infections. The problems are compounded by the frequent need for urgent life-saving transfusions. This article examines the problems in supply, safety, and use of blood and how they are being addressed in LMICs, predominantly focusing on sub-Saharan Africa. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Acidente vascular cerebral de etiologia rara com indicação cirúrgica urgente: caso clínico Stroke of a rare etiology with need of urgent surgery: case report

    Directory of Open Access Journals (Sweden)

    Ana Vieira Baptista

    2012-03-01

    Full Text Available Doente de 19 anos com quadro de febre com 8 dias de evolução e posterior instalação súbita de afasia, hemiparésia esquerda e alterações do comportamento. Aumento das proteínas de fase aguda no estudo analítico. TAC e RMN crânio-encefálicas revelaram lesão isquémica temporo-parietal direita. Ecocardiograma excluiu endocardite. Eco-döppler e angio-TAC carotídeo-vertebrais mostraram formação vegetante, móvel com a pulsação cardíaca, na artéria carótida comum direita. Submetido, de urgência, a cirurgia carotídea. Intraoperatoriamente constatou-se a presença de trombo ligeiramente aderente à artéria carótida comum e na dependência de lesão da íntima subjacente, tendo-se procedido à sua exérese e a arteriorrafia primária. Aponta-se como etiologia mais provável do quadro, uma vasculite secundária a infecção por HSV1 (infecção activa ou por Rickettsia conorii.19 years old patient with fever for 8 days associated with sudden aphasia, left hemiparesis and abnormal behavior. Increased acute phase proteins in the analytical study. Head CT scan and MRI revealed a right temporo-parietal ischemic lesion. An echocardiogram excluded endocarditis. Ultrasound and CT angiography scanning of the extracranial cerebral circulation showed a vegetative formation, mobile with the heartbeat, in the right common carotid artery. Submitted, urgently, to carotid surgery. Intraoperatively, a slightly adherent thrombus to the common carotid artery was found and in the dependence of an underlying injury to the intima. The thrombus was ressected and a primary arteriorrhaphy performed. It is pointed out a vasculitis secondary to HSV1 (active infection or to Rickettsia conorii infection as the most likely etiology of the clinic.

  1. Country report on contamination monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Oyuntulkhuur, Navaangalsan [National Centre for Hygiene, Epidemiology and Microbiology (Mongolia). Central Radiological Laboratory

    1997-06-01

    Mongolia is a non-nuclear country and has currently neither nuclear power plants nor research reactors. This country joined the Regional Co-operation Agreement (RCA) for the Asia Pacific region for research, development and training related to nuclear science and technology in 1993. Various measures has been taken for strengthening of radiation protection, cooperated with several international organizations mainly with IAEA. In Mongolia radioactive substances and sources are used for the following purposes: for research work; medical radiotherapy and diagnostic radiology in hospitals; industrial enterprises for technological processes; and for non-destructive testing in industry. Radiation safety inspection is conducted by the CRL. The inspections consist of verification of compliance with radiation safety requirements and with any additional requirements specified in the authorization of accounting records and a physical check on the presence of radiation sources; check on the work carried out by the radiation safety services to monitor radioactive contamination of the environment; and measurements and sampling. CRL should take much attention for improvement and development of the activities in the field of surface contamination monitoring concerning a wide use of radionuclides in different field of economy. (G.K.)

  2. Tales From Two Countries

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    2006-01-01

    Place branding has become popular. Places brand themselves to attract tourists, talented foreign workers, investments and businesses. The brand accentuates the positive characteristics of the place; it frames the society and sells its cultures. In the context of tourism, this paper examines...... to present a prevailing reality. To the Danes, the brand is descriptive and should portray the country in a positive and accurate manner. To the Singaporeans, the brand is normative and a vision of what Singaporean society ought to become. These countries share common goals when branding themselves...

  3. Country report Egypt 1993

    International Nuclear Information System (INIS)

    1993-07-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  4. Country report Belgium 1993

    International Nuclear Information System (INIS)

    1993-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  5. Country report Belarus 1994

    International Nuclear Information System (INIS)

    1994-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  6. Country report Brazil 1994

    International Nuclear Information System (INIS)

    1994-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  7. A Weighted Goal Programming model for planning sustainable development applied to Gulf Cooperation Council Countries

    International Nuclear Information System (INIS)

    Jayaraman, Raja; Colapinto, Cinzia; La Torre, Davide; Malik, Tufail

    2017-01-01

    Highlights: • Application of multi-criteria optimization model for sustainable development. • GHG emissions targets cannot be attainable due to reliance on hydrocarbon sources. • Provides quantitative evidence for future investments in green energy. • Application to Gulf Cooperation Countries. - Abstract: The United Nations agenda for sustainable development by the year 2030 proposes 17 sustainable development goals which include access to affordable, reliable and clean energy, sustained economic growth with full productive employment and, urgent action to mitigate environmental degradation. Planning for sustainable development requires integrating conflicting criteria on economy, energy, environment and social aspects. In this paper, we introduce a Weighted Goal Programming model involving criteria on the economic development (GDP), the electricity consumption, the greenhouse gas emissions, and the total number of employees to determine optimal labor allocation across various economic sectors. The proposed model is validated with data from the six members of the Gulf Cooperation Council (namely Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates). The results of the model aim to provide empirical evidence and insights to decision makers and policy analysts in developing optimal strategies able to simultaneously satisfy energy demand, economic growth, labor development and reduction in greenhouse gas emissions to achieve sustainability targets by the year 2030.

  8. Achieving value for money in health: a comparative analysis of OECD countries and regional countries.

    Science.gov (United States)

    Çelik, Yusuf; Khan, Mahmud; Hikmet, Neşet

    2017-10-01

    To measure efficiency gains in health sector over the years 1995 to 2013 in OECD, EU, non-member European countries. An output-oriented DEA model with variable return to scale, and residuals estimated by regression equations were used to estimate efficiencies of health systems. Slacks for health care outputs and inputs were calculated by using DEA multistage method of estimating country efficiency scores. Better health outcomes of countries were related with higher efficiency. Japan, France, or Sweden were found to be peer-efficient countries when compared to other developed countries like Germany and United States. Increasing life expectancy beyond a certain high level becomes very difficult to achieve. Despite declining marginal productivity of inputs on health outcomes, some developed countries and developing countries were found to have lowered their inefficiencies in the use of health inputs. Although there was no systematic relationship between political system of countries and health system efficiency, the objectives of countries on social and health policy and the way of achieving these objectives might be a factor increasing the efficiency of health systems. Economic and political stability might be as important as health expenditure in improving health system goals. A better understanding of the value created by health expenditures, especially in developed countries, will require analysis of specific health interventions that can increase value for money in health. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Reporting about disability evaluation in European countries.

    Science.gov (United States)

    Anner, Jessica; Kunz, Regina; Boer, Wout de

    2014-01-01

    To compare the official requirements of the content of disability evaluation for social insurance across Europe and to explore how the International Classification of Functioning, Disability and Health is currently applied, using the rights and obligations of people with disabilities towards society as frame of reference. Survey. We used a semi-structured questionnaire to interview members of the European Union of Medicine in Assurance and Social Security (EUMASS), who are central medical advisors in social insurance systems in their country. We performed two email follow-up rounds to complete and verify responses. Fifteen respondents from 15 countries participated. In all countries, medical examiners are required to report about a claimant's working capacity and prognosis. In 14 countries, medical reports ought to contain information about socio-medical history and feasible interventions to improve the claimant's health status. The format of medical reporting on working capacity varies widely (free text, semi- and fully structured reports). One country makes a reference to the ICF in their reports on working capacity, others consider doing so. Official requirements on medical reporting about disability in social insurance across Europe follow the frame of four features: work capacity, socio-medical history, feasibility of intervention and prognosis of disability. There is an increasing trend to make formal or informal reference to the ICF in the reports about working capacity. The four features and the ICF may provide common references across countries to describe disability evaluation, facilitating national and international research. Implications for Rehabilitation Reporting about disability in social insurance in different countries is about work capacity, social medical history, feasibility of intervention and prognosis of disability. Formats of reporting on work capacity vary among countries, from free text to semi-structured report forms to fully structured

  10. System of urgent psychological aid to subjects of educational settings in the USA (review of the studies for the last decade

    Directory of Open Access Journals (Sweden)

    Pavlova T. S.

    2012-06-01

    Full Text Available The article analyzes the strategies of urgent psychological aid in the USA in a chronological order: preparation for critical situations in educational settlements (school crisis plans, immediate reaction to a crisis (the first psychological aid, work with psychological trauma.

  11. Survivability on the Island of Spice: The Development of the UH-60 Blackhawk and Its Baptism of Fire in Operation Urgent Fury

    Science.gov (United States)

    2015-06-12

    SURVIVABILITY ON THE ISLAND OF SPICE : THE DEVELOPMENT OF THE UH-60 BLACKHAWK AND ITS BAPTISM OF FIRE IN OPERATION URGENT FURY......THESIS APPROVAL PAGE Name of Candidate: Major Matthew G. Easley Thesis Title: Survivability on the Island of Spice : The Development of the UH

  12. Risk score for identifying adults with CSF pleocytosis and negative CSF Gram stain at low risk for an urgent treatable cause

    NARCIS (Netherlands)

    Hasbun, Rodrigo; Bijlsma, Merijn; Brouwer, Matthijs C.; Khoury, Nabil; Hadi, Christiane M.; van der Ende, Arie; Wootton, Susan H.; Salazar, Lucrecia; Hossain, Md Monir; Beilke, Mark; van de Beek, Diederik

    2013-01-01

    We aimed to derive and validate a risk score that identifies adults with cerebrospinal fluid (CSF) pleocytosis and a negative CSF Gram stain at low risk for an urgent treatable cause. Patients with CSF pleocytosis and a negative CSF Gram stain were stratified into a prospective derivation (n = 193)

  13. RECOMMENDATIONS OF PILOTING A HELICOPTER AND FIGHTING AGAINST EXTERNAL GOODS OSCILLATIONS DURING THE CONDUCT OF URGENT AERIAL WORKS WITH EXTERNAL SUSPENSION

    Directory of Open Access Journals (Sweden)

    A. A. Lebedev

    2014-01-01

    Full Text Available Сonsidered question of reducing oscillations of cargo on helicopter external sling to improve the safety and efficiency of flight operations during the conduct of urgent aerial works. Offered practical recommendations of piloting a helicopter and effective maneuvers to eliminate oscillations of cargo on external sling.

  14. Country programme review. Mongolia

    International Nuclear Information System (INIS)

    Dolnicar, J.; Kamel, R.; Perera, O.; Tauchid, M.

    1992-08-01

    This document reviews the current nuclear program in Mongolia, identifying the peaceful uses of nuclear technology in the country and possible future technical co-operation activities. Separate brief sections deal with food and agriculture; mineral resources; nuclear chemistry, nuclear physics and instrumentation; human health; radiation protection; water resources and nuclear energy. 1 tab

  15. RIO Country Report 2015

    DEFF Research Database (Denmark)

    Grimpe, Christoph; Mitchell, Jessica

    The 2015 series of RIO Country Reports analyse and assess the policy and the national research and innovation system developments in relation to national policy priorities and the EU policy agenda with special focus on ERA and Innovation Union. The executive summaries of these reports put forward...

  16. Touring the Low Countries

    NARCIS (Netherlands)

    Strien, van Kees

    1998-01-01

    Touring the Low Countries is an anthology of approximately forty travel documents by British tourists - journals, letters, and financial accounts - most of them published here for the first time.The United Provinces and the Spanish Netherlands, with all the variety of their contrasting cultural

  17. in a Developing Country

    African Journals Online (AJOL)

    GB

    This could have contributed to the refusal for readmission. In conclusion, identification and management of mucopolysaccharidosis type II in affected patients pose a problem in resource-constrained countries due to late identification and presentation, lack of facilities for diagnosis and treatment, as well as the cost and the.

  18. Algeria: Country Status Report.

    Science.gov (United States)

    McFerren, Margaret

    A survey of the status of language usage in Algeria begins with an overview of the usage patterns of Arabic, the Berber languages, and French. The country's return to Arabic as its official language after independence from France in 1962 is discussed along with the resultant language planning, issues of language of instruction at the elementary,…

  19. CAPTURED India Country Evaluation

    NARCIS (Netherlands)

    O'Donoghue, R.; Brouwers, J.H.A.M.

    2012-01-01

    This report provides the findings of the India Country Evaluation and is produced as part of the overall CAPTURED End Evaluation. After five years of support by the CAPTURED project the End Evaluation has assessed that results are commendable. I-AIM was able to design an approach in which health

  20. Radiotherapy in developing countries

    International Nuclear Information System (INIS)

    1987-01-01

    The Symposium presentations are divided into 6 chapters devoted to the following topics: radiation therapy for carcinoma of the cervix (6 papers), different approaches in radiation therapy (15 papers), hyperthermia (7 papers), chemical modifiers (7 papers), dosimetry and technology (5 papers), organization of radiation therapy in developing countries (5 papers). A separate abstract was prepared for each of these papers

  1. Country programme review. Ethiopia

    International Nuclear Information System (INIS)

    1991-01-01

    This document reviews the current nuclear program in Ethiopia, identifying the peaceful uses of nuclear technology in the country and possible future technical cooperation activities. Separate brief sections deal with food and agriculture; human health; water and geothermal resources; industrial applications and instrumentation; radiation protection; higher education; programming, coordination and development

  2. Countries in transition

    International Development Research Centre (IDRC) Digital Library (Canada)

    tant role in an open global economy? Would it have the ... topics such as urban migration, labour issues, HIV/AIDS, and the ... A new approach to finding local solutions to armed conflict grew ... the fighting in four test countries: Somalia,. Eritrea ...

  3. Country programme review. Guatemala

    International Nuclear Information System (INIS)

    1992-09-01

    This document reviews the current nuclear program in Guatemala, identifying the peaceful uses of nuclear technology in the country and possible future technical co-operation activities. Separate brief sections deal with food and agriculture; human health; radiation protection; industrial applications and hydrology; nuclear analytical techniques; nuclear instrumentation and nuclear information

  4. Problems facing developing countries

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    Financing, above all political and technical considerations, remains the major obstacle faced by developing countries who wish to embark on a nuclear power programme. According to the IAEA, the support of the official lending agencies of the suppliers is essential. (author)

  5. Denmark. [CME Country Reports].

    Science.gov (United States)

    Council of Europe, Strasbourg (France). Documentation Center for Education in Europe.

    According to an agreement between the parties of the labour market and the Ministry of Labour, the immigration of foreign workers into Denmark takes place on a quota basis and conforms to a series of regulations, including a rule that the foreign worker, prior to departing from his country, must have made contract arrangements for his job. This…

  6. Current challenges for radiographers and following changes in the education and the qualification requirements

    International Nuclear Information System (INIS)

    Taneva, E.; Gagova, E.

    2006-01-01

    Full text: The communication is intended to present the new requisites for the activity of the X-ray laboratory assistant, laying changes in the educational background and the qualification of the respective medical specialists. The need of new knowledge and skills lead to changes in the competence of the X-ray laboratory assistants and call for urgent measures for updating the curriculum, programmes and exercises. The implementation of new technologies in the profession requires an education of new quality that complies with the needs of the health care in the country and harmonizing it with the requirements of the European Union. Having made an analysis of the education so far and comparing its condition with that of the leading European countries we came to the conclusion that not only the contents of the education should be changed, but also the teaching hours and the qualification of the X-ray laboratory assistants. Knowing the new realities and challenges in the health care system, the professors of the medical colleges and the health specialists are aware of the need to introduce changes in the medical practice and work together for its implementation

  7. Saline Agriculture in the 21st Century: Using Salt Contaminated Resources to Cope Food Requirements

    Directory of Open Access Journals (Sweden)

    Bruno Ladeiro

    2012-01-01

    Full Text Available With the continue increase of the world population the requirements for food, freshwater, and fuel are bigger every day. This way an urgent necessity to develop, create, and practice a new type of agriculture, which has to be environmentally sustainable and adequate to the soils, is arising. Among the stresses in plant agriculture worldwide, the increase of soil salinity is considered the major stress. This is particularly emerging in developing countries that present the highest population growth rates, and often the high rates of soil degradation. Therefore, salt-tolerant plants provide a sensible alternative for many developing countries. These plants have the capacity to grow using land and water unsuitable for conventional crops producing food, fuel, fodder, fibber, resin, essential oils, and pharmaceutical products. In addition to their production capabilities they can be used simultaneously for landscape reintegration and soil rehabilitation. This review will cover important subjects concerning saline agriculture and the crop potential of halophytes to use salt-contaminated resources to manage food requirements.

  8. Population living in the Red Sea State of Sudan may need urgent intervention to correct the excess dietary iodine intake.

    Science.gov (United States)

    Izzeldin, H S; Crawford, M A; Jooste, P L

    2007-01-01

    Both inadequate and high intakes of iodine are associated with thyroid disease and associated abnormalities. Consumption of foods deficient in iodine induces hypothyroidism. Conversely, excessive intake of the nutrient precipitates hyperthyroidism. Iodine deficiency causes impairment of thyroid hormonogenesis resulting in goiter (struma), cretinism which is associated with increased prenatal and infant mortality, deafness, motor disabilities and mental retardation due to damage during fetal and neonatal brain development. We have assessed the iodine status of school children from the locality of Port Sudan, Red Sea State of Eastern Sudan. The primary sources of iodine of the children are mainly iodized salt and rations supplied by local donors and various aid agencies operating in the Sudan. Male and female children (n=141), aged 6 to 12 years (median age 9.8 years), were selected for the survey using a multistage random sampling technique, between May 22 and August 25, 2006. All the children were assessed for urinary iodine and visible goiter. In addition, the iodine content of twenty salt samples was determined using the lodometric titration method and spot test kits. The components of other foods that are routinely consumed by the children and households were noted using a questionnaire form. Urinary iodine concentration exceeded 300 microg/l and 1000 microg/l in 65% and 9.9% of the children, respectively. The highest urinary iodine level was 1470 microg/l. The prevalence of visible goiter was 17%. All the salt samples collected from the schools had more than 150mg potassium iodate per kg of salt. The results of this pilot survey reveal that excessive intake of iodine in children exists in Port Sudan. Inappropriate and unregulated local fortification of salt and lack of monitoring of the imported and donated salt is the primary reason for the excessive intake. There is an urgent need for a regulatory mechanism during the process of iodine fortification and at

  9. Regulatory pathways for vaccines for developing countries.

    Science.gov (United States)

    Milstien, Julie; Belgharbi, Lahouari

    2004-01-01

    Vaccines that are designed for use only in developing countries face regulatory hurdles that may restrict their use. There are two primary reasons for this: most regulatory authorities are set up to address regulation of products for use only within their jurisdictions and regulatory authorities in developing countries traditionally have been considered weak. Some options for regulatory pathways for such products have been identified: licensing in the country of manufacture, file review by the European Medicines Evaluation Agency on behalf of WHO, export to a country with a competent national regulatory authority (NRA) that could handle all regulatory functions for the developing country market, shared manufacturing and licensing in a developing country with competent manufacturing and regulatory capacity, and use of a contracted independent entity for global regulatory approval. These options have been evaluated on the basis of five criteria: assurance of all regulatory functions for the life of the product, appropriateness of epidemiological assessment, applicability to products no longer used in the domestic market of the manufacturing country, reduction of regulatory risk for the manufacturer, and existing rules and regulations for implementation. No one option satisfies all criteria. For all options, national infrastructures (including the underlying regulatory legislative framework, particularly to formulate and implement local evidence-based vaccine policy) must be developed. WHO has led work to develop this capacity with some success. The paper outlines additional areas of action required by the international community to assure development and use of vaccines needed for the developing world. PMID:15042235

  10. The Etiology and Clinical Features of Anaphylaxis in a developing country: A nationwide survey in Turkey.

    Science.gov (United States)

    Civelek, Ersoy; Erkoçoğlu, Mustafa; Akan, Ayşegül; Özcan, Celal; Kaya, Ayşenur; Vezir, Emine; Giniş, Tayfur; Azkur, Dilek; Toyran, Müge; Tokaç, Mahmut; Kocabaş, Can Naci

    2017-12-01

    Despite the increasing frequency of anaphylaxis, there is inadequate information on the etiology and clinical features in various countries, regions and age groups, especially in developing countries. Our aim is to assess the etiology and clinical findings of anaphylaxis in Turkey. Gathering reliable data about the etiology and clinical findings of anaphylaxis in the general population will decrease the related morbidity and mortality. We obtained the names and phone numbers of individuals who had been prescribed an epinephrine auto-injector with a diagnosis of anaphylaxis from ministry of health. Demographic data, clinical history of the first episode of anaphylaxis including the triggering agent, clinical findings, course of hospitalization, and the management of anaphylaxis were obtained by phone survey. A total of 843 patients with a mean age of 21.4±17.3 years were evaluated. There was a significant male predominance among children younger than 10 years of age but a female predominance in older subjects. The most common causes of anaphylaxis were foods(40.1%) in children and bee venom(60.8%) in adults. The biphasic reaction rate was 4.3% and the median length of stay at an emergency department was 4.0 hours. Almost 60% of the patients had recurrent anaphylaxis episodes. Only 10.7% of the cases were prescribed an epinephrine auto-injector at their first anaphylaxis episode and only 59.2% of the patients were referred to an allergist during discharge from the emergency department. In Turkey, bee venom was the most common cause of anaphylaxis, followed by food and drug. While more than a half of patients reported recurrent attacks; only 10% had been prescribed epinephrine auto-injector kit after their first episode. Strategies to improve the anaphyalxis management are therefore urgently required.

  11. Macroeconomics in develpoing countries

    Directory of Open Access Journals (Sweden)

    Deepak Nayyar

    2007-09-01

    Full Text Available This essay analyzes the differences between the economies of industrialized countriesand developing countries, which have important implications for macroeconomics interms of theory and policy. It considers the differences in macroeconomic objectives andexamines why the reach of macroeconomic policies is different in the two sets ofcountries. It argues that the distinction between short-run macroeconomic models andlong-term growth models is not quite appropriate for developing countries, wheremacroeconomic constraints on growth straddle time horizons and short-term policieshave long-term consequences. The essential hypothesis is that the nature of relationshipsand the direction of causation in macroeconomics, which shape analysis, diagnosis andprescription, depend on the institutional setting and not the analytical structure of models.And even if some laws of economics are universal, the functioning of economies can bemarkedly different. Therefore, economic theory and policy analysis should recognize,rather than ignore, such myriad differences.

  12. Botswana country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    This study was carried out in Botswana, Tanzania and Zambia as part of the project `Climate Change Mitigation in Southern Africa` funded by the Danish International Development Agency (Danida). The project was conducted parallel to the UNEP/GEF project `Economics of Greenhouse Gas Limitations` which involved 8 other developing countries and 2 regional projects in Latin America and the SADC region. The limitation of greenhouse gas (GHG) emissions is a complex issue, intimately connected with economic development at local, national, regional and global levels. Key economic sectors such as energy, agriculture, industry and forestry all produce GHGs, and are likely to be affected directly and indirectly by any mitigation policy. The UNEP Greenhouse Gas Abatement Costing Studies, initiated in 1991, attempted to address these complex issues, developing a methodological framework and testing it through practical application in ten countries. (EHS) 28 refs.

  13. Tanzania country study

    Energy Technology Data Exchange (ETDEWEB)

    Meena, H E [Centre for Energy, Environment, Science and Technology, Dar es Salaam (Tanzania, United Republic of)

    1998-10-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  14. MICROFINANCE AND POOREST COUNTRIES

    OpenAIRE

    阿部, 清司

    2004-01-01

    The world is divided into developing and developed countries. There are two kinds of banks: conventional ones and unconventional. Commercial banks are usually based on mutual distrust, while new unconventional banks, microfinances, are based on mutual trust. The origin of micro finance is deeply rooted in Asia. In 1976, Grameen Bank in Bangladesh was founded by Dr. Muhammad Yunus. It reverses conventional banking practice by removing the need for collateral. It creates a banking system based ...

  15. Germany - an immigration country

    OpenAIRE

    Siebert, Horst

    2003-01-01

    Germany has about the same proportion of foreigners in its population as the United States, it is an immigration country. In a way, Germany has let immigration happen, but it did not really have an explicit immigration policy in the past. Now it has to make up its mind on its immigration policy in the future. The paper looks at the experience with immigration in the past, at the integration of foreigners and at the issues of immigration policy.

  16. Zambia country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    The Zambia Country Study, which was part of the Danida-funded project Climate Change Mitigation in Southern Africa: Phase 2, aimed at methodological development, national mitigation analysis and institutional capacity building in Zambia. The study comprised the following five elements: Comprehensive evaluation of national social and economic development framework for climate change; Baseline scenario(s) projection(s); Mitigation scenario(s) projection(s); Macro-economic assessment; Implementation Issues. (au) 17 refs.

  17. Tanzania country study

    International Nuclear Information System (INIS)

    Meena, H.E.

    1998-01-01

    An objective of this study is to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass. This is a follow up study on an earlier effort which worked on mitigation options in the country without an in-depth analysis of the forestry and land use sectors. (au)

  18. Youth Entrepreneurship in Visegrad Countries

    Directory of Open Access Journals (Sweden)

    Marian Holienka

    2016-12-01

    Full Text Available Objective: The aim of our paper is to analyse the entrepreneurial activity drivers of youth and young adults in Visegrad countries, considering the opportunity/necessity motivation dichotomy. Research Design & Methods: We employ the Global Entrepreneurship Monitor data for young individuals (18 to 34 years from V4 countries for years 2011 to 2013. We use the binomial logistic regression modelling with logit transformation. Separate models are constructed for youth and young adults, as well as for opportunity- and necessity-driven entrepreneurial activity. Findings: We found common drivers and distinctive attributes affecting involvement of young people in business start-up according to its motivation. Self-confidence and access to networks are universally important factors. In most examined cases, fear of failure and being a female reduces chance of business start-up. Especially among youth, being a student significantly inhibits involvement in enterprising efforts. Implications & Recommendations: In order to support youth entrepreneurship, an emphasis should be put on education and training to build skills and knowledge required to business start-up, together with capacity to spot opportunities, and reduce fear of failure.  Also, formal and informal networking plays an important role. Contribution & Value Added: Based on empirical analysis, our findings point out the key drivers of entrepreneurial activity among young people in V4 countries. We show directions for policy makers aiming to foster entrepreneurship within young generation as both way to exploit available business opportunities, as well as reaction to necessity situations.

  19. Nuclear cardiology for developing countries

    International Nuclear Information System (INIS)

    Feinendegen, L.E.

    1986-01-01

    The role of nuclear medicine in developing countries must be oriented to the local needs for clinical practice, the health care of large populations and the demands for research with sometimes extremely limited resources. To help define the locally differing needs, it is stressed that nuclear medicine provides the unique opportunity to observe the body at the molecular level of organization and thus makes the body biochemically transparent. Depending on the particular diagnostic demands, complex imaging with gamma scintigraphy or emission tomography may be the only method to choose in some instances, but for others it may be an unnecessary luxury. Nuclear cardiology, with the purpose of non-invasively assessing cardiac function, myocardial perfusion and myocardial metabolism, is a particular challenge in both respects for developing countries. Given such requirements, single-probe devices with multipurpose application are less expensive than gamma cameras and promise advanced diagnostic uses. In one examination, left ventricular function, global cardio-pulmonary circulation and the general circulatory adaptation to exercise can be investigated by non-gated simultaneous blood pool measurements over four lung regions, the heart and the liver. In addition, such devices have the advantages of compactness, robustness and electronic stability. Despite enormous difficulties regarding funding, infrastructure, equipment and maintenance, developing countries should be encouraged to participate in the evolution of nuclear medicine by responding and adapting to defined needs and perhaps by maintaining at least one national centre of excellence with capacities for research and training. Funds are best secured by providing an indispensable service in co-operation with the various clinical disciplines. (author)

  20. Derivation and validation of a diagnostic score based on case-mix groups to predict 30-day death or urgent readmission.

    Science.gov (United States)

    van Walraven, Carl; Wong, Jenna; Forster, Alan J

    2012-01-01

    Between 5% and 10% of patients die or are urgently readmitted within 30 days of discharge from hospital. Readmission risk indexes have either excluded acute diagnoses or modelled them as multiple distinct variables. In this study, we derived and validated a score summarizing the influence of acute hospital diagnoses and procedures on death or urgent readmission within 30 days. From population-based hospital abstracts in Ontario, we randomly sampled 200 000 discharges between April 2003 and March 2009 and determined who had been readmitted urgently or died within 30 days of discharge. We used generalized estimating equation modelling, with a sample of 100 000 patients, to measure the adjusted association of various case-mix groups (CMGs-homogenous groups of acute care inpatients with similar clinical and resource-utilization characteristics) with 30-day death or urgent readmission. This final model was transformed into a scoring system that was validated in the remaining 100 000 patients. Patients in the derivation set belonged to 1 of 506 CMGs and had a 6.8% risk of 30-day death or urgent readmission. Forty-seven CMG codes (more than half of which were directly related to chronic diseases) were independently associated with this outcome, which led to a CMG score that ranged from -6 to 7 points. The CMG score was significantly associated with 30-day death or urgent readmission (unadjusted odds ratio for a 1-point increase in CMG score 1.52, 95% confidence interval [CI] 1.49-1.56). Alone, the CMG score was only moderately discriminative (C statistic 0.650, 95% CI 0.644-0.656). However, when the CMG score was added to a validated risk index for death or readmission, the C statistic increased to 0.759 (95% CI 0.753-0.765). The CMG score was well calibrated for 30-day death or readmission. In this study, we developed a scoring system for acute hospital diagnoses and procedures that could be used as part of a risk-adjustment methodology for analyses of postdischarge

  1. Housing policies in developing countries: Microfinance

    NARCIS (Netherlands)

    Smets, P.G.S.M.; Smith, S.J.; Elsinga, M.; O’Mahony, L.H.; Ong, S.E.; Wachter, S.; Wood, G.

    2012-01-01

    Shelter is a basic human need for which financial means are required. Poorer sections of society face difficulties in accessing and coping with conventional mortgage finance and are better assisted with housing microfinance. This enables the poor, especially in 'developing' countries to build their

  2. Infection control in developing countries.

    Science.gov (United States)

    Meers, P D

    1988-02-01

    The level of socio-political and economic development achieved by a country determines the quality and quantity of the health care its citizens receive. These factors also govern the amount of attention given to hospital-acquired infection. The problems of infection control in 'developing' countries include, first, the international problems that arise from clashes of personality and viewpoint among those responsible for it, exacerbated in some places by ethnic or religious traditions. Second are problems imposed by factors that affect the spectrum of infectious disease, and third is a variable deficiency of human and financial resources. In the search for solutions, an analysis suggests that nurses are particularly suited to take the lead in the prevention of infection, so that a special initiative directed towards their education in the rapidly developing science of hospital infection and its control is likely to be the most cost effective and appropriate initial approach. This needs to be accompanied by parallel improvements in the education of medical undergraduates. Anything else should be applied in response to measured need, and then only as money and manpower permit. Careful thought is required to avoid squandering scarce resources by applying inappropriate infection control technology.

  3. Evaluating the efficiency of nuclear energy policies: an empirical examination for 26 countries.

    Science.gov (United States)

    Gozgor, Giray; Demir, Ender

    2017-08-01

    The decarbonization of the global economy is an urgent concern. As a potential solution, it can be important to understand the efficiency of nuclear energy policies. For this purpose, the paper analyzes whether there is a unit root in nuclear energy consumption in 26 countries and it uses the unit root tests with two endogenous (unknown) structural breaks. The paper finds that nuclear energy consumption is stationary around a level and the time trend in 25 of 26 countries and nuclear energy consumption contains a unit root only in France. The paper also discusses the potential implications of the findings.

  4. Evaluating the relative environmental impact of countries.

    Science.gov (United States)

    Bradshaw, Corey J A; Giam, Xingli; Sodhi, Navjot S

    2010-05-03

    -developed countries, especially those in Asia, there is also a requirement to focus on the development of environmentally friendly practices in wealthier countries.

  5. Evaluating the Relative Environmental Impact of Countries

    Science.gov (United States)

    Bradshaw, Corey J. A.; Giam, Xingli; Sodhi, Navjot S.

    2010-01-01

    -developed countries, especially those in Asia, there is also a requirement to focus on the development of environmentally friendly practices in wealthier countries. PMID:20454670

  6. Evaluating the relative environmental impact of countries.

    Directory of Open Access Journals (Sweden)

    Corey J A Bradshaw

    less-developed countries, especially those in Asia, there is also a requirement to focus on the development of environmentally friendly practices in wealthier countries.

  7. Human rights conflicts experienced by nurses migrating between developed countries.

    Science.gov (United States)

    Palese, Alvisa; Dobrowolska, Beata; Squin, Anna; Lupieri, Giulia; Bulfone, Giampiera; Vecchiato, Sara

    2017-11-01

    Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

  8. A call for an urgent ban on E-cigarettes in India--a race against time.

    Science.gov (United States)

    Kaur, Jagdish; Rinkoo, Arvind Vashishta

    2015-06-01

    Being the second largest consumer of tobacco in the world and with more than 65% of its population below the age of 35, India would face electronic cigarettes (ECs) as an enormous public health challenge in future. In the absence of established facilities for tobacco cessation in the country, ECs may provide an additional opportunity for the industry to project itself as a harm-reduction crusader. Regulating ECs as tobacco products or as drugs is not a prudent option in the Indian context. Banning ECs seems to be the most plausible approach at present. However, in the long run, India should be open to new research. More significantly, policy makers in India should be wary of the lead time before a ban is implemented-a shorter intervening period could ensure that a well-established, better politically connected and more defiant EC industry, aggressively promoting ECs to Indian youth, never becomes a reality. © The Author(s) 2014.

  9. Comparative Characteristics of Technology Transfer in Developed Countries

    Directory of Open Access Journals (Sweden)

    Natalia Palii

    2013-08-01

    Full Text Available The research into innovation transfer in the global economy is a very urgent issue under the modern conditions of development of any country. Comparative characteristics of technology transfer in such countries and regions as the USA, EU, Asia, presented in the article, permit us to detect certain patterns of this process inherent both in developed and developing countries. The analysis made in the article can be useful for developing technology transfer processes in the Danube countries’ economy. The analytical method used in this research allowed us to determine the factor that is crucial for the growth of the world market of high-technology products and services. The analysis was conducted on several criteria such as the level of expenditure on R&D in the whole global economy, as well as in individual countries and regions. Besides, there were taken into account the added value of high-tech industries and the share of expenditure on R&D in total production costs. The conclusions regarding the effectiveness of funds allocated for scientific research and experimental development in the U.S. can be drawn on the basis of data presented in the paper on the amount of added value of the U.S. high-tech industries.

  10. New world balance and emerging countries - democracy, energy, technology

    International Nuclear Information System (INIS)

    Coulom, Steve

    2011-01-01

    The serious economic crisis which rages since 2008 has been the result of a troubled era which started years before and contributed to aggravate the phenomenon. Energy crisis, biodiversity loss, global warming and its effects, markets deregulation have added up to economic recession. We are today the witnesses of a new deal of the cards illustrated by the social revolts of several Arab countries around the Mediterranean Sea. In this changing world, the declining occident cannot impose its economical or political leadership and the main emerging countries (Brazil, Russia, India, China and South Africa: BRICS) play a more and more important role. With 30% of population increase expected in 2050, the emerging countries represent the driver of the world growth and have become the keys of development questions. In front of this irreversible movement, urgent and worldwide changes have to be done. First of all, huge technological efforts and changes of the existing international institutions (IMF, UNO, WTO) and of their governance are necessary to build up a sustainable economy and energy policy with emerging countries. Such a transformation will be painful for the Occident as it will change its vision of growth based on political domination and search of financial wealth, energy and resources. It is this effort that the author aims to present in this book in a practical and visionary way, where technological progress occupies an important place

  11. Economic Indicators Selected Countries.

    Science.gov (United States)

    1987-12-01

    DEFENCE I ECONOMIC INDICATORS SELECTED COUNTRIES DECEMBER QUARTER 1987 . ’-H ISSUED BY MANPOWER POLICY & STRATEGIES BRANCH " "’ :.S S ’,1l f ,am -m mW...100 Sour:e: Main Economic Indicators (OECD) Manufactured Basic Metal Year Goods Chemicals Metals Products 1980 100 100 100 100 1981 110 117 102 107...Earnings of all 1982 1986 7.4 Male Employees (a) Aug 1986 Aug 1987 4.8 Hourly Wace Rates 3 1979 1987 lt.2 Garden Island 1983 1987 6.7 Dockyards Dec

  12. Denmark country report 2016

    DEFF Research Database (Denmark)

    Bloksgaard, Lotte; Rostgaard, Tine

    2016-01-01

    The LP&R network produces an annual review of leave policies and related research, starting in 2004. The review covers Maternity, Paternity and Parental leaves; leave to care for sick children and other employment-related measures to support working parents; and early childhood education and care....... In addition to the new country, these are: Australia, Austria, Brazil, Belgium, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Lithuania, Luxembourg, Malta, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal...

  13. Denmark country note

    DEFF Research Database (Denmark)

    Bloksgaard, Lotte; Rostgaard, Tine

    2014-01-01

    The LP&R network produces an annual review of leave policies and related research, starting in 2004 (for earlier reviews, go to Archive 2005-2013). The review covers Maternity, Paternity and Parental leaves; leave to care for sick children and other employment-related measures to support working......, Israel. Altogether, it covers 35 countries. In addition to Israel, these are: Austria, Australia, Belgium, Brazil, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Lithuania, Luxembourg, Netherlands, New Zealand, Norway, Poland...

  14. Education in European countries

    Directory of Open Access Journals (Sweden)

    Petcu, N.

    2010-12-01

    Full Text Available Education, vocational training and lifelong learning play a vital role in both an economic and social context. The paper herein aims to identify Romania’s place within the UE-countries, considering a series of general indices: total public expenditure on education as a percentage of GDP, private expenditure on education as % of GDP, annual expenditure on public and private educational institutions per pupil/student - by level of education, school expectancy, pupils and students, students - tertiary education, mobility of students in Europe, science and technology graduates, doctorate students in science and technology fields. Analysis methods: main components analysis, cluster analysis.

  15. Using systems thinking to identify workforce enablers for a whole systems approach to urgent and emergency care delivery: a multiple case study.

    Science.gov (United States)

    Manley, Kim; Martin, Anne; Jackson, Carolyn; Wright, Toni

    2016-08-09

    Overcrowding in emergency departments is a global issue, which places pressure on the shrinking workforce and threatens the future of high quality, safe and effective care. Healthcare reforms aimed at tackling this crisis have focused primarily on structural changes, which alone do not deliver anticipated improvements in quality and performance. The purpose of this study was to identify workforce enablers for achieving whole systems urgent and emergency care delivery. A multiple case study design framed around systems thinking was conducted in South East England across one Trust consisting of five hospitals, one community healthcare trust and one ambulance trust. Data sources included 14 clinical settings where upstream or downstream pinch points are likely to occur including discharge planning and rapid response teams; ten regional stakeholder events (n = 102); a qualitative survey (n = 48); and a review of literature and analysis of policy documents including care pathways and protocols. The key workforce enablers for whole systems urgent and emergency care delivery identified were: clinical systems leadership, a single integrated career and competence framework and skilled facilitation of work based learning. In this study, participants agreed that whole systems urgent and emergency care allows for the design and implementation of care delivery models that meet complexity of population healthcare needs, reduce duplication and waste and improve healthcare outcomes and patients' experiences. For this to be achieved emphasis needs to be placed on holistic changes in structures, processes and patterns of the urgent and emergency care system. Often overlooked, patterns that drive the thinking and behavior in the workplace directly impact on staff recruitment and retention and the overall effectiveness of the organization. These also need to be attended to for transformational change to be achieved and sustained. Research to refine and validate a single

  16. Argentina [Country report

    International Nuclear Information System (INIS)

    Ferreyra, R.

    2005-01-01

    The airborne geophysical surveys developed in Argentina are described. They have got more than 500.000 km 2 acquiring data for U, Th, K and total background activity. Other types of published data are also mentioned (satellite imagery, seismic hazard, climate, soil distributions, etc.). The availability of maps with the abundances of elements analyzed at the country and also at laboratories from Canada is described, as well as data of analysis of several elements at two study areas proposed at the outset of the project. The availability of process rate data and epidemiological data is also explained. Argentina intended fully to participate in the CRP at the outset of the project. Due, however, to external resource constraints imposed on the participating organization (Comision Nacional de Energia Atomica, CNEA), the level of participation had to be significantly reduced. Nonetheless, in the first period of the CRP, Argentina undertook to collate existing geological and geochemical information within the country, and began to define potential areas for site specific natural systems safety indicator studies. (author)

  17. Country Presentation Congo

    International Nuclear Information System (INIS)

    Mwata, P.K.; SAKI, A.; KAZADI, J.

    2010-01-01

    Illicit trafficking of radioactive minerals, precious metals and nuclear materials is generally expanded practice in some parts of the Democratic Republic of Congo. The phenomenon took place early in 1990 and amplified from 1998. The main causes of this practice are political instability that led to general poverty among population and the lack of legal framework governing the exploitation of minerals. Nuclear Illicit trafficking in Congo concerns radioactive mineral sand precious metals in eastern and southern parts of the country. The unfavorable political environment that took place in Congo in the 1990s resulted in local manpower and mine workers immigrating to neighboring countries. A great fraction of these new jobless started exploiting abandoned mines residues searching for Cu, Co and Au for survival. First cases of illicit exploitation of uranium minerals were reported very soon after rock sliding that occurred in 2004 on Shinkolobwe site in Katanga region. This uncontrolled mineral exploitation got worse when several mining companies were licensed by GECAMINES company to explore, exploit, purchase minerals from individuals and export raw materials and concentrates.

  18. Influence of country brand slogan and logo in country positioning

    Directory of Open Access Journals (Sweden)

    Gina Pipoli de Azambuja

    2015-09-01

    Full Text Available To build the image of a country minds consumers’ minds, countries apply marketing strategies that are based on their country brand development, in the same way that companies apply marketing to their products and services. The development of the logo and slogan to be used in the communication strategy, are two key elements of its success in the process of building the country brand (Keller 2008. Thus the objective of this research is to know the importance of using the logo and slogan in international marketing strategies of countries. To do this, this research analyzes the use of the logo and slogan, in country brand strategies of countries in the top places in the Country Brand Index (2009 of Future Brand.

  19. Requirements of quality standards

    International Nuclear Information System (INIS)

    Mueller, J.

    1977-01-01

    The lecture traces the development of nuclear standards, codes, and Federal regulations on quality assurance (QA) for nuclear power plants and associated facilities. The technical evolution of the last twelve years, especially in the area of nuclear technology, led to different activities and regulatory initiatives, and the present result is: several nations have their own homemade standards. The lecture discusses the former and especially current activities in standard development, and gives a description of the requirements of QA-standards used in USA and Europe, especially Western Germany. Furthermore the lecture attempts to give a comparison and an evaluation of the international quality standards from the author's viewpoint. Finally the lecture presents an outlook for the future international implications of QA-standards. There is an urgent need within the nuclear industry for simplification and standardization of QA-standards. The relationship between the various standards, and the applicability of the standards need clarification and a better transparancy. To point out these problems is the purpose of the lecture. (orig.) [de

  20. Vocational education in the Nordic countries

    DEFF Research Database (Denmark)

    a common heritage in education policy. This volume will help strengthen the knowledge base required for transnational policy learning, and for developing vocational education internationally for the future. As a result, the book will be of interest to researchers, academics and postgraduate students......Vocational Education in the Nordic Countries: Learning from Diversity is the second of two books that disseminates new and systematic knowledge on the strengths and weaknesses of the different models of vocational education and training (VET) in four Nordic countries. Vocational education in Europe...... involved in the study of vocational education, educational studies and educational policy, as well as policy makers....

  1. Nuclear power programmes in developing countries

    International Nuclear Information System (INIS)

    Anon.

    1988-01-01

    The paper on ''Nuclear power programmes in developing countries'' is a report to the IAEA by a Senior Expert Group. A description is given of the requirements for a successful nuclear power programme, including the constraints that developing countries might face in the introduction and execution of the programme. The group attempted to identify the main issues affecting the financing of nuclear power projects and suggested specific actions that could be undertaken in order to reduce economic and financial risks. The various issues were discussed under the topic headings:-programme-project-related factors, investment climate, financing plan, export credits and creditworthiness. (U.K.)

  2. Precipitation Indices Low Countries

    Science.gov (United States)

    van Engelen, A. F. V.; Ynsen, F.; Buisman, J.; van der Schrier, G.

    2009-09-01

    Since 1995, KNMI published a series of books(1), presenting an annual reconstruction of weather and climate in the Low Countries, covering the period AD 763-present, or roughly, the last millennium. The reconstructions are based on the interpretation of documentary sources predominantly and comparison with other proxies and instrumental observations. The series also comprises a number of classifications. Amongst them annual classifications for winter and summer temperature and for winter and summer dryness-wetness. The classification of temperature have been reworked into peer reviewed (2) series (AD 1000-present) of seasonal temperatures and temperature indices, the so called LCT (Low Countries Temperature) series, now incorporated in the Millennium databases. Recently we started a study to convert the dryness-wetness classifications into a series of precipitation; the so called LCP (Low Countries Precipitation) series. A brief outline is given here of the applied methodology and preliminary results. The WMO definition for meteorological drought has been followed being that a period is called wet respectively dry when the amount of precipitation is considerable more respectively less than usual (normal). To gain a more quantitative insight for four locations, geographically spread over the Low Countries area (De Bilt, Vlissingen, Maastricht and Uccle), we analysed the statistics of daily precipitation series, covering the period 1900-present. This brought us to the following definition, valid for the Low Countries: A period is considered as (very) dry respectively (very) wet if over a continuous period of at least 60 days (~two months) cq 90 days (~three months) on at least two out of the four locations 50% less resp. 50% more than the normal amount for the location (based on the 1961-1990 normal period) has been measured. This results into the following classification into five drought classes hat could be applied to non instrumental observations: Very wet period

  3. [The current situation of acupuncture definition in international organizations and legislation of some countries].

    Science.gov (United States)

    Sun, Yujie; Liu, Baoyan; He, Liyun; Wu, Xiaodong; Liu, Jia

    2017-12-12

    Acupuncture is developing rapidly in the world, and more attention is paid on acupuncture in various countries. Because of the cultural differences, there are different views on acupuncture between China and the west, which has brought influence and challenge to the development of acupuncture in the world. Acupuncture-related research is becoming increasingly extensive and complex, but the definition of acupuncture is lack of unified standards. The definition of acupuncture is in urgent need. Based on the analysis of acupuncture definition in the 201 international organizations of 48 countries on five continents and legislation of representative countries, this paper summarized the development status of acupuncture in foreign countries, and put forward that the definition of acupuncture should adopt the model of small connotation and large extension, integrate discipline superiority, expand the scope of acupuncture, and focus on the overall situation.

  4. Strategy to combat obesity and to promote physical activity in Arab countries.

    Science.gov (United States)

    Musaiger, Abdulrahman O; Al Hazzaa, Hazzaa M; Al-Qahtani, Aayed; Elati, Jalila; Ramadan, Jasem; Aboulella, Nebal A; Mokhtar, Najat; Kilani, Hashem A

    2011-01-01

    Obesity has become a major public health problem in the Arab countries, creating a health and economic burden on these countries' government services. There is an urgent need to develop a strategy for prevention and control of obesity. The third Arab Conference on Obesity and Physical Activity was held in Bahrain in January 2010, and proposed the Strategy to Combat Obesity and Promote Physical Activity in Arab Countries. This strategy provides useful guidelines for each Arab country to prepare its own strategy or plan of action to prevent and control obesity. The strategy focused on expected outcomes, objectives, indicators to measure the objectives, and action needs for 9 target areas: child-care centers for preschool children, schools, primary health care, secondary care, food companies, food preparation institutes, media, public benefit organizations, and the workplace. Follow-up and future developments of this strategy were also included.

  5. Diabetes and complications of the heart in Sub-Saharan Africa: An urgent need for improved awareness, diagnostics and management.

    Science.gov (United States)

    Glezeva, Nadezhda; Chisale, Master; McDonald, Kenneth; Ledwidge, Mark; Gallagher, Joe; Watson, Chris J

    2018-03-01

    Type 2 diabetes mellitus is no longer a disease of high income countries but a global health pandemic. With the continued and rapid increase in its prevalence worldwide it is forecasted that diabetes will be a leading cause of morbidity and mortality. A major concern stems from its role in development and progression of cardiovascular disease, including cardiac dysfunction and heart failure. Within low- and middle-income areas such as Sub-Saharan Africa the burden of diabetes is already significant driven by many factors, including, socioeconomic (urbanisation), nutritional (high-calorie "western-diet", obesity) and lifestyle (physical inactivity) changes. Insufficient economic and community resources, poor health care system development and chronic disease management, poor education, and a lack of preventative and diagnostic measures further aggravate the severity of the diabetes problem. This review outlines the burden of type 2 diabetes mellitus in Sub-Saharan Africa and highlights the need for improved community health care and regulations to reduce its epidemiological spread and devastating impact on health. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Country profile: Hungary

    Energy Technology Data Exchange (ETDEWEB)

    1991-09-01

    Country Profile: Hungary has been prepared as a background document for use by US Government agencies and US businesses interested in becoming involved with the new democracies of Eastern Europe as they pursue sustainable economic development. The focus of the Profile is on energy and highlights information on Hungary`s energy supply, demand, and utilization. It identifies patterns of energy usage in the important economic sectors, especially industry, and provides a preliminary assessment for opportunities to improve efficiencies in energy production, distribution and use by introducing more efficient technologies. The use of more efficient technologies would have the added benefit of reducing the environmental impact which, although is not the focus of the report, is an issue that effects energy choices. The Profile also presents considerable economic information, primarily in the context of how economic restructuring may affect energy supply, demand, and the introduction of more efficient technologies.

  7. Country profile: Hungary

    Energy Technology Data Exchange (ETDEWEB)

    1991-09-01

    Country Profile: Hungary has been prepared as a background document for use by US Government agencies and US businesses interested in becoming involved with the new democracies of Eastern Europe as they pursue sustainable economic development. The focus of the Profile is on energy and highlights information on Hungary's energy supply, demand, and utilization. It identifies patterns of energy usage in the important economic sectors, especially industry, and provides a preliminary assessment for opportunities to improve efficiencies in energy production, distribution and use by introducing more efficient technologies. The use of more efficient technologies would have the added benefit of reducing the environmental impact which, although is not the focus of the report, is an issue that effects energy choices. The Profile also presents considerable economic information, primarily in the context of how economic restructuring may affect energy supply, demand, and the introduction of more efficient technologies.

  8. Indonesian country report

    International Nuclear Information System (INIS)

    Munawir Zulqarnain, M.

    2005-01-01

    BATAN started to study EB (electron beam) flue gas treatment in 2001 after a joint memorandum of understanding on application of EB flue gas treatment in Power Plant between BATAN (National Nuclear Energy Agency), BPPT (Technology Implementation and Assessment Agency) and Indonesia Power Company was signed. Among several power plants (coal or oil) in Indonesia only one is installed with flue gas treatment equipment. This is to reduce CO 2 emission from the newest of coal power plant in Indonesia with 1200 MWe. The BATAN starts by seeking and learning data and engineering concept and processes from other countries to install an EB flue gas treatment equipment. The role of demonstration plant installation is very important to the future EB flue gas treatment in Indonesia. (S. Ohno)

  9. Country programme review Bangladesh

    International Nuclear Information System (INIS)

    Kamel, R.; Maluszynski, Y.; Maudarbocus, Y.; Cherif, H.S.; Morre, P.

    1993-12-01

    A five-expert mission was organized from 21-26 August 1993 and this document reflects the findings and recommendations of the team. Intensive contacts with heads of institutions, scientists and decision making persons in various sectors in the country were co-ordinated by the Bangladesh Atomic Energy Commission. The terms of reference of the mission were: To assess the on-going TC projects; to assist the Bangladesh nationals to finalize the formulation of the new requests for 1995-96 TC programme and to establish priority areas with regard to the introduction of national projects involving accelerated technological transfer in order to catalyze national development plans in specific areas; to examine institutional framework suitable for the introduction of these priority nuclear techniques

  10. Country Presentation Angola

    International Nuclear Information System (INIS)

    Cardoso, L.; Ferreira, Edson; Goma, A.

    2010-01-01

    The Republic of Angola joined the IAEA in September 1999. Since then, the country started by designing, promoting and developing its programme on nuclear and technology through the Unit for Nuclear Science and Technology created by the Ministry of Science and Technology.The Angolan Atomic Law was approved on June 28 and published on September 05, 2007.Radioactive Waste Every person who is licensed to generate, keep or manage radioactive waste shall be responsible for the safe management of radioactive waste generated by the practice or source for which he/she is authorized. No person shall transport any radioactive material, radioactive substance or radiation generator on any vessel or boat within the territorial waters or the exclusive economic zone of Angola; on any aircraft within the airspace of Angola; or any means of land transport without authorization from the Regulatory Authority of Atomic Energy

  11. Peer Country Comments Paper - Denmark

    DEFF Research Database (Denmark)

    Bredgaard, Thomas

    Bidrag til EU-kommissionens peer-review on "Strategies for Employment policy Reform. Implementation Challenges in Decentralised Countries"......Bidrag til EU-kommissionens peer-review on "Strategies for Employment policy Reform. Implementation Challenges in Decentralised Countries"...

  12. The AEC and developing countries

    International Nuclear Information System (INIS)

    Ouvrieu, J.B.

    1983-01-01

    A historical background shows how AEC's activities have changed and consequently, the development of the AEC's relations with developing countries. Some examples serve to illustrate the different types of AEC cooperation with developing countries [fr

  13. Wood biomass gasification: Technology assessment and prospects in developing countries

    International Nuclear Information System (INIS)

    Salvadego, C.

    1992-05-01

    This investigation of the technical-economic feasibility of the development and use of wood biomass gasification plants to help meet the energy requirements of developing countries covers the following aspects: resource availability and production; gasification technologies and biomass gasification plant typology; plant operating, maintenance and safety requirements; the use of the biomass derived gas in internal combustion engines and boilers; and the nature of energy requirements in developing countries. The paper concludes with a progress report on biomass gasification research programs being carried out in developing countries world-wide

  14. Which Countries Become Tax Havens?

    OpenAIRE

    Dhammika Dharmapala; James R. Hines Jr.

    2006-01-01

    This paper analyzes the factors influencing whether countries become tax havens. Roughly 15 percent of countries are tax havens; as has been widely observed, these countries tend to be small and affluent. This paper documents another robust empirical regularity: better-governed countries are much more likely than others to become tax havens. Using a variety of empirical approaches, and controlling for other relevant factors, governance quality has a statistically significant and quantitativel...

  15. Export Variety and Country Productivity

    OpenAIRE

    Feenstra, Robert; Looi Kee, Hiau

    2004-01-01

    The authors study the link between export product variety and country productivity based on data from 34 industrial and developing countries, from 1982 to 1997. They measure export product variety by the share of U.S. imports on the set of goods exported by each sampled country relative to the world. It is a theoretically sound index which is consistent with within-country GDP maximization...

  16. Literacy Campaigns in Developing Countries.

    Science.gov (United States)

    Odunuga, Segun

    1984-01-01

    Discusses the problem of eradicating illiteracy in developing countries, where the illiteracy rate may average about 70 percent. Looks at the Arab countries, Latin America, Africa, and India and the factors that thwart attempts to increase literacy in those countries. These include religious habits and the problem of language in multilingual…

  17. Nuclear power in the Nordic countries

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Of the Nordic countries-Sweden, Finland, Denmark, and Norway-the first two have chosen nuclear energy to supply a large portion of their electrical generation requirements. Finland has opted for two Western-style boiling water reactors and two modified Russian-designed pressurized water reactors. The country has led the nuclear nations of the world in the 1990s with its capacity factor. Domestic reports state that nuclear is the lowest-cost electrical generation source, and Finland will need additional capacity by 2000. The country's nuclear waste storage facilities are in operation, with more under construction. In this, the second part of a two-part feature (the first part viewed Sweden's nuclear program), the attention is focused on Finland: its government, where it has positioned itself in the world economy, and the internal conflicts of how, or if, to add the needed electrical capacity

  18. WHAT CAN TANZANIA'S HEALTH CARE SYSTEM LEARN FROM OECD COUNTRIES?

    OpenAIRE

    Kajuna, Dezidery Theobard

    2014-01-01

    Abstract Healthcare systems around the world have different shapes that are largely affected by socio-economic and political situations of a particular country. It is essential for the population to have better health services which requires the country to have better health policies, enough funding for health care sector, and a well structured delivery system. Tanzania like any other developing countries continue to face different challenges in healthcare sector greatly influenced by poor ec...

  19. Country Stakes in Climate Change Negotiations. Two Dimensions of Vulnerability

    International Nuclear Information System (INIS)

    Buys, P.; Deichmann, U.; Meisner, C.; That, Thao Ton; Wheeler, D.

    2007-01-01

    Using a comprehensive geo-referenced database of indicators relating to global change and energy, the paper assesses countries' likely attitudes with respect to international treaties that regulate carbon emissions. The authors distinguish between source and impact vulnerability and classify countries according to these dimensions. The findings show clear differences in the factors that determine likely negotiating positions. This analysis and the resulting detailed, country level information help to explain the incentives required to make the establishment of such agreements more likely.

  20. Hungary: A Country Study

    Science.gov (United States)

    1990-01-01

    as prime minister, April 1943-August 1944, followed by Giza Laka- tos, August-October 1944. Leader of fascist Arrow Cross Party, Ferenc SzSlasi...organizational pyramid were the basic organizations, which required a minimum of three members. Local organizations were to be set up in election districts

  1. Greening government procurement in developing countries: building capacity in China.

    Science.gov (United States)

    Geng, Yong; Doberstein, Brent

    2008-09-01

    With increasing environmental issues and depleting resources, the effective application of green government procurement (GGP) is urgently needed and potentially can have greater impacts in the developing world rather than in the developed world. Such an approach can help promote the general goal of sustainable development and address environmental issues through purchasing and facilitating the use of environmentally friendly services and products. This paper addresses this issue by employing a case study on China. We first trace the development of the GGP concept, its spread to Asian countries, and a number of approaches used to expand GGP adoption. We then review current practices in China on GGP, and analyze and identify some of the current barriers and problems in promoting green procurement in the Chinese governmental sector. We finally seek to identify possible appropriate capacity-building solutions, in order to facilitate the application of GGP in China.

  2. Software requirements

    CERN Document Server

    Wiegers, Karl E

    2003-01-01

    Without formal, verifiable software requirements-and an effective system for managing them-the programs that developers think they've agreed to build often will not be the same products their customers are expecting. In SOFTWARE REQUIREMENTS, Second Edition, requirements engineering authority Karl Wiegers amplifies the best practices presented in his original award-winning text?now a mainstay for anyone participating in the software development process. In this book, you'll discover effective techniques for managing the requirements engineering process all the way through the development cy

  3. The Adoption of Urgent Measures to Protect the Population in the Event of an Accidental Release of Radioactivity into the Environment; 041f 0420 0414

    Energy Technology Data Exchange (ETDEWEB)

    Dikobes, I. K.; Il' In, L. A.; Kozlov, V. M.; Moiseev, A. A. [Ministerstvo Zdravoohranenija SSSR, Moskva, SSSR (Russian Federation); Konstantinov, Ju. O.; Tarasov, S. I.; Shamov, V. P. [Nauchno-Issledovatel' skij Institut Radiacionnoj Gigieny Ministerstva Zdravoohranenija RSFSR, Leningrad, SSSR (Russian Federation)

    1969-10-15

    The authors consider a situation in which there is a risk of the population being seriously exposed to radiation through the accidental entry of radioactive material into the environment. The specific features of the situation under consideration are such that the appropriate protective measures can only be effective if implemented in time, i.e. within the first few hours or days of the emergency. Hence a programme providing for protection of the population against radiation in an emergency should include (a) methods by which the dosimetric information required for a rapid evaluation of the potential radiation hazard can be promptly obtained, and (b) criteria for the . adoption of urgent measures, i.e., the levels of radioactive contamination or irradiation justifying or not justifying the need for the implementation of specific protective measures. The authors make recommendations (draft regulations) on which to base such decisions. The criterion for the decisions is based on two hazard levels (A and B) for each of the irradiation paths, potentially significant in the given situation: external and contact irradiation, inhalation, and contamination of foodstuffs. Decisions to adopt immediate protective measures should be based on a comparison between the evaluated (predicted) hazard levels and the critical levels, defined as those hazard levels at which implementation of the protective measures under consideration is (A) desirable or (B) obligatory, irrespective of the specific circumstances. Figures for the critical levels are chosen with regard to the specific nature of the situation and protective measures, maximum permissible levels for occupational exposure, and known information on the biological risk of certain exposure levels. (author) [Russian] Rassmatrivaetsja takaja situacija, kogda v rezul'tate avarijnogo postuplenija radioaktivnyh veshhestv vo vneshnjuju sredu sozdaetsja opasnost' sushhestvennogo obluchenija naselenija. Specifika rassmatrivaemoj

  4. Uranium exploration in developing countries

    International Nuclear Information System (INIS)

    Premoli, C.

    1982-01-01

    The advantages to the developing countries of exploiting their uranium deposits in the next two decades to aid their own economic growth are considered. It is pointed out that in spite of the little known geology of these countries less sophisticated surveying methods have turned up large uranium deposits even in developed countries. Carborne surveys with simple crystal-detectors coupled to scintillators can be effective. Intelligent exploration in developing countries can be cheap due to low labour costs and less stringent environmental restraints and the uranium found could be sold to developed countries for their nuclear power programme. (U.K.)

  5. Urgent Need to Strengthen the Chain of Survival in the United Arab Emirates; a Letter to the Editor

    Directory of Open Access Journals (Sweden)

    Alan Michael Batt

    2017-01-01

    Full Text Available Further to our recently published findings, we have completed the analysis of our second year of prehospital data collection for the same service. We wish to expedite the availability of this data to clinicians, researchers and policy makers in the region.Our 2015/2016 out-of-hospital cardiac arrest (OHCA data displayed the following demographic results: 514 OHCA resuscitation attempts were attended by national ambulance (NA emergency medical services (EMS in the Northern Emirates region (75% male. Male patients continued on average to be younger than female ones (50 vs. 61 years, and the median age of OHCA cases in the United Arab Emirates remains well below that of cases in Western countries (52 years, interquartile range: 38; 69.Over half of these cases occurred at a home residence, with the next most common location being a street or highway. A total of 282 (54.5% incidents were witnessed by a bystander, 43 (8.3% events by NA crew, and 189 (36.7% incidents were not witnessed. Bystander cardiopulmonary resuscitation (CPR was attempted in 135 (28.6% of non-EMS-witnessed cases (n=471. A bystander or public access defibrillator was applied in only five cases (1% and no shocks were delivered by bystanders in any case. A total of 34 (6.6% patients had a return of spontaneous circulation in the pre-hospital setting, over twice the rate demonstrated in the first year of our study. Survival to discharge data has been collected for the first time by our hospital partners, and the publication of these results in the near future will contribute greatly to our understanding of the OHCA issue in the region.The increase in the number of OHCA responses by NA crew is notable in our findings. This may be attributable to several reasons, including greater public awareness of EMS capabilities, and improved access to EMS via the dedicated 998 emergency number and the NA mobile application. This trend is to be welcomed, as implementation of the chain of survival

  6. Rapid Fishery Assessment by Market Survey (RFAMS--an improved rapid-assessment approach to characterising fish landings in developing countries.

    Directory of Open Access Journals (Sweden)

    William T White

    Full Text Available The complex multi-gear, multi-species tropical fisheries in developing countries are poorly understood and characterising the landings from these fisheries is often impossible using conventional approaches. A rapid assessment method for characterising landings at fish markets, using an index of abundance and estimated weight within taxonomic groups, is described. This approach was developed for contexts where there are no detailed data collection protocols, and where consistent data collection across a wide range of fisheries types and geographic areas is required, regardless of the size of the site and scale of the landings. This methodology, which was demonstrated at seven fish landing sites/fish markets in southern Indonesia between July 2008 and January 2011, provides a rapid assessment of the abundance and diversity in the wild catch over a wide variety of taxonomic groups. The approach has wider application for species-rich fisheries in developing countries where there is an urgent need for better data collection protocols, monitoring future changes in market demographics, and evaluating health of fisheries.

  7. Medicines registration in Portuguese-speaking African countries, focusing in the following countries: Angola, Cap Verde and Mozambique

    OpenAIRE

    Figueiredo, Alina Maria Moreira de

    2015-01-01

    This work aims to present the regulation perspective on the medicines registration in PALOPs – Países Africanos de Língua Oficial Portuguesa (Portuguese‐speaking African countries), their regulatory requirements, constraints and opportunities, focusing on the following countries: Angola, Cape Verde and Mozambique. This thesis has as purpose to deepen and systematize knowledge with regard to the registration procedure of medicines in the selected countries. Regulatory pers...

  8. Nuclear power for developing countries. Key issue paper no. 1

    International Nuclear Information System (INIS)

    Rogner, H.-H.; Khan, A.M.

    2000-01-01

    Is there a rationale for developing countries to adopt nuclear power? This paper explores this rationale and the suitability of nuclear power for developing countries by surveying the prerequisites for and implications of developing a nuclear power program: infrastructure availability, economics and finance, environment, the needs for technology transfer, the regulatory and institutional frameworks required and the awareness of public concerns. (author)

  9. A general neurologist's perspective on the urgent need to apply resilience thinking to the prevention and treatment of Alzheimer's disease.

    Science.gov (United States)

    Pomorska, Grazyna; Ockene, Judith K

    2017-11-01

    The goal of this article was to look at the problem of Alzheimer's disease (AD) through the lens of a socioecological resilience-thinking framework to help expand our view of the prevention and treatment of AD. This serious and complex public health problem requires a holistic systems approach. We present the view that resilience thinking, a theoretical framework that offers multidisciplinary approaches in ecology and natural resource management to solve environmental problems, can be applied to the prevention and treatment of AD. Resilience thinking explains a natural process that occurs in all complex systems in response to stressful challenges. The brain is a complex system, much like an ecosystem, and AD is a disturbance (allostatic overload) within the ecosystem of the brain. Resilience thinking gives us guidance, direction, and ideas about how to comprehensively prevent and treat AD and tackle the AD epidemic.

  10. Initiating a Human Variome Project Country Node.

    Science.gov (United States)

    AlAama, Jumana; Smith, Timothy D; Lo, Alan; Howard, Heather; Kline, Alexandria A; Lange, Matthew; Kaput, Jim; Cotton, Richard G H

    2011-05-01

    Genetic diseases are a pressing global health problem that requires comprehensive access to basic clinical and genetic data to counter. The creation of regional and international databases that can be easily accessed by clinicians and diagnostic labs will greatly improve our ability to accurately diagnose and treat patients with genetic disorders. The Human Variome Project is currently working in conjunction with human genetics societies to achieve this by establishing systems to collect every mutation reported by a diagnostic laboratory, clinic, or research laboratory in a country and store these within a national repository, or HVP Country Node. Nodes have already been initiated in Australia, Belgium, China, Egypt, Malaysia, and Kuwait. Each is examining how to systematically collect and share genetic, clinical, and biochemical information in a country-specific manner that is sensitive to local ethical and cultural issues. This article gathers cases of genetic data collection within countries and takes recommendations from the global community to develop a procedure for countries wishing to establish their own collection system as part of the Human Variome Project. We hope this may lead to standard practices to facilitate global collection of data and allow efficient use in clinical practice, research and therapy. © 2011 Wiley-Liss, Inc.

  11. Status of nuclear power in developing countries

    International Nuclear Information System (INIS)

    Laue, H.J.

    1982-01-01

    In the context of the world-wide energy situation and the key position energy plays and will play for the economic and social development of any country, the energy demand situation up to the year 2000 is analysed. As a result, the world-wide energy demand will continue to increase, however, mainly in the developing world. Nuclear power is one of the important component in the energy mix of today and in the future. Status of nuclear power application in developing countries up to the end of the century. Any further growth of the peaceful use of nuclear power in developing countries is closely linked with the following requirements: - qualified manpower, - industrial infrastructure, - energy demand and supply assessments, - high investments, - assurance of supply of nuclear fuel and fuel cycle services, - availability of small and medium power reactors. The possible role of the IAEA in developing countries and international measures to remove some of the limitations for the peaceful use of nuclear energy in developing countries are discussed. (orig.)

  12. Countries and companies

    International Nuclear Information System (INIS)

    Jenning, J.S.

    1990-01-01

    The trends and factors currently emerging are likely to have significant influence on the way the upstream oil and gas industry evolves in the coming decade. This paper discusses how these trends might influence events in the 1990s, particularly how they might influence relationships between host countries and companies in the oil industry. State owned companies will dominate the industry in resource terms. These statcos fall into three groups: a small group of technically able, financially sound, well-managed companies; a group of consumer statcos that have limited domestic production but significant domestic demand; a large group that are finding it difficult to maintain their production facilities in good standing to maximize recovery from their resources. This paper describes the future private sector as consisting of the Surviving Sisters and smaller, private companies very active in the upstream. How will these various players behave in the years to come? Conventional activity in the upstream will continue as companies seek to optimize their upstream portfolios

  13. Tanzania country study

    Energy Technology Data Exchange (ETDEWEB)

    1999-09-01

    Objectives of this study are to analyse the role of the land use sectors of Tanzania (especially forestry) on mitigation of greenhouse gases. Specific emphasis is placed on the relationship between forestry and energy supply from biomass, as well as other forestry products. This is a follow up study on an earlier effort which worked on mitigation options in the country without and in-depth analysis of the forestry and land use sectors. Analysis of the mitigation scenario has been based on Comprehensive Mitigation Analysis (COMAP). This study has analysed the forestry and land use sector behaviour on the basis of the current policies on land and environment. Furthermore three scenarios have been developed on the basis of what is expected to happen in the sectors, the worse scenario being a catastrophic one where if things takes the business as usual trend then the forest resources will easily be depleted. The TFAP scenario takes into account the implementation of the current plans as scheduled while the mitigation scenario takes into account the GHG mitigation in the implementation of the plans. A Comprehensive Mitigation Analysis Process (COMAP) has been used to analyse the GHG and cost implications of the various programmes under the mitigation scenario. (au) 30 refs.

  14. Country watch. Brazil.

    Science.gov (United States)

    Turra, M D

    1994-01-01

    Persons who are infected with human immunodeficiency virus (HIV) or who suffer from acquired immunodeficiency syndrome (AIDS) often have their civil rights violated in Brazil. To remedy this, the Candido Mendes College in Rio de Janeiro introduced a voluntary course, "AIDS - Legal Approaches", into its law curriculum. Incentive was provided by the college's Model Law Office (MLO), where students learn to defend the rights of people in need. Class size is about 25; law professors use recent magazine and newspaper articles, and documentation on lawsuits concerning persons with HIV to teach the class. Course topics include relevant civil law (suits against blood banks), contract law (suits against private health insurance companies which refuse to cover treatment expenses related to HIV or AIDS), family law, inheritance law, labor law (unjust dismissal of persons with HIV), criminal law (intentional transmission of AIDS), violations of basic human rights, and comparative jurisprudence and constitutional law (a comparison of Brazilian law in this area to the laws of other countries). Students, during their field practice periods at the MLO, provide legal assistance to persons with HIV. Approximately 150 cases have been handled, often with positive outcomes, to date. Clients hear about the program via television, radio, and newspapers. Materials and information about lawsuits handled by the MLO are available to other colleges and universities with the hope of stimulating the formation of similar programs elsewhere.

  15. Swaziland: country profile.

    Science.gov (United States)

    Carrington, L

    1988-06-01

    Although Swaziland had been independent from colonialism for 20 years, a powerful monarch, King Mswati II, continues to control the country's political, religious, and social system. Swaziland has a population of 676,000, half of whom are under 15 years of age. The infant mortality rate is 105/1000 live births and 25% of children die before they reach their 5th birthday. Life expectancy is 54 years. Tribal chiefs, representing the king, hold and distribute about half of the national land. Most of the fertile land remains in the hands of white settler farmers. The concentration of income in foreign companies and urban centers has exacerbated poverty in rural areas. Depreciation of rand-linked local currency has boosted export earnings, but it has also raised the price of food and medical imports. Swaziland's main exports are sugar, wood pulp, chemicals, and fruit, most of which go to the UK and South Africa. The major food crops are maize, beans, groundnuts, and sorghum. About half of the working population is engaged in small-scale subsistence farming, but food yields are declining. The major producers are foreign companies attracted by Swaziland's low taxes and cheap labor supply.

  16. Contraceptive issues of youth and adolescents in developing countries: highlights from the Philippines and other Asian countries.

    Science.gov (United States)

    Alesna-Llanto, Emma; Raymundo, Corazon M

    2005-10-01

    This article highlights contraceptive issues in Asia, home to some 700 million adolescents. It starts with a description of the socio-cultural milieu of adolescents in South and Southeast Asia, their knowledge and use of contraceptives, the myriad barriers to access, and the many innovative programs to broaden contraceptive availability. The reproductive health needs of adolescents in poor countries cannot be solved by merely supplying them with contraceptives--these needs can only be fully addressed in the context of gender equality, poverty alleviation and the conviction that investing in the reproductive health of adolescents is a most urgent priority. Investing in the reproductive health of adolescents will have an impact not only on birth and abortion rates, maternal health, and the spread of STI/HIV but also on the demographics and economic development of the region--and beyond.

  17. Country report: Bulgaria

    International Nuclear Information System (INIS)

    1993-01-01

    Bulgaria has only one site with operating nuclear energy reactors - Kozloduy nuclear power plant with six units in operation, four of them are WWER-440 type and two are WWER-1000. Spent fuel is to be stored for a three year period in water pools at reactors and after that to be transported to the away from reactor storage (AFRS) or back to the supplier. The AFRS operator has not been granted operating license until more stringent safety requirements will be met

  18. Childhood obesity in developing countries: epidemiology, determinants, and prevention.

    Science.gov (United States)

    Gupta, Nidhi; Goel, Kashish; Shah, Priyali; Misra, Anoop

    2012-02-01

    Rapidly changing dietary practices and a sedentary lifestyle have led to increasing prevalence of childhood obesity (5-19 yr) in developing countries recently: 41.8% in Mexico, 22.1% in Brazil, 22.0% in India, and 19.3% in Argentina. Moreover, secular trends indicate increasing prevalence rates in these countries: 4.1 to 13.9% in Brazil during 1974-1997, 12.2 to 15.6% in Thailand during 1991-1993, and 9.8 to 11.7% in India during 2006-2009. Important determinants of childhood obesity include high socioeconomic status, residence in metropolitan cities, female gender, unawareness and false beliefs about nutrition, marketing by transnational food companies, increasing academic stress, and poor facilities for physical activity. Childhood obesity has been associated with type 2 diabetes mellitus, the early-onset metabolic syndrome, subclinical inflammation, dyslipidemia, coronary artery diseases, and adulthood obesity. Therapeutic lifestyle changes and maintenance of regular physical activity through parental initiative and social support interventions are the most important strategies in managing childhood obesity. Also, high-risk screening and effective health educational programs are urgently needed in developing countries. Copyright © 2012 by The Endocrine Society

  19. Understanding the Role and Impact of Effective Country and Community Leadership in Progress Toward the Global Plan.

    Science.gov (United States)

    Lyons, Charles; Pillay, Yogan

    2017-05-01

    Individual leadership and leaders have played pivotal roles in the history of efforts to end the AIDS epidemic. The goal of this article is to reflect on and understand how leadership and leaders have impacted and enabled the success of the Global Plan Towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive (Global Plan). To accomplish this goal, multiple interviews were conducted with individuals in positions of leadership who had been identified as people whose actions drove progress. Interviewees were selected from all levels of traditional hierarchies and sectors to provide a more complete account and representation of leadership, with a particular emphasis on the community, district, and country levels. The leaders interviewed provide insight into their work, motivations, and approaches to effective leadership. Through their experiences, they shed light on the strategies they used to drive changes in policy, programs, practice, and communities that allowed for progress toward the goals of the Global Plan. Leaders also identify future challenges and areas of improvement in the effort to end the AIDS epidemic that they feel require leadership and urgent action. In conclusion, this article identifies common characteristics of effective leadership and reflects on the experiences of individuals who are leaders in the effort to end the AIDS epidemic, and how their lessons learned can be applied to help realize future global public health goals.

  20. Perfil de la demanda urgente e influencia del fútbol televisado en un servicio extrahospitalario en la Zona Básica de Salud de Tafalla, Navarra

    OpenAIRE

    Pérez-Ciordia, Ignacio; Catalán Fabo, Francisca; Zalacain Nicolay, Fernando; Barriendo Antoñanzas, Maite; Solaegui Diaz de Guereñu, Ramón; Guillén Grima, Francisco

    2003-01-01

    Fundamento: La demanda a los servicios de urgencias, tanto hospitalarios como extrahospitalarios, mantiene un ritmo creciente. El objetivo del presente trabajo es doble: cuantificación y estudio de las características personales de los usuarios demandantes de atención urgente y valorar si el fútbol televisado influye en la utilización del servicio de urgencias. Métodos: Estudio descriptivo longitudinal (9.723 usuarios demandantes) y estudio de casos y controles (1.284 usuarios demandantes) se...

  1. Economic growth cannot be taken for granted: Need for urgent reforms – an interview with Dr. A. Virmani

    Directory of Open Access Journals (Sweden)

    Charan Singh

    2013-12-01

    Full Text Available Growth of the Indian economy has suffered in the recent years as indicated by decline in industrial production, capital formation, exports, etc. Weakening of aggregate demand and decline in investment could be some of the contributing factors for this phenomenon. While the slowdown can also be attributed to global slowdown, a high current account deficit and gross fiscal deficit, and continuance of a high rate of inflation are some of the most worrying signs for the policy makers. Restoration of fiscal sustainability and macroeconomic balance through stepped-up reforms are some of the key issues that need urgent focus of the government.

  2. Sistema de Apoio à Decisão para o Transporte Não Urgente de Doentes em Veículo Partilhado

    Directory of Open Access Journals (Sweden)

    José António Oliveira

    2014-06-01

    Full Text Available O transporte não urgente de doentes em Portugal foi alvo de reformulação legislativa de modo a reduzir os custos que acarretava. Neste artigo apresentam-se métodos heurísticos para a formação de agrupamentos de doentes a serem transportados na mesma viatura. São apresentados resultados computacionais que validam os algoritmos desenvolvidos. Os algoritmos podem ser facilmente integrados num sistema de apoio à decisão.

  3. Cáncer de mama en México: una prioridad apremiante Breast cancer in Mexico: an urgent priority

    Directory of Open Access Journals (Sweden)

    Felicia Marie Knaul

    2009-01-01

    Full Text Available El cáncer de mama es una grave amenaza para la salud de la mujer a nivel mundial y constituye una prioridad no reconocida en los países de ingresos medios. Este trabajo presenta datos de México y revela que desde 2006 el cáncer de mama es causante de un mayor número de muertes que el cáncer cérvicouterino. Esta afección es la segunda causa de muerte en mujeres de 30 a 54 años de edad y amenaza a todos los grupos socioeconómicos. Los datos sobre detección, si bien subreportados, muestran 6000 nuevos casos en 1990 y se estima un incremento cercano a 16500 nuevos casos anuales para 2020. Más aún, la mayoría de los casos se autodetecta y sólo 10% de todos los casos se identifica en etapa I. La seguridad social en México cubre alrededor de 40 a 45% de la población e incluye tratamiento del cáncer de mama. A partir de 2007, la población sin seguridad social tiene derecho a tratamiento de cáncer de mama a través del Seguro Popular de Salud. A pesar de esto, los servicios escasean y las intervenciones de detección temprana, en particular la mamografía, son muy limitadas. Desde el año 2006, sólo 22% de las mujeres de 40 a 69 años se sometió a una mamografía en el último año. Existen barreras tanto en la demanda como en la oferta. El cabildeo, la educación, la creación de conciencia y una respuesta articulada de políticas son importantes para garantizar una mayor cobertura, acceso y aceptación tanto del tratamiento como de la detección temprana.Breast cancer is a serious threat to the health of women globally and an unrecognized priority in middle-income countries. This paper presents data from Mexico. It shows that breast cancer accounts for more deaths than cervical cancer since 2006. It is the second cause of death among women aged 30 to 54 and affects all socioeconomic groups. Data on detection, although underreported, show 6000 new cases in 1990 and a projected increase to over 16500 per year by 2020. Further, the

  4. Prospects and future of conservative management of beta thalassemia major in a developing country

    International Nuclear Information System (INIS)

    Rahman, M.; Lodhi, Y.

    2004-01-01

    Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 regular patients who adhered best to our selection criteria. Main Outcome Measures: 1) The study highlights the deficiencies and problems of conservative management for beta thalassemia major. 2) The major impact of our study is the message that conservative management in a poor country, like ours, is a no-win situation. 3) There is an urgent need to immediately start a prevention programme. Results: In the younger patients, blood consumption even on the moderate transfusion regimen is 120ml/kg/year, however with ascending age the consumption increases to 240ml/kg/year. A substantive number of the patients are either Hep C (35%) or Hep B (1.7%) positive. There are no HIV positive patients. Serum ferritin levels vary widely and could not be controlled due to poor compliance to chelation. 50% of the patients developed one or other complications of iron overload. The cost of treatment depending on the quality of care, is tremendous and beyond the reach of the common man. Conclusions: Conservative management may be the best alternative and at times the only hope for patients in our country

  5. A Tale of Five Countries: Background and Confidence in Preservice Primary Teachers in Drama Education across Five Countries

    Science.gov (United States)

    Russell-Bowie, Deirdre E.

    2013-01-01

    In many public primary schools across different countries, generalist primary teachers are required to teach all subjects, including music, dance, drama and visual arts. This study investigates the background and confidence of preservice primary teachers from five countries in relation to drama and drama education. It also examines if there is a…

  6. The Demand for Calories in Developing Countries

    OpenAIRE

    Odin K. Knudsen; Pasquale L. Scandizzo

    1982-01-01

    This paper employs characteristic demand theory to estimate demand functions for calories for a set of developing countries and to investigate the potential impact of income growth, redistribution, and price changes on alleviating underconsumption of calories. The analysis finds that, although calorie elasticities with respect to income are substantial for the poorer consumers, income growth above historical rates is required for the food needs of the entire population to be satisfied within ...

  7. Country watch: India.

    Science.gov (United States)

    Mukhopadhyay, A; Sehgal, P N

    1995-01-01

    Linking more than 3000 health and development organizations, the Voluntary Health Association of India (VHAI) is one of the largest networks in the country. In 1990 VHAI began incorporating HIV/STD-related activities into its broader programs. An existing infrastructure for intersectoral collaboration in the areas of community health promotion, public policy, information and documentation, and communications facilitated inclusion of the new activities. Several VHAI departments collaborate in offering training courses, workshops, and seminars at the state and community levels to involve nongovernmental organizations and professional groups in HIV/STD prevention and counseling. More than 950 persons have been trained so far, including trainers of primary health care workers, family physicians, medical practitioners, social scientists, teachers, community volunteer workers, and youth leaders. Local experts act as training resource persons; materials produced locally, abroad, and by VHAI itself are used. Training facilities are offered free of charge to member organizations; VHAI also awards fellowships for field training and financial support for approved projects. VHAI suggests intervention measures to governmental and nongovernmental organizations related to drug users, youth, truck drivers, blood donors, and people living with HIV/AIDS. The information, documentation, and communications departments provide members with a wide variety of information, education, and communication (IEC) materials that can be translated into local languages: posters, folders, flip charts, stickers, and folk songs. VHAI advocacy issues that have been highlighted through the press include: confidentiality, protection against discrimination, the right of all persons to health care, and the need to make properly-equipped STD clinics available. VHAI has established sub-networks in Tamil Nadu (155 organizations) and Manipur (55 organizations) states. VHAI has found that incorporating HIV

  8. Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries.

    Science.gov (United States)

    McLane, Hannah C; Berkowitz, Aaron L; Patenaude, Bryan N; McKenzie, Erica D; Wolper, Emma; Wahlster, Sarah; Fink, Günther; Mateen, Farrah J

    2015-11-03

    To determine the availability, accessibility, and affordability of EEG, EMG, CSF analysis, head CT, and brain MRI for neurologic disorders across countries. An online, 60-question survey was distributed to neurology practitioners in 2014 to assess the presence, wait time, and cost of each test in private and public health sectors. Data were stratified by World Bank country income group. Affordability was calculated with reference to the World Health Organization's definition of catastrophic health expenditure as health-related out-of-pocket expenditure of >40% of disposable household income, and assessment of providers' perceptions of affordability to the patient. Availability of EEG and EMG is correlated with higher World Bank income group (correlation coefficient 0.38, test for trend p = 0.046; 0.376, p = 0.043); CSF, CT, and MRI did not show statistically significant associations with income groups. Patients in public systems wait longer for neurodiagnostic tests, especially MRI, EEG, and urgent CT (p private sector (US $55.25 vs $214.62, p income group is associated with a 29% decrease in the estimated share of the population who can afford a given test (95% confidence interval -33.4, 25.2; p income countries surveyed, only the top 10% or 20% of the population was able to afford tests below catastrophic levels. In surveyed lower-middle-income countries, >40% of the population, on average, could not afford neurodiagnostic tests. Neurodiagnostic tests are least affordable in the lowest income settings. Closing this "diagnostic gap" for countries with the lowest incomes is essential. © 2015 American Academy of Neurology.

  9. Effective notification of important non-urgent radiology results: a qualitative study of challenges and potential solutions

    International Nuclear Information System (INIS)

    Georgiou, Andrew; Horden, Antonia; Callen, Joanne; Westbrook, Johanna I.; Dimigen, Marion; Zogovic, Branimir; Schlaphoff, Glen

    2014-01-01

    We report on the implementation of a Radiology Notification System (RNS), set up by the medical imaging department of a major Sydney teaching hospital in March 2010. This study aimed to investigate the views of the medical imaging department staff about: (i) the results follow-up problem encountered by the medical imaging department prior to the implementation of the RNS; (ii) what changes occurred following implementation of the RNS; and (iii) suggestions for improving the RNS. This is a cross-sectional qualitative study incorporating semi-structured interviews with 16 staff (15 radiologists and 1 clerk) after the implementation of the RNS. Interviews were conducted in August/September 2011. The reasons behind the development of the RNS were related to: (i) major existing problems with the communication of results between the imaging department and hospital wards; (ii) cumbersome and inefficient paper-based notification systems; and (iii) the absence of standardised guidelines and procedures for radiology test notification and follow-up. The RNS managed to free up a significant proportion of radiologist time, resulting in greater efficiencies. Study participants also highlighted a number of areas for improvement, including the need for a 24-h service, feedback and acknowledgement of test results by clinicians and the standardisation of test management definitions and procedures. Test management systems can play an important part in enhancing safe and effective communications between wards and hospital departments. However, their uptake and sustainability will require the establishment of a multidisciplinary and hospital-wide collaboration that includes clinicians.

  10. Country-level predictors of vaccination coverage and inequalities in Gavi-supported countries.

    Science.gov (United States)

    Arsenault, Catherine; Johri, Mira; Nandi, Arijit; Mendoza Rodríguez, José M; Hansen, Peter M; Harper, Sam

    2017-04-25

    Important inequalities in childhood vaccination coverage persist between countries and population groups. Understanding why some countries achieve higher and more equitable levels of coverage is crucial to redress these inequalities. In this study, we explored the country-level determinants of (1) coverage of the third dose of diphtheria-tetanus-pertussis- (DTP3) containing vaccine and (2) within-country inequalities in DTP3 coverage in 45 countries supported by Gavi, the Vaccine Alliance. We used data from the most recent Demographic and Health Surveys (DHS) conducted between 2005 and 2014. We measured national DTP3 coverage and the slope index of inequality in DTP3 coverage with respect to household wealth, maternal education, and multidimensional poverty. We collated data on country health systems, health financing, governance and geographic and sociocultural contexts from published sources. We used meta-regressions to assess the relationship between these country-level factors and variations in DTP3 coverage and inequalities. To validate our findings, we repeated these analyses for coverage with measles-containing vaccine (MCV). We found considerable heterogeneity in DTP3 coverage and in the magnitude of inequalities across countries. Results for MCV were consistent with those from DTP3. Political stability, gender equality and smaller land surface were important predictors of higher and more equitable levels of DTP3 coverage. Inequalities in DTP3 coverage were also lower in countries receiving more external resources for health, with lower rates of out-of-pocket spending and with higher national coverage. Greater government spending on heath and lower linguistic fractionalization were also consistent with better vaccination outcomes. Improving vaccination coverage and reducing inequalities requires that policies and programs address critical social determinants of health including geographic and social exclusion, gender inequality and the availability of

  11. Structural change in developing countries: has it decreased gender inequality?

    OpenAIRE

    Michelle Rendall

    2012-01-01

    This paper examines the evolution of female labor market outcomes from 1987 to 2008 by assessing the role of changing labor demand requirements in four developing countries: Brazil, Mexico, India and Thailand. The results highlight the importance of structural change in reducing gender disparities by decreasing the labor demand for physical attributes. The results show that India, the country with the greatest physical labor requirements, exhibits the largest labor market gender inequality. I...

  12. Pakistan mental health country profile.

    Science.gov (United States)

    Karim, Salman; Saeed, Khalid; Rana, Mowaddat Hussain; Mubbashar, Malik Hussain; Jenkins, Rachel

    2004-01-01

    The Republic of Pakistan is a South East Asian country with a population of over 140.7 million. Its population is fast growing and the majority (70%) live in rural areas with a feudal or tribal value system. The economy is dependent on agriculture and 35% of the population live below the poverty line. Islam is the main religion and 'mental illnesses' are stigmatized and widely perceived to have supernatural causes. The traditional healers along with psychiatric services are the main mental health service providers. The number of trained mental health professionals is small as compared to the population demands and specialist services are virtually non-existent. Lack of data on prevalence of various mental illnesses and monitory constraints are the major hurdles in the development of mental health services. A number of innovative programmes to develop indigenous models of care like the 'Community Mental Health Programme' and 'Schools Mental Health Programme' have been developed. These programmes have been found effective in reducing stigma and increase awareness of mental illness amongst the adults and children living in rural areas. Efforts by the government and mental health professionals have led to the implementation of a 'National Mental Health Policy' and 'Mental Health Act' in 2001. These aim at integrating mental health services with the existing health services, improving mental health care delivery and safeguarding the rights of mentally ill people. A favourable political will and the help of international institutions like the World Health Organization are required to achieve these aims.

  13. Nuclear power in developing countries

    International Nuclear Information System (INIS)

    Laue, H.J.; Bennett, L.L.; Skjoeldebrand, R.

    1984-01-01

    Experience clearly indicates that most developing countries actively planning and implementing nuclear power require broad-scope assistance if their use of nuclear technology is to be safe, economic, and reliable. The IAEA's assistance is directed both to general planning, and to the development of supporting structures and is based on an assessment of needs which cannot be satisfied by other means. The Agency's Division of Nuclear Power has the technical background and tools to support a comprehensive programme of assistance in nuclear power assessment, planning, and implementation. The overall objective of such a programme is to help strengthen national capabilities of executing the following tasks: Analysis of overall energy and electricity demand and supply projections; planning the possible role of nuclear power in electricity supply, through determining the economically optimal extent and schedule for the introduction of nuclear power plants; assessing the available infrastructures and the need, constraints, and possibilities for their development; and developing master schedules, programmes, and recommendations for action. Proposed programmes must be reviewed periodically, and one of the Agency's aims is to ensure that national competence to carry out such reviews exists or can be developed. Training of local staff is therefore one of the most important objectives

  14. Effective notification of important non-urgent radiology results: a qualitative study of challenges and potential solutions.

    Science.gov (United States)

    Georgiou, Andrew; Hordern, Antonia; Dimigen, Marion; Zogovic, Branimir; Callen, Joanne; Schlaphoff, Glen; Westbrook, Johanna I

    2014-01-01

    We report on the implementation of a Radiology Notification System (RNS), set up by the medical imaging department of a major Sydney teaching hospital in March 2010. This study aimed to investigate the views of the medical imaging department staff about: (i) the results follow-up problem encountered by the medical imaging department prior to the implementation of the RNS; (ii) what changes occurred following implementation of the RNS; and (iii) suggestions for improving the RNS. This is a cross-sectional qualitative study incorporating semi-structured interviews with 16 staff (15 radiologists and 1 clerk) after the implementation of the RNS. Interviews were conducted in August/September 2011. The reasons behind the development of the RNS were related to: (i) major existing problems with the communication of results between the imaging department and hospital wards; (ii) cumbersome and inefficient paper-based notification systems; and (iii) the absence of standardised guidelines and procedures for radiology test notification and follow-up. The RNS managed to free up a significant proportion of radiologist time, resulting in greater efficiencies. Study participants also highlighted a number of areas for improvement, including the need for a 24-h service, feedback and acknowledgement of test results by clinicians and the standardisation of test management definitions and procedures. Test management systems can play an important part in enhancing safe and effective communications between wards and hospital departments. However, their uptake and sustainability will require the establishment of a multidisciplinary and hospital-wide collaboration that includes clinicians. © 2014 The Royal Australian and New Zealand College of Radiologists.

  15. The importance of being urgent: The impact of surveillance target and scale on mosquito-borne disease control

    Directory of Open Access Journals (Sweden)

    Samantha R. Schwab

    2018-06-01

    Full Text Available With the emergence or re-emergence of numerous mosquito-borne diseases in recent years, effective methods for emergency vector control responses are necessary to reduce human infections. Current vector control practices often vary significantly between different jurisdictions, and are executed independently and at different spatial scales. Various types of surveillance information (e.g. number of human infections or adult mosquitoes trigger the implementation of control measures, though the target and scale of surveillance vary locally. This patchy implementation of control measures likely alters the efficacy of control.We modeled six different scenarios, with larval mosquito control occurring in response to surveillance data of different types and at different scales (e.g. across the landscape or in each patch. Our results indicate that: earlier application of larvicide after an escalation of disease risk achieves much greater reductions in human infections than later control implementation; uniform control across the landscape provides better outbreak mitigation than patchy control application; and different types of surveillance data require different levels of sensitivity in their collection to effectively inform control measures. Our simulations also demonstrate a potential logical fallacy of reactive, surveillance-driven vector control: measures stop being implemented as soon as they are deemed effective. This false sense of security leads to patchier control efforts that will do little to curb the size of future vector-borne disease outbreaks. More investment should be placed in collecting high quality information that can trigger early and uniform implementation, while researchers work to discover more informative metrics of human risk to trigger more effective control. Keywords: Zika control, Epidemiological surveillance, Disease surveillance, Mosquito control, Vector-borne disease control, Epidemiological modeling

  16. Dealing with the problem countries

    International Nuclear Information System (INIS)

    Jones, R.W.

    1985-01-01

    The test of America's policies to prevent nuclear proliferation is the so-called problem countries, those states that pose the greatest risk of ''going nuclear.'' Most visible - and the source of greatest concern - are those countries which have developed or appear to be in the process of developing nuclear weapons capabilities. In addition to Pakistan, near-nuclear countries of note include India, Israel, South Africa, Argentina, South Korea, and Taiwan. Several other countries, including Iraq, Iran, Libya, and Brazil, seem to pose proliferation risks in the longer term. More problematic are countries, such as Mexico, that, although they seem to represent little or no proliferation risk themselves, pose difficult problems by challenging restrictions in nuclear export policy. The author examines US policy toward some of the problem countries, paying particular attention to Pakistan. The constants in US policy and the few changes wrought by the Reagan administration are noted throughout

  17. Hungary country study

    Energy Technology Data Exchange (ETDEWEB)

    Uerge-Vorsatz, D.; Fuele, M. [eds.

    1999-09-01

    Hungary recognises the importance of limiting greenhouse gas emissions in order to prevent or mitigate their impact on the global climate. On an international level, Hungary is not a significant carbon dioxide emitter, neither to the absolute degree nor on a per capita basis. This means that the principal reason for Hungarian participation in emission`s reduction is not perceivable international consequences but solidarity and participation in the common action of the countries of the world. Hungary is a signatory to both the Framework Convention on Climate Change and the Kyoto protocol. However, the (Hungarian) National Environmental Program also emphasises that the fulfilment of international conventions must happen at a level and pace reasonable for Hungary. The goal of this study is to investigate the potentials, costs and implementation strategies of greenhouse gas abatement in Hungary. First presented is a background of Hungary`s economy and a summary of the economic transitions in Hungary. A brief description of the Hungarian energy sector is included, with a short summary of carbon dioxide emissions, and of the Hungarian forestry sector. The following chapter is devoted to the development of baseline scenarios, from bottom-up and top-down perspectives. In the chapter on mitigation, the spectrum of energy efficiency measures in the residential and public sectors is discussed. Fifteen specific measures, whose impact is considered important, are selected and discussed in detail. The cost curves are developed for the discussed mitigation options. Then, we discuss the issues related to the implementation of energy efficiency measures in the Hungarian residential and commercial sectors. After a general background and a framework on the implementation of the energy efficiency measures in the sectors chosen, we elaborate on the practicality of these concepts. As a case study, the concept and the feasibility of carbon/energy taxes are examined. To complete the

  18. Application of technetium-99m hexamethylpropylene amine oxime single-photon emission tomography to neurologic prognosis in patients undergoing urgent carotid surgery

    International Nuclear Information System (INIS)

    Shvera, I.Y.; Cherniavsky, A.M.; Ussov, W.Yu.; Plotnikov, M.P.; Sokolov, A.A.; Shipulin, V.M.; Chernov, V.I.

    1995-01-01

    In this study we aimed to work out a quantitative prognostic index for preoperative assessment of brain technetium-99m hexamethylpropylene amine oxime (HMPAO) single-photon emission tomography (SPET) in patients referred for urgent carotid endarterectomy due to acute abstructive disease of the internal carotid artery (ICA) and neurological deficit. To this end we compared data from preoperative SPET studies with the postinterventional changes in neurological status in 20 patients (17 males, three females; mean age 53 years, SD 4 years) with acute ischaemic cerebral disorders induced by obstruction of the ICA. Carotid obstruction was diagnosed by ultrasound B-mode study. All patients underwent urgent carotid endarterectomy from the ICA. Patients were divided into two groups in accordance with the results of postoperative follow-up: group A comprised patients with significant (more than 3 points) postoperative improvement in neurological condition as quantified by the Canadian Neurological Scale (11 patients); group B consisted of patients with minimal improvement or deterioration (nine, three of whom died). All patients were studied preoperatively by 99m Tc-HMPAO SPET. The volume of nonperfused tissue (VS, cm 3 ) was quantified using the Mountz technique. Hypoperfused volume (V hypoperf , cm 3 ) in the affected hemisphere was calculated as the total volume of voxels with 99m Tc-HMPAO uptake hypoperf ). Patients with preoperative PF values 8.90 comprised patients who demonstrated minimal improvement or deterioration. PF values in the range 8.20-8.90 carried an indefinite prognosis. (orig.)

  19. The duplex-Doppler colour echography of the scrotum and testicles in adults and boys. II. the contribution of the urgent study of acute scrotum symptoms

    International Nuclear Information System (INIS)

    Rangel-Villalobos, E.; Jimenez-Castellanos, R.; Bustos, C.; Linares, A.; Gonzalez-Prada, F.

    1999-01-01

    To analyse the findings, contributions and limitations of the Doppler echography for the urgent study of acute scrotum symptoms, both in adults and in boys. 60 patients (22 adults and 38 boys) with acute scrotal symptomatology were examined using B mode echography, followed by a colour duplex-Doppler (CDD) echography with a lineal 7.5 MHz transducer. We compared the findings obtained with those of the healthy contralateral testicle and with surgery or clinical-echographical evolution. The most common pathology was inflammation (27%) followed by ischemic (24%) and traumatic (17%). 12% of the patients had miscellaneous conditions. To conclude, in 20% of the cases the B mode and the Doppler examination was normal, the symptoms were resolved spontaneously. After carrying out the CDD only 14 (23%) of the cases needed immediate surgery and 3 (5%) delayed surgery, the remaining 43 (72%) patients responded to the traditional treatment. The CDD allows for a safe, quick and harmless diagnosis in practically all the acute scrotum cases, for both adults and boys. Its limitations in pre-puberty patients or in cases that were atypical are overcome when put in the hands of an expert radiologist, as they need a longer exploration time and suitable Doppler equipment. The main contribution to the urgent diagnosis of acute scrotum symptoms is that it accurately establishes which patients should be chosen for immediate surgery. (Author) 33 refs

  20. Nuclear energy for developing countries

    International Nuclear Information System (INIS)

    Kemery, L.S.

    1980-01-01

    This paper examines the circumstances which must prevail before a reasonable technical, administrative and sociological case can be made to justify the introduction of nuclear power technology to a developing country. The role played by the IAEA in responding to needs of developing countries is considered and problems of nuclear plant safety and materials safeguards discussed. Plans for nuclear power in several developing countries are outlined

  1. Renewable Energy Country Attractiveness Indices

    International Nuclear Information System (INIS)

    2011-02-01

    Since 2003 Ernst and Young team has been releasing quarterly data that ranks national renewable energy markets, and their suitability for individual technologies. The Country Attractiveness Indices now track the relative attractiveness of 30 countries' renewable energy markets across a selection of technologies each quarter. The Renewable Energy Country Attractiveness Indices publication scores and comments on various technologies, including: on-shore wind, off-shore wind, solar PV, solar CSP, biomass, and geothermal.

  2. Nuclear medicine in developing countries

    International Nuclear Information System (INIS)

    Kremenchuzky, S.; Degrossi, O.J.

    1991-01-01

    The economic crisis through which developing countries are passing means that every field of endeavour must adapt to new realities imposed by each particular's country's situation. Public health is no exception, although it is obviously a priority field in view of the repercussions which social and economic phenomena can have on the health of a country's inhabitants. This article briefly considers ways in which nuclear medicine facilities in Argentina may be improved

  3. Culture at the Country Level

    OpenAIRE

    Maseland, R.K.J.; Hoorn, A.A.J. van; Herk, H. van; Torelli, C.J.

    2017-01-01

    This chapter introduces and critically discusses the idea of measuring the culture of countries and cross-national differences therein. We start by elaborating the theoretical foundations for studying culture at the country level. We highlight the use of countries or nations as a unit of analysis and pay special attention to the way in which a group-level construct such as culture has implications at lower levels of analysis, affecting the values and beliefs of individuals. After briefly trac...

  4. Renewable Energy Country Profiles. Caribbean

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-15

    IRENA Renewable Energy Country Profiles take stock of the latest developments in the field of renewables at country level around the world. Each profile combines analysis by IRENA's specialists with the latest available country data and additional information from a wide array of sources. The resulting reports provide a brief yet comprehensive picture of the situation with regard to renewable energy, including energy supply, electrical generation and grid capacity, and access. Energy policies, targets and projects are also considered, along with each country's investment climate and endowment with renewable energy resources. The energy statistics presented here span the period from 2009 until 2012, reflecting varying timelines in the source material. Since data availability differs from country to country, wider regional comparisons are possible only for the latest year with figures available for every country included. Despite the time lag in some cases, the evident differences and disparities between countries and regions around the world remain striking. The current package of country profiles is just a starting point. The geographic scope will continue to expand, and existing profiles will be enhanced with new indicators, with the whole series maintained as a live product on the IRENA website (www.irena.org)

  5. 76 FR 61132 - Privacy Act; System of Records: State-77, Country Clearance Records

    Science.gov (United States)

    2011-10-03

    ... name, email address, phone number, passport country and number, agency, employment type, country of...-07-16 security requirements, which include but are not limited to two-factor authentication and time...

  6. 16 CFR 303.33 - Country where textile fiber products are processed or manufactured.

    Science.gov (United States)

    2010-01-01

    ... [Foreign Country]”. (ii) When the U.S. Customs Service requires an origin label on the unfinished product... manufactured. Further work or material added to the textile fiber product in another country must effect a...

  7. Religious Diversity and Freedom of Conscience in the Arabic Countries Facing Globalization and Migration

    Directory of Open Access Journals (Sweden)

    Raoudha Elguédri

    2017-10-01

    Full Text Available Muslim societies are facing the new challenges of cultural and religious diversity. They are experiencing migratory phenomena, or because they are countries of immigration (such as in the Persian Gulf monarchies and emirates or countries that are becoming a new destination of migrants (such as Morocco and other North African nations. These challenges are increasingly urgent due to the effects of other globalization vectors such as new communication technologies that cross all boundaries and foster unprecedented conversions. The purpose of this contribution is limited to the religious aspect of the new forms of diversification faced by Muslim countries. The goal is to analyze to what extent this process biases traditional ways of managing religious diversity.

  8. Indonesia country report

    Energy Technology Data Exchange (ETDEWEB)

    Murni Soedyartomo Soentono, Tri [National Nuclear Energy Agency of Indonesia - Batan, Radioisotopes and Radiopharmaceuticals Development Centre, Pasar Jum' at, Cinere Raya, 12570 Jakarta (Indonesia)

    2008-07-01

    Several nuclear research are currently operation in Serpong, Jakarta, Bandung and Yogyakarta; these facilities has been in operation step wisely and having strong link with various universities and laboratories within the country (30 MW in Serpong, 2 MW in Bandung, Cyclotron CS-30 Serpong, Accelerator Yogyakarta, Irradiator Co-60). Public Acceptance: Further more the routine activities of the public information by WiN regarding the peaceful uses of nuclear energy, especially to the immediate environment of the NPP candidate site are indeed of important steps. Future of nuclear power: Since 1990's, Indonesia planned to build NPP station in Jepara to anticipate future energy crisis. Indonesia National Energy Policy has four main objectives: - Securing the continuity of energy supply for domestic use at price affordable to the public, - Enhancing the life quality of the people, - Stimulating economic growth, and, - Reserving an adequate supply of oil and gas for expert to provide source of foreign exchange to fund the national development program. Nuclear Waste Management Policy: Law no 10/1997 on nuclear power became the basic policy in management of radioactive waste The only national agency dealing with radioactive substances, BATAN possesses all data and information concerning the use of nuclear power. Radioactive waste management is particularly earmarked for maximum protection of living creatures, the environment and its ecosystems. In order to guarantee maximum safety and protection, all parties involved in the acquisition of radioactive materials should abide by the ALARA (As Low As Reasonably Achievable) principle. In order to achieve radioactive waste management that complies with the principle of sustainable development, technological applications should be technically and economically viable for maximum protection of the environment and safety from any potential nuclear hazards, now and in future. The application must also be accepted by the community

  9. Utility requirements for fusion

    International Nuclear Information System (INIS)

    Vondrasek, R.J.

    1982-02-01

    This report describes work done and results obtained during performance of Task 1 of a study of Utility Requirements and Criteria for Fusion Options. The work consisted of developing a list of utility requirements for fusion optics containing definition of the requirements and showing their relative importance to the utility industry. The project team members developed a preliminary list which was refined by discussions and literature searches. The refined list was recast as a questionnaire which was sent to a substantial portion of the utility industry in this country. Forty-three questionnaire recipients responded including thirty-two utilities. A workshop was held to develop a revised requirements list using the survey responses as a major input. The list prepared by the workshop was further refined by a panel consisting of vice presidents of the three project team firms. The results of the study indicate that in addition to considering the cost of energy for a power plant, utilities consider twenty-three other requirements. Four of the requirements were judged to be vital to plant acceptability: Plant Capital Cost, Financial Liability, Plant Safety and Licensability

  10. Zika virus causes microcephaly? Prophylaxis and treatment are more urgent as the causal relationship is sure%寨卡病毒引发小头症?关系越确定,防治越迫切!

    Institute of Scientific and Technical Information of China (English)

    汪小欢; 邹鹏; 黎媛; 陆路

    2017-01-01

    自2015年初至今,寨卡病毒(Zika virus,ZIKV)以巴西为首先后在数十个国家和地区暴发流行.几乎同时,与日俱增的小头症患儿使全球对此陷入警惕状态.目前,全球正在积极探索ZIKV感染所引发的各种神经系统疾病.在越来越多证据表明在细胞水平和动物模型中ZIKV能直接损伤胚胎脑部发育的同时,ZIKV感染者的防治需求也越来越迫切.本文从ZIKV的流行病学、与小头畸形因果关系的研究进展及其预防疫苗和治疗药物的研究现状等方面进行概述.%Since early 2015, Zika virus has caused severe epidemic outbreaks, which started from Brazil involving dozens of regions and countries successively, and contemporaneously growing infants with microcephaly have made the whole global alert against Zika virus.A variety of potential neurological disorders caused by Zika virus infection are under exploring worldwide.The need of treatments for infectors is more and more urgent because of increasing evidences indicating that Zika virus is able to impair the brain development of the embryo in cellular level and animal model.This review will summarize recent research achievements concerning epidemiology and advances among causal relationship with microcephaly, potential preventive vaccines and therapeutic drugs of Zika virus.

  11. Measures which host countries and countries of origin could adopt to promote the return of migrants.

    Science.gov (United States)

    Debart, M H

    1986-03-01

    The immigration wave in the 1960s and 1970s brought scores of migrants to Europe. Most intended to work a few years in a foreign country and return to their homeland; however, poor economies in their own countries discouraged their return. At the same time, jobs became scarcer in their host countries. Several European countries today are resorting to measures designed to promote the return of migrants to their countries of origin. This paper outlines the two major options open to governments in their reintegration efforts. Option 1 requires instituting a definite reintegration policy. Public aid to promote reintegration may be provided. For example, the French give aid contingent upon the return of foreign workers in the labor force to the country of origin and not just upon their departure from the host country. Classical methods pay conpensation to the foreign worker; the problem then is to determine at what point to limit the funds. It must be decided whether or not unemployment benefits should be capitalized and whether or not to reimburse social security and old age contributions. It is also desirable for foreign workers to have access to a specialized organization which is able to advise them on setting up a project or business on their return; ideally, this organization should finance the project. Perhaps the best solution is to enlist participation of the governments of the countries of origin to make job openings known to their nationals desiring to return. Option 2 requires that reintegration be introduced into other economic and social programs. Returning foreign workers would be included as a factor in overall policy planning. Vocational training for return migrants could be proposed to job seekers as well as to dismissed workers. A portion of money used to finance housing projects could be earmarked for construction or reservation of housing in the country of origin. Bilateral vocational training programs can be addressed to nationals who want to

  12. Closure requirements

    International Nuclear Information System (INIS)

    Hutchinson, I.P.G.; Ellison, R.D.

    1992-01-01

    Closure of a waste management unit can be either permanent or temporary. Permanent closure may be due to: economic factors which make it uneconomical to mine the remaining minerals; depletion of mineral resources; physical site constraints that preclude further mining and beneficiation; environmental, regulatory or other requirements that make it uneconomical to continue to develop the resources. Temporary closure can occur for a period of several months to several years, and may be caused by factors such as: periods of high rainfall or snowfall which prevent mining and waste disposal; economic circumstances which temporarily make it uneconomical to mine the target mineral; labor problems requiring a cessation of operations for a period of time; construction activities that are required to upgrade project components such as the process facilities and waste management units; and mine or process plant failures that require extensive repairs. Permanent closure of a mine waste management unit involves the provision of durable surface containment features to protect the waters of the State in the long-term. Temporary closure may involve activities that range from ongoing maintenance of the existing facilities to the installation of several permanent closure features in order to reduce ongoing maintenance. This paper deals with the permanent closure features

  13. Microneedle patches for vaccination in developing countries.

    Science.gov (United States)

    Arya, Jaya; Prausnitz, Mark R

    2016-10-28

    Millions of people die of infectious diseases each year, mostly in developing countries, which could largely be prevented by the use of vaccines. While immunization rates have risen since the introduction of the Expanded Program on Immunization (EPI), there remain major challenges to more effective vaccination in developing countries. As a possible solution, microneedle patches containing an array of micron-sized needles on an adhesive backing have been developed to be used for vaccine delivery to the skin. These microneedle patches can be easily and painlessly applied by pressing against the skin and, in some designs, do not leave behind sharps waste. The patches are single-dose, do not require reconstitution, are easy to administer, have reduced size to simplify storage, transportation and waste disposal, and offer the possibility of improved vaccine immunogenicity, dose sparing and thermostability. This review summarizes vaccination challenges in developing countries and discusses advantages that microneedle patches offer for vaccination to address these challenges. We conclude that microneedle patches offer a powerful new technology that can enable more effective vaccination in developing countries. Copyright © 2015. Published by Elsevier B.V.

  14. Do all countries grow alike?

    NARCIS (Netherlands)

    Bos, J. W. B.; Economidou, C.; Koetter, M.; Kolari, J. W.

    This paper investigates the driving forces of output change in 77 countries during the period 1970-2000. A flexible modeling strategy is adopted that accounts for (i) the inefficient use of resources, and (ii) different production technologies across countries. The proposed model can identify

  15. Ukraine : Country Procurement Assessment Report

    OpenAIRE

    World Bank

    2001-01-01

    The main objectives of the country procurement assessment are to diagnose the public procurement system in Ukraine, assess compatibility of the country's laws, policies and procedures with international best practices, review compliance with the procurement laws and regulations and identify areas for improvement of the procurement system in Ukraine. With due recognition of the considerable...

  16. Rural poverty in transition countries

    OpenAIRE

    Macours, K; Swinnen, Jo

    2006-01-01

    This paper uses new poverty data based on household level surveys to analyze changes in rural poverty and rural-urban poverty differences in 23 transition countries of Central and Eastern Europe and the firmer Soviet Union. The paper presents a series of hypotheses to explain differences across countries and changes over time.

  17. List of High risk countries

    International Development Research Centre (IDRC) Digital Library (Canada)

    Francine Sinzinkayo

    2013-07-26

    Higher Risk Countries and Territories. Reviewed regularly. Last update: July 26, 2013. Country/Territory. Note (1). Sources of Concern. Canadian. Law or. Policy. Knowledge of research setting. Ability to monitor research activities. (Note 2). Operational. Issues. (Note 3). Banking. Restrictions. (Note 4). Afghanistan. X. X.

  18. Natural gas in developing countries

    International Nuclear Information System (INIS)

    Holwerda, B.

    1998-01-01

    Everywhere in the world plans are being made to stimulate the natural gas industry in developing countries. High investment costs are the biggest problem almost everywhere. Even countries with a closed economy realize that they do not get far without foreign capital. Cases are presented for Africa, Pakistan, and Indonesia

  19. Globalization : Countries, Cities and Multinationals

    NARCIS (Netherlands)

    McCann, Philip; Acs, Zoltan J.

    2011-01-01

    McCann P. and Acs Z. J. Globalization: countries, cities and multinationals, Regional Studies. This paper explores the relationship between the size of a country, the size of its cities, and the importance of economies of scale in the modern era of globalization. In order to do this, it integrates

  20. Japan country report

    Energy Technology Data Exchange (ETDEWEB)

    Morisaki, Rieko [Energy Communication Planning, 3-9-16 Aobadai, 818-0137 Dazaifu (Japan)

    2008-07-01

    1. Nuclear 2007 highlights: - A magnitude 6.8 earthquake occurred in Niigata on July 16 2007. Owing to this earthquake, 3 units operating and 1 unit during start-up were shutdown automatically at TEPCO's Kashiwazaki-Kariwa NPS. Now, all 7 units of the NPS are in an outage for investigation. This influenced the capacity factor of Japanese NPPs in FY 2007, which stood at just 60.7%. - Debate on global warming is more and more active in Japan, as it is the host country of the G8 Hokkaido Toyako Summit in July. The Japan Atomic Energy Commission released 'White Paper on Nuclear Energy 2007' in March 2008. In the paper, they first expressed the view that the expansion of the peaceful use of nuclear energy is indispensable. 2. Nuclear overview: a. Energy policy: Electricity share: 25.4% of nuclear. The energy policy of Japan aims at nuclear power generation being maintained at the current level (30 to 40% of the total electricity generation) or increasing even after 2030, for stable energy supply and as a countermeasure against global warming. - Nuclear Fuel Cycle: The active tests at the JNFL reprocessing plant in Rokkasho-mura are in the final phase for commercial operation in 2008. By FY 2010 Plutonium utilization in LWRs in 16 to 18 NPP units. Around FY 2010 Installment of new centrifuges at the uranium enrichment plant at Rokkasho-mura. In FY 2012 Start of commercial operation of MOX fuel fabrication plant. Fast-breeder reactor cycle: Operation of the prototype reactor 'MONJU' has been suspended since a secondary sodium leak in 1995. JAEA (Japan Atomic Energy Agency) completed full-scale remodeling work and is implementing various tests to confirm the capabilities and soundness of MONJU. They aim to start its operation within FY 2008. Around 2025 Building a demonstration FBR. Before 2050 Development of a commercial FBR. - Electricity production (Operating): BWR: 32 units (including 4 units of APWR), PWR: 23 units. - Electricity production