WorldWideScience

Sample records for shortage prevention act

  1. Marine Pollution Prevention Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Pollution Prevention Act of 2008 implements the International Convention for the Prevention of Pollution from Ships, including related Protocols (MARPOL)...

  2. Preventive Radiation Protection Act

    International Nuclear Information System (INIS)

    Roewer, H.

    1988-01-01

    The commentary is intended to contribute to protection of the population by a practice-oriented discussion and explanation of questions arising in connection with the Preventive Radiation Protection Act. Leaving aside discussions about abandonment of nuclear power, or criticism from any legal point of view, the commentary adopts the practical approach that accepts, and tries to help implementing, the act as it is. It is a guide for readers who are not experts in the law and gives a line of orientation by means of explanations and sometimes by citations from other acts (in footnotes). The commentary also presents the EURATOM Directive No. 3954/87 dated 22 December 1987, the EC Directive No. 3955/87 dated 22 December 1987, and the EC Directive No. 1983/88 dated 5 July 1988. A tabular survey shows the system of duties and competences defined by the Preventive Radiation Protection Act. (RST) [de

  3. Estimating Demand for and Supply of Pediatric Preventive Dental Care for Children and Identifying Dental Care Shortage Areas, Georgia, 2015.

    Science.gov (United States)

    Cao, Shanshan; Gentili, Monica; Griffin, Paul M; Griffin, Susan O; Harati, Pravara; Johnson, Ben; Serban, Nicoleta; Tomar, Scott

    Demand for dental care is expected to outpace supply through 2025. The objectives of this study were to determine the extent of pediatric dental care shortages in Georgia and to develop a general method for estimation that can be applied to other states. We estimated supply and demand for pediatric preventive dental care for the 159 counties in Georgia in 2015. We compared pediatric preventive dental care shortage areas (where demand exceeded twice the supply) designated by our methods with dental health professional shortage areas designated by the Health Resources & Services Administration. We estimated caries risk from a multivariate analysis of National Health and Nutrition Examination Survey data and national census data. We estimated county-level demand based on the time needed to perform preventive dental care services and the proportion of time that dentists spend on pediatric preventive dental care services from the Medical Expenditure Panel Survey. Pediatric preventive dental care supply exceeded demand in Georgia in 75 counties: the average annual county-level pediatric preventive dental care demand was 16 866 hours, and the supply was 32 969 hours. We identified 41 counties as pediatric dental care shortage areas, 14 of which had not been designated by the Health Resources & Services Administration. Age- and service-specific information on dental care shortage areas could result in more efficient provider staffing and geographic targeting.

  4. The strategic relevance of manufacturing technology: An overall quality concept to promote innovation preventing drug shortage.

    Science.gov (United States)

    Panzitta, Michele; Ponti, Mauro; Bruno, Giorgio; Cois, Giancarlo; D'Arpino, Alessandro; Minghetti, Paola; Mendicino, Francesca Romana; Perioli, Luana; Ricci, Maurizio

    2017-01-10

    Manufacturing is the bridge between research and patient: without product, there is no clinical outcome. Shortage has a variety of causes, in this paper we analyse only causes related to manufacturing technology and we use shortage as a paradigm highliting the relevance of Pharmaceutical Technology. Product and process complexity and capacity issues are the main challenge for the Pharmaceutical Industry Supply chain. Manufacturing Technology should be acknowledged as a R&D step and as a very important matter during University degree in Pharmacy and related disciplines, promoting collaboration between Academia and Industry, measured during HTA step and rewarded in terms of price and reimbursement. The above elements are not yet properly recognised, and manufacturing technology is taken in to consideration only when a shortage is in place. In a previous work, Panzitta et al. proposed to perform a full technology assessment at the Health Technological Assessment stage, evaluating three main technical aspects of a medicine: manufacturing process, physicochemical properties, and formulation characteristics. In this paper, we develop the concept of manufacturing appraisal, providing a technical overview of upcoming challenges, a risk based approach and an economic picture of shortage costs. We develop also an overall quality concept, not limited to GMP factors but broaden to all elements leading to a robust supply and promoting technical innovation. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Marine Debris Research, Prevention, and Reduction Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Debris Research, Prevention, and Reduction Act legally establishes the National Oceanic and Atmospheric Administration's (NOAA) Marine Debris Program. The...

  6. [Physician Shortage: How to Prevent Generation Y From Staying Away - Results of a Nationwide Survey].

    Science.gov (United States)

    Kasch, R; Engelhardt, M; Förch, M; Merk, H; Walcher, F; Fröhlich, S

    2016-04-01

    Medical students' attitudes and expectations about their future working life are changing. To hire the best talents from Generation Y, hospitals must pay attention to these factors to make working in patient care more attractive. However, little detailed knowledge about the professional and career expectations of today's medical students is available to date. In a nationwide online survey, a total of 9079 medical students from all German medical faculties returned the questionnaire. Twenty-one questions related to future career choices and work satisfaction, followed by 21 questions dealing with reasons for not working in patient care. Factor analysis yielded five factors: work-life balance, career, professional needs, working atmosphere, and prestige. A correlation analysis between these factors and respondents' socio-demographic data revealed significant correlations with sex, specialty choice, and marital/parental status. A correlation analysis with "reasons for not working in patient care" revealed that work-life balance, career, professional needs, and working atmosphere had high priority for both sexes. It is crucial to collect data on the work satisfaction of Generation Y, whose members are motivated and willing to perform in today's highly demanding work environment. However, sex-dependent/independent expectations must be met to make the medical profession more attractive, to overcome the Germany-wide shortage of physicians, and to attract young doctors to the hospitals. Georg Thieme Verlag KG Stuttgart · New York.

  7. Systemic Measures and Legislative and Organizational Frameworks Aimed at Preventing or Mitigating Drug Shortages in 28 European and Western Asian Countries

    Science.gov (United States)

    Bochenek, Tomasz; Abilova, Vafa; Alkan, Ali; Asanin, Bogdan; de Miguel Beriain, Iñigo; Besovic, Zeljka; Vella Bonanno, Patricia; Bucsics, Anna; Davidescu, Michal; De Weerdt, Elfi; Duborija-Kovacevic, Natasa; Fürst, Jurij; Gaga, Mina; Gailīte, Elma; Gulbinovič, Jolanta; Gürpınar, Emre U.; Hankó, Balázs; Hargaden, Vincent; Hotvedt, Tor A.; Hoxha, Iris; Huys, Isabelle; Inotai, Andras; Jakupi, Arianit; Jenzer, Helena; Joppi, Roberta; Laius, Ott; Lenormand, Marie-Camille; Makridaki, Despina; Malaj, Admir; Margus, Kertu; Marković-Peković, Vanda; Miljković, Nenad; de Miranda, João L.; Primožič, Stanislav; Rajinac, Dragana; Schwartz, David G.; Šebesta, Robin; Simoens, Steven; Slaby, Juraj; Sović-Brkičić, Ljiljana; Tesar, Tomas; Tzimis, Leonidas; Warmińska, Ewa; Godman, Brian

    2018-01-01

    Drug shortages have been identified as a public health problem in an increasing number of countries. This can negatively impact on the quality and efficiency of patient care, as well as contribute to increases in the cost of treatment and the workload of health care providers. Shortages also raise ethical and political issues. The scientific evidence on drug shortages is still scarce, but many lessons can be drawn from cross-country analyses. The objective of this study was to characterize, compare, and evaluate the current systemic measures and legislative and organizational frameworks aimed at preventing or mitigating drug shortages within health care systems across a range of European and Western Asian countries. The study design was retrospective, cross-sectional, descriptive, and observational. Information was gathered through a survey distributed among senior personnel from ministries of health, state medicines agencies, local health authorities, other health or pharmaceutical pricing and reimbursement authorities, health insurance companies and academic institutions, with knowledge of the pharmaceutical markets in the 28 countries studied. Our study found that formal definitions of drug shortages currently exist in only a few countries. The characteristics of drug shortages, including their assortment, duration, frequency, and dynamics, were found to be variable and sometimes difficult to assess. Numerous information hubs were identified. Providing public access to information on drug shortages to the maximum possible extent is a prerequisite for performing more advanced studies on the problem and identifying solutions. Imposing public service obligations, providing the formal possibility to prescribe unlicensed medicines, and temporary bans on parallel exports are widespread measures. A positive finding of our study was the identification of numerous bottom-up initiatives and organizational frameworks aimed at preventing or mitigating drug shortages. The

  8. The Latino Physician Shortage: How the Affordable Care Act Increases the Value of Latino Spanish-Speaking Physicians and What Efforts Can Increase Their Supply.

    Science.gov (United States)

    Daar, David A; Alvarez-Estrada, Miguel; Alpert, Abigail E

    2018-02-01

    The United States Latino population is growing at a rapid pace and is set to reach nearly 30% by 2050. The demand for culturally and linguistically competent health care is increasing in lockstep with this growth; however, the supply of doctors with skills and experience suited for this care is lagging. In particular, there is a major shortage of Latino Spanish-speaking physicians, and the gap between demand and supply is widening. The implementation of the Affordable Care Act (ACA) has increased the capacity of the US healthcare system to care for the growing Latino Spanish-speaking population, through health insurance exchanges, increased funding for safety net institutions, and efforts to improve efficiency and coordination of care, particularly with Accountable Care Organizations and the Hospital Readmissions Reduction Program. With these policies in mind, the authors discuss how the value of Latino Spanish-speaking physicians to the healthcare system has increased under the environment of the ACA. In addition, the authors highlight key efforts to increase the supply of this physician population, including the implementation of the Deferred Action for Childhood Arrivals Act, premedical pipeline programs, and academic medicine and medical school education initiatives to increase Latino representation among physicians.

  9. [The new German prevention act: an effective strategy?].

    Science.gov (United States)

    Garlichs, Dietrich

    2015-10-01

    The new German prevention act attempts to deal with the influx of obesity and chronic diseases by educating and informing. It seeks to change individual behaviour and supress lifestyle-related risk factors. In the past, however this behavioural prevention strategy has proved ineffective. A structural prevention strategy, as requested by the WHO, should additionally be put into effect with measures that reach all walks of life, not just the health-conscious people in society. It proposes the following: · At least one hour of daily physical activity or sport at school and kindergarten. · A differential food tax that makes unhealthy foods more expensive and healthy foods cheaper (taxing sugary / fatty foods). · Mandatory quality standards for kindergarten and school meals. · Banning food advertising targeted at children. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Addressing the labour shortage

    Energy Technology Data Exchange (ETDEWEB)

    Riemer, J. [Alberta Economic Development, Edmonton, AB (Canada)

    2005-07-01

    Labour shortages are an increasing concern for companies in Alberta, where the economy is booming. This presentation provided statistics on labour shortages and Alberta's labour force. Between 1995 and 2004, employment in Alberta increased by more than 433,000 jobs, and is predicted to grow, but the natural population increase in the province is only 19,600 per year. It is expected that by 2010, immigrants will account for all growth in Canada's labour force. By 2020, an additional $100 billion of capital will be invested in Alberta, which is competing for labour with every other industrialized economy in the world. This presentation included a series of graphs and charts depicting Canada's national unemployment rate by province; Alberta's unemployment rate; oil sands capital expenditure; regional workforce requirements; and new jobs in the oil sands industry from 1998 to 2010. Employment requirements by trade were also highlighted along with projected labour shortages in 16 different trades. The author recommended that better long-term labour supply and demand models are needed along with rationalization and streamlining of credentials systems. Other solutions to labour shortages may include the removal of barriers to interprovincial and foreign workers; education and training; enhanced productivity; industry collaboration; and maximization of the labour pool to include women and Aboriginal workers. tabs., figs.

  11. Labour Shortages in Saskatchewan

    Directory of Open Access Journals (Sweden)

    J.C. Herbert Emery

    2013-01-01

    Full Text Available The predictions in the media and from think tanks sound altogether alarming: Saskatchewan, with its booming economy, could be facing a worker shortage so severe that it could drastically hobble the province’s ultimate economic potential. While the world craves only more of Saskatchewan’s abundant natural resources, the province won’t possibly be able to keep up, due to a scarcity of workers that could be as significant as one-fifth of the labour supply by 2020. The Saskatchewan government has rushed to analyze the predicament, issuing reports that urgently seek solutions. But it hasn’t really developed any solutions. In fact, it hasn’t done much about the supposedly looming crisis at all. And that, actually, might just be all it can — and should — do. In truth, Saskatchewan can’t be sure it will be facing a serious shortage, or any shortage, at all. And any attempt by the provincial government to substantially intervene in the labour market could cause more problems for employers and the economy, than it addresses. Saskatchewan’s labour market has already shown a remarkable ability to adjust, on its own, to the commodities boom, and what employers today call a shortage, could well just be everyone getting used to a much tighter, but still very functional, labour market. The province’s lack of action did mean it missed a once-in-a-lifetime opportunity to redirect a huge cohort of Gen-Y students into training for trades that are in high demand (that cohort is already in its mid-20s and finished, or finishing, its career training. That was a mistake. But one big thing the Saskatchewan government can still do to help employers — and workers — is to stop making the strains on labour worse by launching imminent public infrastructure projects that compete with the private sector for labour. Instead, the province should plan those for when the boom slows down and workers need the jobs. It should also abandon any ideas of ramping

  12. Actos Now for the prevention of diabetes (ACT NOW study

    Directory of Open Access Journals (Sweden)

    Reaven Peter D

    2009-07-01

    Full Text Available Abstract Background Impaired glucose tolerance (IGT is a prediabetic state. If IGT can be prevented from progressing to overt diabetes, hyperglycemia-related complications can be avoided. The purpose of the present study was to examine whether pioglitazone (ACTOS® can prevent progression of IGT to type 2 diabetes mellitus (T2DM in a prospective randomized, double blind, placebo controlled trial. Methods/Design 602 IGT subjects were identified with OGTT (2-hour plasma glucose = 140–199 mg/dl. In addition, IGT subjects were required to have FPG = 95–125 mg/dl and at least one other high risk characteristic. Prior to randomization all subjects had measurement of ankle-arm blood pressure, systolic/diastolic blood pressure, HbA1C, lipid profile and a subset had frequently sampled intravenous glucose tolerance test (FSIVGTT, DEXA, and ultrasound determination of carotid intima-media thickness (IMT. Following this, subjects were randomized to receive pioglitazone (45 mg/day or placebo, and returned every 2–3 months for FPG determination and annually for OGTT. Repeat carotid IMT measurement was performed at 18 months and study end. Recruitment took place over 24 months, and subjects were followed for an additional 24 months. At study end (48 months or at time of diagnosis of diabetes the OGTT, FSIVGTT, DEXA, carotid IMT, and all other measurements were repeated. Primary endpoint is conversion of IGT to T2DM based upon FPG ≥ 126 or 2-hour PG ≥ 200 mg/dl. Secondary endpoints include whether pioglitazone can: (i improve glycemic control (ii enhance insulin sensitivity, (iii augment beta cell function, (iv improve risk factors for cardiovascular disease, (v cause regression/slow progression of carotid IMT, (vi revert newly diagnosed diabetes to normal glucose tolerance. Conclusion ACT NOW is designed to determine if pioglitazone can prevent/delay progression to diabetes in high risk IGT subjects, and to define the mechanisms (improved insulin

  13. Cancer preventive services, socioeconomic status, and the Affordable Care Act.

    Science.gov (United States)

    Cooper, Gregory S; Kou, Tzuyung Doug; Dor, Avi; Koroukian, Siran M; Schluchter, Mark D

    2017-05-01

    Out-of-pocket expenditures are thought to be an important barrier to the receipt of cancer preventive services, especially for those of a lower socioeconomic status (SES). The Affordable Care Act (ACA) eliminated out-of-pocket expenditures for recommended services, including mammography and colonoscopy. The objective of this study was to determine changes in the uptake of mammography and colonoscopy among fee-for-service Medicare beneficiaries before and after ACA implementation. Using Medicare claims data, this study identified women who were 70 years old or older and had not undergone mammography in the previous 2 years and men and women who were 70 years old or older, were at increased risk for colorectal cancer, and had not undergone colonoscopy in the past 5 years. The receipt of procedures in the 2-year period before the ACA's implementation (2009-2010) and after its implementation (2011 to September 2012) was also identified. Multivariate generalized estimating equation models were used to determine the independent association and county-level quartile of median income and education with the receipt of testing. For mammography, a lower SES quartile was associated with less uptake, but the post-ACA disparities were smaller than those in the pre-ACA period. In addition, mammography rates increased from the pre-ACA period to the post-ACA period in all SES quartiles. For colonoscopy, in both the pre- and post-ACA periods, there was an association between uptake and educational level and, to some extent, income. However, there were no appreciable changes in colonoscopy and SES after implementation of the ACA. The removal of out-of-pocket expenditures may overcome a barrier to the receipt of recommended preventive services, but for colonoscopy, other procedural factors may remain as deterrents. Cancer 2017;123:1585-1589. © 2017 American Cancer Society. © 2017 American Cancer Society.

  14. Economic Impacts of Power Shortage

    Directory of Open Access Journals (Sweden)

    Peng Ou

    2016-07-01

    Full Text Available The electricity industry is a basic industry of the national economy. It has experienced several large-scale power shortages, hard power shortage and soft power shortage, which have brought a great threat to China’s sustainable economic development. To solve this problem better, it is necessary to make a quantitative assessment of the economic impacts of power shortage. The CGE model is commonly used for simulating economic shocks and policy effects. It describes supply, demand and equilibrium in different markets by simulating the economic mechanism through a set of equations. Once changed, the exogenous variables will affect a certain part of the system and then the whole system, leading to changes in quantities and prices. The equilibrium state will also change from one to another. A static CGE model is built in this paper, and the Social Accounting Matrix (SAM of eight sectors of China in 2007 is compiled, in order to simulate the economic impacts of hard power shortage and soft power shortage. Simulation results show that the negative effects of power shortage on economic development are very significant, and the effects vary in different sectors. Especially, under the background of hard power shortage, the industrial sector suffers most. The economic cost of power shortage is considerable, and the main reason for it is the specific administrative pricing system in China. The low electricity price in the long term will lead to insufficient construction and hard power shortage; moreover, that in the short run would result in soft power shortage. In order to solve the problem of power shortage completely, power system reform is inevitable.

  15. Competence building capacity shortage

    International Nuclear Information System (INIS)

    Doorman, Gerard; Wangensteen, Ivar; Bakken, Bjoern

    2005-02-01

    The objective of the project 'Competence Building Capacity Shortage' has been 'to increase knowledge about central approaches aimed at solving the peaking capacity problem in restructured power systems'. With respect to reserve markets, a model was developed in the project to analyze the relations between reserve requirements and prices in the spot and reserve markets respectively. A mathematical model was also developed and implemented, which also includes the balance market, and has a good ability to predict the relations between these markets under various assumptions. With some further development, this model can be used fore realistic analyses of these markets in a Nordic context. It was also concluded that certain system requirements with respect to frequency and time deviation can be relaxed without adverse effects. However, the requirements to system bias, Frequency Activated Operating Reserves and Frequency Activated Contingency Reserves cannot be relaxed, the latter because they must cover the dimensioning fault in the system. On the other hand, Fast Contingency Reserves can be reduced by removing requirements to national balances. Costs can furthermore be reduced by increasingly adapting a Nordic as opposed to national approach. A model for stepwise power flow was developed in the project, which is especially useful to analyze slow power system dynamics. This is relevant when analysing the effects of reserve requirements. A model for the analysis of the capacity balance in Norway and Sweden was also developed. This model is useful for looking at the future balance under various assumptions regarding e.g. weather conditions, demand growth and the development of the generation system. With respect to the present situation, if there is some price flexibility on the demand side and system operators are able to use reserves from the demand side, the probability for load shedding during the peak load hour is close to zero under the weather conditions after

  16. 18 CFR 294.101 - Shortages of electric energy and capacity.

    Science.gov (United States)

    2010-04-01

    ... customers; and (ii) It will report any modifications to its contingency plans for accommodating shortages... REGULATORY POLICIES ACT OF 1978 § 294.101 Shortages of electric energy and capacity. (a) Definition of... customers. (4) If a plan for accommodating any shortages of electric energy or capacity affecting its firm...

  17. Preventing perinatal HIV transmission - nowisthe time to act!

    African Journals Online (AJOL)

    been met with denial, procrastination and bungling. From a public health point of view this has been a disaster. Will we again miss the chance to act decisively when it comes to perinatal transmission? For African scientists to try to politicise criticism of placebo trials as intervention from the. West is wrong. Rather, they must ...

  18. Malicious acts involving radioactive sources: prevention and preparedness for response

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.

    2008-01-01

    Full text: The increasing concern over the malevolent use of radioactive sources and radiological terrorism demands strengthening the preparedness for response to radiological emergencies. In spite of various security measures adopted internationally, availability of orphan sources cannot be completely ruled out. The trends in terrorism also indicates the possibility of various means which may be adopted by terrorists especially if they are aware of the challenges of radioactive contamination in public domain and the capability of 'denial of area' and the fear factor which can be injected during such radiological emergencies. It is to be well understood that whatever measures are taken by some countries in preventing the sources from getting stolen or smuggled in/out of their country are not adequate to eliminate radiological terrorism in a global level unless all nations collectively address and ensure the security of radioactive sources, hence preventing the generation of any orphan sources. While preparedness for response to various radiological emergency scenario have many common factors, the challenges involved in responding to radiological terrorism involves understanding the fear factor due to the presence of radioactive contamination after the blast and thermal effects on the victims and issues like handling of contaminated and seriously injured persons, restriction on the movement of responders and forensic teams in a contaminated field etc. Hence an understanding and anticipation of all possible means of radiological terrorism is very essential to prevent and to reduce the consequences. There are many deterrents, which are to be developed and maintained by all nations collectively which should include intelligence, wide usage of radiation monitors by customs, police and other security agencies, installation of state of the art high sensitive radiation monitors and systems etc to prevent and deter stealing and illicit trafficking of radioactive sources

  19. 28 CFR 501.3 - Prevention of acts of violence and terrorism.

    Science.gov (United States)

    2010-07-01

    ... deterring future acts of violence or terrorism; (ii) That communications between the inmate and attorneys or... terrorism. 501.3 Section 501.3 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE GENERAL MANAGEMENT AND ADMINISTRATION SCOPE OF RULES § 501.3 Prevention of acts of violence and terrorism. (a) Upon...

  20. Prevention of diabetes with pioglitazone in ACT NOW: physiologic correlates.

    Science.gov (United States)

    Defronzo, Ralph A; Tripathy, Devjit; Schwenke, Dawn C; Banerji, Maryann; Bray, George A; Buchanan, Thomas A; Clement, Stephen C; Gastaldelli, Amalia; Henry, Robert R; Kitabchi, Abbas E; Mudaliar, Sunder; Ratner, Robert E; Stentz, Frankie B; Musi, Nicolas; Reaven, Peter D

    2013-11-01

    We examined the metabolic characteristics that attend the development of type 2 diabetes (T2DM) in 441 impaired glucose tolerance (IGT) subjects who participated in the ACT NOW Study and had complete end-of-study metabolic measurements. Subjects were randomized to receive pioglitazone (PGZ; 45 mg/day) or placebo and were observed for a median of 2.4 years. Indices of insulin sensitivity (Matsuda index [MI]), insulin secretion (IS)/insulin resistance (IR; ΔI0-120/ΔG0-120, ΔIS rate [ISR]0-120/ΔG0-120), and β-cell function (ΔI/ΔG × MI and ΔISR/ΔG × MI) were calculated from plasma glucose, insulin, and C-peptide concentrations during oral glucose tolerance tests at baseline and study end. Diabetes developed in 45 placebo-treated vs. 15 PGZ-treated subjects (odds ratio [OR] 0.28 [95% CI 0.15-0.49]; P IGT > T2DM) was associated with improvements in insulin sensitivity (OR 0.61 [95% CI 0.54-0.80]), IS (OR 0.61 [95% CI 0.50-0.75]), and β-cell function (ln IS/IR index and ln ISR/IR index) (OR 0.26 [95% CI 0.19-0.37]; all P < 0.0001). Of the factors measured, improved β-cell function was most closely associated with final glucose tolerance status.

  1. Prevention of Diabetes With Pioglitazone in ACT NOW

    Science.gov (United States)

    DeFronzo, Ralph A.; Tripathy, Devjit; Schwenke, Dawn C.; Banerji, MaryAnn; Bray, George A.; Buchanan, Thomas A.; Clement, Stephen C.; Gastaldelli, Amalia; Henry, Robert R.; Kitabchi, Abbas E.; Mudaliar, Sunder; Ratner, Robert E.; Stentz, Frankie B.; Musi, Nicolas; Reaven, Peter D.

    2013-01-01

    We examined the metabolic characteristics that attend the development of type 2 diabetes (T2DM) in 441 impaired glucose tolerance (IGT) subjects who participated in the ACT NOW Study and had complete end-of-study metabolic measurements. Subjects were randomized to receive pioglitazone (PGZ; 45 mg/day) or placebo and were observed for a median of 2.4 years. Indices of insulin sensitivity (Matsuda index [MI]), insulin secretion (IS)/insulin resistance (IR; ΔI0–120/ΔG0–120, ΔIS rate [ISR]0–120/ΔG0–120), and β-cell function (ΔI/ΔG × MI and ΔISR/ΔG × MI) were calculated from plasma glucose, insulin, and C-peptide concentrations during oral glucose tolerance tests at baseline and study end. Diabetes developed in 45 placebo-treated vs. 15 PGZ-treated subjects (odds ratio [OR] 0.28 [95% CI 0.15–0.49]; P IGT > T2DM) was associated with improvements in insulin sensitivity (OR 0.61 [95% CI 0.54–0.80]), IS (OR 0.61 [95% CI 0.50–0.75]), and β-cell function (ln IS/IR index and ln ISR/IR index) (OR 0.26 [95% CI 0.19–0.37]; all P < 0.0001). Of the factors measured, improved β-cell function was most closely associated with final glucose tolerance status. PMID:23863810

  2. Radiation Protection Ordinance. Preventive Radiation Protection Act. 3. rev. and enlarged ed.

    International Nuclear Information System (INIS)

    Kramer, R.; Zerlett, G.

    1990-01-01

    This 3rd edition presents the official explanations of the legislative intent behind the Radiation Protection Ordinance of 1976 and the 2nd amending ordinance, and the commentaries which as usual refer to the legal aspects and the related medical, scientific, and technical aspects. As a consequence of the reactor accident at Chernobyl, the existing radiation protection law has been extended by the Act for Preventive Measures for Pretection of the Population Against the Hazards of Ionizing Radiation (Preventive Radiation Protection Act), establishing preventive legal provisions and measures, so that this new edition has likewise been extended by commentaries on the Protective Radiation Protection Act and an introduction to the new area of law. The material also includes the Act for Establishment of a Federal Office for Radiation Protection, of October 9, 1989, which amended the Atomic Energy Act and the Preventive Radiation Protection Act. The correction of the Radiation Protection Ordinance of October 16, 1989 (BGBl. I p. 1926) has been incorporated into the text of the amended version of the Radiation Protection Ordinance. Court decisions and literature referred to cover material published up to the first months of 1989. (orig.) [de

  3. Drug shortages: Implications for medical toxicology.

    Science.gov (United States)

    Mazer-Amirshahi, Maryann; Hawley, Kristy L; Zocchi, Mark; Fox, Erin; Pines, Jesse M; Nelson, Lewis S

    2015-07-01

    Drug shortages have significantly increased over the past decade. There are limited data describing how shortages impact medical toxicology of drugs. To characterize drug shortages affecting the management of poisoned patients. Drug shortage data from January 2001 to December 2013 were obtained from the University of Utah Drug Information Service. Shortage data for agents used to treat poisonings were analyzed. Information on drug type, formulation, reason for shortage, shortage duration, marketing, and whether the drug was available from a single source was collected. The availability of a substitute therapy and whether substitutes were in shortage during the study period were also investigated. Of 1,751 shortages, 141 (8.1%) impacted drugs used to treat poisoned patients, and as of December 2013, 21 (14.9%) remained unresolved. New toxicology shortages increased steadily from the mid-2000s, reaching a high of 26 in 2011. Median shortage duration was 164 days (interquartile range: 76-434). Generic drugs were involved in 85.1% of shortages and 41.1% were single-source products. Parenteral formulations were often involved in shortages (89.4%). The most common medications in shortage were sedative/hypnotics (15.6%). An alternative agent was available for 121 (85.8%) drugs; however, 88 (72.7%) alternatives were also affected by shortages at some point during the study period. When present, the most common reasons reported were manufacturing delays (22.0%) and supply/demand issues (17.0%). Shortage reason was not reported for 48.2% of drugs. Toxicology drug shortages are becoming increasingly prevalent, which can result in both suboptimal treatment and medication errors from using less familiar alternatives. Drug shortages affected a substantial number of critical agents used in the management of poisoned patients. Shortages were often of long duration and for drugs without alternatives. Providers caring for poisoned patients should be aware of current shortages and

  4. Los Angeles County Juvenile Justice Crime Prevention Act. Fiscal Year 2009-2010 Report. Technical Report

    Science.gov (United States)

    Fain, Terry; Turner, Susan; Ridgeway, Greg

    2012-01-01

    In 2000, the California State Legislature passed what is now known as the Juvenile Justice Crime Prevention Act (JJCPA). This effort was designed to provide a stable funding source to counties for juvenile programs that have been proven effective in curbing crime among juvenile probationers and young at-risk offenders. The Corrections Standards…

  5. 78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Science.gov (United States)

    2013-02-06

    ... 2713 of the Public Health Service Act requires coverage without cost sharing of certain preventive... Requirement to Cover Contraceptive Services Without Cost Sharing Under Section 2713 of the Public Health..., non-stock, public benefit, and similar types of corporations. However, for this purpose an...

  6. ROMANIAN TOURISM FACING LABOUR SHORTAGE

    Directory of Open Access Journals (Sweden)

    Cristina Simon

    2008-05-01

    Full Text Available The purpose of this paper is to present the main trends în the Romanian tourism sector andtheir impact on the labour market. The first part of the paper presents the main trends în the travel and tourismsector. The second part of the paper focuses on the challenges of the labour market în the hotel sector,highlighting essential aspect related to the declining of population, shortage of the workforce, emigration,financial compensations. The final part exposes few ideas and possible suggestions that can be applied into thetravel and tourism sector în order to better manage the multiple dimensions of growth.

  7. Preventing Interpersonal Violence on College Campuses: The Effect of One Act Training on Bystander Intervention.

    Science.gov (United States)

    Alegría-Flores, Kei; Raker, Kelli; Pleasants, Robert K; Weaver, Mark A; Weinberger, Morris

    2015-05-22

    Sexual assault, stalking, dating violence, and intimate partner violence, herein collectively termed interpersonal violence (IV), are public health problems affecting 20% to 25% of female college students. Currently, One Act is one of the few IV prevention training programs at universities that teach students bystander skills to intervene in low- and high-risk IV situations. The objectives of this study were 1) to evaluate One Act's effects on date rape attitudes and behaviors, and bystanders' confidence, willingness to help, and behavior, and 2) to compare the effects on bystander skills between One Act and Helping Advocates for Violence Ending Now (HAVEN), an IV response training program with similar participants. Data were collected over 2 years, before and after One Act and HAVEN trainings. We measured outcomes with four scales: College Date Rape Attitudes and Behaviors, Bystander Confidence, Willingness to Help, and Bystander Behavior. The analysis compared within- and between-group mean differences in scale scores pre- and post-trainings using linear mixed models. One Act showed improvements for date rape attitudes and behaviors (p trainings' effects on bystander willingness to help and behavior had similar patterns but were not statistically significant. We found a larger positive impact on bystander confidence among students who participated in the bystander prevention training compared with the response training. Further research is needed to improve the measures for bystander behavior and measure the bystander trainings' larger impact on the community. © The Author(s) 2015.

  8. 28 CFR 0.177 - Applications for orders under the Comprehensive Drug Abuse Prevention and Control Act.

    Science.gov (United States)

    2010-07-01

    ... Comprehensive Drug Abuse Prevention and Control Act. 0.177 Section 0.177 Judicial Administration DEPARTMENT OF... the Comprehensive Drug Abuse Prevention and Control Act. Notwithstanding the delegation of functions... authorized to exercise the authority vested in the Attorney General by section 514 of the Comprehensive Drug...

  9. Regulatory challenges in developing long-acting antiretrovirals for treatment and prevention of HIV infection.

    Science.gov (United States)

    Arya, Vikram; Au, Stanley; Belew, Yodit; Miele, Peter; Struble, Kimberly

    2015-07-01

    To outline some of the regulatory challenges inherent to the development of long-acting antiretrovirals (ARVs) for the treatment or prevention of HIV infection. Despite advances in drug development that have reduced ARV dosing to once daily, suboptimal drug adherence remains an obstacle to successful HIV treatment. Further, large randomized trials of once daily oral ARVs for preexposure prophylaxis (PrEP) have shown that drug adherence correlates strongly with prophylactic effect and study outcomes. Thus, the prospect of developing long-acting ARVs, which may mitigate drug adherence issues, has attracted considerable attention lately. Because of their pharmacokinetic properties, the development of long-acting ARVs can present novel regulatory challenges. Chief among them is determining the appropriate dosing regimen, the need for an oral lead-in, and whether existing data with an approved oral agent, if available, can be leveraged for a treatment or prevention indication. For PrEP, because validated biomarkers are lacking, additional nonclinical studies and evaluation of tissue concentrations in multiple compartments may be necessary to identify optimal dosages. Study design and choice of controls for registrational trials of new long-acting PrEP agents might also prove challenging following the availability of an oral PrEP drug.

  10. The Patient Protection and Affordable Care Act and Utilization of Preventive Health Care Services

    Directory of Open Access Journals (Sweden)

    Victor Eno

    2016-02-01

    Full Text Available We examined how (a health insurance coverage, and (b familiarity with the Patient Protection and Affordable Care Act (ACA’s or ObamaCare mandate of cost-free access to preventive health services, affect the use of preventive services by residents of a minority community. It was based on primary data collected from a survey conducted during March to April 2012 among a sample of self-identified African American adults in Tallahassee-Leon County area of northwest Florida. The Statistical Package for the Social Sciences (SPSS Version 22 was used for running frequency analysis on the data set and multivariable regression modeling. The results showed that of 524 respondents, 382 (73% had health insurance while 142 (27% lacked insurance. Majority of insured respondents, 332 (87%, used preventive health services. However, the remaining 13% of respondents did not use preventive services because they were unfamiliar with the ACA provision of free access to preventive services for insured people. Regression analysis showed a high (91.04% probability that, among the insured, the use of preventive health services depended on the person’s age, income, and education. For uninsured residents, the lack of health insurance was the key reason for non-use of preventive health services, while among the insured, lack of knowledge about the ACA benefit of free access contributed to non-use of preventive services. Expansion of Medicaid eligibility can increase insurance coverage rates among African Americans and other minority populations. Health promotion and awareness campaigns about the law’s benefits by local and state health departments can enhance the use of preventive services.

  11. Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan

    Directory of Open Access Journals (Sweden)

    Min-Li Chen

    2017-06-01

    Full Text Available Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1 to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2 to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70, grocery stores (n = 83, and betel nut stalls (n = 81. The results indicated that among the 234 retailers, 171 (73.1% of them routinely failed to confirm the buyers’ ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1% to 59 (25.2% and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9% to 175 (74.8% after counseling strategies had been provided, thereby revealing statistical significance (χ2 = 11.26, p < 0.001. Study II: A total of 476 (89.1% participants had received tobacco hazards prevention education and 58 (10.9% had not. Among the various residential areas, the highest percentage of participants that did not received tobacco hazards prevention education located in the plane regions (8.4%. The government organizations should continue to adopt counseling strategies to reduce the rate of disobedience of the Tobacco Hazards

  12. Providing a Clean Environment for Adolescents: Evaluation of the Tobacco Hazards Prevention Act in Taiwan.

    Science.gov (United States)

    Chen, Min-Li; Chou, Li-Na; Zheng, Ya-Cheng

    2017-06-13

    Cigarette smoking not only damages the health of adolescents, but also contributes to air pollution. The Tobacco Hazards Prevention Act in Taiwan stipulates that cigarettes should not be sold to persons younger than 18 years. Therefore, schools should actively educate students and raise awareness of the Tobacco Hazards Prevention Act to reduce the level of damage to the health of adolescents and maintain good air quality. This study had two main goals: (1) to evaluate the stipulation that no person shall provide tobacco products to persons under the age of 18 and the effects of counseling strategies on store managers confirming customer ages before tobacco sale in southern Taiwan; and (2) to evaluate the situation of tobacco hazard prevention education conducted by school in southern Taiwan. A cross-sectional design was adopted for this study. Study I: The investigation involved an analysis of 234 retailers including convenience stores (n = 70), grocery stores (n = 83), and betel nut stalls (n = 81). The results indicated that among the 234 retailers, 171 (73.1%) of them routinely failed to confirm the buyers' ages before allowing them to purchase tobacco. The number of retailers who exhibited failure to confirm customer ages before selling tobacco products had decreased from 171 (73.1%) to 59 (25.2%) and that of those who confirmed customer ages before selling tobacco products had increased from 63 (26.9%) to 175 (74.8%) after counseling strategies had been provided, thereby revealing statistical significance (χ² = 11.26, p selling tobacco products to minors. Schools should pay close attention to tobacco hazard prevention education for junior high school students to ensure that such students are adequately educated about tobacco hazard prevention.

  13. Nursing and Allied Health Shortages: TBR Responds.

    Science.gov (United States)

    Berryman, Treva

    Staff members of the Tennessee Board of Regents (TBR) and the Tennessee Higher Education Commission worked jointly to establish a task force to investigate and develop recommendations for addressing the workforce shortages in nursing and allied health in Tennessee. The investigation established that Tennessee already has a workforce shortage of…

  14. Drug shortages in Israel: regulatory perspectives, challenges and solutions.

    Science.gov (United States)

    Schwartzberg, Eyal; Ainbinder, Denize; Vishkauzan, Alla; Gamzu, Ronni

    2017-01-01

    Pharmaceutical drug shortages (DSs) are a global problem which presents challenges to countries around the world. Shortages of pharmaceutical products may have a direct detrimental impact on public health and patients' wellbeing by causing delayed, or even lack of, treatment. Moreover, DSs may force both patients and caregivers to use unfamiliar drugs, which could lead to medication errors. The objective of our study was to analyze DSs in Israel during the years 2013-2015, assessing their etiology and exploring the steps taken for their mitigation and prevention. The database of the Israeli Ministry of Health (MoH) on drug shortages contains all the DSs recorded in Israel since 2013, detailing the cause of the DS, its duration, steps taken in its' management and the availability of generic or therapeutic alternatives. Selected examples of DSs from the database are described in this paper in order to identify the causes of DSs, the scope of the problem and possible solutions. Additionally, we have reviewed the recent activities performed by European Medicine Agency (EMA) and the American Food and Drug Administration (FDA) in their efforts to minimize this problem. Several factors contributing towards DSs in Israel were identified, including quality problems in both the final drug product and in the raw materials, upgrades and improvements of the manufacturing process required by the MoH, manufacturing by a sole supplier, dramatic price decrease in off-patent medications causing the manufacturer to discontinue the distribution of the product in Israel, just-in-time inventory control, and others. One of the most important steps in managing drug shortages was identified to be early notification of the shortage by the Marketing Authorization Holder (MAH) to the MoH. In 2013, the Israeli MoH updated the regulation on drug shortages instructing MAHs on their obligation of early notification to the MoH. Furthermore, various steps dealing with marketing withdrawal of drugs

  15. Drug shortage management in Alabama hospital pharmacies

    Directory of Open Access Journals (Sweden)

    Oliver W. Holmes, III

    2013-01-01

    Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages. Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used. Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals. Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.   Type: Original Research

  16. Drug shortage management in Alabama hospital pharmacies

    Directory of Open Access Journals (Sweden)

    Oliver W. Holmes III, Pharm.D. Candidate 2013

    2013-01-01

    Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages.Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used.Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals.Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.

  17. Administration of the natural gas shortage in the USA

    Energy Technology Data Exchange (ETDEWEB)

    Pluge, W [Koeln Univ. (Germany, F.R.). Inst. fuer Energiewirtschaft

    1978-05-01

    The natural gas deficit is basically a consequence of the price policy of the U.S. government which keeps the prices of natural gas transported from one state to another subject to a maximum-price regulation. In the course of this development, the U.S. natural gas market has been characterized by three different types of shortage since the early seventies. There are regional differences in the administration of the shortage. Compared to the alternatives the rationing plan of the Federal Energy Regulatory Commission (FERC) is the best solution from on overall economic point of view, but it is rather impracticable and hard to put through completely. Natural gas rationing in the USA did not prevent temporary production losses and unemployment due to shortage. If the maximum-price regulation policy for natural gas is continued, the supply deficit for this energy carrier will become even greater. If, as the National Energy Plan proposes, the maximum-price regulation for natural gas would also pertain to the intrastate market in the future, natural gas shortages would occur there, too.

  18. Overview of allied health personnel shortages.

    Science.gov (United States)

    Elwood, T W

    1991-01-01

    Upon learning that 95% of all fatal traffic accidents occur within three miles of one's home, an acquaintance moved to another residence four miles away and is still alive today. The world might be a much better place if most obstacles could be overcome this handily. Unfortunately, the problem of allied health personnel shortages appears to be more intractable. Because the situation is complicated in nature, it is most unlikely that any single remedy will suffice. Public and private interests have joined forces in many states, but it is abundantly clear that conventional market forces are unlikely to prevail. These forces usually focus on supply and demand. While shortages may cause entry-level salaries to rise, they do not stimulate academic institutions to increase their output nor will they affect the availability of research funding and/or doctoral training programs. Current market forces compel health facilities to engage in bidding wars for scarce manpower. Although individual job seekers may benefit, this practice does not increase the number of training program graduates. The federal government has a decisive role to play in assuring an adequate number of personnel to meet this nation's health care needs. Assistance is necessary in the form of providing entry- and advanced-level traineeships to accelerate the flow of part-time students pursuing doctorates, and to fund model student recruitment/retention projects. This role should encompass attracting students (particularly from minority and underserved portions of the population) to academic programs. The Disadvantaged Minority Health Improvement Act, PL 101-527 that was enacted in November 1990, contains only minimal provisions for allied health. Eligibility for student scholarship assistance is restricted to a small handful of allied health professions. Moreover, allied health is not eligible for the loan repayment program aimed at individuals who agree to serve on the faculty of health professions

  19. A Shortage of Medical Residency Positions: Parallels with Psychology.

    Science.gov (United States)

    LaPaglia, Donna; Robiner, William N; Yozwiak, John A; Brosig, Cheryl; Cubic, Barbara; Leventhal, Gerald

    2015-12-01

    Physician shortages in the US are expected to intensify with the implementation of the Patient Protection and Affordable Care Act. These shortages may negatively impact access to care, quality of care, and confidence in the system's ability to adequately provide for health needs in the US. Concerns regarding physician demand underscore how critical Graduate Medical Education funding is to preparing the physician workforce. In 2014 5.6 % of US medical school seniors did not match into residency. Psychology has faced longstanding training imbalance issues with a misalignment between the number of internship positions and the number of applicants. The authors summon attention to the damaging effects a training imbalance poses to a health care profession, its trainees, and ultimately the public it serves.

  20. FINANCIAL INSTRUMENTS OF THE STATE POLICY FOR THE PREVENTION OF TERRORIST ACTS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    Mykola Bunchuk

    2017-11-01

    Full Text Available The article’s objective is to determine the mechanism for implementing the financial instruments of the state policy to counter terrorist acts in the territory not controlled by Ukrainian authorities in Donetsk and Luhansk regions. Methodology. Within the scientific research, for the most effective approaches at the national level to prevent the threat of international terrorism, under the conditions of the deep internal political crisis and extremely difficult economic situation, in order to improve the efficiency of public administration in developing and implementing the anti-terrorism state policies in Ukraine, the paper analyses international and domestic regulations on preventing the terrorist financing, considers factors that affect the deterioration of the social and economic situation of the temporarily occupied parts of Donbas. Results of the research allow formulating the definition of financial instruments of antiterrorist policies, the paper develops and proposes a series of organizational measures in order to prevent the terrorist financing in Ukraine. Practical implications. Based on the above, we propose an option of classification of main illegal mechanisms that may be used to finance terrorist activities in the territories of Donetsk and Luhansk regions uncontrolled by Ukrainian authorities, dividing them into internal and external. Given the above studied factors and classification of financing of terrorist acts in eastern Ukraine, we can assume that for the purpose of evading duty payable to relevant state bodies of Ukraine, external supplies of inventories in the uncontrolled areas of the Donetsk region, which are later obtained by illegal armed groups, are possibly carried out as follows: on behalf of a commercial entity registered in a foreign country for the Ukrainian commercial entity, registered in settlements located in the uncontrolled territory; crossing of international transit traffic that moves through the

  1. Retailer adherence to Family Smoking Prevention and Tobacco Control Act, North Carolina, 2011.

    Science.gov (United States)

    Rose, Shyanika W; Myers, Allison E; D'Angelo, Heather; Ribisl, Kurt M

    2013-04-04

    The Family Smoking Prevention and Tobacco Control Act regulates the sales and marketing of tobacco products in the United States; poor adherence by tobacco retailers may reduce the effectiveness of the Act's provisions. The objectives of this study were 1) to assess whether and to which provisions retailers were adherent and 2) to examine differences in adherence by county, retailer neighborhood, and retailer characteristics. We conducted multivariate analysis of tobacco retailers' adherence to 12 point-of-sale provisions of the Tobacco Control Act in 3 North Carolina counties. We conducted observational audits of 324 retailers during 3 months in 2011 to assess adherence. We used logistic regression to assess associations between adherence to provisions and characteristics of each county, retailer neighborhood, and retailer. We found 15.7% of retailers did not adhere to at least 1 provision; 84.3% adhered to all provisions. The provisions most frequently violated were the ban on sales of cigarettes with modified-risk labels (eg, "light" cigarettes) (43 [13.3%] retailers nonadherent) and the ban on self-service for cigarettes and smokeless tobacco (6 [1.9%] retailers nonadherent). We found significant differences in rates of nonadherence by county and type of retailer. Pharmacies and drug stores were more than 3 times as likely as grocery stores to be nonadherent. Most tobacco retailers have implemented regulatory changes without enforcement by the US Food and Drug Administration. Monitoring rates of adherence by store type and locale (eg, county) may help retailers comply with point-of-sale provisions.

  2. Seasonal blood shortages can be eliminated.

    Science.gov (United States)

    Gilcher, Ronald O; McCombs, Suzanne

    2005-11-01

    This review is designed to help readers understand seasonal blood shortages and provide solutions through the use of technology that can increase the number of red blood cell units collected and the use of recruitment and marketing initiatives that appeal to the increasingly diverse donor base. Seasonal shortages are, in reality, mostly shortages of group O red blood cells and occur most commonly during midsummer and early winter. The shortages occur primarily from increased use of group O red blood cells at times of decreased donor availability. While reducing the disproportionate use of red cells will help, blood centers can more quickly reduce the seasonal deficits by using automated red cell technology to collect double red blood cell units; targeted marketing programs to provide effective messages; seasonal advertising campaigns; and recognition, benefits, and incentives to enhance the donor motivation donation threshold. A multi-level approach to increasing blood donations at difficult times of the year can ensure that donations are increased at a time when regular donor availability is decreased. Seasonal blood shortages can be eliminated by understanding the nature of the shortages, why and when they occur, and using more sophisticated recruitment and marketing strategies as well as automated collection technologies to enhance the blood supply.

  3. Treatment and prevention of HIV infection with long-acting antiretrovirals.

    Science.gov (United States)

    Benítez-Gutiérrez, Laura; Soriano, Vicente; Requena, Silvia; Arias, Ana; Barreiro, Pablo; de Mendoza, Carmen

    2018-05-01

    Current antiretroviral therapy allows to achieve and sustain maximal suppression of HIV replication in most treated patients. As result, the life expectancy of HIV-infected persons has improved dramatically and is nowadays similar to that of the HIV-negative population. However, oral antiretrovirals have to be taken daily and indefinitely to avoid resumption of HIV replication and selection of drug resistance. Unfortunately, drug adherence is often suboptimal and tends to decline over time. Areas covered: New drugs, formulations and delivery systems are being developed for extended-release of antiretrovirals. At this time, intramuscular cabotegravir and rilpivirine, dapivirine vaginal rings and tenofovir alafenamide subdermal implants are the products in more advanced stages of clinical development. Their pharmacokinetics/dynamics and safety/efficacy are reviewed. Expert commentary: In the absence of eradicative therapy for individuals with HIV infection and protective vaccines for persons at risk, long-term antiretroviral therapy is the best approach for preventing disease progression in patients and halting transmissions, either as result of 'treatment as prevention' for HIV carriers or 'pre-exposure prophylaxis' for uninfected individuals at risk. In all these scenarios, the advent of long-acting antiretrovirals will expand options for overcoming the challenge of suboptimal drug adherence and reduce the burden of HIV infection.

  4. Combination treatment with risperidone long-acting injection and psychoeducational approaches for preventing relapse in schizophrenia

    Directory of Open Access Journals (Sweden)

    Zhao Y

    2013-10-01

    Full Text Available Yueren Zhao,1–3 Taro Kishi,1 Nakao Iwata,1 Manabu Ikeda3,4 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Okehazama Hospital Fujita Kokoro Care Center, Toyoake, Aichi, Japan; 3Department of Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan; 4Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan Abstract: A recent meta-analysis showed that long-acting injectable (LAI antipsychotics were not superior to oral antipsychotics for preventing relapse in patients with schizophrenia. We therefore designed a treatment strategy combining risperidone LAI and COMPASS (COMprehensive Psycho-educational Approach and Scheme Set, an original psychoeducational program supporting treatment with risperidone LAI and evaluating subjective treatment satisfaction, transition of symptoms, and effectiveness in preventing symptomatic relapse. The aim of this study was to examine whether addition of COMPASS to risperidone LAI was more effective in preventing relapse in schizophrenia patients than risperidone LAI alone, with the latter group consisting of patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients were followed up for 6 months, with COMPASS continuously implemented from the transition to the observation phase. The primary efficacy measurements were relapse rate (rates of rehospitalization and discontinuation due to inefficacy. Secondary efficacy measurements were the Brief Psychiatric Rating Scale (BPRS and Global Assessment of Functioning (GAF scores. Of the 96 patients originally enrolled, 19 (19.8% were discontinued from all causes. During the 6-month study period, ten of the 96 patients (10.4% relapsed, compared with a 12.2% relapse rate in patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients showed significant improvements in BPRS total

  5. Pollution prevention incentives and disincentives created by the Clean Air Act

    International Nuclear Information System (INIS)

    Webb, C.F.; Wolffe, G.S.

    1998-01-01

    Environmental laws and regulations have not always been implemented in a manner that allows for the consideration of pollution prevention (P2) alternatives as a means of achieving progress toward air quality goals. Recently, the US Environmental Protection Agency (EPA) has been making strides to reinterpret laws and regulations to be more flexible and encourage P2 projects that do not involve end-of-the-pipe controls. For instance, when conducting control technology evaluations such as best available control technology (BACT) and lowest achievable emission rate (LAER), facilities can and should take into consideration P2 options that accomplish the same emission reduction goals as traditional end-of-the-pipe controls. There are also new emissions trading provisions building on those allowed in the acid rain and offset trading programs that promise to make P2 projects much more cost-effective. Several traditional 'command-and-control' programs of the Clean Air Act (CAA) also promote P2 projects. For instance, emission reductions realized through P2 projects show managers a direct cost savings due to reductions in Title V facility annual emissions fees and possibly a direct cost benefit through sale of emission credits. Furthermore, the CAA encourages P2 indirectly through the detail understanding of processes gained from emissions inventories and risk management plans (RMPs). However, many CAA prescriptive programs create disincentives for industry to select P2 alternatives. 30 refs

  6. Family Smoking Prevention And Tobacco Control Act: banning outdoor tobacco advertising near schools and playgrounds.

    Science.gov (United States)

    Luke, Douglas A; Ribisl, Kurt M; Smith, Carson; Sorg, Amy A

    2011-03-01

    The tobacco industry has challenged new FDA rules restricting outdoor tobacco advertising near schools and playgrounds on First Amendment grounds, arguing that they would lead to a near complete ban on tobacco advertising in dense urban areas. To examine how the 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) rules banning outdoor tobacco advertising near schools and playgrounds would affect tobacco retailers. GIS spatial analyses of two different states (Missouri, New York), along with more detailed analyses of two urban areas within those states (St. Louis, New York City), were conducted in 2010. The percentage of tobacco retailers falling within 350-, 500-, and 1000-foot buffer zones was then calculated. 22% of retailers in Missouri and 51% in New York fall within 1000-foot buffers around schools. In urban settings, more retailers are affected, 29% in St. Louis and 79% in New York City. Sensitivity analyses demonstrate that smaller buffers decrease the proportion of affected retailers. That is, 350-foot buffers affect only 6.7% of retailers in St. Louis and 29% in New York City. The effects of new outdoor tobacco advertising restrictions vary by location and population density. In Missouri and New York, outdoor tobacco advertising would still be permitted in many locations if such advertising was prohibited in a 1000-foot buffer zone around schools and playgrounds. Much smaller buffer zones of 350 feet may result in almost no reduction of outdoor advertising in many parts of the country. Copyright © 2011. Published by Elsevier Inc.

  7. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  8. The role of nuclear forensics in the prevention of acts of nuclear terrorism

    International Nuclear Information System (INIS)

    Nilsson, A.

    2002-01-01

    Full text: States continue to report cases of illicit trafficking that involve nuclear material and other radioactive materials. Over the past decade a total of about 500 cases have been confirmed by States Points of Contact, another 300 remains unconfirmed. Most of the confirmed cases have a criminal dimension, even if not for known terrorist purposes. Much can be learned from the analysis of reported cases: What specifically could the material have been used for? Where was the material obtained, in stock, scrap or waste? Was the small quantity seized only a sample of a much more significant quantity? These and many other questions can be answered through detailed technical characterization of seized material samples. The scientific methods used for this purpose is normally referred to as nuclear forensics, an indispensable tool for use in law enforcement investigations of nuclear trafficking. The events of 11 September 2001 was a wake-up call for the need to protect against nuclear terrorism. In response to a resolution by the IAEA General Conference, the IAEA Director General has reviewed thoroughly the Agency's activities and programmes with a view of strengthening the protection against acts of terrorism involving nuclear and other radioactive materials. A set of specific proposals for the protection against nuclear terrorism, a plan of action, was approved, in principle, by the IAEA Board of Governors in March 2002. While the plan emphasizes prevention, it also recognizes that measures are required to detect and respond to malicious acts involving nuclear and other radioactive materials. The combating of illicit nuclear trafficking remains important in the plan of action. The implementation of the plan will be funded through Member States extra-budgetary contributions. The Agency has adopted an integrated approach to the protection against nuclear terrorism. This brings together Agency activities concerned with physical protection of nuclear material and

  9. Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

    Science.gov (United States)

    ... in existing guidelines. Health Resources and Services Administration Women's Preventive Services Guidelines Non-grandfathered plans (plans or policies created or sold after March 23, 2010, or older plans or policies that ...

  10. "Dynamic Labor Shortage" In the Offing.

    Science.gov (United States)

    Olson, Lawrence

    1982-01-01

    The United States is on the verge of a labor shortage that is partly the result of declining birth rates. An increase in work force participation by older adults, encouraged by reversals of early retirement and other policy changes, would be advantageous to employers, workers, and the economy. (Author/SK)

  11. The Minority Teacher Shortage: Fact or Fable?

    Science.gov (United States)

    Ingersoll, Richard M.; May, Henry

    2011-01-01

    This research examines national data on the status of the minority teacher shortage--the low proportion of minority teachers in comparison to the increasing numbers of students of color in schools. The authors show that efforts over recent decades to recruit more minority teachers, and place them in disadvantaged schools, have been very…

  12. Nursing shortages and international nurse migration.

    Science.gov (United States)

    Ross, S J; Polsky, D; Sochalski, J

    2005-12-01

    The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce. To predict the international migration of nurses to the UK using widely available data on country characteristics. The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country-level data from sources such as the World Bank and the World Health Organization. The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low-income, English-speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK. Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.

  13. Comparative decision models for anticipating shortage of food grain production in India

    Science.gov (United States)

    Chattopadhyay, Manojit; Mitra, Subrata Kumar

    2018-01-01

    This paper attempts to predict food shortages in advance from the analysis of rainfall during the monsoon months along with other inputs used for crop production, such as land used for cereal production, percentage of area covered under irrigation and fertiliser use. We used six binary classification data mining models viz., logistic regression, Multilayer Perceptron, kernel lab-Support Vector Machines, linear discriminant analysis, quadratic discriminant analysis and k-Nearest Neighbors Network, and found that linear discriminant analysis and kernel lab-Support Vector Machines are equally suitable for predicting per capita food shortage with 89.69 % accuracy in overall prediction and 92.06 % accuracy in predicting food shortage ( true negative rate). Advance information of food shortage can help policy makers to take remedial measures in order to prevent devastating consequences arising out of food non-availability.

  14. Evaluating the implementation of "managing the risk of suicide: a suicide prevention strategy for the ACT 2009-2014".

    Science.gov (United States)

    Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley

    2015-01-01

    Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.

  15. Nuclear industry prepares fore shortage of engineers

    International Nuclear Information System (INIS)

    Gauker, Lynn.

    1991-01-01

    It is predicted that the Canadian nuclear industry will experience a shortage of qualified personnel within the next five to ten years. The reasons for this prediction are as follows: enrollment in engineering courses, particularly five courses in nuclear engineering has been declining; immigration can no longer be expected to fill the gap; the workforce is aging. Solutions may include promotional campaigns, student employment programs, and educating workers to a professional level

  16. Reducing Air Force Fighter Pilot Shortages

    Science.gov (United States)

    2015-12-31

    units). Pilot positions can be divided into two categories: absorbing and nonabsorbing. Absorbing positions are in operational units to which...Continued Attention to Aircrew Management Dynamics The primary source of stress in fighter- pilot management has been reductions in aircraft inventories...Fighter Pilot Shortages C O R P O R A T I O N Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are

  17. Looming labour shortages challenge Alberta resource industries

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, R.

    2005-07-01

    The shortage of skilled manpower that is threatening the viability of Alberta's resource industry is discussed. According to statistics compiled by the Canadian Resource Development the Canadian labour force grew by about 226,000 per year during the last quarter century; this will be reduced by about 125,000 per year during the current decade. It is forecast that by 2016, the annul growth will be near zero. To make up for this unprecedented shortfall, the annual rate of immigration required would have to be as high as 650,000 per year. The Alberta Chamber's Workforce Development Committee is aware of the urgency of the situation and is attempting to aggressively investigate the causes of the shortage of skilled labour and finding ways to deal with the problem. Current investigation appears to point the finger at the state of post-secondary education, most particularly the significantly higher underemployment among aboriginal youth and the likelihood that skills programs training developed to encourage First Nation's people would be the most effective way to help easing the growing labour shortage. Too few educational placement for students, a lack of adequate training equipment and financial resources in post-secondary institutions, and the variations in the quality of provincial educational standards receive the most blame, combined with a lack of awareness of employment opportunities or training programs, and the inability to migrate to high opportunity employment areas. A notable program addressing this issue is the Alberta Apprenticeship and Industry Training System which helps young people to start their apprenticeship training while still in high school, and encourage them to continue their training after graduation from high school. The federal government and other groups also encourage participation among Ab originals and work towards eliminating some of the underlying factors of labour shortages, including cultural biases, barriers to inter

  18. Comparison of conventional and long-acting oxytetracyclines in prevention of induced Actinobacillus (Haemophilus) pleuropneumoniae infection of growing swine.

    OpenAIRE

    Kiorpes, A L; Bäckström, L R; Collins, M T; Kruse, G O

    1989-01-01

    These experiments tested the hypothesis that long-acting oxytetracycline (oxytetracycline-LA) was more effective than regular oxytetracycline in preventing porcine pleuropneumonia when administered either 24 or 48 h prior to experimental challenge with virulent strains of Actinobacillus pleuropneumoniae. Two experiments (1 and 2) were conducted using growing pigs (average weight 12-15 kg). Antibiotic treatments were administered once intramuscularly at 20 mg/kg body weight; controls received ...

  19. 76 FR 5131 - Solicitation of Nomination of Veterinary Shortage Situations for the Veterinary Medicine Loan...

    Science.gov (United States)

    2011-01-28

    ... Science; National Institute of Food and Agriculture; U.S. Department of Agriculture; STOP 2220; 1400... and State Allocation Method 4. State Allocation of Nominations 5. FY 2011 Shortage Situation..., Extension, and Teaching Policy Act of 1997 (NARETPA). This law established a new Veterinary Medicine Loan...

  20. Find Shortage Areas: HPSA & MUA/P by Address

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Find Shortage Areas: Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUA/P) by Address tool helps you determine if a specific...

  1. Fact Sheet: Clean Air Act Section 112(r): Accidental Release Prevention / Risk Management Plan Rule

    Science.gov (United States)

    EPA is required to publish regulations and guidance for chemical accident prevention at facilities that pose the greatest risk of harm from accidental releases of regulated flammable and toxic substances above threshold quantities.

  2. Clean/alternative fueled fleet programs - 1990 Amendments to the Clean Air Act, the Colorado Air Pollution Prevention and Control Act, and Denver City and County regulations

    International Nuclear Information System (INIS)

    Bowles, S.L.; Manderino, L.A.

    1993-01-01

    Despite substantial regulations for nearly two decades, attainment of this ambient standards for ozone and carbon monoxide (CO) remain difficult goals to achieve, Even with of ozone precursors and CO. The 1990 Amendments to the Clean Air Act (CAA90) prescribe further reductions of mobile source emissions. One such reduction strategy is using clean fuels, such as methanol, ethanol, or other alcohols (in blends of 85 percent or more alcohol with gasoline or other fuel), reformulated gasoline or diesel, natural gas, liquified petroleum gas, hydrogen, or electricity. There are regulatory measures involving special fuels which will be required in areas heavily polluted with ozone and CO. The state of Colorado recently passed the 1992 Air Pollution Prevention and Control Act which included provisions for the use of alternative fuels which will be implemented in 1994. In addition to adhering to the Colorado state regulations, the city and county of Denver also have regulations pertaining to the use of alternative fuels in fleets of 10 or more vehicles. Denver's program began in 1992. This paper will address the issue of fleet conversion and its impact on industry in Colorado, and Denver in particular

  3. Water shortage risk assessment considering large-scale regional transfers: a copula-based uncertainty case study in Lunan, China.

    Science.gov (United States)

    Gao, Xueping; Liu, Yinzhu; Sun, Bowen

    2018-06-05

    The risk of water shortage caused by uncertainties, such as frequent drought, varied precipitation, multiple water resources, and different water demands, brings new challenges to the water transfer projects. Uncertainties exist for transferring water and local surface water; therefore, the relationship between them should be thoroughly studied to prevent water shortage. For more effective water management, an uncertainty-based water shortage risk assessment model (UWSRAM) is developed to study the combined effect of multiple water resources and analyze the shortage degree under uncertainty. The UWSRAM combines copula-based Monte Carlo stochastic simulation and the chance-constrained programming-stochastic multiobjective optimization model, using the Lunan water-receiving area in China as an example. Statistical copula functions are employed to estimate the joint probability of available transferring water and local surface water and sampling from the multivariate probability distribution, which are used as inputs for the optimization model. The approach reveals the distribution of water shortage and is able to emphasize the importance of improving and updating transferring water and local surface water management, and examine their combined influence on water shortage risk assessment. The possible available water and shortages can be calculated applying the UWSRAM, also with the corresponding allocation measures under different water availability levels and violating probabilities. The UWSRAM is valuable for mastering the overall multi-water resource and water shortage degree, adapting to the uncertainty surrounding water resources, establishing effective water resource planning policies for managers and achieving sustainable development.

  4. How Do Dual Long-acting Bronchodilators Prevent Exacerbations of Chronic Obstructive Pulmonary Disease?

    DEFF Research Database (Denmark)

    Beeh, Kai M; Burgel, Pierre-Regis; Franssen, Frits M E

    2017-01-01

    that combinations of long-acting β2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events....... In this review, small groups of experts critically evaluated mechanisms potentially responsible for the increased benefit of LABA/LAMA combinations over single LABDs or LABA/ICS in decreasing exacerbation. These included effects on lung hyperinflation and mechanical stress, inflammation, excessive mucus...... production with impaired mucociliary clearance, and symptom severity. The data assembled and analyzed by each group were reviewed by all authors and combined into this manuscript. Available clinical results support the possibility that effects of LABA/LAMA combinations on hyperinflation, mucociliary...

  5. Will the new Consumer Protection Act prevent harm to nutritional supplement users?

    Science.gov (United States)

    Gabriels, Gary; Lambert, Mike; Smith, Pete; Hiss, Donavon

    2011-07-25

    BACKGROUND. There is no clear distinction between the regulation of food, supplements and medicines in South Africa. Consequently, grey areas exist in implementing the legislation, particularly in the supplement industry. The increase in supplement sales in South Africa can be attributed to aggressive marketing by manufacturers whose claims are not always supported by published peer-reviewed evidence. Such claims often go unchecked, resulting in consumers being mislead about the role of supplements. As a result of poor regulation, contaminants or adulterants in supplements may also cause insidious effects unrelated to the listed ingredients. AIM. To assess the regulations, legislation, and claims associated with nutritional supplement products in South Africa. METHOD. Peer-reviewed literature and the relevant South African statutes were consulted. RESULTS. The National Health Act incorporates the Medicine Control Council, which is charged with ensuring the safety, quality and effectiveness of medicines, and related matters, including complementary/alternative medicines. The South African Institute for Drug-Free Sport and Amendment Act provides for testing athletes for using banned substances, but currently does not concern itself with monitoring nutritional supplements for contaminants or adulterants that may cause a positive drug test, which has implications for sports participants and also the health of the general population. The implementation of the Consumer Protection Act 68 of 2008 (CPA) could protect consumer rights if it is administered and resourced appropriately. CONCLUSION. The CPA should promote greater levels of policy development, regulatory enforcement, and consumer education of South Africa's supplement industry.

  6. Research gaps related to tobacco product marketing and sales in the Family Smoking Prevention and Tobacco Control Act.

    Science.gov (United States)

    Ribisl, Kurt M

    2012-01-01

    This paper is part of a collection that identifies research priorities that will help guide the efforts of the U.S. Food and Drug Administration (FDA) as it regulates tobacco products. This paper examines the major provisions related to tobacco product advertising, marketing, sales, and distribution included in Public Law 111-31, the "Family Smoking Prevention and Tobacco Control Act". This paper covers 5 areas related to (a) marketing regulations (e.g., ban on color and imagery in ads, ban on nontobacco gifts with purchase); (b) granting FDA authority over the sale, distribution, accessibility, advertising, and promotion of tobacco and lifting state preemption over advertising; (c) remote tobacco sales (mail order and Internet); (d) prevention of illicit and cross-border trade; and (e) noncompliant export products. Each of the 5 sections of this paper provides a description and brief history of regulation, what is known about this regulatory strategy, and research opportunities.

  7. Pollution prevention opportunity assessment for the K-25 Site Toxic Substances Control Act Incinerator Operations, Level III

    International Nuclear Information System (INIS)

    1995-09-01

    A Level III pollution prevention opportunity assessment (PPOA) was performed for the Oak Ridge K-25 Site Toxic Substances Control Act (TSCA) Incinerator to evaluate pollution prevention (P2) options for various waste streams: The main objective of this study was to identify and evaluate options to reduce the quantities of each waste stream generated by the TSCA Incinerator operations to realize significant environmental and/or economic benefits from P2. For each of the waste streams, P2 options were evaluated following the US Environmental Protection Agency (EPA) hierarchy to (1) reduce the quantity of waste generated, (2) recycle the waste, and/or (3) use alternate waste treatment or segregation methods. This report provides process descriptions, identification and evaluation of P2 options, and final recommendations

  8. 78 FR 39869 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Science.gov (United States)

    2013-07-02

    ... example, prevention of certain cancers, menstrual disorders, and acne).\\13\\ In addition, by reducing the... copy of the self- certification needs to be provided to a new health insurance issuer or a new third... meet the self-certification standard and provide to the issuer a copy of its self-certification. The...

  9. Putting the Barker Theory into the Future: Time to Act on Preventing Pediatric Obesity.

    Science.gov (United States)

    Pietrobelli, Angelo; Agosti, Massimo; Zuccotti, Gianvincenzo

    2016-11-17

    Growth and development are key characteristics of childhood and sensitive markers of health and adequate nutrition. The first 1000 days of life-conception through 24 months of age-represent a fundamental period for development and thus the prevention of childhood obesity and its adverse consequences is mandatory. There are many growth drivers during this complex phase of life, such as nutrition, genetic and epigenetic factors, and hormonal regulation. The challenge thus involves maximizing the potential for normal growth without increasing the risk of associated disorders. The Mediterranean Nutrition Group (MeNu Group), a group of researchers of the Mediterranean Region, in this Special Issue titled "Prevent Obesity in the First 1000 Days", presented results that advanced the science of obesity risk factors in early life, coming both from animal model studies and studies in humans. In the future, early-life intervention designs for the prevention of pediatric obesity will need to look at different strategies, and the MeNu Group is available for guidance regarding an appropriate conceptual framework to accomplish either prevention or treatment strategies to tackle pediatric obesity.

  10. Putting the Barker Theory into the Future: Time to Act on Preventing Pediatric Obesity

    Directory of Open Access Journals (Sweden)

    Angelo Pietrobelli

    2016-11-01

    Full Text Available Growth and development are key characteristics of childhood and sensitive markers of health and adequate nutrition. The first 1000 days of life—conception through 24 months of age—represent a fundamental period for development and thus the prevention of childhood obesity and its adverse consequences is mandatory. There are many growth drivers during this complex phase of life, such as nutrition, genetic and epigenetic factors, and hormonal regulation. The challenge thus involves maximizing the potential for normal growth without increasing the risk of associated disorders. The Mediterranean Nutrition Group (MeNu Group, a group of researchers of the Mediterranean Region, in this Special Issue titled “Prevent Obesity in the First 1000 Days”, presented results that advanced the science of obesity risk factors in early life, coming both from animal model studies and studies in humans. In the future, early-life intervention designs for the prevention of pediatric obesity will need to look at different strategies, and the MeNu Group is available for guidance regarding an appropriate conceptual framework to accomplish either prevention or treatment strategies to tackle pediatric obesity.

  11. The Occupational Disease Prevention and Control Act of the People's Republic of China: an awareness assessment among workers at foreign-invested enterprises.

    Science.gov (United States)

    Yongming, Shou; Rongzhu, Lu; Jie, Lin; Yan, Xu; Zhu, Yiliang; Schweigert, Michael

    2011-01-01

    The Occupational Disease Prevention and Control Act (ODPC-Act) of the People's Republic of China came into effect on May 1, 2002. Given the scope of foreign-invested enterprises (FIEs) in China and an unabated increasing trend of foreign investment, compliance with the ODPC-Act among FIEs is of particular interest, yet little is known. The extent to which an employer educates its workforce to understand the ODPC-Act may be a measure of an employer's compliance. Based on a 25-item questionnaire survey, we found that among 166 workers from three FIEs in Wuxi, Jiangsu Province, the majority had little knowledge regarding the ODPC-Act; many were unaware of their rights granted under the ODPC-Act. They were also unable to recognize employers' potential violations of the ODPC-Act. Improving FIE workers' awareness of the ODPC-Act is desirable.

  12. Up-to-Date on Preventive Care Services Under Affordable Care Act: A Trend Analysis From MEPS 2007-2014.

    Science.gov (United States)

    Hong, Young-Rock; Jo, Ara; Mainous, Arch G

    2017-08-01

    The utilization of preventive care services has been less than optimal. As part of an effort to address this, the Affordable Care Act (ACA) mandated that private health insurance plans cover evidence-based preventive services. To evaluate whether the provisions of ACA have increased being up-to-date on recommended preventive care services among privately insured individuals aged 18-64. Multivariate linear regression models were used to examine trends in prevalence of being up-to-date on selected preventive services, diagnosis of health conditions, and health expenditures between pre-ACA (2007-2010) and post-ACA (2011-2014). Adjusted difference-in-difference analyses were used to estimate changes in those outcomes in the privately insured that differed from changes in the uninsured (control group). After the passage of ACA, up-to-date rates of routine checkup (2.7%; 95% confidence interval, 0.8%-4.7%; P=0.007) and flu vaccination (5.9%; 95% confidence interval, 4.2%-7.6%; Ppreventive care services. Additional efforts may be required to take full advantage of the elimination of cost-sharing under the ACA.

  13. Suicide Prevention in Schizophrenia: Do Long-Acting Injectable Antipsychotics (LAIs) have a Role?

    Science.gov (United States)

    Pompili, Maurizio; Orsolini, Laura; Lamis, Dorian A; Goldsmith, David R; Nardella, Adele; Falcone, Giulia; Corigliano, Valentina; Luciano, Mario; Fiorillo, Andrea

    2017-01-01

    Suicide risk is a major cause of death among patients with schizophrenia. Death by suicide has been reported in approximately 5% of schizophrenia patients although this figure appears to be an underestimate of the problem. A number of risk factors are routinely reported as associated with suicide risk among these patients, some of which are modifiable by targeted therapeutic strategies. Clozapine is the only compound that gathered evidence as an effective treatment for reducing suicide risk in schizophrenia. Long-Acting Injectable Antipsychotics (LAIs) have a range of advantages in terms of efficacy, safety and tolerability in the treatment of schizophrenia, and one area of interest is whether LAI-treatment may decrease suicidality by indirectly acting on a range of risk factors for suicide specific to schizophrenia patients. This background encouraged the present review of research pertaining to LAIs in relation to modifiable risk factors for suicide in schizophrenia. We viewed our task as gathering, speculating and critically appraising the available research relevant to the topic, with the aim of formulating a hypothesis to be tested with further research. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Prolactin prevents acute stress-induced hypocalcemia and ulcerogenesis by acting in the brain of rat.

    Science.gov (United States)

    Fujikawa, Takahiko; Soya, Hideaki; Tamashiro, Kellie L K; Sakai, Randall R; McEwen, Bruce S; Nakai, Naoya; Ogata, Masato; Suzuki, Ikukatsu; Nakashima, Kunio

    2004-04-01

    Stress causes hypocalcemia and ulcerogenesis in rats. In rats under stressful conditions, a rapid and transient increase in circulating prolactin (PRL) is observed, and this enhanced PRL induces PRL receptors (PRLR) in the choroid plexus of rat brain. In this study we used restraint stress in water to elucidate the mechanism by which PRLR in the rat brain mediate the protective effect of PRL against stress-induced hypocalcemia and ulcerogenesis. We show that rat PRL acts through the long form of PRLR in the hypothalamus. This is followed by an increase in the long form of PRLR mRNA expression in the choroid plexus of the brain, which provides protection against restraint stress in water-induced hypocalcemia and gastric erosions. We also show that PRL induces the expression of PRLR protein and corticotropin-releasing factor mRNA in the paraventricular nucleus. These results suggest that the PRL levels increase in response to stress, and it moves from the circulation to the cerebrospinal fluid to act on the central nervous system and thereby plays an important role in helping to protect against acute stress-induced hypocalcemia and gastric erosions.

  15. 25 CFR 63.13 - What does the Indian Child Protection and Family Violence Prevention Act require of the Bureau of...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What does the Indian Child Protection and Family Violence... GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY VIOLENCE PREVENTION Minimum Standards of Character and Suitability for Employment § 63.13 What does the Indian Child Protection and Family Violence Prevention Act...

  16. 42 CFR 136.404 - What does the Indian Child Protection and Family Violence Prevention Act require of the IHS and...

    Science.gov (United States)

    2010-10-01

    ... Protection and Family Violence Prevention § 136.404 What does the Indian Child Protection and Family Violence... 42 Public Health 1 2010-10-01 2010-10-01 false What does the Indian Child Protection and Family Violence Prevention Act require of the IHS and Indian Tribes or Tribal organizations receiving funds under...

  17. The nursing shortage: part way down the slippery slope.

    Science.gov (United States)

    Cowin, Leanne; Jacobsson, Denise

    2003-07-01

    The shortage of nurses has reached a crisis point for health care services. A number of issues including the effects of economic rationalism, generational differences, working conditions and nurse education are revisited in a discussion that aims to refuel the debate on workplace reform for nurses. Economic rationalism has altered the healthcare service landscape. Attempts to balance service delivery with workforce resources have led to possibly unforeseen changes. Highly skilled nurses are required in acute services, however resource allocation may prevent this. The nursing workforce is aging although the current nursing workforce consists of three generations: baby boomers, generation X and generation Y. There are significant ideological and work organisational differences between these generations leading to possible conflict between nurses. The pool of available nurses to fill employment vacancies is finite. Attracting overseas nurses to fill nurse vacancies will leave vacancies elsewhere and is not a long-term solution to the nursing shortage. Moreover, if the workplace has not addressed the reasons why nurses have left the health care workplace then there is a real danger of losing those recently attracted back into the workplace. Working conditions are a critical element within the retention puzzle. Job satisfaction dimensions such as autonomy and professional relationships are key components for improving working conditions. The final issue explored is the question of whether the tertiary education system is the most appropriate place in which to develop and educate nurses. It is suggested that workplace reforms should be the target of retention strategies rather than changes in the educational process of nursing.

  18. Are You Covered? Associations Between Patient Protection and Affordable Care Act Knowledge and Preventive Reproductive Service Use.

    Science.gov (United States)

    Sawyer, Ashlee N; Kwitowski, Melissa A; Benotsch, Eric G

    2018-05-01

    Sexual and reproductive health conditions (eg, infections, cancers) represent public health concerns for American women. The present study examined how knowledge of the Patient Protection and Affordable Care Act (PPACA) relates to receipt of preventive reproductive health services among women. Cross-sectional online survey. Online questionnaires were completed via Amazon Mechanical Turk, a crowdsourcing website where individuals complete web-based tasks for compensation. Cisgendered women aged 18 to 44 years (N = 1083) from across the United States. Participants completed online questionnaires assessing demographics, insurance status, preventive service use, and knowledge of PPACA provisions. Chi-squares showed that receipt of well-woman, pelvic, and breast examinations, as well as pap smears, was related to insurance coverage, with those not having coverage at all during the previous year having significantly lower rates of use. Hierarchical logistic regressions determined the independent relationship between PPACA knowledge and use of health services after controlling for demographic factors and insurance status. Knowledge of PPACA provisions was associated with receiving well-woman, pelvic, and breast examinations, human papillomavirus vaccination, and sexually transmitted infections testing, after controlling for these factors. Results indicate that expanding knowledge about health-care legislation may be beneficial in increasing preventive reproductive health service use among women. Current findings provide support for increasing resources for outreach and education of the general population about the provisions and benefits of health-care legislation, as well as personal health coverage plans.

  19. Prevention of water hammers behind fast acting shut-off valves

    International Nuclear Information System (INIS)

    Dudlik, A.; Schlueter, S.; Prasser, H.M.

    1999-01-01

    Shut-off valves are often applied for a quick safety shut-down of pipelines for dangerous liquids. When the valve is suddenly closed at a certain flow rate, the pressure behind the valve decreases due to the momentum of the liquid. This leads to an evaporation and to a formation of a cavitation bubble if the resulting minimum pressure becomes lower than the saturation pressure at the given temperature. This type of water hammer was studied at a test facility of Fraunhofer UMSICHT in Oberhausen. The task of FZR was the development of an adequate two-phase flow instrumentation to visualise the cavitation phenomenon. During the project unique digital movie sequences of appearing and condensing cavitation bubbles were recorded, that gave valuable insights into the transient process. In the result, a new method was found to prevent the collapse of the cavitation bubbles and to avoid the corresponding pressure peaks. (orig.)

  20. Drugs, money, and power: the Canadian drug shortage.

    Science.gov (United States)

    Kaposy, Chris

    2014-03-01

    This article describes the shortage of generic injectable medications in Canada that affected hospitals in 2012. It traces the events leading up to the drug shortage, the causes of the shortage, and the responses by health administrators, pharmacists, and ethicists. The article argues that generic drug shortages are an ethical problem because health care organizations and governments have an obligation to avoid exposing patients to resource scarcity. The article also discusses some options governments could pursue in order to secure the drug supply and thereby fulfill their ethical obligations.

  1. Respiratory metabolism and calorie restriction relieve persistent endoplasmic reticulum stress induced by calcium shortage in yeast

    OpenAIRE

    Busti, Stefano; Mapelli, Valeria; Tripodi, Farida; Sanvito, Rossella; Magni, Fulvio; Coccetti, Paola; Rocchetti, Marcella; Nielsen, Jens; Alberghina, Lilia; Vanoni, Marco

    2016-01-01

    Calcium homeostasis is crucial to eukaryotic cell survival. By acting as an enzyme cofactor and a second messenger in several signal transduction pathways, the calcium ion controls many essential biological processes. Inside the endoplasmic reticulum (ER) calcium concentration is carefully regulated to safeguard the correct folding and processing of secretory proteins. By using the model organism Saccharomyces cerevisiae we show that calcium shortage leads to a slowdown of cell growth and met...

  2. Combating pharmacist shortage through labor certification.

    Science.gov (United States)

    Maswoswe, J J; Stewart, K R; Enigbokan, M; Egbunike, I; Jackson, D M

    1994-06-01

    Several solutions, ranging from increased technician duties to salary raises, automation, and increasing job satisfaction, have been presented in the literature as methods of assuaging the pharmacist shortage. Although a significant portion of pharmacy graduates from American pharmacy colleges are foreign nationals, no marketing strategies have been elucidated in the retention and recruitment of foreign nationals through labor certification. Labor certifications are generally approved by the Secretary of Labor if the following factors have been verified: 1) there are not sufficient United States workers who are able, willing, qualified, and available for employment; and 2) the employment of the foreign national will not adversely affect the wages and working conditions of U.S. workers similarly employed. When properly understood, the labor certification process is a test of the job market where foreigners, by virtue of their skills and qualifications, attain certification which subsequently leads to permanent residency (green card). The objective of this report is to elucidate the tedious yet effective method of retaining American-educated foreign nationals through labor certification.

  3. Desalination - A solution to water shortage

    International Nuclear Information System (INIS)

    Shakaib, M.

    2005-01-01

    Pakistan as well as neighbouring countries are faced with critical water shortage for the last few decades. The demand for water has outstripped its supply making the availability of safe water sources an issue Also conflicts over water sharing are expected in many regions of the world. Thus, because of this looming crisis water problems are getting increasing attention all over the world. With the advancement of desalination technology many countries had resorted removal of salts from brackish and sea water as an alternative water supply and they are now viewing desalination as a future solution to problems of lack of water. Today, over 100 countries use desalting requirement. A total of 12,451 desalting units (of a unit size of 100 m/sup 3//d or more) with a total capacity of 22,735,000 m /d had been installed or contracted worldwide. Brackish water desalination plants contribute with 9,400,000 m3/d, whereas the capacity of the sea water plants had reached up to 13,300,000 m3/d. This paper will discuss the use of desalination to produce potable water from saline water for domestic or municipal purposes and also the available desalination techniques that have been developed over the years and have achieved commercial success. (author)

  4. The Nursing Shortage Impact on Job Outcome (The Case in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Kumari Shammika Senani Mudihanselage Hellerawa

    2015-09-01

    Full Text Available The nursing shortage is a common problem throughout the world. Nurses form the largest proportion of the healthcare system and play a significant role in providing direct patient care. Considering the importance of the role of nurses in the healthcare system, it is important to investigate how nursing shortage effects the quality of patient care, nurses’ job satisfaction and their work stress. A study was conducted to investigate the correlation between these at the Polonnaruwa District General Hospital in Sri Lanka with a random sample of nurses working in the hospital and using a self-administered questionnaire. This study uses an explanatory research design. The statistical analysis confirmed a positive relationship between nurse shortage and workload. It also shows a significant positive relationship between workload and the quality of patient care. Furthermore, a negative relationship was observed between workload and the quality of patient care. In addition, this study calculates the mean effect of emotional intelligence of these factors, and a significant correlation is found between emotional intelligence and workload as well as work stress. There is a firm evidence that in Sri Lanka, nursing shortage influences the workload of the employee, finally affecting the quality of patient care. In addition, the study recognized the capability of nurses to manage their emotions as well as emotions of others, which has increased their tolerance to control psychological stress in performing their duty. This study confirms that nurse’s emotional intelligence act as a partial oderating variable for job outcomes of nurses.

  5. Ergonomic analyses within the French transport and logistics sector: first steps towards a new "act elsewhere" prevention approach.

    Science.gov (United States)

    Wioland, Liên

    2013-10-01

    Statistics from the French Employee National Health Insurance Fund indicate high accident levels in the transport sector. This study represents initial thinking on a new approach to transport sector prevention based on the assumption that a work situation could be improved by acting on another interconnected work situation. Ergonomic analysis of two connected work situations, involving the road haulage drivers and cross-docking platform employees, was performed to test this assumption. Our results show that drivers are exposed to a number of identified risks, but their multiple tasks raise the question of activity intensification. The conditions, under which the drivers will perform their work and take to the road, are partly determined by the quality and organisation of the platform with which they interact. We make a number of recommendations (e.g. changing handling equipment, re-appraising certain jobs) to improve platform organisation and employee working conditions with the aim of also improving driver conditions. These initial steps in this prevention approach appear promising, but more detailed investigation is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Skill Shortages in the Trades during Economic Downturns. Occasional Paper

    Science.gov (United States)

    Oliver, Damian

    2011-01-01

    During the recent economic downturn, media and industry reports of skill shortages in the trades continued to appear. The intent of this paper is to examine the evidence for skill shortages in the trades persisting during the economic downturns over the last 20 years, using various indicators. These include employment growth, vacancy rates,…

  7. The World Language Teacher Shortage: Taking a New Direction

    Science.gov (United States)

    Swanson, Pete; Mason, Shannon

    2018-01-01

    Since the end of World War II, international leaders have made calls addressing the world language teacher shortage. For almost 70 years, such rhetoric has been advanced, yet world language teacher shortages remain in many countries such as Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. In this article, the…

  8. The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

    Science.gov (United States)

    Shane, Dan M; Wehby, George L

    2017-09-01

    Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

  9. [Mutual aid societies for industrial accidents and occupational diseases in the social security service within the framework of the Prevention of Occupational Risk Act].

    Science.gov (United States)

    Albalá-Ortiz, M

    The passing of the Prevention of Industrial Risks Act, in force from 9 February 1996 has altered previous ideas on the subject, which is currently considered to be of utmost importance for national and community legislation. In this article we describe the preventive functions of the Mutual Aid Societies for Industrial Accidents and professional diseases of the National Health Service. We have analysed the current legislation so as to clarify the activities of the Mutual Aid Societies in the field of the prevention of industrial accidents, and have defined the actions which may be taken in this field according to the present laws. Two different types of preventive activities are considered: (1) Those which depend on contributions, included in the professional risks cover, and which are obliged to prepare an annual plan of the measures taken to prevent industrial accidents and professional illness, following the guidelines established by the Ministry of Labor and Social Services and according to certain priorities. (2) The functions corresponding to the services for third-party prevention exclusively for their associated companies when the Mutual Aid Society is approved as a service for third party cover. This requires a voluntary or professional contract and the financial cost is borne by the company which requests it. The objective of the current legislation is, amongst other things, to introduce the new preventive approach established by the Prevention of Industrial Risks Act in the workplace and through the Mutual Aid Societies as well as to foment a new culture of prevention.

  10. Mobile radiation monitoring of Delhi for the prevention of malicious acts during the Common Wealth Games (CWG-2010)

    International Nuclear Information System (INIS)

    Saindane, Shashank S.; Chatterjee, M.K.; Romal, Jis; Pradeepkumar, K.S.; Singh, B.R.

    2012-01-01

    Radioactive sources are widely used in industry, research, agriculture and medical applications. In spite of various measures adopted for ensuring the safety and security of these sources, similar to Mayapuri incident, many cases of lost, misplaced, stolen radioactive sources and inadvertent radiation exposure due to radiological emergencies are reported world over. In the aftermath of the attack on the World Trade Center 2001, malicious acts using radioactive material is considered as a threat for which prevention and preparedness for response are recommended by IAEA. Hence radiation monitoring of all related area prior to and during Major Public Events (MPEs) like Olympics, World cup football etc are implemented by many nations for prevention and preparedness to such radiological threats/emergencies. Department of Atomic Energy (DAE) through their Emergency Response Centres planned and executed detailed radiation monitoring programme for the Delhi Common Wealth Games (CWG 2010) which covered all CWG stadiums. Commonwealth village etc. In addition to DAE emergency response teams of 15 members in readiness, source recovery and shielding facilities, Portable Personnel Decontamination Unit (PPDU), Radiation monitors, Protective gears, Aerial Gamma Spectrometry System (AGSS for Aerial surveys) etc. were maintained at two DAE control rooms. This paper discusses the mobile radiation monitoring carried out on Delhi city roads with the help of various state-of-the-art monitoring systems to detect the presence or movement of any orphan sources. The mobile radiation monitoring was focused on main road networks connecting to stadiums, areas surrounding stadiums, airport and Games village. For this state-of-the-art systems like Portable Mobile Gamma Spectrometry System (PMGSS), Portable Radiation Scanner (PRS), Compact Radiation Monitoring System integrated with GPS, GSM based Radiation Monitoring System (GRaMS), Gammatracers, Selection and placement of different monitoring

  11. Sustainable economic production quantity models for inventory systems with shortage

    DEFF Research Database (Denmark)

    Taleizadeh, Ata Allah; Soleymanfar, Vahid Reza; Govindan, Kannan

    2018-01-01

    optimal values of inventory system variables, we solve four independent profit maximization problems for four different situations. These proposed models include a basic model in which shortages are not allowed, and when shortages are allowed, the lost sale, full backordering and partial backordering...... (EPQ). The theoretical sustainable EOQ and EPQ models are basic models that ignore many real-life conditions such as the possibility of stock-out in inventory systems. In this paper, we develop four new sustainable economic production quantity models that consider different shortage situations. To find...

  12. Developing an intervention to prevent acute kidney injury: using the Plan, Do, Study, Act (PDSA) service improvement approach.

    Science.gov (United States)

    Byrne, Jo; Xu, Gang; Carr, Sue

    2015-03-01

    In the UK, recent National Institute for Health and Care Excellence guidelines for acute kidney injury point to the need for interventions to help prevent this condition. Effective medicines management is of prime importance in reducing the risk of AKI. Part of this challenge is to increase patients' awareness of their medicines and the possible need to temporarily withhold certain medications when acutely unwell. The objectives were to use a service improvement approach (the Plan, Do, Study, Act cycle) to develop an intervention and to evaluate current delivery of acute kidney injury management and to test and generate new ideas relating to patients' needs. A postal feedback form sent to a random sample of over 200 patients with chronic kidney disease. The feedback form collected information on: what patients know about acute kidney injury and managing medicines; where patients get their information from; whether patients want more information and where from; and what patients feel about self-managing their medicines. Completed feedback forms were received from 113 participants. Of these, 92% said they had received no advice, 77% of respondents wanted more advice but only 17% said they would feel comfortable to stop their own medication without medical consent. The PDSA cycle offered a very useful framework to evaluate the current service delivery and to test and generate new ideas for the development of an AKI intervention. Our findings highlighted that the current service is limited and more robust research is needed. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  13. Public Support for Family Smoking Prevention and Tobacco Control Act Point-of-Sale Provisions: Results of a National Study.

    Science.gov (United States)

    Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; McNaughton Reyes, Heath Luz; Scott, John C; Ribisl, Kurt M

    2015-10-01

    We assessed public and smoker support for enacted and potential point-of-sale (POS) tobacco-control policies under the Family Smoking Prevention and Tobacco Control Act. We surveyed a US nationally representative sample of 17, 507 respondents (6595 smokers) in January through February 2013, and used linear regression to calculate weighted point estimates and identify factors associated with support for POS policies among adults and smokers. Overall, nonsmokers were more supportive than were smokers. Regardless of smoking status, African Americans, Hispanics, women, and those of older ages were more supportive than White, male, and younger respondents, respectively. Policy support varied by provision. More than 80% of respondents supported minors' access restrictions and more than 45% supported graphic warnings. Support was lowest for plain packaging (23%), black-and-white advertising (26%), and a ban on menthol cigarettes (36%). Public support for marketing and POS provisions is low relative to other areas of tobacco control. Tobacco-control advocates and the Food and Drug Administration should build on existing levels of public support to promote and maintain evidence-based, but controversial, policy changes in the retail environment.

  14. What's the ROI for resolving the nursing faculty shortage?

    Science.gov (United States)

    Kowalski, Karren; Kelley, Brian M

    2013-01-01

    The nursing faculty shortage will have a fundamental impact on the ability to produce nurses. For most nursing schools and states, however, concerns about the relative merits of different solutions to the nursing faculty shortage are misplaced. Without significantly increased visibility and definition, accompanied by a clear public, private, and health care organization return on investment (ROI), proposing solutions to the nursing faculty shortage is at best premature and at worst irrelevant. There is simply too much competition for resources to expect that a vaguely defined and invisible problem with no rationale for increased investment will receive sufficient support from critical decision makers and constituencies. First must come problem definition, visibility, and ROI. Only then can the case be made for implementing solutions to the nursing faculty shortage.

  15. Ethical framework for resource allocation during a drug supply shortage.

    Science.gov (United States)

    Gibson, Jennifer L; Bean, Sally; Chidwick, Paula; Godkin, Dianne; Sibbald, Robert W; Wagner, Frank

    2012-01-01

    Drug supply shortages are common in health systems due to manufacturing and other delays. Frequently, shortages are successfully addressed through conservation and redistribution efforts, with limited impact on patient care. However, when Sandoz Canada Inc. announced in February 2012 that it was reducing production of a number of generic injectable drugs at its Quebec facility, the scope and magnitude of the drug supply shortage were unprecedented in Canada. The potential for an extreme scarcity of some drugs raised ethical concerns about patient care, including the need to limit access to some health services. In this article, the authors describe the development and implementation of an ethical framework to promote equitable access to drugs and healthcare services in the context of a drug supply shortage within and across health systems.

  16. Toward a Comprehensive Strategy for Addressing the Teacher Shortage.

    Science.gov (United States)

    Hawley, Willis D.

    1986-01-01

    The likely consequences of different educational policies affecting teacher supply and demand are examined in relation to the predicted teacher shortage. Includes a table describing 23 policies and practices of schools that attract qualified teachers. (MD)

  17. Can state-supported interprofessional coalitions cure preceptor shortages?

    Science.gov (United States)

    Woodall, Lesli; Smith, Gigi; Garr, David; Hopla, Deborah; Kern, Donna

    2018-06-01

    The shortage of clinical preceptors compromises the current and future supply of healthcare providers and patient access to primary care. This article describes how an interprofessional coalition in South Carolina formed and sought government support to address the preceptor shortage. Some states have legislated preceptor tax credits and/or deductions to support the clinical education of future primary care healthcare providers. As a result of the coalition's work, a bill to establish similar incentives is pending in the South Carolina legislature.

  18. Strategies to address the nursing shortage in Saudi Arabia.

    Science.gov (United States)

    Aboshaiqah, A

    2016-09-01

    To investigate the nursing shortage in Saudi Arabia and specifically the shortage of Saudi nurses in the healthcare workforce and to propose solutions. Literature published from 1993 to 2013 providing relevant information on the nursing shortage, cultural traditions and beliefs, and nursing education and policies in Saudi was accessed from multiple sources including Medline, CINAHL Plus and Google Scholar and from official Saudi government document and was reviewed. Saudi Arabia depends largely on an expatriate workforce, and this applies to nursing. Saudi Arabia is experiencing a nursing shortage in common with most countries in the world and a shortage of Saudi nationals, especially women, in the healthcare workforce. The world shortage of nursing is extrinsic to Saudi, but intrinsic factors include a poor image of the nursing profession in the country that is exacerbated by cultural factors. With the call for the Saudization of the workforce to replace the imported workforce by Saudi nationals, including nurses, through the 1992 Royal Decree, Saudi Arabia faces a problem in attracting and retaining Saudi nationals in the nursing workforce. Solutions are suggested that are aimed at improving the public image of nursing through education and the use of the media and improvements in the workplace by addressing working processes such as teamwork, ensuring adequate staffing levels and addressing some aspects of culture which may make working in nursing more compatible with being a Saudi national. © 2016 International Council of Nurses.

  19. Nurse Reinvestment Act. Public Law.

    Science.gov (United States)

    Congress of the U.S., Washington, DC.

    This document contains the text of the Nurse Reinvestment Act, which amends the Public Health Service Act to address the increasing shortage of registered nurses by instituting a series of policies to improve nurse recruitment and nurse retention. Title I details two initiatives to boost recruitment of nurses. The first initiative includes the…

  20. Fuel shortage hits eastern Siberia region

    International Nuclear Information System (INIS)

    Land, R.

    1992-01-01

    Moscow's loss of absolute authority over the Russian economy has contributed to growing chaos in the supply of oil and gas to the former U.S.S.R.'s far eastern territories. This paper reports that Sakhalin Island, which has provided a substantial portion of the area's hydrocarbon fuels, has shown increasing reluctance to sell oil and gas for nearly worthless rubles to its eastern Siberian neighbors. Instead, it is bartering as much as possible of its surplus petroleum for foreign food and consumer goods. Moscow's Izvestia newspaper strongly criticized Sakhalin authorities for placing the island's interests ahead of the welfare of the Russian republic as a whole. It the Sakhalin's selfish attitude resulted in near disaster last winter for the economy and populace of neighboring Khabarovsk territory on the Siberian mainland. Only milder than normal winter weather prevented a catastrophe, Izvestia reported. Even so, some old people died from the cold in Khabarovsk, a city of 600,000 population

  1. Efficacy of long-acting release octreotide for preventing chemotherapy-induced diarrhoea: protocol for a systematic review.

    Science.gov (United States)

    Deng, Chao; Deng, Bo; Jia, Liqun; Tan, Huangying

    2017-06-21

    Diarrhoea is a common adverse effect induced by chemotherapy that can reduce the dose of chemotherapeutic drugs or interrupt the chemotherapy schedule. The current treatment strategies have various limitations. It has been shown that long-acting release octreotide (octreotide LAR) can decrease the occurrence and severity of diarrhoea, yet the efficacy of octreotide LAR in preventing chemotherapy-induced diarrhoea (CID) remains to be assessed. The main objective of this paper was to draw up a protocol for systematic review to evaluate the protective effects of octreotide LAR on CID. We searched Medline, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data and the VIP Database without language restrictions from inception until 1 September 2016. The references of relevant studies were also manually searched. Two investigators independently accessed the selected studies, extracted data and assessed the reliability of the studies. Any discrepancies were resolved by a third investigator. The effect size of the selected studies was assessed by different measures based on the type of data. The selected studies were descriptively analysed. We then chose a fixed-effect model or a random-effect model based on statistical homogeneity, and pooled data from the studies for meta-analysis, if possible. The primary outcome was the incidence of diarrhoea. The secondary outcomes were the duration of diarrhoea, incidence of diarrhoea-associated symptoms, physical function and quality of life. All statistical analyses were performed by Review Manager V.5.3. This systematic review did not require ethics approval, because it included aggregated published data, and not individual patient data. The review was published in a peer-reviewed journal. This systematic review protocol was registered with PROSPERO (registration number: CRD 42016048573). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  2. Neighborhood Inequalities in Retailers' Compliance With the Family Smoking Prevention and Tobacco Control Act of 2009, January 2014-July 2014.

    Science.gov (United States)

    Lee, Joseph G L; Baker, Hannah M; Ranney, Leah M; Goldstein, Adam O

    2015-10-08

    Retailer noncompliance with limited US tobacco regulations on advertising and labeling was historically patterned by neighborhood in ways that promote health disparities. In 2010, the US Food and Drug Administration (FDA) began enforcing stronger tobacco retailer regulations under the Family Smoking Prevention and Tobacco Control Act of 2009. However, recent research has found no differences in compliance by neighborhood characteristics for FDA advertising and labeling inspections. We sought to investigate the neighborhood characteristics associated with retailer noncompliance with specific FDA advertising and labeling inspections (ie, violations of bans on self-service displays, selling single cigarettes, false or mislabeled products, vending machines, flavored cigarettes, and free samples). We coded FDA advertising and labeling warning letters (n = 718) for type of violations and geocoded advertising and labeling inspections from January 1 through July 31, 2014 (N = 33,543). Using multilevel models, we examined cross-sectional associations between types of violations and neighborhood characteristics previously associated with disparities (ie, percentage black, Latino, under the poverty line, and younger than 18 years). Retailer advertising and labeling violations are patterned by who lives in the neighborhood; regulated tobacco products are more likely to be stored behind the counter as the percentage of black or Latino residents increases, and single cigarettes are more often available for purchase in neighborhoods as the percentage of black, poor, or young residents increases. Contrary to previous null findings, noncompliance with FDA advertising and labeling regulations is patterned by neighborhood characteristics, sometimes in opposite directions. Given the low likelihood of self-service violations in the same neighborhoods that have high likelihood of single cigarette sales, we suggest targeted approaches to FDA retailer inspections and education campaigns.

  3. Water Management Strategies against Water Shortage in the Alps (Invited)

    Science.gov (United States)

    de Jong, C.

    2009-12-01

    and anthropogenic scenarios. Innovative measures of mitigation and adaptation should predict and prevent future water shortages.

  4. Prevention

    DEFF Research Database (Denmark)

    Halken, S; Høst, A

    2001-01-01

    , breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented extensively hydrolysed formula is recommended if exclusive breastfeeding is not possible for the first 4 months of life. There is no evidence for preventive dietary intervention neither during pregnancy nor lactation...... populations. These theories remain to be documented in proper, controlled and prospective studies. Breastfeeding and the late introduction of solid foods (>4 months) is associated with a reduced risk of food allergy, atopic dermatitis, and recurrent wheezing and asthma in early childhood. In all infants....... Preventive dietary restrictions after the age of 4-6 months are not scientifically documented....

  5. A critical review of the nursing shortage in Malaysia.

    Science.gov (United States)

    Barnett, T; Namasivayam, P; Narudin, D A A

    2010-03-01

    This paper describes and critically reviews steps taken to address the nursing workforce shortage in Malaysia. To address the shortage and to build health care capacity, Malaysia has more than doubled its nursing workforce over the past decade, primarily through an increase in the domestic supply of new graduates. Government reports, policy documents and ministerial statements were sourced from the Ministry of Health Malaysia website and reviewed and analysed in the context of the scholarly literature published about the health care workforce in Malaysia and more generally about the global nursing shortage. An escalation in student numbers and the unprecedented number of new graduates entering the workforce has been associated with other impacts that have been responded to symptomatically rather than through workplace reform. Whilst growing the domestic supply of nurses is a critical key strategy to address workforce shortages, steps should also be taken to address structural and other problems of the workplace to support both new graduates and the retention of more experienced staff. Nursing shortages should not be tackled by increasing the supply of new graduates alone. The creation of a safe and supportive work environment is important to the long-term success of current measures taken to grow the workforce and retain nurses within the Malaysian health care system.

  6. An analysis of news flow on the nation's nurse shortage.

    Science.gov (United States)

    Kalisch, B J; Kalisch, P A; Clinton, J

    1981-09-01

    Using data from national newspaper clipping services, this article analyzes characteristics of 1978 news coverage of the nation's nurse shortage. Based on a content analysis of nearly 3,000 newspaper articles, findings revealed that 14 per cent of the articles mentioned problems of nurse supply. Articles on nurse shortage were most frequent in the Pacific, Mid-Atlantic and South-Atlantic states and occurred least in the West-North Central and East-South Central states. Articles mentioning nurse shortage were more frequently placed on page 1, associated with clinical nursing in hospital settings and explained as the result of maldistribution of nurses, poor salaries, deficient working conditions and lack of job satisfaction. The reading public was confronted with three major consequences of current and continued shortages in nursing: 1) decline in the availability and diversity of health services; 2) erosion in the quality of care offered the public and jeopardized patient welfare; and 3) escalating health care costs. Solutions to the nurse shortage appear to be closely tied to further expansion of the issue among the public, the initiation of remedial governmental action and timely relocation of scarce resources within the health care industry.

  7. Surface Acting and Job-Related Affective Wellbeing: Preventing Resource Loss Spiral and Resource Loss Cycle for Sustainable Workplaces

    Directory of Open Access Journals (Sweden)

    Seongwook Ha

    2018-04-01

    Full Text Available This study empirically examines the synergistic negative effect of two kinds of job demand on job-related affective wellbeing (JAW and the accelerating effects of cynicism in the negative relationships between job demands and JAW using a sample of 299 employees in the Chinese banking industry. Job demands include quantitative role overload and surface acting to represent the quantitative and qualitative aspects of job demands. Cynicism is introduced as a state where one’s energy resource is lost. The results of this study show that surface acting has a negative relationship with JAW, but quantitative role overload has no relationship with JAW. High levels of quantitative role overload exacerbate the negative relationship between surface acting and JAW. Cynicism also exacerbates the negative relationship between surface acting and JAW but does not have any moderating effect in the relationship between quantitative role overload and JAW. These results are consistent with the relationships predicted by resource loss spiral and resource loss cycle. The resource loss spiral means that resource loss, caused by handling with a quantitative role overload, lessens the employee’s ability to cope with surface acting. The resource loss cycle represents a vicious circle that amplifies the resource loss caused by surface acting. Surface acting reduces the level of one’s resources. Furthermore, surface acting reduces JAW and resources more strongly when an individual has low levels of previous energy resources than it reduces JAW and resources when he or she has high levels of previous energy resources.

  8. Act No. 87-565 of 22 July 1987 on the organization of public safety measures, forestry protection against fires and the prevention of major risks

    International Nuclear Information System (INIS)

    1987-01-01

    As defined by this Act, the objective of the public safety measures is to prevent all types of major risks and to protect persons, property and the environment, including forests, against accidents, disasters and catastrophes. It deals with the conditions for preparing preventive measures and for implementing necessary measures in case of major risks or accidents. The preparation and organization of assistance are determined within the framework of ORSEC (ORganisation des SECours) plans and emergency plans; the first assess the possibilities for facing up to disasters while the latter provide for measures and means to overcome a particular risk [fr

  9. The nurse manager: job satisfaction, the nursing shortage and retention.

    Science.gov (United States)

    Andrews, Diane Randall; Dziegielewski, Sophia F

    2005-07-01

    A critical shortage of registered nurses exists in the United States and this shortage is expected to worsen. It is predicted that unless this issue is resolved, the demand for nursing services will exceed the supply by nearly 30% in 2020. Extensive analysis of this pending crisis has resulted in numerous recommendations to improve both recruitment and retention. The purpose of this article is to clearly outline the issues contributing to this problem, and to provide the nurse manager with information regarding specific influences on job satisfaction as it relates to job turnover and employee retention. To accomplish this, an analysis of the literature using both national and international sources is used to formulate the lessons learned as well as strategies and future courses of action designed to address this shortage.

  10. Act No. 89-487 of 10 July 1989 relating to the prevention of the mistreatment of minors and protection of childhood.

    Science.gov (United States)

    1989-01-01

    This Act amends the French Family and Social Aid Code to insert provisions designed to prevent the mistreatment of minors. It provides that childhood social aid services are to have the additional objectives of preventing mistreatment and collecting information on the mistreatment of minors and are to inform and sensitize the public at large, as well as concerned persons, about the conditions of mistreated minors. The Act requires the president of each local general council to establish a system for collection of information, require the collaboration of professionals and associations dealing with the protection of the family and children, and notify legal authorities when a minor has or appears to have been mistreated and it is impossible to evaluate the situation or the family refuses to cooperate. The Act also creates a free telephone service to respond at any time of the day to requests for information or advice on minors who are or appear to be mistreated and to convey to the presidents of local general councils information and recommendations about these minors. In addition, all physicians, medical and paramedical personnel, magistrates, teachers, and police are to receive initial and continuing training to allow them to respond to cases of mistreated children and take actions necessary to prevent mistreatment and protect children.

  11. Shortage of Mathematics Teachers in Thai Basic Education Level

    Science.gov (United States)

    Puncreobutr, Vichian; Rattanatumma, Tawachai

    2016-01-01

    The objective of this study was to identify the reasons for shortage of Mathematics teachers at Thai Basic Education level. This research is both quantitative and qualitative in nature. For the purpose of study, survey was conducted with senior high school students, in order to find out their willingness to pursue mathematics in Bachelor of…

  12. SREB Study Indicates Serious Shortage of Nursing Faculty.

    Science.gov (United States)

    Southern Regional Education Board, Atlanta, GA. Council on Collegiate Education for Nursing.

    The Southern Regional Education Board (SREB) Council on Collegiate Education for Nursing appointed an ad hoc committee to study the implications of nursing shortages for nursing education programs in the 16 SREB states and the District of Columbia. In May 2001, surveys were sent to 491 colleges and universities that prepare students for licensure…

  13. 7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

    Science.gov (United States)

    2010-01-01

    ... Secretary reserves the right to solicit veterinarian shortage situations every year or every three years, as... of nominations that may be submitted by each State animal health official. (e) Nominations... the position is not secured. (f) Nominating Official. The State animal health official in each state...

  14. Energy network dispatch optimization under emergency of local energy shortage

    International Nuclear Information System (INIS)

    Cai, Tianxing; Zhao, Chuanyu; Xu, Qiang

    2012-01-01

    The consequence of short-time energy shortage under extreme conditions, such as earthquake, tsunami, and hurricane, may cause local areas to suffer from delayed rescues, widespread power outages, tremendous economic losses, and even public safety threats. In such urgent events of local energy shortage, agile energy dispatching through an effective energy transportation network, targeting the minimum energy recovery time, should be a top priority. In this paper, a novel methodology is developed for energy network dispatch optimization under emergency of local energy shortage, which includes four stages of work. First, emergency-area-centered energy network needs to be characterized, where the capacity, quantity, and availability of various energy sources are determined. Second, the energy initial situation under emergency conditions needs to be identified. Then, the energy dispatch optimization is conducted based on a developed MILP (mixed-integer linear programming) model in the third stage. Finally, the sensitivity of the minimum dispatch time with respect to uncertainty parameters is characterized by partitioning the entire space of uncertainty parameters into multiple subspaces. The efficacy of the developed methodology is demonstrated via a case study with in-depth discussions. -- Highlights: ► Address the energy network dispatch problem under emergency of local energy shortage. ► Minimize the energy restoration time for the entire energy network under emergency events. ► Develop a new MILP model and a sensitivity analysis method with respect to uncertainties.

  15. The Effect of Labor Supply Shortages on Asymmetric Cost Behavior

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    facing restrictions in labor supply increase costs (and resources) less than companies operating with sufficient access to additional personnel. This leads to a more symmetrical cost behavior for increasing activity compared to decreasing activity. Additional analyses show that shortages in labor supply......, such as prior period slack creation or pessimistic managerial expectations with respect to future demand....

  16. Intergration in community relations: water shortage and social ...

    African Journals Online (AJOL)

    The topography of the environment; few boreholes/wells; lack of pipe-borne water; lack of maintenance of boreholes; increase in population; and lack of projection for the future constitute reasons responsible for water shortage. On the other hand, disrupting queue; giving preference to friends to fetch water at the expense of ...

  17. The Impact of Water Shortages on Educational Delivery in Selected ...

    African Journals Online (AJOL)

    The goal of the study was to investigate the impact of water shortages on educational delivery in selected schools in Harare East District. The population included school heads, teachers and pupils all drawn from selected schools of Harare East District. The sample consisted of five school heads, fifty teachers and one ...

  18. Waste minimization concepts applied to oil spill response or (integrating the Pollution Prevention Act of 1990 with the Oil Pollution Act of 1990)

    International Nuclear Information System (INIS)

    Ferriere, D.V.

    1993-01-01

    As of July 23, 1993 the National Contingency Plan (NCP) for oil spills and hazardous substance releases (40CFR300) is being revised to comply with Oil Pollution Act 1990 (OPA '90) requirements. An important OPA '90 development is the creation of localized groups to write Area Contingency Plans (ACPs). During the ACP process many political, economical, and environmental issues will be addressed by representatives from several local, county, state, federal agencies and industry. Some of the difficulty decision makers must face is weighing environmental tradeoffs considering socio-economic aspects and determining what is the most effective ecologically sensible/environmental protection oil spill response strategy. Ideally, the NCP is designed as a democratic process providing a voice to all effected parties on how to best protect the environment, natural resources, and commercial resources. However, practice has shown successful emergency response is best handled when a single focal point of command, commonly referred to as incident command, has an agreed upon response agenda. The following will address the need for decision makers and contingency planners to at least address waste minimization principles, if not make it their primary focus, when developing and executing the oil spill response plan

  19. U.S. vaccine and immune globulin product shortages, 2001-15.

    Science.gov (United States)

    Ziesenitz, Victoria C; Mazer-Amirshahi, Maryann; Zocchi, Mark S; Fox, Erin R; May, Larissa S

    2017-11-15

    Trends in shortages of vaccines and immune globulin products from 2001 through 2015 in the United States are described. Drug shortage data from January 2001 through December 2015 were obtained from the University of Utah Drug Information Service. Shortage data for vaccines and immune globulins were analyzed, focusing on the type of product, reason for shortage, shortage duration, shortages requiring vaccine deferral, and whether the drug was a single-source product. Inclusion of the product into the pediatric vaccination schedule was also noted. Of the 2,080 reported drug shortages, 59 (2.8%) were for vaccines and immune globulin products. Of those, 2 shortages (3%) remained active at the end of the study period. The median shortage duration was 16.8 months. The most common products on shortage were viral vaccines (58%), especially hepatitis A, hepatitis B, rabies, and varicella vaccines (4 shortages each). A vaccine deferral was required for 21 shortages (36%), and single-source products were on shortage 30 times (51%). The most common reason for shortage was manufacturing problems (51%), followed by supply-and-demand issues (7%). Thirty shortages (51%) were for products on the pediatric schedule, with a median duration of 21.7 months. Drug shortages of vaccines and immune globulin products accounted for only 2.8% of reported drug shortages within a 15-year period, but about half of these shortages involved products on the pediatric vaccination schedule, which may have significant public health implications. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Environmental impacts of water resources exploitation works: prevention acts; Impactos ambientais de obras de exploracao de recursos hidricos: acoes preventivas

    Energy Technology Data Exchange (ETDEWEB)

    Mota, Suetonio [Ceara Univ., Fortaleza, CE (Brazil)

    1989-11-01

    This paper discusses the environmental impacts that becomes from works of water resources exploitation, like dam construction, river rectification and irrigation projects, and its impacts on the biotic, physical and social environment, and shows the actions will be made to prevent or minimize this impacts 6 refs., 3 tabs.

  1. Early Intervention and Maltreated Children: A Current Look at the Child Abuse Prevention and Treatment Act and Part C

    Science.gov (United States)

    Moxley, Kathleen M.; Squires, Jane; Lindstrom, Lauren

    2012-01-01

    Current literature regarding the prevalence of child abuse and neglect, resulting developmental impacts on children, and early intervention services for children and families involved in the child welfare system is summarized. While early intervention eligibility referrals are mandated for this population under the Child Abuse Prevention and…

  2. Water shortages and extreme events: a call for research.

    Science.gov (United States)

    Carmichael, Catriona; Odams, Sue; Murray, Virginia; Sellick, Matthew; Colbourne, Jeni

    2013-09-01

    Water shortages as a result of extreme weather events, such as flooding and severe cold, have the potential to affect significant numbers of people. Therefore, the need to build robust, coordinated plans based on scientific evidence is crucial. The literature review outlined in this short communication was conducted as part of a joint Drinking Water Inspectorate and Health Protection Agency (now Public Health England) report which aimed to review the scientific evidence base on extreme events, water shortages and the resulting health impacts. A systematic literature review was undertaken to identify published literature from both peer-reviewed and grey literature sources. The retrieved literature was then assessed using the Scottish Intercollegiate Guidelines Network quality assessment. The authors found very few scientific studies. However, a great deal of valuable grey literature was retrieved and used by the research team. In total, six main themes of importance that were identified by the review and discussed included health impacts, water quantity and quality, alternative supplies, vulnerable groups, communication with those affected and the emergency response. The authors conclude that more research needs to be conducted on health impacts and extreme events water shortages in order to build the future knowledge base and development of resilience.

  3. Xenotransplantation: A Potential Solution to the Critical Organ Donor Shortage

    Directory of Open Access Journals (Sweden)

    K Howe Sim

    1999-01-01

    Full Text Available The success of allotransplantation as a treatment for end-stage organ failure has resulted in the need for an increasing number of organ donors. Attempts to meet this need include the use of organs from living related and unrelated donors, financial or other incentives for the donor family, and even the reuse of transplanted organs. Despite these initiatives, the supply of organs for transplantation still falls far short of the demand, as evidenced by longer waiting times for transplantation and decreasing transplantation rates. Even if Canada were able to increase its organ donor rate to that of Spain (40 to 50/million, where organ donation is governed by ‘presumed consent’ legislation, this would not alleviate the problem of donor shortage. Interest in xenotransplantation stems from the need to overcome this increasingly severe shortage of human organs. Indeed, some argue that xenotransplantation is the only potential way of addressing this shortage. As immunological barriers to xenotransplantation are better understood, those hurdles are being addressed through genetic engineering of donor animals and the development of new drug therapies. However, before xenotransplantation can be fully implemented, both the scientific/medical communities and the general public must seriously consider and attempt to resolve the many complex ethical, social and economic issues that it presents.

  4. Research on water shortage risks and countermeasures in North China

    Science.gov (United States)

    Cheng, Yuxiang; Fang, Wenxuan; Wu, Ziqin

    2017-05-01

    In the paper, a grey forecasting model and a population growth model are established for forecasting water resources supply and demand situation in the region, and evaluating the scarcity of water resources thereof in order to solve the problem of water shortage in North China. A concrete plan for alleviating water resources pressure is proposed with AHP as basis, thereby discussing the feasibility of the plan. Firstly, water resources supply and demand in the future 15 years are predicted. There are four sources for the demand of water resources mainly: industry, agriculture, ecology and resident living. Main supply sources include surface water and underground water resources. A grey forecasting method is adopted for predicting in the paper aiming at water resources demands since industrial, agricultural and ecological water consumption data have excessive decision factors and the correlation is relatively fuzzy. Since residents' water consumption is determined by per capita water consumption and local population, a logistic growth model is adopted to forecast the population. The grey forecasting method is used for predicting per capita water consumption, and total water demand can be obtained finally. International calculation standards are adopted as reference aiming at water supply. The grey forecasting method is adopted for forecasting surface water quantity and underground water quantity, and water resources supply is obtained finally. Per capita water availability in the region is calculated by comparing the water resources supply and demand. Results show that per capita water availability in the region is only 283 cubic meters this year, people live in serious water shortage region, who will suffer from water shortage state for long time. Then, sensitivity analysis is applied for model test. The test result is excellent, and the prediction results are more accurate. In the paper, the following measures are proposed for improving water resources condition

  5. Implementation of the Preventive Radiation Protection Act; here: Regulation governing ambient radioactivity monitoring subject to the Preventive Radiation Protection Act. Pt. 1. Measuring programme for specified normal operation monitoring (routine measuring programme). BMU circular letter dated 28.07.94 -RS II 6 - 15 603/3

    International Nuclear Information System (INIS)

    1994-01-01

    The regulation addresses the competent Federal and Land authorities responsible for implementation of the Preventive Radiation Protection Act, and the competent highest Land authorities. The regulation defines the scope of obligatory measurement of ambient radioactivity during normal operation of installations and determines the measuring techniques to be applied for this purpose. The programme determines compulsory instructions to be observed in the performance of the routine measuring programme by the competent Federal and Land authorities and thus ensures nationwide application of standard procedures

  6. The social impacts of the energy shortage, behavioral and attitude shifts

    Science.gov (United States)

    1975-09-01

    An analysis of the social impacts of the energy shortage; specifically, an : analysis of shifts in social behavior, or trip-making characteristics, and : shifts in social attitudes towards the energy shortage and conservation policies, : Data were ob...

  7. Satisfaction in nursing in the context of shortage.

    Science.gov (United States)

    Morgan, Jennifer Craft; Lynn, Mary R

    2009-04-01

    This paper describes the central themes nurses identify as important to their overall evaluation of their work. In particular, this paper highlights how the context of the nursing shortage interacts with what nurses understand to be satisfying about their work. On the brink of a current and enduring nursing shortage in the US, this study provides Nurse Managers with an understanding of the dimensions of work satisfaction which they can then utilize to improve retention of incumbent nurses. Semi-structured interviews were conducted with 20 currently employed nurses to explore the concepts that shape their work satisfaction. The nurses, 25 to 55 years old, were predominantly female and Associate Degree or Baccalaureate prepared. Nurses have both intrinsic and extrinsic satisfiers in their work. The traditional satisfiers (pay and benefits) are not the principle satisfiers of today's nurses. In the context of shortage, the aspects of nursing that are the most rewarding are the aspects that are most often sacrificed in the interest of 'getting the job done'. Nurses are finding it difficult to continue to do 'more with less' and are frustrated they are not able to provide the care they were educated to be able to deliver. The description of the dimensions of work satisfaction can provide insight for Nurse Managers and administrators who are interested in improving both recruitment and retention of nurses. Areas identified worthy of focus in retention efforts include: increasing autonomy; reallocating work in a more patient-centred way; creating systems to recognize achievement in the areas of mentoring nurses, educating patients and personal growth in practice; creating meaningful internal labour markets; and enhancing supervisor and administrative support. Managers and administrators should focus on the satisfiers nurses identify if they wish to retain nurses. The traditional focus on extrinsic rewards will not likely be sufficient to retain today's nurses. Retention

  8. A production inventory model with deteriorating items and shortages

    Directory of Open Access Journals (Sweden)

    Samanta G.P.

    2004-01-01

    Full Text Available A continuous production control inventory model for deteriorating items with shortages is developed. A number of structural properties of the inventory system are studied analytically. The formulae for the optimal average system cost, stock level, backlog level and production cycle time are derived when the deterioration rate is very small. Numerical examples are taken to illustrate the procedure of finding the optimal total inventory cost, stock level, backlog level and production cycle time. Sensitivity analysis is carried out to demonstrate the effects of changing parameter values on the optimal solution of the system.

  9. Research priorities to achieve universal access to hepatitis C prevention, management and direct-acting antiviral treatment among people who inject drugs.

    Science.gov (United States)

    Grebely, Jason; Bruneau, Julie; Lazarus, Jeffrey V; Dalgard, Olav; Bruggmann, Philip; Treloar, Carla; Hickman, Matthew; Hellard, Margaret; Roberts, Teri; Crooks, Levinia; Midgard, Håvard; Larney, Sarah; Degenhardt, Louisa; Alho, Hannu; Byrne, Jude; Dillon, John F; Feld, Jordan J; Foster, Graham; Goldberg, David; Lloyd, Andrew R; Reimer, Jens; Robaeys, Geert; Torrens, Marta; Wright, Nat; Maremmani, Icro; Norton, Brianna L; Litwin, Alain H; Dore, Gregory J

    2017-09-01

    Globally, it is estimated that 71.1 million people have chronic hepatitis C virus (HCV) infection, including an estimated 7.5 million people who have recently injected drugs (PWID). There is an additional large, but unquantified, burden among those PWID who have ceased injecting. The incidence of HCV infection among current PWID also remains high in many settings. Morbidity and mortality due to liver disease among PWID with HCV infection continues to increase, despite the advent of well-tolerated, simple interferon-free direct-acting antiviral (DAA) HCV regimens with cure rates >95%. As a result of this important clinical breakthrough, there is potential to reverse the rising burden of advanced liver disease with increased treatment and strive for HCV elimination among PWID. Unfortunately, there are many gaps in knowledge that represent barriers to effective prevention and management of HCV among PWID. The Kirby Institute, UNSW Sydney and the International Network on Hepatitis in Substance Users (INHSU) established an expert round table panel to assess current research gaps and establish future research priorities for the prevention and management of HCV among PWID. This round table consisted of a one-day workshop held on 6 September, 2016, in Oslo, Norway, prior to the International Symposium on Hepatitis in Substance Users (INHSU 2016). International experts in drug and alcohol, infectious diseases, and hepatology were brought together to discuss the available scientific evidence, gaps in research, and develop research priorities. Topics for discussion included the epidemiology of injecting drug use, HCV, and HIV among PWID, HCV prevention, HCV testing, linkage to HCV care and treatment, DAA treatment for HCV infection, and reinfection following successful treatment. This paper highlights the outcomes of the roundtable discussion focused on future research priorities for enhancing HCV prevention, testing, linkage to care and DAA treatment for PWID as we strive

  10. Implementation of the Clean Air Act, Title III, Section 112(r) Prevention of Accidental Release Rule requirements at U.S. DOE Oak Ridge Reservation facilities

    International Nuclear Information System (INIS)

    Humphreys, M.P.

    1997-01-01

    Title III, Section 112(r) of the Clean Air Act (CAA) Amendments of 1990 requires the Environmental Protection Agency (EPA) to promulgate regulations to prevent accidental releases of regulated substances and to reduce the severity of those releases that do occur. The final EPA rule for Risk Management Programs under Section 112(r)(7) of the CAA, promulgated June 20, 1996, applies to all stationary sources with processes that contain more than a threshold quantity of any of 139 regulated substances listed under 40 CFR 68.130. All affected sources will be required to prepare a risk management plan which must be submitted to EPA and be made available to state and local governments and to the public. This paper will provide details of initiatives underway at US Department of Energy (DOE) Oak Ridge Reservation (ORR) Facilities for implementation of the Prevention of Accidental Release Rule. The ORR encompasses three DOE Facilities: the Y-12 Plant, Oak Ridge National Laboratory (ORNL), and the K-25 Site. The Y-12 Plant manufactures component parts for the national nuclear weapons program; the ORNL is responsible for research and development activities including nuclear engineering, engineering technologies, and the environmental sciences; and the K-25 Site conducts a variety of research and development activities and is the home of a mixed waste incinerator. ORR activities underway and soon to be undertaken toward implementation of the Prevention of Accidental Release Rule include: compilation of inventories of regulated substances at all processes at each of the three ORR Facilities for determination of affected processes and facilities; plans for inventory reduction to levels below threshold quantities, where necessary and feasible; determination of the overlap of processes subject to the OSHA PSM Standard and determination of parallel requirements; preparation of Risk Management Plans and Programs for affected processes and facilities including detailed requirements

  11. Inflow shortages in deregulated power markets - Reasons for concern?

    Energy Technology Data Exchange (ETDEWEB)

    Bye, Torstein; Bruvoll, Annegrete; Aune, Finn Roar [Research Department, Statistics Norway, P.O. Box 8131 Dep., 0033 Oslo (Norway)

    2008-07-15

    In many countries hydropower constitutes a large share of the electricity producing capacity. In the earlier regulated electricity markets, production capacities exceeded demand due to security of supply concerns. The present deregulated markets base investments upon profitability alone, and security of supply issues are claimed to be less important. Market operators trust the pricing mechanism in competitive markets to clear. Then low inflow constitutes a less problem. Several markets, both under regulated and deregulated regimes, have faced serious droughts. Some of them have experienced problems with market clearance (Chile, Brazil, California) while other markets functioned well (The Nordic market). Important features to the market response are the flexibility of demand, the pattern of inflow shortage, the storage capacities, the possibility of trade between regions with different production technologies, and the market design and concentration. We apply an empirical based market model to simulate the effects under two inflow shortage scenarios in an international market with combined hydro and thermal capacities and restricted transmission capacities. We compare the scenarios with actual events and show that the model and the real market outcome are comparable. The simulations do not reveal any problems with the functioning of the market, which should calm down the anxiousness about security of supply in deregulated markets with stochastic energy supply. (author)

  12. Inflow shortages in deregulated power markets - Reasons for concern?

    International Nuclear Information System (INIS)

    Bye, Torstein; Bruvoll, Annegrete; Aune, Finn Roar

    2008-01-01

    In many countries hydropower constitutes a large share of the electricity producing capacity. In the earlier regulated electricity markets, production capacities exceeded demand due to security of supply concerns. The present deregulated markets base investments upon profitability alone, and security of supply issues are claimed to be less important. Market operators trust the pricing mechanism in competitive markets to clear. Then low inflow constitutes a less problem. Several markets, both under regulated and deregulated regimes, have faced serious droughts. Some of them have experienced problems with market clearance (Chile, Brazil, California) while other markets functioned well (The Nordic market). Important features to the market response are the flexibility of demand, the pattern of inflow shortage, the storage capacities, the possibility of trade between regions with different production technologies, and the market design and concentration. We apply an empirical based market model to simulate the effects under two inflow shortage scenarios in an international market with combined hydro and thermal capacities and restricted transmission capacities. We compare the scenarios with actual events and show that the model and the real market outcome are comparable. The simulations do not reveal any problems with the functioning of the market, which should calm down the anxiousness about security of supply in deregulated markets with stochastic energy supply

  13. Credit financing for deteriorating imperfect quality items with allowable shortages

    Directory of Open Access Journals (Sweden)

    Aditi Khanna

    2016-01-01

    Full Text Available The outset of new technologies, systems and applications in manufacturing sector has no doubt lighten up our workload, yet the chance causes of variation in production system cannot be eliminated completely. Every produced/ordered lot may have some fraction of defectives which may vary from process to process. In addition the situation is more susceptible when the items are deteriorating in nature. However, the defective items can be secluded from the good quality lot through a careful inspection process. Thus, a screening process is obligatory in today’s technology driven industry which has the customer satisfaction as its only motto. Moreover, in order to survive in the current global markets, credit financing has been proven a very influential promotional tool to attract new customers and a good inducement policy for the retailers. Keeping this scenario in mind, the present paper investigates an inventory model for a retailer dealing with imperfect quality deteriorating items under permissible delay in payments. Shortages are allowed and fully backlogged. This model jointly optimizes the order quantity and shortages by maximizing the expected total profit. A mathematical model is developed to depict this scenario. Results have been validated with the help of numerical example. Comprehensive sensitivity analysis has also been presented.

  14. Optimal Intermittent Operation of Water Distribution Networks under Water Shortage

    Directory of Open Access Journals (Sweden)

    mohamad Solgi

    2017-07-01

    Full Text Available Under water shortage conditions, it is necessary to exercise water consumption management practices in water distribution networks (WDN. Intermittent supply of water is one such practice that makes it possible to supply consumption nodal demands with the required pressure via water cutoff to some consumers during certain hours of the day. One of the most important issues that must be observed in this management practice is the equitable and uniform water distribution among the consumers. In the present study, uniformity in water distribution and minimum supply of water to all consumers are defined as justice and equity, respectively. Also, an optimization model has been developed to find an optimal intermittent supply schedule that ensures maximum number of demand nodes are supplied with water while the constraints on the operation of water distribution networks are also observed. To show the efficiency of the proposed model, it has been used in the Two-Loop distribution network under several different scenarios of water shortage. The optimization model has been solved using the honey bee mating optimization algorithm (HBMO linked to the hydraulic simulator EPANET. The results obtained confirm the efficiency of the proposed model in achieving an optimal intermittent supply schedule. Moreover, the model is found capable of distributing the available water in an equitable and just manner among all the consumers even under severe water shoratges.

  15. ACTING OF THE MEDICAL GENETIC ADVISORY CENTER IN THE EARLY DETECTION AND PREVENTION OF PERSONS WITH PSHYCHOPHYSICAL DISORDERS IN THEIR DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    M. KJAEVA-PEJKOVSKA

    1997-03-01

    Full Text Available There had been a great dedication on the prevention of the acquired disease in the past. The well known are eugenetic advisory centers in which people could get information for a given inherited disease, later so called genetic advisory centers. Their work, besides is based on the principles of informing the patients for the difficulties, importance and prognoses of determined inherited disease. This activity, which is the highest achievement in the medical genetics, can be called genetic information, which is very important for regular treatment of every patient.The accurate etiological diagnosis is an essential precondition for giving the genetic information, assessment of the risk, the eventual treatment, as for the prenatal diagnosis e.i. prevention of congenital malformations.The genetic consulting is applicable in all possible phenotype manifestations of the breaking genes, regardless to the categorical custody of the examinees with retards in their development. In fact, that’s a summary of standards which are applicable in the basic prevention in disabilities in the psycho-physical development, whose reasons are genetically determined. Preventive activities are mostly used with mentally retarded as a result of the frequent intercession of the psychological disorders all together in different syndromes and diseases.The genetic consulting activities of the Center for Mental Health for children and adolescents in Skopje are based on the appliance of the following methodology: fortification of the risk for the appearance of inherited anomalies; explanation and assessment of the established risk in the concrete family situation, assurance of adequate assistance concerning the accurate and practical assessment of the risk and preparation of rational plan for subsequent treatment and decisions; consequent observation of the situations and evaluation of achieved results etc. In that way, the acting of medical-genetic advising center in the

  16. The FDA Unapproved Drugs Initiative: An Observational Study of the Consequences for Drug Prices and Shortages in the United States.

    Science.gov (United States)

    Gupta, Ravi; Dhruva, Sanket S; Fox, Erin R; Ross, Joseph S

    2017-10-01

    Hundreds of drug products are currently marketed in the United States without approval from the FDA. The 2006 Unapproved Drugs Initiative (UDI) requires manufacturers to remove these drug products from the market or obtain FDA approval by demonstrating evidence of safety and efficacy. Once the FDA acts against an unapproved drug, fewer manufacturers remain in the market, potentially enabling drug price increases and greater susceptibility to drug shortages. There is a need for systematic study of the UDI's effect on prices and shortages of all targeted drugs. To examine the clinical evidence for approval and association with prices and shortages of previously unapproved prescription drugs after being addressed by the UDI. Previously unapproved prescription drugs that faced UDI regulatory action or with at least 1 product that received FDA approval through manufacturers' voluntary compliance with the UDI between 2006 and 2015 were identified. The clinical evidence was categorized as either newly conducted clinical trials or use of previously published literature and/or bioequivalence studies to demonstrate safety and efficacy. We determined the change in average wholesale price, presence of shortage, and duration of shortage for each drug during the 2 years before and after UDI regulatory action or approval through voluntary compliance. Between 2006 and 2015, 34 previously unapproved prescription drugs were addressed by the UDI. Nearly 90% of those with a drug product that received FDA approval were supported by literature reviews or bioequivalence studies, not new clinical trial evidence. Among the 26 drugs with available pricing data, average wholesale price during the 2 years before and after voluntary approval or UDI action increased by a median of 37% (interquartile range [IQR] = 23%-204%; P Innovation; from the Blue Cross Blue Shield Association to better understand medical technology evidence generation; from the Centers for Medicare & Medicaid Services to

  17. Caffeine acts through neuronal adenosine A2A receptors to prevent mood and memory dysfunction triggered by chronic stress.

    Science.gov (United States)

    Kaster, Manuella P; Machado, Nuno J; Silva, Henrique B; Nunes, Ana; Ardais, Ana Paula; Santana, Magda; Baqi, Younis; Müller, Christa E; Rodrigues, Ana Lúcia S; Porciúncula, Lisiane O; Chen, Jiang Fan; Tomé, Ângelo R; Agostinho, Paula; Canas, Paula M; Cunha, Rodrigo A

    2015-06-23

    The consumption of caffeine (an adenosine receptor antagonist) correlates inversely with depression and memory deterioration, and adenosine A2A receptor (A2AR) antagonists emerge as candidate therapeutic targets because they control aberrant synaptic plasticity and afford neuroprotection. Therefore we tested the ability of A2AR to control the behavioral, electrophysiological, and neurochemical modifications caused by chronic unpredictable stress (CUS), which alters hippocampal circuits, dampens mood and memory performance, and enhances susceptibility to depression. CUS for 3 wk in adult mice induced anxiogenic and helpless-like behavior and decreased memory performance. These behavioral changes were accompanied by synaptic alterations, typified by a decrease in synaptic plasticity and a reduced density of synaptic proteins (synaptosomal-associated protein 25, syntaxin, and vesicular glutamate transporter type 1), together with an increased density of A2AR in glutamatergic terminals in the hippocampus. Except for anxiety, for which results were mixed, CUS-induced behavioral and synaptic alterations were prevented by (i) caffeine (1 g/L in the drinking water, starting 3 wk before and continued throughout CUS); (ii) the selective A2AR antagonist KW6002 (3 mg/kg, p.o.); (iii) global A2AR deletion; and (iv) selective A2AR deletion in forebrain neurons. Notably, A2AR blockade was not only prophylactic but also therapeutically efficacious, because a 3-wk treatment with the A2AR antagonist SCH58261 (0.1 mg/kg, i.p.) reversed the mood and synaptic dysfunction caused by CUS. These results herald a key role for synaptic A2AR in the control of chronic stress-induced modifications and suggest A2AR as candidate targets to alleviate the consequences of chronic stress on brain function.

  18. Endoplasmic reticulum proteins SDF2 and SDF2L1 act as components of the BiP chaperone cycle to prevent protein aggregation.

    Science.gov (United States)

    Fujimori, Tsutomu; Suno, Ryoji; Iemura, Shun-Ichiro; Natsume, Tohru; Wada, Ikuo; Hosokawa, Nobuko

    2017-08-01

    The folding of newly synthesized proteins in the endoplasmic reticulum (ER) is assisted by ER-resident chaperone proteins. BiP (immunoglobulin heavy-chain-binding protein), a member of the HSP70 family, plays a central role in protein quality control. The chaperone function of BiP is regulated by its intrinsic ATPase activity, which is stimulated by ER-resident proteins of the HSP40/DnaJ family, including ERdj3. Here, we report that two closely related proteins, SDF2 and SDF2L1, regulate the BiP chaperone cycle. Both are ER-resident, but SDF2 is constitutively expressed, whereas SDF2L1 expression is induced by ER stress. Both luminal proteins formed a stable complex with ERdj3 and potently inhibited the aggregation of different types of misfolded ER cargo. These proteins associated with non-native proteins, thus promoting the BiP-substrate interaction cycle. A dominant-negative ERdj3 mutant that inhibits the interaction between ERdj3 and BiP prevented the dissociation of misfolded cargo from the ERdj3-SDF2L1 complex. Our findings indicate that SDF2 and SDF2L1 associate with ERdj3 and act as components in the BiP chaperone cycle to prevent the aggregation of misfolded proteins, partly explaining the broad folding capabilities of the ER under various physiological conditions. © 2017 Molecular Biology Society of Japan and John Wiley & Sons Australia, Ltd.

  19. Shift in U.S. payer responsibility for the acute care of violent injuries after the Affordable Care Act: Implications for prevention.

    Science.gov (United States)

    Coupet, Edouard; Karp, David; Wiebe, Douglas J; Kit Delgado, M

    2018-03-28

    Investment in violence prevention programs is hampered by lack of clearly identifiable stakeholders with a financial stake in prevention. We determined the total annual charges for the acute care of injuries from interpersonal violence and the shift in financial responsibility for these charges after the Medicaid expansion from the Affordable Care Act in 2014. We analyzed all emergency department (ED) visits from 2009 to 2014 with diagnosis codes for violent injury in the Nationwide Emergency Department Sample (NEDS). We used sample weights to estimate total charges with adjusted generalized linear models to estimate charges for the 15% of ED visits with missing charge data. We then calculated the share attributable by payer and determined the difference in proportion by payer from 2013 to 2014. Between 2009 and 2013, the uninsured accounted for 28.2-31.3% of annual charges for the acute care of violent injury, while Medicaid was responsible for a similar amount (29.0-31.0%). In 2014, there were $10.7 billion in total charges for violent injury. Medicaid assumed the greatest share, 39.8% (95% CI: 38.0-41.5%, $3.5-5.1 billion), while the uninsured accounted for 23.6% (95% CI: 22.2-24.9%, $2.0-3.0 billion), and Medicare accounted for 7.8% (95% CI: 7.7-8.0%, $0.7-1.0 billion). After Medicaid expansion, taxpayers are now accountable for nearly half of the $10.7 billion in annual charges for the acute care of violent injury in the U.S. These findings highlight the benefit to state Medicaid programs of preventing interpersonal violence. Published by Elsevier Inc.

  20. Is There a Shortage of Obstetrician-Gynecologists?

    Science.gov (United States)

    Stonehocker, Jody; Muruthi, Joyce; Rayburn, William F

    2017-03-01

    Projections of supply and demand for obstetricians-gynecologists suggest a current minimal or modest shortage that will worsen in the future. The US adult female population is expected to increase by more than 20% by 2045 and represents a key driver for increased demand for health care services. The annual number of obstetrician-gynecologists (ob-gyn) residency graduates has increased negligibly, whereas the proportion accepted into fellowships increased steadily, reducing those in general practice. The gradual increase in proportion of ob-gyns who are women coincides with desires for more work-life balance and earlier retirement from clinical practice. As the supply of advanced practice providers of women's health services grows, the need for more ob-gyns could be less to meet the projected demand. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. A strategy to address the nursing faculty shortage.

    Science.gov (United States)

    Ganley, Barbara J; Sheets, Ingrid

    2009-07-01

    This article describes one university's experience in creating a master's geriatric clinical nurse specialist-nurse educator program to address the nursing faculty shortage and the need for geriatric clinical nurse specialists. The successes and challenges are outlined, and curricular ideas that may be beneficial to other nursing programs also are presented. This program has enhanced the university's pool of clinical instructors, increased its ability to provide services to older adults, and allowed faculty to instruct and focus undergraduates in the distinctions of geriatric nursing care. The biggest challenges faced were marketing and recruitment of nurses; these challenges were addressed, and possible solutions are offered. The most immediate benefit of this program was the generation of geriatric clinical nurse specialists.

  2. Is there a shortage of neurosurgeons in the United States?

    Science.gov (United States)

    Rosman, Judy; Slane, Steve; Dery, Beth; Vogelbaum, Michael A; Cohen-Gadol, Aaron A; Couldwell, William T

    2013-08-01

    Neurosurgical workforce decision-making is typically driven by the 1 neurosurgeon per 100,000 population ratio proposed in 1977 in the Study on Surgical Services for the United States report. The actual ratio has always been higher than suggested. We evaluated whether the 1:100,000 ratio from the Study on Surgical Services for the United States report is still valid, whether there are enough neurosurgeons in the United States to meet patient needs, and whether demand is driven by patient need. For our analysis, the distribution of practicing US neurosurgeons was merged with census data to yield density indices of neurosurgeons by state; a survey assessing practice characteristics was e-mailed to practicing neurosurgeons; and a compilation of job advertisements for US neurosurgeons was evaluated. Multivariant statistical analyses yielded inconclusive results regarding patient demand because existing data sets are not designed to establish patient demand and many neurosurgeons are subspecialized. The data indicated that the ratio of neurosurgeons to total US population is 1:65,580. In the survey responses, neurosurgeon-to-patient ratios varied dramatically by state and were inconsistently correlated with whether neurosurgeons indicated they were overworked or underworked. The 305 job advertisements may indicate a shortage. Twenty-four percent of advertising practices indicated that they are recruiting only for emergency department coverage, and an additional 26% indicated that they might not be recruiting if not for the need for emergency coverage. Demand ratios should be reevaluated by region and subspecialty to consider changes in neurosurgery practice. A "shortage" in the employment market may reflect factors other than patient need.

  3. The knowledge status EFFEKT: Efficiency shortage. Basis for further research

    International Nuclear Information System (INIS)

    Doorman, Gerard; Grande, Ove S.

    2002-02-01

    This report gives a survey of results from the ''Norges forskningsraad'' ( The Norwegian Research Council) program EFFEKT (1996-2000) and some other relevant projects. The report focuses on areas relevant to the efficiency shortage problems and is made as a part of the foundation for the start of the competence project ''Competence Building - Capacity Shortage''. The challenge is to find adequate solutions that satisfies the demands from market participants, systems operators and market actors. This mainly contains problems of both operational and long term strategic character which primarily touches the following main areas: Peak load coverage, operating security and reserves, network capacity and environmental aspects. The results are reported under these headings from several relevant projects. The major challenges in the future will be: 1) Development of mechanisms that bring the right incentives for improved use of the flexibility in the end consumption. 2) Adaptation of the market and organisational conditions in order to improve the consumer flexibility. 3) Further development of the incentive structures for the network owners and systems operators so that the existing transferring capacity is used as well as possible and the macro economic development of the network is encouraged. 4) Profit estimations and financing of larger co-originated connections particularly across the country borders, in deregulated power markets. Particularly the first two challenges are probably a condition for the deregulated power markets as the Nordic one, shall be able to survive in the long run. In an appendix main data studied in the projects as a basis for this report, are referred

  4. China's water shortage could shake world food security.

    Science.gov (United States)

    Brown, L R; Halweil, B

    1998-01-01

    This report indicates the global concern about China's water shortages and describes basin supplies, global availability of grain, and reasons for water losses. There is little precise data on how land productivity will be affected by declines in irrigation. Reports from the "China Daily" indicate that the 1995 grain harvest in Shandong province declined by 2.7 million tons (food for 9 million people) due to water failures of the Yellow River. A delegate at the 1998 National People's Congress pointed out that rural villages nationwide had shortages of 30 billion cu. m and losses of 20 million tons of grain production. About 70% of grain harvests rely on irrigation. Water demand for residential use and industrial use is likely to increase and compete with farm use. One unlikely option is to divert irrigation water to cities as needed and import grain. The entire agricultural, energy, and industrial economies need to be made more water efficient. Agriculture will need to produce more water efficient crops and livestock products and less water intensive energy supplies. Another alternative is to divert water from one location to another. Water pricing could reinforce efficiency of use. Use of composting toilets could reduce human residential water demand. Urban capacity building should rely on separate industrial and residential wastewater systems. Investing in technologies for industry can reduce water demand among paper and steel producers. The fastest growing grain market is in North Africa and the Middle East. Trends in principal grain exporting countries with 85% of global exports indicate no growth in grain production for export since 1980.

  5. Model of Management (Mo.Ma) for the patient with schizophrenia: crisis control, maintenance, relapse prevention, and recovery with long-acting injectable antipsychotics (LAIs).

    Science.gov (United States)

    Brugnoli, Roberto; Rapinesi, Chiara; Kotzalidis, Georgios D; Marcellusi, Andrea; Mennini, Francesco S; De Filippis, Sergio; Carrus, Dario; Ballerini, Andrea; Francomano, Antonio; Ducci, Giuseppe; Del Casale, Antonio; Girardi, Paolo

    2016-01-01

    Schizophrenia is a severe mental disease that affects approximately 1% of the population with a relevant chronic impact on social and occupational functioning and daily activities. People with schizophrenia are 2-2.5 times more likely to die early than the general population. Non-adherence to antipsychotic medications, both in chronic and first episode schizophrenia, is one of the most important risk factors for relapse and hospitalization, that consequently contributes to increased costs due to psychiatric hospitalization. Atypical long-acting injectable (LAI) antipsychotics can improve treatment adherence and decrease re-hospitalization rates in patients with schizophrenia since its onset. The primary goals in the management of schizophrenia are directed not only at symptom reduction in the short and long term, but also at maintaining physical and mental functioning, improving quality of life, and promoting patient recovery. To propose a scientific evidence-based integrated model that provides an algorithm for recovery of patients with schizophrenia and to investigate the effectiveness and safety of antipsychotics LAI in the treatment, maintenance, relapse prevention, and recovery of schizophrenia. After an accurate literature review we identified, collected and analyzed the crucial points in taking care schizophrenia patients, through which we defined the steps described in the model of management and the choice of the better treatment option. Results. In the management model we propose, the choice of a second generation long acting antipsychotic, could allow from the earliest stages of illness better patient management, especially for young individuals with schizophrenia onset, a better recovery and significant reductions of relapse and health care costs. LAI formulations of antipsychotics are valuable, because they help patients to remain adherent to their medication through regular contact with healthcare professionals and to prevent covert non-adherence. The

  6. Fuzzy inventory model for deteriorating items, with time depended demand, shortages, and fully backlogging

    OpenAIRE

    Wasim Akram Mandal; Sahidul Islam

    2016-01-01

    In this paper analyzes fuzzy inventory system for deterioration item with time depended demand. Shortages are allowed under fully backlogged. Fixed cost, deterioration cost, shortages cost, holding cost are the cost considered in this model. Fuzziness is applying by allowing the cost components (holding cost, deterioration, shortage cost, holding cost, etc). In fuzzy environment it considered all required parameter to be triangular fuzzy numbers. One numerical solution of the model is obtaine...

  7. Long-acting injectable paliperidone palmitate versus oral paliperidone extended release: a comparative analysis from two placebo-controlled relapse prevention studies.

    Science.gov (United States)

    Markowitz, Michael; Fu, Dong-Jing; Levitan, Bennett; Gopal, Srihari; Turkoz, Ibrahim; Alphs, Larry

    2013-07-11

    Increasing availability and use of long-acting injectable antipsychotics have generated a need to compare these formulations with their oral equivalents; however, a paucity of relevant data is available. This post hoc comparison of the long-term efficacy, safety and tolerability of maintenance treatment with paliperidone palmitate (PP) versus oral paliperidone extended release (ER) used data from two similarly designed, randomised, double-blind (DB), placebo-controlled schizophrenia relapse prevention trials. Assessments included measures of time to relapse, symptom changes/functioning and treatment-emergent adverse events (TEAEs). Time to relapse between treatment groups was evaluated using a Cox proportional hazards model. Between-group differences for continuous variables for change scores during the DB phase were assessed using analysis of co-variance models. Categorical variables were evaluated using Chi-square and Fisher's exact tests. No adjustment was made for multiplicity. Approximately 45% of enrolled subjects in both trials were stabilised and randomised to the DB relapse prevention phase. Risk of relapse was higher in subjects treated with paliperidone ER than in those treated with PP [paliperidone ER/PP hazard ratio (HR), 2.52; 95% confidence interval (CI), 1.46-4.35; p 70, both approximately 58.5%; p = 1.000] compared with a 10.9% decrease for paliperidone ER (58.5% vs 47.6%, respectively; p = 0.048). The least squares mean change for Positive and Negative Syndrome Scale (PANSS) total score at DB end point in these previously stabilised subjects was 3.5 points in favour of PP (6.0 vs 2.5; p = 0.025). The rates of TEAEs and AEs of interest appeared similar. This analysis supports maintenance of effect with the injectable compared with the oral formulation of paliperidone in patients with schizophrenia. The safety profile of PP was similar to that of paliperidone ER. Future studies are needed to confirm these findings.

  8. Noradrenaline from Locus Coeruleus Neurons Acts on Pedunculo-Pontine Neurons to Prevent REM Sleep and Induces Its Loss-Associated Effects in Rats.

    Science.gov (United States)

    Khanday, Mudasir Ahmad; Somarajan, Bindu I; Mehta, Rachna; Mallick, Birendra Nath

    2016-01-01

    Normally, rapid eye movement sleep (REMS) does not appear during waking or non-REMS. Isolated, independent studies showed that elevated noradrenaline (NA) levels inhibit REMS and induce REMS loss-associated cytomolecular, cytomorphological, psychosomatic changes and associated symptoms. However, the source of NA and its target in the brain for REMS regulation and function in health and diseases remained to be confirmed in vivo . Using tyrosine hydroxylase (TH)-siRNA and virus-coated TH-shRNA in normal freely moving rats, we downregulated NA synthesis in locus coeruleus (LC) REM-OFF neurons in vivo . These TH-downregulated rats showed increased REMS, which was prevented by infusing NA into the pedunculo-pontine tegmentum (PPT), the site of REM-ON neurons, normal REMS returned after recovery. Moreover, unlike normal or control-siRNA- or shRNA-injected rats, upon REMS deprivation (REMSD) TH-downregulated rat brains did not show elevated Na-K ATPase (molecular changes) expression and activity. To the best of our knowledge, these are the first in vivo findings in an animal model confirming that NA from the LC REM-OFF neurons (1) acts on the PPT REM-ON neurons to prevent appearance of REMS, and (2) are responsible for inducing REMSD-associated molecular changes and symptoms. These observations clearly show neuro-physio-chemical mechanism of why normally REMS does not appear during waking. Also, that LC neurons are the primary source of NA, which in turn causes some, if not many, REMSD-associated symptoms and behavioral changes. The findings are proof-of-principle for the first time and hold potential to be exploited for confirmation toward treating REMS disorder and amelioration of REMS loss-associated symptoms in patients.

  9. Price signals and end consumer flexibility in shortage situations

    International Nuclear Information System (INIS)

    Hunnes, Arngrim; Grande, Ove S.

    2002-08-01

    following alternatives: 1) Fixed part + loss part + energy part which is only active in shortage periods. 2) Fixed part + loss part + effect part which is only active in shortage periods. 3) Discontinued tariff with 15 minutes warning period

  10. The future of the nurse shortage: will wage increases close the gap?

    Science.gov (United States)

    Spetz, Joanne; Given, Ruth

    2003-01-01

    In recent years the U.S. media have been reporting a shortage of registered nurses (RNs). In theory, labor-market shortages are self-correcting; wage increases will bring labor markets into equilibrium, and policy intervention is not necessary. In this paper we develop a simple forecasting model and ask the question: How high must RN wages rise in the future to end the RN shortage? We find that inflation-adjusted wages must increase 3.2-3.8 percent per year between 2002 and 2016, with wages cumulatively rising up to 69 percent, to end the shortage. Total RN expenditures would more than double by 2016.

  11. Concerns for Skills Shortages in the 21st Century: A Review into the Construction Industry, Australia

    Directory of Open Access Journals (Sweden)

    Michelle Watson

    2012-11-01

    Full Text Available The Australian Construction Industry is now facing skills shortages in all trades. As an industry focused on the skill of its workforce, there is now concern the Australian standard in quality, workmanship, and productivity will inhibit both at national and international level.This research paper addresses the underlying, influential factors concerning skills shortages in the Australian construction industry. The influential factors addressed include funding, training statistics, employer expectations, financial limitations, Industrial Relations and immigration. Given the reference to skills shortages within the industry, and documented in related literature, if skills shortages are to continue to exist, their effect will impact upon the overall performance of construction companies throughout Australia.

  12. Routine referrals: A possible solution for transplantation shortages

    African Journals Online (AJOL)

    2017-06-16

    Jun 16, 2017 ... National Health Act 61 of 2003 (NHA) requires a signed document that has been ..... Organisation (SANOPO),[23] functioning as a not-for-profit company, could assist with .... donations-305841 (accessed 30 August 2016). 15.

  13. Scoping Summary Report: Development of Lower Basin Shortage Guidelines and Coordinated Management Strategies for Lake Powell and Lake Mead, Particularly Under Low Reservoir Conditions

    OpenAIRE

    U.S. Department of the Interior, Bureau of Reclamation

    2006-01-01

    The Bureau of Reclamation (Reclamation) acting on behalf of the Secretary of the Department of the Interior (Secretary) proposes to take action to adopt specific Colorado River Lower Basin shortage guidelines and coordinated reservoir management strategies to address operations of Lake Powell and Lake Mead, particularly under low reservoir conditions. This proposed Action will provide a greater degree of certainty to all water users and managers in the Colorado River Basin by providing more d...

  14. Comparative efficacy of inhaled corticosteroid and long-acting beta agonist combinations in preventing COPD exacerbations: a Bayesian network meta-analysis.

    Science.gov (United States)

    Oba, Yuji; Lone, Nazir A

    2014-01-01

    A combination therapy with inhaled corticosteroid (ICS) and a long-acting beta agonist (LABA) is recommended in severe chronic obstructive pulmonary disease (COPD) patients experiencing frequent exacerbations. Currently, there are five ICS/LABA combination products available on the market. The purpose of this study was to systematically review the efficacy of various ICS/LABA combinations with a network meta-analysis. Several databases and manufacturer's websites were searched for relevant clinical trials. Randomized control trials, at least 12 weeks duration, comparing an ICS/LABA combination with active control or placebo were included. Moderate and severe exacerbations were chosen as the outcome assessment criteria. The primary analyses were conducted with a Bayesian Markov chain Monte Carlo method. Most of the ICS/LABA combinations reduced moderate-to-severe exacerbations as compared with placebo and LABA, but none of them reduced severe exacerbations. However, many studies excluded patients receiving long-term oxygen therapy. Moderate-dose ICS was as effective as high-dose ICS in reducing exacerbations when combined with LABA. ICS/LABA combinations had a class effect with regard to the prevention of COPD exacerbations. Moderate-dose ICS/LABA combination therapy would be sufficient for COPD patients when indicated. The efficacy of ICS/LABA combination therapy appeared modest and had no impact in reducing severe exacerbations. Further studies are needed to evaluate the efficacy of ICS/LABA combination therapy in severely affected COPD patients requiring long-term oxygen therapy.

  15. Understanding the pediatric dermatology workforce shortage: mentoring matters.

    Science.gov (United States)

    Admani, Shehla; Caufield, Maura; Kim, Silvia S; Siegfried, Elaine C; Friedlander, Sheila Fallon

    2014-02-01

    To target pediatric dermatologists directly in order to evaluate their current demographics and the most important motivating factors that influenced their career choice. Pediatric dermatology is one of the pediatric subspecialties with an inadequate supply to meet current patient needs. A survey was designed to evaluate the training pathway, employment status, participation in teaching, and clinical practice characteristics of pediatric dermatologists. The survey was administered to attendants of the 2010 Society for Pediatric Dermatology annual meeting. Any remaining board certified pediatric dermatologists who had not previously responded were queried via Survey Monkey. There was a 71% response rate. The majority chose a career in pediatric dermatology early, often prior to starting a dermatology residency. The vast majority of respondents noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology. The most common obstacles cited by respondents were financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics. Our survey provides evidence to support the importance of early exposure to the field and, most importantly, to committed pediatric dermatologists who can serve as mentors. This information may be helpful in approaching solutions to the workforce shortage in the field of pediatric dermatology. Copyright © 2014 Mosby, Inc. All rights reserved.

  16. Energy shortages in Europe? strategic meetings on energy security

    International Nuclear Information System (INIS)

    Derdevet, M.

    2005-01-01

    On the RTE's initiative, the Economic and Social Council welcome the first 'Strategic Meetings on Energy Security' event on July 11, 2005. With its 'Energy Shortages in Europe?' subtitle, the convention was in line with the topical issue of oil price increases. Opening the convention, Hubert Bouchet, the vice-president of the Research and Technology Productive Activities section of the Economic and Social Council (CES) stated that with its 400 million citizens, Europe uses over 2 500 tWh of electricity a year, and that its demand for primary energy is growing, making it the largest importer of energy in the world and the top second user after the United States. The trend should continue at least until 2030. H Bouchet also stress that though the worlds is using increasing amounts of energy, over 1.5 billion people do not have access to modern energy sources. Therefore, there are huge needs. There were four round-tables introducing rich debates with the room. The first one was about the issue of the 'energy market: the end of overcapacity', and the second one, dedicated so secure supplies, was titled: 'An ill adapted regulatory framework and European context'. In the afternoon, exchanges covered 'Strategies to prepare the energy offer for new stakes' and 'Major strategies for France and Europe'. (author)

  17. Solve the organ shortage: let the bidding begin!

    Science.gov (United States)

    Kevorkian, J

    2001-01-01

    Commercialization of transplantable human organs is the only sure way to end the crisis of their supply. This is best accomplished by implementing a free, non-profit, nationwide, ultimately global online auction market. It should be independent of the current United Network of Organ Sharing (UNOS) system dealing solely with altruistic donation, and of governmental, sectarian, academic, and other bureaucratic control. The operation of such an auction is described with a hypothetical example. An included provision guarantees equity for poor, uninsured, and indigent recipients. Money accrued can be substantial, and would be disbursed by established formula, with major portions going to donors' families and to special funds to be used to bid for the poor and to defray costs incurred by them. As the organ shortage eases, bid prices should drop, resulting perhaps in eventual altruistic donation. Objections to commericalization based on ethics, bodily sanctity, inequity, pecuniary greed, and the slippery slope tocsin are nullified by cogent arguments and examples. The current situation has worsened despite so-called required request laws, proposed token payments to cover funeral expenses for donor families, and extensive media advertising to spur altruistic donation. Prohibitive national and state laws must be rescinded for the sake of more than 60,000 patients now on lengthening waiting lists. A profession committed to saving lives is duty-bound to endorse, help implement, and participate in an auction system dedicated to that end.

  18. Enterprise Policies for Tackling the Digital Skills Shortage

    Directory of Open Access Journals (Sweden)

    Daniela BORISOV

    2013-06-01

    Full Text Available Nowadays as results of the turbulent crisis, economies are confronted with the effects of the financial crisis, consequently many European states members are faced with strategic challenges in decisions about personnel development. Some of industries have faced shortages in the digital skill attainment of the currently employed personnel, or short supply of IT-related personnel due to the inadequacy of new entrants on the labor market. These problems are encountered in several traditional industries affected too rapidly by the technological advance. Along to these aspects, there are other difficulties for employers and employees as well, such as structural changes in job offering in various sectors or disparity in the employees; age categories – because of high unemployment rates in youth for instance. These are complemented by fewer job opportunities for young individuals (eventually, graduates for the tertiary sector of formal education that fit according to their specializations or even new type of skills’ demand – much oriented on the digitalization. The paper intends to presents some empirical aspects raised from the statistical evidence useful to point out critical aspects in the domestic and eventually, European approach to entreprice policy, in developing proper curricula to empower the academic institutions to provide knowledge, to foster skills for current enrolled students. On short term already, the future workforce needs to be prepared for the digitalization of the professional activity, regardless the specific domain of work and, in this view; companies should be in the position to manage this potential crisis of the labour market.

  19. Identifying Areas of Primary Care Shortage in Urban Ohio

    Directory of Open Access Journals (Sweden)

    Hsin-Chung Liao

    Full Text Available ABSTRACT: This study considers both spatial and a-spatial variables in examining accessibility to primary healthcare in the three largest urban areas of Ohio (Cleveland, Columbus, and Cincinnati. Spatial access emphasizes the importance of geographic barriers between individuals and primary care physicians, while a-spatial variables include non-geographic barriers or facilitators such as age, sex, race, income, social class, education, living conditions and language skills. Population and socioeconomic data were obtained from the 2000 Census, and primary care physician data for 2008 was provided by the Ohio Medical Board. We first implemented a two-step method based on a floating catchment area using Geographic Information Systems to measure spatial accessibility in terms of 30-minute travel times. We then used principal component analysis to group various socio-demographic variables into three groups: (1 socioeconomic disadvantages, (2 living conditions, and (3 healthcare needs. Finally, spatial and a-spatial variables were integrated to identify areas with poor access to primary care in Cleveland, Columbus, and Cincinnati. KEYWORDS: Geographic information systems, healthcare access, spatial accessibility, primary care shortage areas

  20. On the electricity shortage, price and electricity theft nexus

    International Nuclear Information System (INIS)

    Jamil, Faisal

    2013-01-01

    Pakistan is facing severe electricity shortfall of its history since 2006. Several measures have been implemented in order to mitigate electricity shortage. The focus has been on raising the installed capacity of electricity generation and transmission. The present policy results in expensive thermal electricity generation mostly using expensive and environmentally hazardous furnace oil and inability of utilities to recover their cost of supply although there is unprecedented rise in electricity tariffs. This study concentrates on the electricity demand and traces the relationship between electricity shortfalls, tariff rate and electricity theft in the background of recent electricity crisis using the data for the period 1985–2010. We employed the Granger causality test through error correction model and out-of-sample causality through variance decomposition method. Empirical evidence shows that electricity theft greatly influences electricity shortfalls through lowering investment and inefficient use of electricity. The study concludes that electricity crisis cannot be handled without combating rampant electricity theft in the country. - Highlights: ► The study investigates relationship among electricity outages, price and electricity theft. ► It employed Johansen approach, ECM and variance decomposition analysis. ► Empirical evidence shows that electricity theft causes outages and rising tariff rates. ► Variance decomposition analysis results are slightly different from ECM

  1. Third statutory ordinance for assignment of competence for environmental radioactivity measuring and evaluation under the German Preventive Radiation Protection Act (StrSchVG). As of 16 October 1997

    International Nuclear Information System (INIS)

    1997-01-01

    The German Bundesamt fuer Strahlenschutz (Radiation Protection Office) is assigned the competence to perform the necessary activities for measurement and large-area monitoring of ambient gamma dose rates on behalf of the Federal Government in compliance with the German Preventive Radiation Protection Act (StrSchVG). (orig./CB) [de

  2. Medicine shortages in Australia: causes, impact and management strategies in the community setting.

    Science.gov (United States)

    Tan, Yee Xi; Moles, Rebekah J; Chaar, Betty B

    2016-10-01

    Background Medicine shortages are an ongoing global problem. The Therapeutic Goods Administration (TGA) dedicated a website for monitoring of medicine shortages in Australia in May 2014, as part of the Medicine Shortage Information Initiative. This study aimed to explore the views of pharmacists regarding medicine shortages in the community setting and the impact of the TGA website in Australia. Setting Community pharmacies in New South Wales, Australia. Method Twenty semi-structured interviews were conducted with community pharmacists. Data collected were analysed thematically utilising the framework analysis method. Main outcome measure Qualitative analysis conducted using the framework approach. Results Findings clearly indicated that medicine shortages were experienced on a regular basis, but most participants were unaware of the TGA website. Medicine shortages reportedly impacted both pharmacists and consumers; and various workarounds were undertaken to manage the issue. The "price disclosure policy" was found to be a prominent contributing factor in emerging shortages. Suggestions were made for ways to improve the growing occurrence of shortages. Conclusion Overall, the study found that there was a lack of familiarity with the TGA website, despite experiencing regular shortages of medicines in practice. Also highlighted, was the importance of pharmacists prioritising patient care over business decisions. To reduce prescribing of out-of-stock medicines notifying doctors about shortages was also considered important, to allow for early action to be taken at higher levels of the supply chain. Findings of this study may help direct future policy-making around the world, as medicine shortages is a problem shared by healthcare providers in most countries around the world.

  3. Can alternative sugar sources buffer pollinators from nectar shortages?

    Science.gov (United States)

    Gardner-Gee, Robin; Dhami, Manpreet K; Paulin, Katherine J; Beggs, Jacqueline R

    2014-12-01

    Honeydew is abundant in many ecosystems and may provide an alternative food source (a buffer) for pollinators during periods of food shortage, but the impact of honeydew on pollination systems has received little attention to date. In New Zealand, kānuka trees (Myrtaceae: Kunzea ericoides (A. Rich) Joy Thompson) are often heavily infested by the endemic honeydew-producing scale insect Coelostomidia wairoensis (Maskell) (Hemiptera: Coelostomidiidae) and the period of high honeydew production can overlap with kānuka flowering. In this study, we quantified the sugar resources (honeydew and nectar) available on kānuka and recorded nocturnal insect activity on infested and uninfested kānuka during the flowering period. Insects were abundant on infested trees, but flowers on infested trees received fewer insect visitors than flowers on uninfested trees. There was little evidence that insects had switched directly from nectar-feeding to honeydew-feeding, but it is possible that some omnivores (e.g., cockroaches) were distracted by the other honeydew-associated resources on infested branches (e.g., sooty molds, prey). Additional sampling was carried out after kānuka flowering had finished to determine honeydew usage in the absence of adjacent nectar resources. Moths, which had fed almost exclusively on nectar earlier, were recorded feeding extensively on honeydew after flowering had ceased; hence, honeydew may provide an additional food source for potential pollinators. Our results show that honeydew resources can impact floral visitation patterns and suggest that future pollinator studies should consider the full range of sugar resources present in the study environment.

  4. A Microeconomic Model of the Personnel Shortage in Public Rehabilitation Agencies

    Science.gov (United States)

    Schultz, Jared C.; Millington, Michael J.

    2007-01-01

    There is a well-documented, growing shortage of rehabilitation counseling professionals in the public sector. Using microeconomics principles, a theoretical model is offered to account for the personnel shortage and propose potential solutions to recruit and retain rehabilitation counselors in the public sector. Suggestions for rehabilitation…

  5. AACJC/Metropolitan Life Foundation Registered Nurse Shortage Project: Status Report.

    Science.gov (United States)

    McKenney, James F.

    The American Association of Community and Junior Colleges's Nurse Shortage Project was designed to alleviate the nurse shortage by helping community colleges improve recruitment, retention, and graduation in nursing programs through direct mini-grants, with a special emphasis on Tech Prep/Associate Degree initiatives between secondary schools and…

  6. 19 CFR 18.6 - Short shipments; shortages; entry and allowance.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Short shipments; shortages; entry and allowance...; DEPARTMENT OF THE TREASURY TRANSPORTATION IN BOND AND MERCHANDISE IN TRANSIT General Provisions § 18.6 Short shipments; shortages; entry and allowance. (a) When there has been a short shipment and the short-shipped...

  7. Assessment of serious water shortage in the Icelandic water resource system

    DEFF Research Database (Denmark)

    Jonsdottir, Harpa; Madsen, Henrik

    2005-01-01

    there will be a shortage of electrical power. This is politically acceptable as long as it only touches heavy industries but not power deliveries to the common market. Empty or near empty reservoirs cause power shortage that will be felt by homeowners and businesses, until spring thaw sets in and inflow to the reservoirs...

  8. Neighborhood Inequalities in Retailers’ Compliance With the Family Smoking Prevention and Tobacco Control Act of 2009, January 2014–July 2014

    Science.gov (United States)

    Baker, Hannah M.; Ranney, Leah M.; Goldstein, Adam O.

    2015-01-01

    Introduction Retailer noncompliance with limited US tobacco regulations on advertising and labeling was historically patterned by neighborhood in ways that promote health disparities. In 2010, the US Food and Drug Administration (FDA) began enforcing stronger tobacco retailer regulations under the Family Smoking Prevention and Tobacco Control Act of 2009. However, recent research has found no differences in compliance by neighborhood characteristics for FDA advertising and labeling inspections. We sought to investigate the neighborhood characteristics associated with retailer noncompliance with specific FDA advertising and labeling inspections (ie, violations of bans on self-service displays, selling single cigarettes, false or mislabeled products, vending machines, flavored cigarettes, and free samples). Methods We coded FDA advertising and labeling warning letters (n = 718) for type of violations and geocoded advertising and labeling inspections from January 1 through July 31, 2014 (N = 33,543). Using multilevel models, we examined cross-sectional associations between types of violations and neighborhood characteristics previously associated with disparities (ie, percentage black, Latino, under the poverty line, and younger than 18 years). Results Retailer advertising and labeling violations are patterned by who lives in the neighborhood; regulated tobacco products are more likely to be stored behind the counter as the percentage of black or Latino residents increases, and single cigarettes are more often available for purchase in neighborhoods as the percentage of black, poor, or young residents increases. Conclusion Contrary to previous null findings, noncompliance with FDA advertising and labeling regulations is patterned by neighborhood characteristics, sometimes in opposite directions. Given the low likelihood of self-service violations in the same neighborhoods that have high likelihood of single cigarette sales, we suggest targeted approaches to FDA

  9. Defining Primary Care Shortage Areas: Do GIS-based Measures Yield Different Results?

    Science.gov (United States)

    Daly, Michael R; Mellor, Jennifer M; Millones, Marco

    2018-02-12

    To examine whether geographic information systems (GIS)-based physician-to-population ratios (PPRs) yield determinations of geographic primary care shortage areas that differ from those based on bounded-area PPRs like those used in the Health Professional Shortage Area (HPSA) designation process. We used geocoded data on primary care physician (PCP) locations and census block population counts from 1 US state to construct 2 shortage area indicators. The first is a bounded-area shortage indicator defined without GIS methods; the second is a GIS-based measure that measures the populations' spatial proximity to PCP locations. We examined agreement and disagreement between bounded shortage areas and GIS-based shortage areas. Bounded shortage area indicators and GIS-based shortage area indicators agree for the census blocks where the vast majority of our study populations reside. Specifically, 95% and 98% of the populations in our full and urban samples, respectively, reside in census blocks where the 2 indicators agree. Although agreement is generally high in rural areas (ie, 87% of the rural population reside in census blocks where the 2 indicators agree), agreement is significantly lower compared to urban areas. One source of disagreement suggests that bounded-area measures may "overlook" some shortages in rural areas; however, other aspects of the HPSA designation process likely mitigate this concern. Another source of disagreement arises from the border-crossing problem, and it is more prevalent. The GIS-based PPRs we employed would yield shortage area determinations that are similar to those based on bounded-area PPRs defined for Primary Care Service Areas. Disagreement rates were lower than previous studies have found. © 2018 National Rural Health Association.

  10. Comprehensive Smoking Prevention Education Act of 1981. Hearing before the Committee on Labor and Human Resources, United States Senate, Ninety-Seventh Congress, Second Session, on S. 1929 to Amend the Public Health Service Act and the Federal Cigarette Labeling and Advertising Act to Increase the Availability to the Americna Public of Information on the Health Consequences of Smoking and Thereby Improve Informed Choice, and for Other Purposes.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    These proceedings detail the first of two hearings on the Comprehensive Smoking Prevention Education Act of 1981. This report of the first hearing focuses on health related issues. The report presents testimony from representatives of the administration, from a panel of scientists, and from representatives of the American Cancer Society, American…

  11. Comprehensive Smoking Prevention Education Act of 1981. Hearing before the Committee on Commerce, Science, and Transportation, United States Senate, Ninety-Seventh Congress, Second Session, on S. 1929 to Amend the Public Health Service Act and the Federal Cigarette Labeling and Advertising Act to Increase the Availability to the American Public of Information on the Health Consequences of Smoking and Thereby Improve Informed Choice, and for Other Purposes.

    Science.gov (United States)

    Congress of the U.S., Washington, DC. Senate Committee on Commerce, Science, and Transportation.

    This report of the second hearing on the Smoking Prevention Education Act focuses on advertising practices of the tobacco industry; the first hearing dealt with health related issues. The report includes testimony of three panels of witnesses who discussed the effectiveness of European programs in cigarette labeling and consumer education, the…

  12. Are radioisotope shortages a thing of the past?

    Energy Technology Data Exchange (ETDEWEB)

    Peykov, Pavel; Cameron, Ron [OECD Nuclear Energy Agency, Issy-les-Moulineaux (France)

    2014-10-15

    Since June 2009, the NEA and its High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) have examined the causes of {sup 99}Mo/{sup 99m}Tc supply shortages and developed a policy approach, including principles and supporting recommendations to address those causes. The NEA has also reviewed the global {sup 99}Mo/{sup 99m}Tc supply situation periodically, using the most up-to-date data from supply chain participants, to highlight periods of reduced supply and underscore the case for implementing the HLG-MR policy approach in a timely and globally-consistent manner. In 2012, the NEA released a {sup 99}Mo supply and demand update for the period up to 2030 (A Supply and Demand Update of the Molybdenum-99 Market, OECD/NEA, 2012), identifying periods of low supply relative to demand. This paper presents the preliminary results from an updated {sup 99}Mo supply and demand forecast, focusing on the potentially critical 2015-2020 period, when two major {sup 99}Mo producers (the NRU reactor in Canada and the OSIRIS reactor in France) are scheduled to cease {sup 99}Mo irradiations. On the demand side, the NEA had previously released a study with the results from a global survey of future demand for {sup 99}Mo/{sup 99m}Tc (OECD-NEA, 2011), devising a scenario based on a data assessment by an expert advisory group. In the current analysis, the expected demand growth rate and total demand have been modified, based on the latest information from supply chain participants. On the supply side, the NEA has updated the list of current and planned new {sup 99}Mo/{sup 99m}Tc irradiation and processing projects. The modelling results incorporate revisions to production start/end dates, potential additional projects, and impacts of converting to the use of low-enriched uranium (LEU) targets on {sup 99}Mo/{sup 99m}Tc capacity and production. The supply forecast horizon (2015 to 2020) has been chosen to reflect upcoming, important changes in global production capacity

  13. Are radioisotope shortages a thing of the past?

    International Nuclear Information System (INIS)

    Peykov, Pavel; Cameron, Ron

    2014-01-01

    Since June 2009, the NEA and its High-level Group on the Security of Supply of Medical Radioisotopes (HLG-MR) have examined the causes of 99 Mo/ 99m Tc supply shortages and developed a policy approach, including principles and supporting recommendations to address those causes. The NEA has also reviewed the global 99 Mo/ 99m Tc supply situation periodically, using the most up-to-date data from supply chain participants, to highlight periods of reduced supply and underscore the case for implementing the HLG-MR policy approach in a timely and globally-consistent manner. In 2012, the NEA released a 99 Mo supply and demand update for the period up to 2030 (A Supply and Demand Update of the Molybdenum-99 Market, OECD/NEA, 2012), identifying periods of low supply relative to demand. This paper presents the preliminary results from an updated 99 Mo supply and demand forecast, focusing on the potentially critical 2015-2020 period, when two major 99 Mo producers (the NRU reactor in Canada and the OSIRIS reactor in France) are scheduled to cease 99 Mo irradiations. On the demand side, the NEA had previously released a study with the results from a global survey of future demand for 99 Mo/ 99m Tc (OECD-NEA, 2011), devising a scenario based on a data assessment by an expert advisory group. In the current analysis, the expected demand growth rate and total demand have been modified, based on the latest information from supply chain participants. On the supply side, the NEA has updated the list of current and planned new 99 Mo/ 99m Tc irradiation and processing projects. The modelling results incorporate revisions to production start/end dates, potential additional projects, and impacts of converting to the use of low-enriched uranium (LEU) targets on 99 Mo/ 99m Tc capacity and production. The supply forecast horizon (2015 to 2020) has been chosen to reflect upcoming, important changes in global production capacity - the planned shutdowns in Canada and France, and the expected

  14. Flu vaccine shortage creates ethical issues, safety challenges.

    Science.gov (United States)

    2004-12-01

    Decisions may have to be made as to whether staff or patients get priority. Centers for Disease Control and Prevention guidelines help ease choices when it comes to inoculating workers. Quality professionals should be aware of the legal implications of their decisions.

  15. Current Situation, Determinants, and Solutions to Drug Shortages in Shaanxi Province, China: A Qualitative Study.

    Science.gov (United States)

    Yang, Caijun; Wu, Lina; Cai, Wenfang; Zhu, Wenwen; Shen, Qian; Li, Zongjie; Fang, Yu

    2016-01-01

    Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. A qualitative methodological approach was conducted during May-June 2015 and December 2015-January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of "too low prices." To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages.

  16. How does a shortage of physicians impact on the job satisfaction of health centre staff?

    Science.gov (United States)

    Saxén, Ulla; Jaatinen, Pekka T; Kivelä, Sirkka-Liisa

    2008-01-01

    The aim was to determine how a shortage of physicians at Finnish health centres has affected the job satisfaction of the entire staff. A questionnaire was posted to 2848 employees working with patients at health centres in the Finnish provinces of Satakunta and Varsinais-Suomi. The information concerning the shortage of physicians at health centres was taken from research undertaken by the Finnish Medical Association in October 2003. The health centres were divided into four groups according to the severity of the shortage. The questionnaire was returned by 1447 employees. The staff at health centres with the most severe shortage of physicians were less satisfied with the management of the organization. Employees at health centres with a minor shortage of physicians were more satisfied with the quality of services in their operational unit. The shortage of physicians had no impact on staff satisfaction regarding the operation of their work unit, the strain of dealing with issues within their work environment, feelings of stress, the strain of working under pressure that they experienced, or interest in finding a new job. The majority of healthcare employees are satisfied and motivated in their work. The shortage of physicians has only a slightly negative impact on their satisfaction.

  17. The nature, extent and effect of skills shortages on skills migration in South Africa

    Directory of Open Access Journals (Sweden)

    Fatima Rasool

    2011-07-01

    Full Text Available Orientation: South Africa is currently experiencing a serious shortage of skilled workers. It has a negative effect on South Africa’s economic prospects and on global participation in South Africa (SA. This skills shortage severely affects socioeconomic growth and development in SA. Research purpose: This study focuses on the causes and effects of the skills shortages in South Africa. Motivation for the study: The researchers undertook this study to highlight the role that skilled foreign workers can play in supplementing the shortage of skilled workers in South Africa. The shortage is partly because of the failure of the national education and training system to supply the economy with much-needed skills. Research design, approach and method: The researchers undertook a literature study to identify the nature, extent and effect of skills shortages in South Africa. They consulted a wide range of primary and secondary resources in order to acquire an in-depth understanding of the problem. The article explains the research approach and method comprehensively. It also outlines the research method the researchers used. Main findings: This study shows that several factors cause serious skills shortages in SA. Practical/managerial implications: The researchers mention only two significant implications. Firstly, this article provides a logical description of the nature, extent and effect of skills shortages on the economy. Secondly, it indicates clearly the implications of skills shortages for immigration policy. Contribution/value-add: This study confirms the findings of similar studies the Centre for Development and Enterprise (CDE conducted. Opening the doors to highly skilled immigrants can broaden the skills pool.

  18. Online Availability and Safety of Drugs in Shortage: A Descriptive Study of Internet Vendor Characteristics

    Science.gov (United States)

    Mackey, Tim K

    2012-01-01

    Background Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. Objective To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. Methods We performed a descriptive study of the prevalence of online marketing for shortage drugs—that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Results Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. Conclusions FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing. PMID:22321731

  19. Online availability and safety of drugs in shortage: a descriptive study of internet vendor characteristics.

    Science.gov (United States)

    Liang, Bryan A; Mackey, Tim K

    2012-02-09

    Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. We performed a descriptive study of the prevalence of online marketing for shortage drugs-that is, offers for sale of each drug, including characteristics of online drug sellers and intermediary sites marketing these drugs. Of the 72 FDA shortage-listed drugs, 68 (94%) were offered for sale online. We found 291 offers for these drugs, the vast majority (n = 207, 71.1%) by online drug sellers selling direct to consumers. Intermediary sites included data aggregators (n = 22, 8%), forum links (n = 23, 8%), and personal page data links (n = 34, 12%), as well as Flickr social media links (n = 5, 2%), all advertising drugs without a prescription. Of the 91 online drug sellers identified, 31 (34%) had more than 1 shortage drug offered for sale, representing most (n = 148, 71%) of all online drug seller sales offers. The majority of these online drug sellers (n = 21, 68%) were on the National Association of Boards of Pharmacy (NABP) Not Recommended Sites list. Finally, for shortage drugs with an online drug seller (n = 58, 85%), 53 (91%) had at least one site on the Not Recommended list and 21 (36%) had only sites on the Not Recommended list. FDA shortage drugs are widely marketed over the Internet. Suspect online drug sellers and intermediaries dominate these sales offers. As a critical risk management issue, patients, providers, and policymakers should be extremely cautious in procuring shortage drugs through Internet sourcing.

  20. Delaware Technical & Community College's response to the critical shortage of Delaware secondary science teachers

    Science.gov (United States)

    Campbell, Nancy S.

    This executive position paper examines the critical shortage of Delaware high school science teachers and Delaware Technical & Community College's possible role in addressing this shortage. A concise analysis of economic and political implications of the science teacher shortage is presented. The following topics were researched and evaluated: the specific science teacher needs for Delaware school districts; the science teacher education program offerings at Delaware universities and colleges; the Alternative Route to Teacher Certification (ARTC); and the state of Delaware's scholarship response to the need. Recommendations for Delaware Tech's role include the development and implementation of two new Associate of Arts of Teaching programs in physics secondary science education and chemistry secondary science education.

  1. Is Storage a Solution to End Water Shortage?

    Science.gov (United States)

    Narayanan, M.

    2009-12-01

    Water shortage is a problem of supply and demand. Some authors refer to it as Water Scarcity. The author has discussed this in his previous presentation at the 2008 AGU International Conference. Part of it is reproduced here for purposes of clarification. It is important to recognize that water is essential for the survival of all life on earth. Many water-rich states have thought of water conservation as an art that is practiced mainly in the arid states. But one has to recite the famous quote: “You will never miss water till the well runs dry.” Researchers have also concluded that quantity deficiency experienced by groundwater supplies are affecting many communities around the world. Furthermore federal regulations pertaining to the quality of potable or drinking water have become more stringent (Narayanan, 2008). One must observe that water conservation schemes and efficient utilization practices also benefit the environment to a large extent. These water conservation practicies indeed have a short payback period althought it may seem that there is a heavy initial investment is required. Research scientists have studied MARR (Mean Annual River Runoff) pattern over the years and have arrived at some significant conclusions. Vörsömarty and other scientists have indicated that water scarcity exists when the demand to supply ratio exceeds the number 0.4. (Vörsömarty, 2005). Furthermore other researchers claim to have documented a six-fold increase in water use in the United States during the last century. It is interesting to note that the population of the United States has hardly doubled during the last century. This obviously, is indicative of higher living standards. Nevertheless, it also emphasizes an urgent need for establishing a strong, sound, sensible and sustainable management program for utilizing the available water supplies efficiently (Narayanan, 2008). Author of the 1998 book, Last Oasis: Facing Water Scarcity, Dr. Sandra Postel predicts big

  2. Factors Other Than Climate Change, Main Drivers of 2014/15 Water Shortage in Southeast Brazil

    Science.gov (United States)

    Otto, Friederike E. L.; Coelho, Caio A. S.; King, Andrew; Coughlan de Perez, Erin; Wada, Yoshihide; van Oldenborgh, Geert Jan; Haarsma, Rein; Haustein, Karsten; Uhe, Peter; van Aalst, Maarten; hide

    2015-01-01

    Southeast Brazil experienced profound water shortages in 2014/15. Anthropogenic climate change is not found to be a major influence on the hazard, whereas increasing population and water consumption increased vulnerability.

  3. Association between shortage of energy supply and nuclear gene mutations leading to carcinomatous transformation.

    Science.gov (United States)

    DU, Jianping

    2016-01-01

    Anaerobic bacteria use glycolysis, an oxygen-independent metabolic pathway, whereas energy metabolism in the evolved eukaryotic cell is performed via oxidative phosphorylation, with all eukaryotic cell activities depending upon high energy consumption. However, in cancer cells evolving from eukaryotic cells, the energy metabolism switches from oxidative phosphorylation to glycolysis. The shortage of energy supply induces cancer cells to acquire specific characteristics. Base pair renewal is the most energy-consuming process in the cell, and shortage of energy supply may lead to errors in this process; the more prominent the shortage in energy supply, the more errors are likely to occur in base pair renewal, resulting in gene mutations and expression of cancer cell characteristics. Thus, shortage of energy supply is associated with carcinomatous transformation.

  4. Marketing nursing as a profession: integrated marketing strategies to address the nursing shortage.

    Science.gov (United States)

    Somers, Mark John; Finch, Linda; Birnbaum, Dee

    2010-07-01

    The nursing shortage in the United States is at a crisis level characterized by critical shortages of highly trained nurses and of nursing faculty. Key issues in addressing these shortages include awareness and image-building, along with enhanced outreach programs. Although these issues are related to marketing theory, most studies in this area are based on a vocational choice model. This study was grounded in marketing theory and the results offer a new perspective for addressing the nursing shortage. In-depth interviews conducted with 31 first-year nursing students indicated that there were two distinct segments among nursing students: traditionals and instrumentals. Traditionals were attracted to nursing as a helping profession while instrumentals were interested in career-related rewards such as variety, mobility, and compensation. These findings were discussed in terms of building awareness and marketing programs for nursing students that are integrated across schools of nursing, private foundations and public agencies.

  5. [Reasons for General Practitioner Shortage – a Comparison Between France and Switzerland].

    Science.gov (United States)

    Cerny, Thomas; Rosemann, Thomas; Tandjung, Ryan; Chmiel, Corinne

    2016-05-25

    Both France and Switzerland face a general practitioner (GP) shortage. What differences or parallels exist between the two countries with regard to the causes for this shortage? What conclusions might be drawn from a systematic comparison? Literature review with qualitative and semi-quantitative content analysis. Parallels exist in the comparing categories work contents, working structure, income and social status, medical school formation, private life, psychological motives. Differences are found in the categories biography and social selection, medical socialisation, residency. In Switzerland, residency is not uniformly structured, rarely institutionally organised and contains only few elements specific to general medicine. In France, medical socialisation not only exalts the specialists, but also strongly devaluates the GPs. By systematic analysis and comparison of both countries' pertinent literature, France and Switzerland can deepen their understanding of GP shortage. This paper identifies possible fields of action from medical school through residency up to workplace conditions that are pivotal in addressing the shortage of GPs.

  6. Addressing the Importance and Scale of the U.S. Teacher Shortage. UCEA Policy Brief 2018-1

    Science.gov (United States)

    Castro, Andrene; Quinn, Daniel J.; Fuller, Edward; Barnes, Michael

    2018-01-01

    Teacher shortages pose a major challenge for state policy makers, district leaders, and school leaders. Importantly, however, the severity of the shortage differs by the particular dynamics of state- and local- teacher labor markets with some regions and states experiencing more severe shortages than others. This brief examines the elements of the…

  7. Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

    Directory of Open Access Journals (Sweden)

    Michelle M. Lamb

    2013-01-01

    Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.   Type: Original Research

  8. Labor Health Shortage and Future Prospects for the Medical Workforce in Morocco

    OpenAIRE

    Zouag, Nada; Driouchi, Ahmed; Achehboune, Amale

    2015-01-01

    Abstract This paper looks at the current situation of health deficits and shortages in Morocco with a focus on the roles of medical education and prospects for the health workforce for the period 2010-2030. The attained results from both trend description and simulations of patterns show major shortages relative to the needs. The existence of these trends appeals for further cooperation in the areas of health care through emphasis on medical education and research. These outcomes appear to be...

  9. Impact of Antibiotic Shortage on H. Pylori Treatment: A Step-Wise Approach for Pharmacist Management

    Directory of Open Access Journals (Sweden)

    Ann Lloyd, Pharm.D., BCPS

    2013-01-01

    Full Text Available The current drug shortage crisis involving multiple oral antibiotics has significantly impacted preferred therapeutic options for treatment of H.pylori infection. Pharmacists may help alleviate the impact of this shortage through a proposed step-wise approach which includes proper inventory management, verification of indication, evaluation of regimen, therapeutic monitoring, and communication with patients and providers regarding alternative therapy or symptomatic relief.

  10. Policy Measures to Alleviate Foreign Currency Liquidity Shortages under Aggregate Risk with Moral Hazard

    OpenAIRE

    Hiroshi Fujiki

    2010-01-01

    During the recent global financial crisis, some central banks introduced two innovative cross-border operations to deal with the problems of foreign currency liquidity shortages: domestic liquidity operations using cross-border collaterals and operations for supplying foreign currency based on standing swap lines among central banks. We show theoretically that central banks improve the efficiency of equilibrium under foreign currency liquidity shortages by those two innovative temporary polic...

  11. [The evolution of nursing shortage and strategies to face it: a longitudinal study in 11 hospitals].

    Science.gov (United States)

    Stringhetta, Francesca; Dal Ponte, Adriana; Palese, Alvisa

    2012-01-01

    To describe the perception of the evolution of nursing shortage from 2000 to 2009 according to Nursing Coordinators and the strategies to face it. Nursing coordinators of 11 hospitals or districts of Friuli Venezia Giulia, Trentino Alto Adige and Veneto regions were interviewed in 2000, 2004 and 2009 to collect data and assess their perception on nurses' shortage. In the first interview the medium gap between staff planned and in service was -5.4%; in 2004 -9.4% and in 2009 -3.3%. The shortage, once with a seasonal trend is now constant and appreciated in all the wards. In years 2000 and 2004 on average 5 strategies to face the shortage were implemented, in 2009 7. No systematic strategies have been used with the exception of the unification of wards, mainly during summer for letting people go on holydays. According to Nursing Coordinators the effects of the shortage are already observable (although not quantified) on patients and nurses. The nurses' shortage has been one of the challenges of the last 10 years. Its causes have changed but not the strategies implemented.

  12. Privacy Act

    Science.gov (United States)

    Learn about the Privacy Act of 1974, the Electronic Government Act of 2002, the Federal Information Security Management Act, and other information about the Environmental Protection Agency maintains its records.

  13. Strategy for Coordinated EPA/Occupational Safety and Health Administration (OSHA) Implementation of the Chemical Accident Prevention Requirements of the Clean Air Act Amendments of 1990

    Science.gov (United States)

    EPA and the Occupational Safety and Health Administration (OSHA) share responsibility for prevention: OSHA has the Process Safety Management Standard to protect workers, and EPA the Risk Management Program to protect the general public and environment.

  14. Forecasting the global shortage of physicians: an economic- and needs-based approach

    Science.gov (United States)

    Liu, Jenny X; Kinfu, Yohannes; Dal Poz, Mario R

    2008-01-01

    Abstract Objective Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals. Methods Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country’s economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country. Findings By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both. Conclusion The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected. PMID:18670663

  15. Medical Supplies Shortages and Burnout among Greek Health Care Workers during Economic Crisis: a Pilot Study

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K.; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  16. Shortage of psychotropic medications in community pharmacies in Saudi Arabia: Causes and solutions.

    Science.gov (United States)

    Al-Ruthia, Yazed Sulaiman; Mansy, Wael; Barasin, Mohammad; Ghawaa, Yazeed Mohammad; AlSultan, Mohammed; Alsenaidy, Mohammad A; Alhawas, Solaiman; AlGhadeer, Sultan

    2017-07-01

    Background: Patients with mental disorders, such as depression and anxiety, who seek medical care in private psychiatric clinics in Riyadh, Saudi Arabia, have recently expressed concerns to doctors about difficulty in filling psychotropic medications, such as Amitriptyline and Aripiprazole, at retail community pharmacies. Objectives: The aim of this study was to investigate whether there is a shortage of some commonly prescribed psychotropic medications in retail community pharmacies in Saudi Arabia, and if so, to explore the possible reasons behind the shortage of these medications. Methods: The availability of 28 commonly prescribed psychotropic medications was checked in multiple retail community pharmacies in 4 different regions of Saudi Arabia. Further, potential reasons behind the shortage of some psychotropic medications in retail community pharmacies were also explored. Results: Amitriptyline, Amoxapine, Aripiprazole, Bupropion, Buspirone, Duloxetine, Haloperidol, Hydroxyzine, Lithium, Prochlorperazine, Procyclidine, Promethazine, Thioridazine, Trazodone, and Trifluoperazine were unavailable in over half of the 248 community pharmacies surveyed. Four possible reasons behind the shortage of these medications were reported by 31 pharmacists working in different retail community pharmacies' purchasing departments, with a majority (58.06%) reporting the primary reason for a shortage of these medications that they are slow-moving items with low profit margins. Conclusions: The findings of this study should expedite the reform process in both the Ministry of Health and the Saudi Food and Drug Authority (SFDA) to publish and enforce an essential list of medications for retail community pharmacies, which should include the most commonly prescribed psychotropic medications.

  17. Research priorities to achieve universal access to hepatitis C prevention, management and direct-acting antiviral treatment among people who inject drugs

    DEFF Research Database (Denmark)

    Grebely, Jason; Bruneau, Julie; Lazarus, Jeffrey V

    2017-01-01

    of HCV among PWID. The Kirby Institute, UNSW Sydney and the International Network on Hepatitis in Substance Users (INHSU) established an expert round table panel to assess current research gaps and establish future research priorities for the prevention and management of HCV among PWID. This round table......, gaps in research, and develop research priorities. Topics for discussion included the epidemiology of injecting drug use, HCV, and HIV among PWID, HCV prevention, HCV testing, linkage to HCV care and treatment, DAA treatment for HCV infection, and reinfection following successful treatment. This paper...

  18. Unpredictable drug shortages: an ethical framework for short-term rationing in hospitals.

    Science.gov (United States)

    Rosoff, Philip M

    2012-01-01

    Periodic and unexpected shortages of drugs, biologics, and even medical devices have become commonplace in the United States. When shortages occur, hospitals and clinics need to decide how to ration their available stock. When such situations arise, institutions can choose from several different allocation schemes, such as first-come, first-served, a lottery, or a more rational and calculated approach. While the first two approaches sound reasonable at first glance, there are a number of problems associated with them, including the inability to make fine, individual patient-centered decisions. They also do not discriminate between what kinds of patients and what types of uses may be more deserving or reasonable than others. In this article I outline an ethically acceptable procedure for rationing drugs during a shortage in which demand outstrips supply.

  19. Skill shortages in health: innovative solutions using vocational education and training.

    Science.gov (United States)

    Kilpatrick, S I; Johns, S S; Millar, P; Le, Q; Routley, G

    2007-01-01

    This article reports findings of a project funded by the Australian National Council for Vocational Education Research. The project explores solutions to current and projected skills shortages within the health and community services sector, from a vocational education and training perspective. Its purpose is to locate, analyse and disseminate information about innovative models of health training and service delivery that have been developed in response to skill shortages. The article begins with a brief overview of Australian statistics and literature on the structure of the national health workforce and perceived skill shortages. The impact of location (state and rurality), demographics of the workforce, and other relevant factors, on health skill shortages is examined. Drawing on a synthesis of the Australian and international literature on innovative and effective models for addressing health skill shortages and nominations by key stakeholders within the health sector, over 70 models were identified. The models represent a mixture of innovative service delivery models and training solutions from Australia, as well as international examples that could be transposed to the Australian context. They include the skill ecosystem approach facilitated by the Australian National Training Authority Skill Ecosystem Project. Models were selected to represent diversity in terms of the nature of skill shortage addressed, barriers overcome in development of the model, healthcare specialisations, and different customer groups. Key barriers to the development of innovative solutions to skills shortages identified were: policy that is not sufficiently flexible to accommodate changing workplace needs; unwillingness to risk take in order to develop new models; delays in gaining endorsement/accreditation; current vocational education and training (VET) monitoring and reporting systems; issues related to working in partnership, including different cultures, ways of operating

  20. Long-acting rilpivirine as potential pre-exposure prophylaxis for HIV-1 prevention (the MWRI-01 study): an open-label, phase 1, compartmental, pharmacokinetic and pharmacodynamic assessment.

    Science.gov (United States)

    McGowan, Ian; Dezzutti, Charlene S; Siegel, Aaron; Engstrom, Jarret; Nikiforov, Alexiy; Duffill, Kathryn; Shetler, Cory; Richardson-Harman, Nicola; Abebe, Kaleab; Back, David; Else, Laura; Egan, Deidre; Khoo, Saye; Egan, James E; Stall, Ronald; Williams, Peter E; Rehman, Khaleel K; Adler, Amy; Brand, Rhonda M; Chen, Beatrice; Achilles, Sharon; Cranston, Ross D

    2016-12-01

    Long-acting injectable antiretroviral agents are being developed for HIV-1 prevention. The MWRI-01 study was done to characterise the safety, acceptability, and pharmacokinetic and pharmacodynamic profile of long-acting rilpivirine. We did a phase 1 open-label study at the University of Pittsburgh. We enrolled healthy individuals (aged 18-45 years) who were seronegative for HIV-1. Participants were assigned alternately one intramuscular dose of either 1200 mg or 600 mg long-acting rilpivirine, beginning with the 1200 mg dose. We obtained plasma specimens, genital and rectal fluids, and tissue samples (rectal, cervical, and vaginal) before and after exposure to long-acting rilpivirine for assessment of pharmacokinetics and ex-vivo biopsy challenge with HIV-1. Our primary objective was to characterise product safety, and the analysis included all enrolled participants. This trial is registered with ClinicalTrials.gov, number NCT01656018. 36 participants were enrolled into the study, of whom 24 were women and 12 men. 12 women and six men received each dose. 204 adverse events were reported among the 36 participants, of which 200 (98%) were grade 1-2. The most common adverse event was injection site reaction. All grade 3 and 4 adverse events were deemed not related to rilpivirine. Geometric mean (90% CI) concentrations in plasma of rilpivirine at day 28 post dose were 53 ng/mL (38-67) in women and 43 ng/mL (23-63) in men for the 1200 mg dose and 28 ng/mL (19-37) in women and 17 ng/mL (9-24) in men for the 600 mg dose. The tissue-to-plasma ratio for rilpivirine in rectal tissue was about two-fold higher than in vaginal and cervical tissue (1·10-1·53 vs 0·61-0·72 and 0·50-0·71, respectively). Exposure to long-acting rilpivirine suppressed viral replication significantly in rectal tissue (psuppression persisted for up to 4 months. By contrast, no viral suppression was seen in cervical or vaginal tissue. Ongoing research will characterise longer term safety and

  1. Calibrating Fundamental British Values: How Head Teachers Are Approaching Appraisal in the Light of the Teachers' Standards 2012, Prevent and the Counter-Terrorism and Security Act, 2015

    Science.gov (United States)

    Revell, Lynn; Bryan, Hazel

    2016-01-01

    In requiring that teachers should "not undermine fundamental British values (FBV)," a phrase originally articulated in the Home Office counter-terrorism document, Prevent, the Teachers' Standards has brought into focus the nature of teacher professionalism. Teachers in England are now required to promote FBV within and outside school,…

  2. Federal Strategy for Prevention of Drug Abuse and Drug Trafficking, 1982. Prepared for the President Pursuant to the Drug Abuse Office and Treatment Act of 1972.

    Science.gov (United States)

    Office of Policy Development, Washington, DC.

    This document describes the Federal response to drug abuse and drug trafficking. The actions of President Reagan, in Executive Order 12368, establishing an official advisor on drug abuse policy matters, and the priorities, issues, and objectives (international cooperation, drug law enforcement, education and prevention, detoxification and…

  3. Are word-of-mouth communications contributing to a shortage of nephrology nurses?

    Science.gov (United States)

    Wolfe, William A

    2014-01-01

    Nephrology nurse shortages have historically been viewed as a subset of the overall nursing supply in the United States. Not-here-to-fore considered as a contributing factor are the effects of word-of-mouth and Internet-based word-of-mouth communications from nurses who have had disappointing work experiences in hemodialysis clinics. This article discusses the potential effects of word-of-mouse communications and posits that negative word-of-mouse communications may discourage new and experienced nurses from considering the specialty of nephrology nursing, thus contributing to a nephrology nursing shortage.

  4. [Shortage of physicians in anaesthesiology and intensive care medicine - Causes, consequences and solutions].

    Science.gov (United States)

    Papenfuß, Tim; Roch, Carmen

    2012-05-01

    74% of all hospitals had vacant positions in 2011, also departments of anaesthesiology and intensive care medicine. More than 50% of these departments work with locums. There are couple of reasons for the shortage of physicians. The consequences in anaesthesiology and intensive care medicine can result in qualitative and financial loss. To solve the shortage of physicians one has to solve the reasons. Main reasons are increasing feminization of medical profession and part-time-work, work-life-balance and a poor specialised education. © Georg Thieme Verlag Stuttgart · New York.

  5. Approaches to tenofovir and abacavir drug shortages in South Africa: A guide for clinicians

    Directory of Open Access Journals (Sweden)

    Laurie Schowalter

    2012-06-01

    Full Text Available Shortages of the nucleoside reverse transcriptase inhibitors (NRTI abacavir and tenofovir have been reported recently at health facilities across South Africa. The Society issued the following clinical advice to healthcare providers experiencing shortages on 29 March 2012. These recommendations are intended only as a guide to clinical therapy, based on expert consensus and best available evidence. Treatment decisions for patients should be made by their responsible clinicians, with due consideration for individual circumstances. S Afr J HIV Med 2012;13(2:56-57.

  6. Renewable energy strategies to overcome power shortage in Kurdistan Region of Iraq

    Directory of Open Access Journals (Sweden)

    Al-Din Salar Salah Muhy

    2017-01-01

    Full Text Available The aim of this paper is to investigate the possibility of applying renewable energy strategies in Kurdistan Region of Iraq to overcome the shortage of electricity supply. Finding alternative renewable sources could overcome the problem. The renewable energy will reduce CO2 emission in the cities which considers the main source of pollution. That will participate in reducing the effect of global warming. The study tries to investigate the direct solar renewable energy through two of the main renewable energy categories to produce electricity based on a survey of literature review. Photovoltaic and wind power technologies are possible to be conducted in the region to overcome power shortage.

  7. Utah’s oldest show the most concern for future water shortages

    OpenAIRE

    Baji, Viviane

    2016-01-01

    Utah is set to double in population by 2050. It is unclear whether current water supplies will be able to accommodate the needs of the future growth. Young people will be in their prime when water shortage predictions come to fruition, so it is important to know how concerned they are about the water issues that will affect them. An understanding of the relationship between age and water shortage concern may also contribute to the development of social science theories relating age and enviro...

  8. Order Level Inventory Models for Deteriorating Seasonable/Fashionable Products with Time Dependent Demand and Shortages

    Directory of Open Access Journals (Sweden)

    K. Skouri

    2009-01-01

    Full Text Available An order level inventory model for seasonable/fashionable products subject to a period of increasing demand followed by a period of level demand and then by a period of decreasing demand rate (three branches ramp type demand rate is considered. The unsatisfied demand is partially backlogged with a time dependent backlogging rate. In addition, the product deteriorates with a time dependent, namely, Weibull, deterioration rate. The model is studied under the following different replenishment policies: (a starting with no shortages and (b starting with shortages. The optimal replenishment policy for the model is derived for both the above mentioned policies.

  9. China's large-scale power shortages of 2004 and 2011 after the electricity market reforms of 2002: Explanations and differences

    International Nuclear Information System (INIS)

    Ming, Zeng; Song, Xue; Lingyun, Li; Yuejin, Wang; Yang, Wei; Ying, Li

    2013-01-01

    Since the electricity market reforms of 2002, two large-scale power shortages, one occurring in 2004 and one in 2011, exerted a tremendous impact on the economic development of China and also gave rise to a fierce discussion regarding electricity system reforms. In this paper, the background and the influence scale of the two power shortages are described. Second, reasons for these two large-scale power shortages are analyzed from the perspectives of power generation, power consumption and coordination of power sources and grid network construction investments. Characteristics of these two large-scale power shortages are then summarized by comparatively analyzing the performance and the formation of the reasons behind these two large-scale power shortages. Finally, some effective measures that take into account the current status of electricity market reforms in China are suggested. This paper concludes that to eliminate power shortages in China, both the supply and the demand should be considered, and these considerations should be accompanied by supervisory policies and incentive mechanisms. - Highlights: • Reasons of these two large-scale power shortages are analyzed. • Characteristics of these two large-scale power shortages are summarized. • Some effective measures to eliminate power shortage are suggested

  10. The immediate eff ect of the Same-Sex Marriage Prohibition Act on stigma, discrimination, and engagement on HIV prevention and treatment services in men who have sex with men in Nigeria: analysis of prospective data from the TRUST cohort.

    Science.gov (United States)

    Schwartz, Sheree R; Nowak, Rebecca G; Orazulike, Ifeanyi; Keshinro, Babajide; Ake, Julie; Kennedy, Sara; Njoku, Ogbonnaya; Blattner, William A; Charurat, Manhattan E; Baral, Stefan D

    2015-07-01

    In January, 2014, the Same-Sex Marriage Prohibition Act was signed into law in Nigeria, further criminalising same-sex sexual relationships. We aimed to assess the immediate effect of this prohibition act on stigma, discrimination, and engagement in HIV prevention and treatment services in men who have sex with men (MSM) in Nigeria. The TRUST cohort study uses respondent-driven sampling to assess the feasibility and effectiveness of engagement of MSM in HIV prevention and treatment services at a clinical site located with a community-based organisation trusted by the MSM community. TRUST is a prospective implementation research cohort of MSM (≥16 years) in Abuja, Nigeria. We compared HIV clinical outcomes and stigma, including fear and avoidance of health care, across baseline and quarterly visits before and after implementation of the the Same-Sex Marriage Prohibition Act. Outcomes assessed were measures of stigma and discrimination, loss to follow-up, antiretroviral therapy status, and viral load. We compared outcomes before and after the legislation with χ2 statistics, and estimated incident stigma-related events and loss to follow-up with Poisson regression. Between March 19, 2013, and Aug 7, 2014, 707 MSM participated in baseline study procedures, contributing to 756 before legislation (prelaw) and 420 after legislation (postlaw) visits. Reported history of fear of seeking health care was significantly higher in postlaw visits than in prelaw visits (n=161 [38%] vs n=187 [25%]; psex practices. The negative effects of HIV treatment and care in MSM reinforce the unintended consequences of such legislation on global goals of HIV eradication. Strategies to reach MSM less likely to engage in HIV testing and care in highly stigmatised environments are needed to reduce time to HIV diagnosis and treatment. National Institutes of Health.

  11. Exploring Future Water Shortage for Large River Basins under Different Water Allocation Strategies

    NARCIS (Netherlands)

    Yan, Dan; Yao, Mingtian; Ludwig, Fulco; Kabat, Pavel; Huang, He Qing; Hutjes, Ronald W.A.; Werners, Saskia E.

    2018-01-01

    Climate change and socio-economic development increase variations in water availability and water use in the Pearl River Basin (PRB), China. This can potentially result in conflicts over water resources between water users, and cause water shortage in the dry season. To assess and manage water

  12. The Congruence of Vocational Interests and the Workplace Environment: Reducing the Language Teacher Shortage

    Science.gov (United States)

    Swanson, Peter B.

    2012-01-01

    There is a shortage of second/foreign language (S/FL) teachers in many parts of the world, and the rates of attrition are cause for alarm in North America. Canadian and US teachers' (N = 323) were administered the Self-Directed Search vocational interest inventory and the Coping in Stressful Situations scale. Results from this quantitative study…

  13. 76 FR 45268 - Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop

    Science.gov (United States)

    2011-07-28

    ...] Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop AGENCY... Administration (FDA) is announcing a public workshop regarding the approach of the Center for Drug Evaluation and..., and to gain additional insight from, professional societies, patient advocates, industry, consumer...

  14. Morale, Participation and Shortage in White-Majority and White-Minority Schools: Principals' Perceptions

    Science.gov (United States)

    Cheema, Jehanzeb R.; Fuller Hamilton, Asia N.

    2017-01-01

    Prior research has shown that teacher-centred factors such as teacher participation in decision making, teacher morale, and shortage of teaching staff, can affect school performance. In this study we examined how these factors differ between White-majority and White-minority schools both before and after controlling for school characteristics such…

  15. Effects of Staff Participation, Morale, and Shortage on Organisational Performance: An International Survey

    Science.gov (United States)

    Cheema, Jehanzeb R.; Asrar-ul-Haq, Muhammad

    2017-01-01

    Prior research has suggested that staff-centred organisational factors such as participation, morale and shortage can have a significant effect on organisational outcomes. However, relatively little attention has been paid to cross-country examination of these relationships specifically for educational organisations such as schools, colleges, and…

  16. 41 CFR 101-26.307 - Processing overages, shortages, and damages.

    Science.gov (United States)

    2010-07-01

    ... United States, when other than GSA or DOD pays the transportation charges. (b) Reporting discrepancies or..., shortages, and damages. (a) Transportation-type discrepancies shall be processed in accordance with the instructions in subpart 101-40.7 when the discrepancies are the fault of the carrier and occur while the...

  17. Shortage of uranium already in the 1980's: expand Ranstad at once

    Energy Technology Data Exchange (ETDEWEB)

    Berg, G

    1975-11-14

    The extraction of uranium at Ranstad must be increased and the construction of thermal nuclear power stations limited until enough breeder reactors are available. A shortage of uranium is expected for the 1980's. Deposits of uranium ore in various countries are tabulated and their yields and cost of extraction stated.

  18. Two Birds with One Social Policy Stone: Youth Employment and Regional Skills Shortages in Australia

    Science.gov (United States)

    Pyke, Joanne; Bertone, Santina; Grace, Marty; Broadbent, Robyn

    2007-01-01

    In June 2005, the Victorian State Government introduced the Regional Jobs Package (RJP)--a twelve-month pilot program that attempted to kill two social policy problems with one stone. The problems were youth unemployment and skills shortages in regional areas of Victoria, Australia. The intention of the RJP was to create a "win-win"…

  19. Applying the International Medical Graduate Program Model to Alleviate the Supply Shortage of Accounting Doctoral Faculty

    Science.gov (United States)

    HassabElnaby, Hassan R.; Dobrzykowski, David D.; Tran, Oanh Thikie

    2012-01-01

    Accounting has been faced with a severe shortage in the supply of qualified doctoral faculty. Drawing upon the international mobility of foreign scholars and the spirit of the international medical graduate program, this article suggests a model to fill the demand in accounting doctoral faculty. The underlying assumption of the suggested model is…

  20. Forecasting the shortage of neurosurgeons in Iran using a system dynamics model approach

    Directory of Open Access Journals (Sweden)

    Sima Rafiei

    2018-01-01

    Conclusions: Shortage of neurosurgeons in some areas of the country relates to maldistribution of the specialists. Accordingly, there is a need to reconsider the allocation system for health professionals within the country instead of increasing the overall number of acceptance quota in training positions.

  1. 78 FR 23742 - Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment...

    Science.gov (United States)

    2013-04-22

    ... DEPARTMENT OF AGRICULTURE National Institute of Food and Agriculture Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment Program (VMLRP) AGENCY: National Institute... information collection for the Veterinary Medicine Loan Repayment Program (VMLRP). This notice initiates a 30...

  2. Stakeholders' Perceptions on Shortage of Healthcare Workers in Primary Healthcare in Botswana: Focus Group Discussions.

    Directory of Open Access Journals (Sweden)

    Oathokwa Nkomazana

    Full Text Available An adequate health workforce force is central to universal health coverage and positive public health outcomes. However many African countries have critical shortages of healthcare workers, which are worse in primary healthcare. The aim of this study was to explore the perceptions of healthcare workers, policy makers and the community on the shortage of healthcare workers in Botswana.Fifteen focus group discussions were conducted with three groups of policy makers, six groups of healthcare workers and six groups of community members in rural, urban and remote rural health districts of Botswana. All the participants were 18 years and older. Recruitment was purposive and the framework method was used to inductively analyse the data.There was a perceived shortage of healthcare workers in primary healthcare, which was believed to result from an increased need for health services, inequitable distribution of healthcare workers, migration and too few such workers being trained. Migration was mainly the result of unfavourable personal and family factors, weak and ineffective healthcare and human resources management, low salaries and inadequate incentives for rural and remote area service.Botswana has a perceived shortage of healthcare workers, which is worse in primary healthcare and rural areas, as a result of multiple complex factors. To address the scarcity the country should train adequate numbers of healthcare workers and distribute them equitably to sufficiently resourced healthcare facilities. They should be competently managed and adequately remunerated and the living conditions and rural infrastructure should also be improved.

  3. Shortage of donation despite an adequate number of donors : A professional attitude?

    NARCIS (Netherlands)

    Ploeg, RJ; Niesing, J; Sieber-Rasch, MH; Willems, L; Kranenburg, K

    2003-01-01

    Background A major problem in the field of transplantation is the persistent shortage of donor organs and tissues for transplantation. This study was initiated to (1) chart the donor potential for organs and tissue in The Netherlands and (2) to identify factors influencing whether donation is

  4. Responding to teacher shortages : Relationships among mobility experiences, attitudes, and intentions of Dutch teachers

    NARCIS (Netherlands)

    van Geffen, R.E.; Poell, R.F.

    2014-01-01

    From all over the world there have been calls from governmental institutions to address a shortage of high quality teachers. As changing jobs generates new experiences, job mobility could be a way for teachers to adhere to the government’s call to develop themselves into the teaching force needed.

  5. Responding to teacher shortages: relationships among mobility experiences, attitudes, and intentions of Dutch teachers

    NARCIS (Netherlands)

    van Geffen, R.E.; Poell, R.F.

    2014-01-01

    From all over the world there have been calls from governmental institutions to address a shortage of high quality teachers. As changing jobs generates new experiences, job mobility could be a way for teachers to adhere to the government’s call to develop themselves into the teaching force needed.

  6. [Application of the xenogenic acellular dermal matrix membrane application used in the postoperative tissue shortage repair].

    Science.gov (United States)

    Bai, Yanxia; Yan, Liying; Zhang, Shaoqiang; Shao, Yuan; Yao, Xiaobao; Li, Honghui; Zhao, Ruimin; Zhao, Qian; Zhang, Pengfei; Yang, Qi

    2014-09-01

    To observe the short-term and long-term curative effect of the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer) application used in the 82 cases postoperative tissue shortage repair that after the head neck carcinoma resection. To held the 82 cases head neck carcinoma postoperative mucosa shortage repaired after resection by the xenogenic acellular dermal matrix membrane (or joint muscle flap transfer), 65 cases mucosa shortage wound be directly covered by the repair membrane and the other 17 cases mucosa shortage wound be repaired by the tranfered muscle tissue flap with the repair membrane covered; 53 cases underwent additional postoperative radiotherapy between 2-4 weeks and follow-up in 1, 3, 6, 12, 18, 24, 30, 36, 48, 60 months and observed the operation site repair process through the electronic laryngoscope, observed the patients respiration, swallow, phonation function. Seventy-seven cases patients operation incision reached I phase healing standard, another 5 cases patients operation incision reached II phase healing standard because of the wound infection and fully-recovered through the local wound drainage,dressing process. All the patients tracheal cannula,the stomach tube be extubated successfully and without the local cicatricial constriction occurred. Seventy-eight cases follow up period reached 1 year including 53 cases who underwent postoperative radiotherapy, 49 cases follow up period reached 3 years including 32 cases who underwent postoperative radiotherapy, 14 cases follow up period reached 5 years including 12 cases who underwent postoperative radiotherapy. The patients with static local lesions discovered no reaction such as exclusion, allergy. The application of xenogenic acellular dermal matrix membrane (or joint muscle flap transfer used in in the postoperative tissue shortage repair that after the head neck carcinoma resection have several advantage such as comparatively easily implementation, operation safety

  7. New Jersey's natural gas shortage: a policy analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cecil, J.L.; Morell, D.

    1976-12-01

    The public policy problems associated with New Jersey's natural gas shortage are extremely complex and rather difficult to examine. They involve a blend of technology, politics and economics; of regulatory mandates and profit-motivated initiatives; of Federal and state interaction and conflict. To understand the state's gas shortage and to lay the basis for recommending measures to deal with it, information about the basic technology, the organization of the gas industry, the national regulatory posture, and the possible causes of the gas shortage encompasses Part I of the overall study. In Part II, the analysis turns from the national level to a direct examination of New Jersey's gas situation. In Part III, Chapter VIII, the following are considered: the state's supply of natural gas, distribution of these supply volumes within New Jersey by the four major gas utilities, and gas consumption patterns within the state as a whole and then for each major consuming sector (electric utility, industrial, commercial, and residential). This chapter concludes with an analysis of the impacts of the gas shortage to date in New Jersey, and of its probable effects in the near-term. In the final chapter, some tentative conclusions and broad suggestions are advanced for public policies to mitigate the gravity of the state's position with respect to natural gas. Analysis proceeds, in turn, through consideration of possible state actions in several areas: increasing total interstate gas supplies; increasing New Jersey's share of whatever national total exists; making greater (or more effective) use of alternate fuels; and moderating demand for gas through aggressive conservation policies. Some short-term measures to cope better with whatever level of gas shortage exists in the state at any particular time are suggested. 151 references. (MCW)

  8. Civil Society and Residents’ Coping Strategies with Water Shortages and Household Food Insecurity in Gweru, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Winmore Kusena

    2017-02-01

    Full Text Available Domestic water shortages are distressing many urban areas in developing countries and require well planned and sustainable coping strategies in order to bequeath citizens decent lives. The objectives of this paper were to identify water related civil society groups present in Gweru; reveal devised coping strategies to combat water shortages and household food insecurity; and challenges faced by civil society and residents in obtaining sustainable coping strategies. A survey was conducted through interviews, questionnaires and observations as data collection instruments. The findings show that residents relied on borehole drilled in their respective areas by the municipality, Non-Governmental Organisations (NGOs and through individual initiatives. Although public boreholes were available, they were found at an average of only two in a given residential area, regardless of its population. Residents also collected water in containers during late hours of the night or early hours of the day. Gweru residents in addition devised strategies to cope with household food insecurity caused by water shortages and high monthly water bills. Combined with the aforementioned water shortage coping strategies, the stratagem by residents included coming up with payment plans, denying city personnel access into their premises for water disconnection; and self-reconnection in the event of disconnection. Community gardens initiated by Non-Governmental Organisations and food imports from neighbouring countries were some of the adaptive mechanisms dealing with household food insecurity. However, despite resolute efforts by civil society and residents to muddle through water supply and food security challenges, the city needs financial aid to enhance service provision that does not solely relying on residents. Financial injection and investment in sustainable alternative water sources for the city’s multiple uses will go a long way in solving the water shortages and

  9. [Guideline to prevent claims due to medical malpractice, on how to act when they do occur and how to defend oneself through the courts].

    Science.gov (United States)

    Bruguera, M; Arimany, J; Bruguera, R; Barberia, E; Ferrer, F; Sala, J; Pujol Robinat, A; Medallo Muñiz, J

    2012-04-01

    Claims due to presumed medical malpractice are increasing in all developed countries and many of them have no basis. To prevent legal complaints, the physicians should know the reasons why complaints are made by their patients and adopt the adequate preventive measures. In the case of a complaint, it is essential to follow the guidelines that allow for adequate legal defense and the action of the physician before the judge that inspires confidence and credibility. The risk of the claims can be reduced with adequate information to the patient, the following of the clinical guidelines, control of the risk factors and adoption of verification lists in each invasive procedure. In case of complication or serious adverse effect, explanations should be given to the patient and family and it should be reported to the facility where one works and to the insurance company. If the physician received a claim, he/she should report it to the insurance compare so that it can name a lawyer responsible for the legal defense who will advise the physician regarding the appearance in court before the judge. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  10. ACTS 2014

    DEFF Research Database (Denmark)

    Co-curator of ACTS 2014 together with Rasmus Holmboe, Judith Schwarzbart and Sanne Kofoed. ACTS is the Museum of Contemporary Art’s international bi-annual festival. ACTS was established in 2011 and, while the primary focus is on sound and performance art, it also looks toward socially oriented art....... For the 2014 festival, the museum has entered into a collaboration with the Department for Performance Design at Roskilde University – with continued focus on sound and performance art, and social art in public spaces. With ACTS, art moves out of its usual exhibition space and instead utilizes the city, its...... various possibilities and public spaces as a stage. ACTS takes place in and around the museum and diverse locations in Roskilde city. ACTS is partly curated by the museum staff and partly by guest curators. ACTS 2014 is supported by Nordea-fonden and is a part of the project The Museum goes downtown....

  11. Ocean Dumping Control Act

    International Nuclear Information System (INIS)

    1975-01-01

    This Act provides for the control of dumping of wastes and other substances in the ocean in accordance with the London Convention of 1972 on Prevention of Marine Pollution by the Dumping of Wastes and other Matter to which Canada is a Party. Radioactive wastes are included in the prohibited and restricted substances. (NEA)

  12. INTER-ACT: prevention of pregnancy complications through an e-health driven interpregnancy lifestyle intervention - study protocol of a multicentre randomised controlled trial.

    Science.gov (United States)

    Bogaerts, Annick; Ameye, Lieveke; Bijlholt, Margriet; Amuli, Kelly; Heynickx, Dorine; Devlieger, Roland

    2017-05-26

    Excessive maternal pre-pregnancy and gestational weight gain are related to pregnancy- and birth outcomes. The interpregnancy time window offers a unique opportunity to intervene in order to acquire a healthy lifestyle before the start of a new pregnancy. INTER-ACT is an e-health driven multicentre randomised controlled intervention trial targeting women at high risk of pregnancy- and birth related complications. Eligible women are recruited for the study at day 2 or 3 postpartum. At week 6 postpartum, participants are randomised into the intervention or control arm of the study. The intervention focuses on weight, diet, physical activity and mental well-being, and comprises face-to-face coaching, in which behavioural change techniques are central, and use of a mobile application, which is Bluetooth-connected to a weighing scale and activity tracker. The intervention is rolled out postpartum (4 coaching sessions between week 6 and month 6) and in a new pregnancy (3 coaching sessions, one in each trimester of pregnancy); the mobile app is used throughout the two intervention phases. Data collection includes data from the medical record of the participants (pregnancy outcomes and medical history), anthropometric data (height, weight, waist- and hip circumferences, skinfold thickness and body composition by bio-electrical impedance analysis), data from the mobile app (physical activity and weight; intervention group only) and questionnaires (socio-demographics, breastfeeding, food intake, physical activity, lifestyle, psychosocial factors and process evaluation). Medical record data are collected at inclusion and at delivery of the subsequent pregnancy. All other data are collected at week 6 and month 6 postpartum and every subsequent 6 months until a new pregnancy, and in every trimester in the new pregnancy. Primary outcome is the composite endpoint score of pregnancy-induced hypertension, gestational diabetes mellitus, caesarean section, and large

  13. The LasB Elastase of Pseudomonas aeruginosa Acts in Concert with Alkaline Protease AprA To Prevent Flagellin-Mediated Immune Recognition.

    Science.gov (United States)

    Casilag, Fiordiligie; Lorenz, Anne; Krueger, Jonas; Klawonn, Frank; Weiss, Siegfried; Häussler, Susanne

    2016-01-01

    The opportunistic pathogen Pseudomonas aeruginosa is capable of establishing severe and persistent infections in various eukaryotic hosts. It encodes a wide array of virulence factors and employs several strategies to evade immune detection. In the present study, we screened the Harvard Medical School transposon mutant library of P. aeruginosa PA14 for bacterial factors that modulate interleukin-8 responses in A549 human airway epithelial cells. We found that in addition to the previously identified alkaline protease AprA, the elastase LasB is capable of degrading exogenous flagellin under calcium-replete conditions and prevents flagellin-mediated immune recognition. Our results indicate that the production of two proteases with anti-flagellin activity provides a failsafe mechanism for P. aeruginosa to ensure the maintenance of protease-dependent immune-modulating functions. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  14. Retailer opinions about and compliance with family smoking prevention and tobacco control act point of sale provisions: a survey of tobacco retailers.

    Science.gov (United States)

    Rose, Shyanika W; Emery, Sherry L; Ennett, Susan; Reyes, Heathe Luz McNaughton; Scott, John C; Ribisl, Kurt M

    2015-09-11

    The objectives of this study were to document retailer opinions about tobacco control policy at the point of sale (POS) and link these opinions with store level compliance with sales and marketing provisions of the Tobacco Control Act. This study conducted interviews of 252 tobacco retailers in three counties in North Carolina and linked their opinions with in-person observational audit data of their stores' compliance with POS policies. We conducted analyses examining retailer factors associated with noncompliance using Generalized Estimating Equations (GEE) controlling for individual, store, neighborhood, and county factors. Over 90 % of retailers support minors' access provisions and a large minority (over 40 %) support graphic warnings and promotion bans. Low levels of support were found for a potential ban on menthol cigarettes (17 %). Store noncompliance with tobacco control policies was associated with both more reported retailer barriers to compliance and less support for POS policies. Awareness of and source of information about tobacco control regulations were not associated with compliance when accounting for neighborhood and county characteristics. Retailers expressed some support for a wide range of POS policies. Advocates and government agencies tasked with enforcement can work with retailers as stakeholders to enhance support, mitigate barriers, and promote compliance with tobacco control efforts at the point of sale.

  15. Organ donor shortage in the Netherlands; Definition of the potential donor pool and the role of family refusal

    NARCIS (Netherlands)

    Frazer-Jansen, N.E.

    2012-01-01

    The shortage of post-mortem organ donors in the Netherlands is a prominent problem for patients on the waiting list for organ transplantation. As long as there is a shortage of suitable organs for transplantation, the need to identify bottlenecks in the organ donation process is crucial to further

  16. 42 CFR Appendix G to Part 5 - Criteria for Designation of Areas Having Shortages of Veterinary Professional(s)

    Science.gov (United States)

    2010-10-01

    ... of Veterinary Professional(s) G Appendix G to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT... Pt. 5, App. G Appendix G to Part 5—Criteria for Designation of Areas Having Shortages of Veterinary Professional(s) Part I—Geographic Areas A. Criteria for Food Animal Veterinary Shortage. A geographic area will...

  17. Analysing monthly sectorial water use and its influence on salt intrusion induced water shortage in urbanized deltas

    NARCIS (Netherlands)

    Yao, Mingtian; Yan, Dan; Kabat, Pavel; Huang, Heqing; Hutjes, Ronald W.A.; Werners, Saskia E.

    2016-01-01

    Urbanizing delta regions face seasonal water shortages induced by rising salt intrusion. Decreasing river discharge is readily listed as the major cause of water shortage events. Yet, observations of river discharge often fail to support this attribution. Evidence of the association between

  18. High Prevalence of Vitamin D Deficiency in Native versus Migrant Mothers and Newborns in the North of Italy: A Call to Act with a Stronger Prevention Program.

    Directory of Open Access Journals (Sweden)

    Francesco Cadario

    Full Text Available Vitamin D status during pregnancy is related to neonatal vitamin D status. Vitamin D deficiency has been associated with an increased risk of rickets in children and osteomalacia in adults. Aim of this study was to investigate 25OHD levels in maternal serum and in neonatal blood spots in native and migrant populations living in Novara (North Italy, 45°N latitude.We carried out a cross sectional study from April 1st 2012 to March 30th 2013, in a tertiary Care Center. Maternal blood samples after delivery and newborns' blood spots were analyzed for 25OHD levels in 533 pairs. Maternal country of origin, skin phototype, vitamin D dietary intake and supplementation during pregnancy were recorded. Multivariate regression analysis, showed a link between neonatal and maternal 25OHD levels (R-square:0.664. Severely deficient 25OHD values (<25 nmol/L were found in 38% of Italian and in 76.2% of migrant's newborns (p <0.0001, and in 18% of Italian and 48,4% of migrant mothers (p <0.0001 while 25OHD deficiency (≥25 and <50 nmol/L was shown in 40.1% of Italian and 21.7% of migrant's newborns (p <0.0001, and in 43.6% of Italian and 41.3% of migrant mothers (p <0.0001. Italian newborns and mothers had higher 25OHD levels (34.4±19.2 and 44.9±21.2 nmol/L than migrants (17.7±13.7 and 29.7±16.5 nmol/L; p<0.0001. A linear decrease of 25OHD levels was found with increasing skin pigmentation (phototype I 42.1 ±18.2 vs phototype VI 17.9±10.1 nmol/l; p<0.0001. Vitamin D supplementation resulted in higher 25OHD values both in mothers and in their newborns (p<0.0001.Vitamin D insufficiency in pregnancy and in newborns is frequent especially among migrants. A prevention program in Piedmont should urgently be considered and people identified as being at risk should be closely monitored. Vitamin D supplementation should be taken into account when considering a preventative health care policy.

  19. Interleukin-17 retinotoxicity is prevented by gene transfer of a soluble interleukin-17 receptor acting as a cytokine blocker: implications for age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Daniel Ardeljan

    Full Text Available Age-related macular degeneration (AMD is a common yet complex retinal degeneration that causes irreversible central blindness in the elderly. Pathology is widely believed to follow loss of retinal pigment epithelium (RPE and photoreceptor degeneration. Here we report aberrant expression of interleukin-17A (IL17A and the receptor IL17RC in the macula of AMD patients. In vitro, IL17A induces RPE cell death characterized by the accumulation of cytoplasmic lipids and autophagosomes with subsequent activation of pro-apoptotic Caspase-3 and Caspase-9. This pathology is reduced by siRNA knockdown of IL17RC. IL17-dependent retinal degeneration in a mouse model of focal retinal degeneration can be prevented by gene therapy with adeno-associated virus vector encoding soluble IL17 receptor. This intervention rescues RPE and photoreceptors in a MAPK-dependent process. The IL17 pathway plays a key role in RPE and photoreceptor degeneration and could hold therapeutic potential in AMD.

  20. Who will educate our nurses? A strategy to address the nurse faculty shortage in New Jersey.

    Science.gov (United States)

    Gerolamo, Angela M; Overcash, Amy; McGovern, Jennifer; Roemer, Grace; Bakewell-Sachs, Susan

    2014-01-01

    The nurse faculty shortage hampers the capacity of the nursing workforce to respond to the demands of the evolving health care system. As a strategy to address the shortage in New Jersey, the Robert Wood Johnson Foundation implemented the New Jersey Nursing Initiative Faculty Preparation Program to prepare nurses for the faculty role. This article highlights program implementation successes and challenges, scholar and faculty perceptions of the program, and provides recommendations for others interested in preparing nurse faculty. This evaluation uses data from scholar surveys and focus groups, interviews with grantees, and grantee reports. Findings suggest that a program that includes generous monetary support, socialization to the nurse faculty role, and formal education courses produces graduates who readily assume a faculty position and are committed to at least a part-time career in nursing education. This evaluation emphasizes the need to carefully design programs that integrate faculty preparation and advanced clinical training. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Exacerbating Staff Shortages and Student Dissatisfaction? The Impact of AACSB Accreditation on Faculty Recruitment in Australia

    Directory of Open Access Journals (Sweden)

    Margaret Lightbody

    2010-09-01

    Full Text Available Australian accounting schools are widely perceived to be experiencing a staffing shortage. Many accountingschools are now seeking AACSB accreditation. There has been no consideration in the accounting literatureof how such accreditation might impact on the future ability of accounting schools to attract the ex-practiceaccountants that have traditionally comprised the majority of their faculty recruits. To examine suchimplications, this paper presents an interpretive case study of an Australian business school which is in theprocess of applying for AACSB accreditation. The paper argues that an implication of the increasinglyinflexible work environment driven by AACSB accreditation may be that academia becomes a less attractiveworkplace for ex-practitioner faculty. This may further exacerbate existing academic staff shortages andreduce diversity and professional knowledge within accounting schools, with consequent implications forteaching, student engagement, and industry engagement. This in turn may have long term ramifications forthe ability of the universities to attract students and thus earn the tuition fees on which they currently rely.

  2. Inventory Model for Deteriorating Items Involving Fuzzy with Shortages and Exponential Demand

    Directory of Open Access Journals (Sweden)

    Sharmila Vijai Stanly

    2015-11-01

    Full Text Available This paper considers the fuzzy inventory model for deteriorating items for power demand under fully backlogged conditions. We define various factors which are affecting the inventory cost by using the shortage costs. An intention of this paper is to study the inventory modelling through fuzzy environment. Inventory parameters, such as holding cost, shortage cost, purchasing cost and deterioration cost are assumed to be the trapezoidal fuzzy numbers. In addition, an efficient algorithm is developed to determine the optimal policy, and the computational effort and time are small for the proposed algorithm. It is simple to implement, and our approach is illustrated through some numerical examples to demonstrate the application and the performance of the proposed methodology.

  3. Dealing with labor shortages in long-term care: a marketing problem.

    Science.gov (United States)

    Moore, S T

    1990-01-01

    A recent analysis of data from the Bureau of Labor statistics raise serious implications for the long-term care industry. The human resource problems faced by managers in long-term care will escalate into a fullblown crisis by the end of this century. This will result from a decrease in the number of young workers available to work in unskilled and semiskilled occupations. The effect of this shortage will be exaggerated by an expansion of other sectors of the service industry. Long-term care facilities will be forced to compete with the fast food and retail industry as well as other sectors of the health industry for scarce workers. This article briefly examines the causes, consequences of this problem and suggests several strategies to mitigate the effect of the coming labor shortage.

  4. International cooperation and shortage of doctors: an analysis of the interaction between Brazil, Angola and Cuba.

    Science.gov (United States)

    Alves, Sandra Mara Campos; Oliveira, Felipe Proenço de; Matos, Mateus Falcão Martins; Santos, Leonor Maria Pacheco; Delduque, Maria Celia

    2017-07-01

    The shortage of doctors, especially in remote areas, is a critical issue for the development of national health systems and has thus been the focus of a number of international cooperation projects. An exploratory and qualitative study was conducted to examine cooperation between Brazil, Angola and Cuba. A nonsystematic literature review was conducted of selected open access articles and official documents addressing relevant health cooperation initiatives. Previously selected characteristics of actions designed to redress the shortage of doctors were compared. It was concluded that the interactions between the three countries were fruitful and potentially beneficial for the health of the population of these countries. South-South cooperation between these countries showed positive results in the educational and regulatory dimensions and adopted a non-dependence perspective that seeks to strengthen endogenous capacity, which are important factors for evaluating the structural components of health systems.

  5. United States Registered Nurse Workforce Report Card and Shortage Forecast: A Revisit.

    Science.gov (United States)

    Zhang, Xiaoming; Tai, Daniel; Pforsich, Hugh; Lin, Vernon W

    This is a reevaluation of registered nurse (RN) supply and demand from 2016 to 2030 using a previously published work forecast model and grading methodology with more recent workforce data. There will be a shortage of 154 018 RNs by 2020 and 510 394 RNs by 2030; the South and West regions will have higher shortage ratios than Northeast and Midwest regions. This reflects a nearly 50% overall improvement when compared with the authors' prior study, and the low-performing states have improved from 18 "D" and 12 "F" grades as published earlier to 13 "D" and 1 "F" in this study. Although progress has been made, efforts to foster the pipelines for improving the nursing workforce need to be continued.

  6. To favor survival under food shortage, the brain disables costly memory.

    Science.gov (United States)

    Plaçais, Pierre-Yves; Preat, Thomas

    2013-01-25

    The brain regulates energy homeostasis in the organism. Under resource shortage, the brain takes priority over peripheral organs for energy supply. But can the brain also down-regulate its own consumption to favor survival? We show that the brain of Drosophila specifically disables the costly formation of aversive long-term memory (LTM) upon starvation, a physiological state required for appetitive LTM formation. At the neural circuit level, the slow oscillations normally triggered in two pairs of dopaminergic neurons to enable aversive LTM formation were abolished in starved flies. Transient artificial activation of these neurons during training restored LTM formation in starved flies but at the price of a reduced survival. LTM formation is thus subject to adaptive plasticity that helps survival under food shortage.

  7. The Basic Act for Suicide Prevention: Effects on Longitudinal Trend in Deliberate Self-Harm with Reference to National Suicide Data for 1996–2014

    Directory of Open Access Journals (Sweden)

    Miharu Nakanishi

    2017-01-01

    Full Text Available A suicide prevention strategy was launched in Japan in 2006 to address the high suicide rate, which had increased considerably since 1998. The national strategy from 2007 involved the enhancement of psychiatric treatment services at emergency medical facilities and supportive observation by individuals close to patients. The national suicide rate has decreased gradually since 2008; however, national information regarding the number of patients who had engaged in deliberate self-harm was absent. Therefore, the present study examined the longitudinal trend in hospital admissions due to deliberate self-harm in Japan. Data from the National Patient Survey between 1996 and 2014—a nationally representative cross-sectional survey of inpatient care every 3 years—were used. Data for 13,014 patients were included in the estimation of the number of hospital admissions due to deliberate self-harm. The results show that the estimated number of admissions due to deliberate self-harm increased from 2078 in September 1996 to 3189 in September 2008, when the national number of suicide cases peaked, and decreased to 1783 in 2014. Approximately half of the patients were admitted to hospital because of self-harm via means other than drug poisoning, which had a high mortality rate (5.6%. The proportion of patients receiving public assistance was higher in those who had engaged in deliberate self-harm (8.5% relative to that observed in the general population. Overall, the trend in deliberate self-harm was synchronous with the number of suicide cases over time. As economic poverty has been associated with suicidal ideation and behavior and some recipients of public assistance tend to abuse psychotropic medication, the public assistance program should provide mental health support for recipients of social benefit schemes.

  8. α2δ ligands act as positive modulators of adult hippocampal neurogenesis and prevent depression-like behavior induced by chronic restraint stress.

    Science.gov (United States)

    Valente, Maria Maddalena; Bortolotto, Valeria; Cuccurazzu, Bruna; Ubezio, Federica; Meneghini, Vasco; Francese, Maria Teresa; Canonico, Pier Luigi; Grilli, Mariagrazia

    2012-08-01

    Although the role of adult hippocampal neurogenesis remains to be fully elucidated, several studies suggested that the process is involved in cognitive and emotional functions and is deregulated in various neuropsychiatric disorders, including major depression. Several psychoactive drugs, including antidepressants, can modulate adult neurogenesis. Here we show for the first time that the α2δ ligands gabapentin [1-(aminomethyl)cyclohexaneacetic acid] and pregabalin (PGB) [(S)-(+)-3-isobutyl-GABA or (S)-3-(aminomethyl)-5-methylhexanoic acid] can produce concentration-dependent increases in the numbers of newborn mature and immature neurons generated in vitro from adult hippocampal neural progenitor cells and, in parallel, a decrease in the number of undifferentiated precursor cells. These effects were confirmed in vivo, because significantly increased numbers of adult cell-generated neurons were observed in the hippocampal region of mice receiving prolonged treatment with PGB (10 mg/kg i.p. for 21 days), compared with vehicle-treated mice. We demonstrated that PGB administration prevented the appearance of depression-like behaviors induced by chronic restraint stress and, in parallel, promoted hippocampal neurogenesis in adult stressed mice. Finally, we provided data suggesting involvement of the α2δ1 subunit and the nuclear factor-κB signaling pathway in drug-mediated proneurogenic effects. The new pharmacological activities of α2δ ligands may help explain their therapeutic activity as supplemental therapy for major depression and depressive symptoms in post-traumatic stress disorder and generalized anxiety disorders. These data contribute to the identification of novel molecular pathways that may represent potential targets for pharmacological modulation in depression.

  9. Geometric representation of the mean-variance-skewness portfolio frontier based upon the shortage function

    OpenAIRE

    Kerstens, Kristiaan; Mounier, Amine; Van de Woestyne, Ignace

    2008-01-01

    The literature suggests that investors prefer portfolios based on mean, variance and skewness rather than portfolios based on mean-variance (MV) criteria solely. Furthermore, a small variety of methods have been proposed to determine mean-variance-skewness (MVS) optimal portfolios. Recently, the shortage function has been introduced as a measure of efficiency, allowing to characterize MVS optimalportfolios using non-parametric mathematical programming tools. While tracing the MV portfolio fro...

  10. The insurance of bulk oil cargoes and adjustment of shortage claims

    International Nuclear Information System (INIS)

    Tavendale, R.

    1993-01-01

    Shortage claims discussed in this article include those due to a definite disaster such as a fire, those due to cargo contamination and storage, and those identified in documentation as occurring between loading and unloading. The principal types of cover are examined, and the distinction between gross and net quantities, claim documentation, the petroleum measurement tables, and guaranteed out turn cover are described in detail. (UK)

  11. Potential Ways to Address Shortage Situations of 99Mo/99mTc.

    Science.gov (United States)

    Filzen, Leah M; Ellingson, Lacey R; Paulsen, Andrew M; Hung, Joseph C

    2017-03-01

    99m Tc, the most common radioisotope used in nuclear medicine, is produced in a nuclear reactor from the decay of 99 Mo. There are only a few aging nuclear reactors around the world that produce 99 Mo, and one of the major contributors, the National Research Universal (Canada), ceased production on October 31, 2016. The National Research Universal produced approximately 40% of the world's 99 Mo supply, so with its shut down, shortages of 99 Mo/ 99m Tc are expected. Methods: Nuclear pharmacies and nuclear medicine departments throughout the United States were contacted and asked to provide their strategies for coping with a shortage of 99 Mo/ 99m Tc. Each of these strategies was evaluated on the basis of its effectiveness for conserving 99m Tc while still meeting the needs of the patients. Results: From the responses, the following 6 categories of strategies, in order of importance, were compiled: contractual agreements with commercial nuclear pharmacies, alternative imaging protocols, changes in imaging schedules, software use, generator management, and reduction of ordered doses or elimination of backup doses. Conclusion: The supply chain of 99 Mo/ 99m Tc is quite fragile; therefore, being aware of the most appropriate coping strategies is crucial. It is essential to build a strong collaboration between the nuclear pharmacy and nuclear medicine department during a shortage situation. With both nuclear medicine departments and nuclear pharmacies implementing viable strategies, such as the ones proposed, the amount of 99m Tc available during a shortage situation can be maximized. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

  12. The shortage of medical workers in Sub-Saharan Africa and substitution policy

    OpenAIRE

    Bourgain, Arnaud; Pieretti, Patrice; Zou, Benteng

    2011-01-01

    Substitution policies are strategies sometimes chosen in Sub-Saharan Africa for curtailing the shortage of health professionals especially caused by the outflow of medical personnel. The aim of our contribution is to propose a way to assess the merits and drawbacks of substitution policies by developing a simple growth model of healthcare productivity with medical brain drain. Within this framework, we use a medical care production function of the CES type which aggregates low and high specia...

  13. The NNP/DNP shortage: transforming neonatal nurse practitioners into DNPs.

    Science.gov (United States)

    Pressler, Jana L; Kenner, Carole A

    2009-01-01

    Neonatal nurse practitioners (NNPs) represent a high-demand specialty practice that is especially targeted for US secondary and tertiary care neonatal intensive care units (NICUs). NNPs make primary decisions about the caregiving of high-risk newborns at the time of admission, throughout hospitalization, at transfer, and at discharge that require an advanced knowledge base in neonatology as well as NICU clinical experience. NNPs prepared at the master's level are currently in very short supply, with some estimates suggesting that for each NNP who graduates, there are 80 positions open across the country. Even with the present shortage, due to the high cost of NNP education, NNP programs are diminishing and those that are remaining are not graduating a sufficient number of new NNPs each year to keep up with the demand. To add to the basic shortage problem, in 2004 the American Association of Colleges of Nursing decided that by 2015, the terminal degree for all nurse practitioners should move from the master's degree to the doctor of nursing practice (DNP) degree. That decision added a minimum of 12 months of full-time education to the advanced education requirements for nurse practitioners. What impact will the decision to require a DNP degree have on NNP specialty practice? Will even more NNP programs close because of faculty shortages of NNPs prepared at the DNP level? If a worse shortage occurs in the number of NNPs prepared to practice in NICUs, will physician assistants or other nonphysician clinicians who meet the need for advanced neonatal care providers replace NNPs? What steps, if any, can nursing take to ensure that NNP specialty practice is still needed and survives after supplementing the DNP requirement to NNP education?

  14. Curatorial Acts

    NARCIS (Netherlands)

    Bal, M.

    2012-01-01

    In a self-critical inquiry into my own recent work of co-curating and the experience of seeing my video work being curated by others, this article examines acts of framing as performative acts that seek to transform visitors' preconceptions. This affective effect is pursued by means of immersion,

  15. Forecasting the shortage of neurosurgeons in Iran using a system dynamics model approach.

    Science.gov (United States)

    Rafiei, Sima; Daneshvaran, Arman; Abdollahzade, Sina

    2018-01-01

    Shortage of physicians particularly in specialty levels is considered as an important issue in Iran health system. Thus, in an uncertain environment, long-term planning is required for health professionals as a basic priority on a national scale. This study aimed to estimate the number of required neurosurgeons using system dynamic modeling. System dynamic modeling was applied to predict the gap between stock and number of required neurosurgeons in Iran up to 2020. A supply and demand simulation model was constructed for neurosurgeons using system dynamic approach. The demand model included epidemiological, demographic, and utilization variables along with supply model-incorporated current stock of neurosurgeons and flow variables such as attrition, migration, and retirement rate. Data were obtained from various governmental databases and were analyzed by Vensim PLE Version 3.0 to address the flow of health professionals, clinical infrastructure, population demographics, and disease prevalence during the time. It was forecasted that shortage in number of neurosurgeons would disappear at 2020. The most dominant determinants on predicted number of neurosurgeons were the prevalence of neurosurgical diseases, the rate for service utilization, and medical capacity of the region. Shortage of neurosurgeons in some areas of the country relates to maldistribution of the specialists. Accordingly, there is a need to reconsider the allocation system for health professionals within the country instead of increasing the overall number of acceptance quota in training positions.

  16. Causes of shortage and delay in material supply: a preliminary study

    Science.gov (United States)

    Rahman, M. M.; Yap, Y. H.; Ramli, N. R.; Dullah, M. A.; Shamsuddin, M. S. W.

    2017-11-01

    Shortage and delay in materials supply is argued to be one of the most important factors that lead to delay in construction project delivery globally. However, the relevant underlying reasons vary from country to country. As such, this paper summarises the outcomes of a study that targeted identifying causes of shortage and delay in materials supply in Brunei Darussalam. The study was conducted through fifteen semi-structured interviews of contractors and materials suppliers in Brunei. The study identified six causes of shortageof materials and nine causes of delay in materials supply in Brunei. The most importantcausefor shortage of materials relates to the origin or availability of construction materials. On the other hand, the most influential cause of delay in material supply was found to be poor materials procurement and inventory management system, which has other underlying reasons such as late identification of the type of materials needed. The observations are expected to help in formulating or reviewing relevant policies, in order to ensure on-time project delivery.

  17. A New Way for Incorporating GCM Information into Water Shortage Projections

    Directory of Open Access Journals (Sweden)

    Seung Beom Seo

    2015-05-01

    Full Text Available Climate change information is essential for water resources management planning, and the majority of research available uses the global circulation model (GCM data to project future water balance. Despite the fact that the results of various GCMs are still heterogeneous, it is common to utilize GCM values directly in climate change impact assessment models. To mitigate these limitations, this study provides an alternative methodology, which uses GCM-based data to assign weights on historical scenarios rather than to directly input their values into the assessment models, thereby reducing the uncertainty involved in the direct use of GCMs. Therefore, the real innovation of this study is placed on the use of a new probability weighting scheme with multiple GCMs rather than on the direct input of GCM-driven data. Applied to make future projections of the water shortage in the Han River basin of Korea, the proposed methodology produced conservative but realistic projection results (15% increase compared to the existing methodologies, which projected a dramatic increase (144% in water shortage over 10 years. As a result, it was anticipated that the amount of water shortages in the Han River basin would gradually increase in the next 90 years, including a 57% increase in the 2080s.

  18. [Acting in the framework of the nicotine addiction prevention--the level of knowledge amongst 6th year students of Wroclaw Medical University].

    Science.gov (United States)

    Kurpas, Donata; Wojtal, Mariola; Bielska, Dorota; Rogalska, Monika; Sapilak, Bartosz; Steciwko, Andrzej

    2009-01-01

    nicotine and every fourth has the knowledge. The preparing graduates of the Medical Faculty for the participation in realization of basic schedules of the promotion of the health and the diseases prevention is developing unusually pessimistically towards above data, the fight against the nicotine addiction is filling one of the essential positions, independently on the medical specialty.

  19. Preferences for Long-Acting Pre-exposure Prophylaxis (PrEP), Daily Oral PrEP, or Condoms for HIV Prevention Among U.S. Men Who Have Sex with Men.

    Science.gov (United States)

    Greene, George J; Swann, Greg; Fought, Angela J; Carballo-Diéguez, Alex; Hope, Thomas J; Kiser, Patrick F; Mustanski, Brian; D'Aquila, Richard T

    2017-05-01

    HIV prevention method preferences were evaluated among 512 U.S. men who have sex with men (MSM; median age: 22 years). Approximately 90 % consistently preferred one option across pairwise comparisons of condoms, daily oral pre-exposure prophylaxis (PrEP), and long-acting PrEP delivered via either an injectable or one of two types of PrEP implants differing in visibility. Condoms were most frequently preferred (33.8 %), followed by non-visible implants (21.5 %), and oral PrEP (17.0 %); HIV risk was reported by more choosing implants. In a follow-up question comparing the four PrEP options only, daily oral pills and non-visible implants were most frequently preferred (35.5 and 34.3 %, respectively), followed by injections (25.2 %) and visible implants (4.3 %). An inductive, open-coding approach determined that convenience, duration of protection, and privacy were the most commonly cited reasons for a PrEP method choice, and associated with self-report of HIV risk. Tailoring PrEP product development to privacy and other concerns important to those at highest HIV risk may improve HIV prevention.

  20. Is The Water Shortage Crisis Really One of the Most Dangerous?

    Science.gov (United States)

    Narayanan, M.

    2010-12-01

    Author of the 1998 book, Last Oasis: Facing Water Scarcity, Dr. Sandra Postel predicts big water availability problems as populations of so-called “water-stressed” countries jump perhaps six fold over the next 30 years. The author has reported on this in his previous AGU presentations. In the next four decades, more than half of the world’s population will have to deal with sever water shortages. The United States has been blessed with several large fresh water lakes. In spite of having this fresh water supply, some states like Arizona could be facing sever fresh water shortages in the next couple of decades. Sid Wilson, general manager of the Central Arizona Project has indicated "It's not a question of if there is a water shortage anymore. It is in reality, when there will be a water shortage. " Several states share water from the Colorado river. The river has limited water supply to cater to the needs of Arizona, Nevada, California, Colorado, New Mexico, Utah and Wyoming. World Health Organization, NASA, Department of the Interior, NOAA and several organizations have observed that there is a real water shortage crisis. This is because the world’s population has tripled in the twentieth century. This has resulted in a six-fold increase of water usage. Fresh water supply is limited. This is because water cannot be replaced with an alternative. It is important to observe that petroleum can be replaced with alternative fuel resources. It is necessary to recognize that fact that irrigation necessitates almost 65% to 70% of water withdrawal. Industry may utilize about 20% and domestic consumption is about 10% Evaporation from reservoirs is also a major factor, depending upon the climate and environment. Therefore there is an urgent need for all the countries to establish a strong, sound, sensible and sustainable management program for utilizing the available water supplies efficiently (Narayanan, 2008). References: Narayanan, Mysore. (2008). Hydrology, Water

  1. Towards risk-based drought management in the Netherlands: quantifying the welfare effects of water shortage

    Science.gov (United States)

    van der Vat, Marnix; Femke, Schasfoort; Rhee Gigi, Van; Manfred, Wienhoven; Nico, Polman; Joost, Delsman; den Hoek Paul, Van; Maat Judith, Ter; Marjolein, Mens

    2016-04-01

    It is widely acknowledged that drought management should move from a crisis to a risk-based approach. A risk-based approach to managing water resources requires a sound drought risk analysis, quantifying the probability and impacts of water shortage due to droughts. Impacts of droughts are for example crop yield losses, hydropower production losses, and water shortage for municipal and industrial use. Many studies analyse the balance between supply and demand, but there is little experience in translating this into economic metrics that can be used in a decision-making process on investments to reduce drought risk. We will present a drought risk analysis method for the Netherlands, with a focus on the underlying economic method to quantify the welfare effects of water shortage for different water users. Both the risk-based approach as well as the economic valuation of water shortage for various water users was explored in a study for the Dutch Government. First, an historic analysis of the effects of droughts on revenues and prices in agriculture as well as on shipping and nature was carried out. Second, a drought risk analysis method was developed that combines drought hazard and drought impact analysis in a probabilistic way for various sectors. This consists of a stepwise approach, from water availability through water shortage to economic impact, for a range of drought events with a certain return period. Finally, a local case study was conducted to test the applicability of the drought risk analysis method. Through the study, experience was gained into integrating hydrological and economic analyses, which is a prerequisite for drought risk analysis. Results indicate that the risk analysis method is promising and applicable for various sectors. However, it was also found that quantification of economic impacts from droughts is time-consuming, because location- and sector-specific data is needed, which is not always readily available. Furthermore, for some

  2. Concise Approach for Determining the Optimal Annual Capacity Shortage Percentage using Techno-Economic Feasibility Parameters of PV Power System

    Science.gov (United States)

    Alghoul, M. A.; Ali, Amer; Kannanaikal, F. V.; Amin, N.; Sopian, K.

    2017-11-01

    PV power systems have been commercially available and widely used for decades. The performance of a reliable PV system that fulfils the expectations requires correct input data and careful design. Inaccurate input data of the techno-economic feasibility would affect the size, cost aspects, stability and performance of PV power system on the long run. The annual capacity shortage is one of the main input data that should be selected with careful attention. The aim of this study is to reveal the effect of different annual capacity shortages on the techno-economic feasibility parameters and determining the optimal value for Baghdad city location using HOMER simulation tool. Six values of annual capacity shortage percentages (0%, 1%, 2%, 3%, 4%, and 5%), and wide daily load profile range (10 kWh - 100 kWh) are implemented. The optimal annual capacity shortage is the value that always "wins" when each techno-economic feasibility parameter is at its optimal/ reasonable criteria. The results showed that the optimal annual capacity shortage that reduces significantly the cost of PV power system while keeping the PV system with reasonable technical feasibility is 3%. This capacity shortage value can be carried as a reference value in future works for Baghdad city location. Using this approach of analysis at other locations, annual capacity shortage can be always offered as a reference value for those locations.

  3. Dumping at Sea Act 1974

    International Nuclear Information System (INIS)

    1974-01-01

    This Act enables the United Kingdom Government to ratify both the Oslo Convention of 1972 for the Prevention of Marine Pollution by Dumping from Ships and Aircraft and the London Convention of 1972 on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter. (NEA) [fr

  4. Is physical water scarcity a new phenomenon? Global assessment of water shortage over the last two millennia

    International Nuclear Information System (INIS)

    Kummu, Matti; Varis, Olli; Ward, Philip J; De Moel, Hans

    2010-01-01

    In this letter we analyse the temporal development of physical population-driven water scarcity, i.e. water shortage, over the period 0 AD to 2005 AD. This was done using population data derived from the HYDE dataset, and water resource availability based on the WaterGAP model results for the period 1961-90. Changes in historical water resources availability were simulated with the STREAM model, forced by climate output data of the ECBilt-CLIO-VECODE climate model. The water crowding index, i.e. Falkenmark water stress indicator, was used to identify water shortage in 284 sub-basins. Although our results show a few areas with moderate water shortage (1000-1700 m 3 /capita/yr) around the year 1800, water shortage began in earnest at around 1900, when 2% of the world population was under chronic water shortage ( 3 /capita/yr). By 1960, this percentage had risen to 9%. From then on, the number of people under water shortage increased rapidly to the year 2005, by which time 35% of the world population lived in areas with chronic water shortage. In this study, the effects of changes in population on water shortage are roughly four times more important than changes in water availability as a result of long-term climatic change. Global trends in adaptation measures to cope with reduced water resources per capita, such as irrigated area, reservoir storage, groundwater abstraction, and global trade of agricultural products, closely follow the recent increase in global water shortage.

  5. ACT Test

    Science.gov (United States)

    ... to clot, the higher the degree of clotting inhibition. During surgery, the ACT is kept above a ... What is ECLS? An Introduction to Extracorporeal Life Support. University of Michigan Health System [On-line information]. ...

  6. Recent food shortage is associated with leprosy disease in Bangladesh: a case-control study.

    Directory of Open Access Journals (Sweden)

    Sabiena G Feenstra

    Full Text Available BACKGROUND: Leprosy is remaining prevalent in the poorest areas of the world. Intensive control programmes with multidrug therapy (MDT reduced the number of registered cases in these areas, but transmission of Mycobacterium leprae continues in most endemic countries. Socio-economic circumstances are considered to be a major determinant, but uncertainty exists regarding the association between leprosy and poverty. We assessed the association between different socio-economic factors and the risk of acquiring clinical signs of leprosy. METHODS AND FINDINGS: We performed a case-control study in two leprosy endemic districts in northwest Bangladesh. Using interviews with structured questionnaires we compared the socio-economic circumstances of recently diagnosed leprosy patients with a control population from a random cluster sample in the same area. Logistic regression was used to compare cases and controls for their wealth score as calculated with an asset index and other socio-economic factors. The study included 90 patients and 199 controls. A recent period of food shortage and not poverty per se was identified as the only socio-economic factor significantly associated with clinical manifestation of leprosy disease (OR 1.79 (1.06-3.02; p = 0.030. A decreasing trend in leprosy prevalence with an increasing socio-economic status as measured with an asset index is apparent, but not statistically significant (test for a trend: OR 0.85 (0.71-1.02; p = 0.083. CONCLUSIONS: Recent food shortage is an important poverty related predictor for the clinical manifestation of leprosy disease. Food shortage is seasonal and poverty related in northwest Bangladesh. Targeted nutritional support for high risk groups should be included in leprosy control programmes in endemic areas to reduce risk of disease.

  7. Land-Water-Food Nexus and Indications of Crop Adjustment for Water Shortage Solution

    Science.gov (United States)

    Yang, Y.; Ren, D.; Zhou, X.

    2017-12-01

    Agriculture places the greatest demand on water resources, and increasing agricultural production is worsening a global water shortage. Reducing the cultivation of water-consuming crops may be the most effective way to reduce agricultural water use. However, when also taking food demand into consideration, sustaining the balance between regional water and food securities is a growing challenge. This paper addresses this task for regions where water is unsustainable for food production (Beijing-Tianjin-Hebei Region for example), by (i) assessing the different effects of wheat and maize on water use; (ii) analyzing virtual water and virtual land flows associated with food imports and exports between Beijing-Tianjin-Hebei and elsewhere in China; (iii) identifying sub-regions where grain are produced using scarce water resources but exported to other regions. (iv) analyzing the potentiality for mitigating water shortage via Land-Water-Food Nexus. In the Beijing-Tianjin-Hebei Region, the study reveals that 29.76 bn m3 of virtual water (10.81 bn m3 of blue virtual water) are used by wheat and maize production and nearly 2 million ha of cropland using 8.77 bn m3 of virtual water overproduced 12 million ton of maize for external food consumption. As an importing-based sub-region with high population density, Beijing and Tianjin (BT) imported mostly grain (wheat and maize) from Shandong (SD). Whereas, Hebei (HB), as an exporting-based sub-region with sever water shortage, overproduced too much grain for other regions (like Central area), which aggravated water crisis. To achieve Beijing-Tianjin-Hebei's integrated and sustainable development, HB should not undertake the breadbasket role for BT but pay more attention to groundwater depletion. The analysis of the Land-Water-Food Nexus indicates how shifts in the cultivated crops can potentially solve the overuse of water resources without adverse effect on food supply, and provides meaningful information to support policy

  8. A fuzzy inventory model with acceptable shortage using graded mean integration value method

    Science.gov (United States)

    Saranya, R.; Varadarajan, R.

    2018-04-01

    In many inventory models uncertainty is due to fuzziness and fuzziness is the closed possible approach to reality. In this paper, we proposed a fuzzy inventory model with acceptable shortage which is completely backlogged. We fuzzily the carrying cost, backorder cost and ordering cost using Triangular and Trapezoidal fuzzy numbers to obtain the fuzzy total cost. The purpose of our study is to defuzzify the total profit function by Graded Mean Integration Value Method. Further a numerical example is also given to demonstrate the developed crisp and fuzzy models.

  9. Notes from the field: national shortage of isoniazid 300 mg tablets.

    Science.gov (United States)

    2012-12-21

    On November 16, 2012, the Illinois State tuberculosis (TB) program notified CDC's Division of Tuberculosis Elimination of a national shortage of 300 mg tablets of the antituberculosis medication isoniazid (INH). Subsequently, other state TB programs (e.g., California, Indiana, Maryland, New York, Virginia, and Wisconsin) reported difficulty obtaining INH 300 mg tablets. Other programs (e.g., San Diego) have experienced difficulties obtaining at least one of the commercially available anti-TB preparations containing the combination of rifampin and INH (IsonaRif [VersaPharm]).

  10. Investing in human capital: an academic-service partnership to address the nursing shortage.

    Science.gov (United States)

    Clark, Rebecca Culver; Allison-Jones, Lisa

    2011-01-01

    The well-documented shortage of nurses and the impact of educational preparation of nurses on patient care outcomes provide a compelling argument for the need to increase the number of registered nurses and to advance their educational preparation. This article describes the application of human capital theory in a creative venture between a health system and a school of nursing that has demonstrated success in addressing these issues. A tuition advancement program was developed to support interested personnel in attaining the associate degree in nursing and to support current RNs in attaining the baccalaureate degree. The venture included support for graduate preparation of nurses interested in becoming faculty.

  11. Alarm bells [Power supply shortage in the Northeast in the 1990's

    International Nuclear Information System (INIS)

    Ray, M.

    1989-01-01

    This article addresses the differing opinions of the Department of Energy(US DOE) and the leaders of the Senate Energy Committee versus utilities and state regulators on whether there will be a power-supply shortage in the Northeast in the 1990's and what should be done to avoid it. Also addressed is where the whole utility industry stands regarding decisions by regulators and governing bodies on competition, independent power plants, transmission and wholesale sales of power and building new nuclear plants

  12. Energy markets: a glut or shortage?; Les marches de l'energie: abondance ou penurie?

    Energy Technology Data Exchange (ETDEWEB)

    Mandil, C. [Agence International de l' Energie, 75 - Paris (France)

    2005-08-01

    Although fossil fuels do not risk being exhausted soon, the specter of scarcity is haunting the oil market. This market has fallen victim to a historical shortage of investments and a rising demand that is less elastic than expected. Moreover, higher oil prices seem to have no effect on investment decisions, nor on consumer behavior. Should we resignedly accept prices rising up to one or even two hundred dollars a barrel? And should we passively accept having poor countries pay for the thoughtlessness of wealthy lands? (author)

  13. Preventive Care Benefits (Affordable Care Act)

    Science.gov (United States)

    ... you can change plans Report income/family changes Saving Money See if you'll save Save on your ... you can change plans Report income/family changes Saving Money See if you'll save Save on your ...

  14. Ensuring sustained ACT production and reliable artemisinin supply

    Directory of Open Access Journals (Sweden)

    Olliaro Piero

    2007-09-01

    Full Text Available Abstract Introduction This paper reviews recent trends in the production, supply and price of the active ingredients as well as finished ACT products. Production and cost data provided in this paper are based on an ongoing project (Artepal. Stability data are derived from a development project on rectal artesunate. Discussion The artemisinin raw material and its derivatives appear to be very stable compared to the finished products. Supply of artemisinin changed in May 2004 when the Global Fund shifted financial support to qualified countries from chloroquine or sulphadoxine-pyrimethamine to an ACT for treatment of malaria. First, there was a sudden shortage of the starting material, and short term scarcity led to a steep rise in API price: it increased dramatically in 2004, from $350 per kg to more than $1000. Second, there was a parallel increase in the number of companies extracting artemisinin from 10 to 80 between 2003 and 2005 in China, and from 3 to 20 in Vietnam. Commercial cultivation began also in East Africa and Madagascar. A steady and predictable demand for the crop can eliminate such wide fluctuations and indirectly contribute to price stability of the herb, the API and ACT. With appropriate mechanisms to reduce those fluctuations, the cost of artemisinin might decrease sustainably to US$ 250–300 per kg. Conclusion Today the global health community is facing the risk of another cyclical swing with lower demand feeding into reduced planting of A. annua and, thereafter, a new shortage of the raw material and higher API prices. International donors, the largest purchasers for ACTs could better coordinate their activities, in order to guarantee purchase of ACTs and consequently of API with manufacturers. In parallel, the base of quality producers of APIs and finished ACT products needs to be broadened. While the ACT programme is still in its early stages, the consequences of another wave of artemisinin and ACT shortages would

  15. Ensuring sustained ACT production and reliable artemisinin supply.

    Science.gov (United States)

    Kindermans, Jean-Marie; Pilloy, Jacques; Olliaro, Piero; Gomes, Melba

    2007-09-15

    This paper reviews recent trends in the production, supply and price of the active ingredients as well as finished ACT products. Production and cost data provided in this paper are based on an ongoing project (Artepal). Stability data are derived from a development project on rectal artesunate. The artemisinin raw material and its derivatives appear to be very stable compared to the finished products. Supply of artemisinin changed in May 2004 when the Global Fund shifted financial support to qualified countries from chloroquine or sulphadoxine-pyrimethamine to an ACT for treatment of malaria. First, there was a sudden shortage of the starting material, and short term scarcity led to a steep rise in API price: it increased dramatically in 2004, from $350 per kg to more than $1000. Second, there was a parallel increase in the number of companies extracting artemisinin from 10 to 80 between 2003 and 2005 in China, and from 3 to 20 in Vietnam. Commercial cultivation began also in East Africa and Madagascar.A steady and predictable demand for the crop can eliminate such wide fluctuations and indirectly contribute to price stability of the herb, the API and ACT. With appropriate mechanisms to reduce those fluctuations, the cost of artemisinin might decrease sustainably to US$ 250-300 per kg. Today the global health community is facing the risk of another cyclical swing with lower demand feeding into reduced planting of A. annua and, thereafter, a new shortage of the raw material and higher API prices. International donors, the largest purchasers for ACTs could better coordinate their activities, in order to guarantee purchase of ACTs and consequently of API with manufacturers. In parallel, the base of quality producers of APIs and finished ACT products needs to be broadened.While the ACT programme is still in its early stages, the consequences of another wave of artemisinin and ACT shortages would permanently discredit it and impede any progress in rolling malaria back.

  16. No 592 - Radiation Act

    International Nuclear Information System (INIS)

    1991-01-01

    This Act will enter into force on 1 January 1992. The scope of the Act is extensive as, in addition to ionizing radiation, it will also apply to activities involving exposure to natural radiation and non-ionizing radiation. Its purpose is to prevent and restrict harmful effects to health resulting from radiation. The basic principles of the Act are that the practice involving radiation should be justified; radiation protection should be optimized; and radiation doses should be as low as reasonably achievable. Licensed organisations using radiation will be responsible for the safety of the activity involving exposure to radiation and for having available the appropriate expertise to this effect. The required so-called safety licence provides the regulatory control to ensure that radiation is used sensibly, that the equipment and shields are technically acceptable and the operating personnel is competent, and that the radioactive waste is dealt with appropriately. The Radiation Act will also apply to nuclear activities within the scope of the 1987 Nuclear Energy Act [fr

  17. The importance of the treatment of the unsafe acts for the prevention of accidents in petrochemical industry; A importancia do tratamento dos atos inseguros para a prevencao de acidentes na industria petroquimica

    Energy Technology Data Exchange (ETDEWEB)

    Meneguetti, Alexander A.; Santos, Helio R.F.; Alevato, Hilda; Lima, Luciana S. [Dupont do Brasil S.A., Paulinia, SP (Brazil)

    2008-07-01

    Due to the fact that, the workers' behavior is characterized by its complexity and diversity, this issue has been seen as a great 'black box' in discussions regarding the Management Systems of SHE. Associated with this issue other arises: How conscious people? How to engage them with the process? How to improve the risk control? How to motivate the prevention? Most of these responses are discussed in the Social and Human Sciences for many years. However, it is necessary to closer the technical-operational knowledge and the human aspects, applying in the organizations' daily work, to make the working environment more safe. The purpose of this study, therefore, is examining the possibility of reducing accidents through the identification and treatment of deviations (unsafe acts and unsafe conditions), cause the whole accident, be it serious or not, begins with a small deviation. It was used as a reference tool, the Behavior audit and it is based on field's observations, applied into a production unit of a large petrochemical industry in northern Brazil, during the years 2006 and 2007. (author)

  18. The Family Smoking Prevention and Tobacco Control Act and the First Amendment: why a substantial interest in protecting public health won't save some new restrictions on tobacco advertising.

    Science.gov (United States)

    Stoll, Elaine

    2010-01-01

    Congress passed the Family Smoking Prevention and Tobacco Control Act in 2009 with the aim of reducing tobacco-related illnesses and deaths by curbing tobacco's appeal to and use by children and adolescents. Legislators considered provisions of the FSPTCA restricting tobacco advertising and labeling key to realizing the law's intended health benefits. But a lawsuit now before the U.S. Court of Appeals for the Sixth Circuit challenges the tobacco marketing restrictions as impermissible restraints on tobacco companies' commercial speech rights under the First Amendment. This article analyzes the constitutionality of each FSPTCA tobacco advertising and labeling restriction in light of U.S. Supreme Court decisions defining the extent of First Amendment protection for commercial speech, prior efforts to restrict tobacco marketing, and the outcomes of legal challenges to some of the prior marketing restrictions. Several of the FSPTCA tobacco advertising and labeling restrictions were drafted with insufficient accommodations for tobacco companies' First Amendment right to convey and consumers' First Amendment right to receive truthful information about lawful tobacco products and are therefore unconstitutional as currently written.

  19. Significance of single lung transplantation in the current situation of severe donor shortage in Japan.

    Science.gov (United States)

    Miyoshi, Ryo; Chen-Yoshikawa, Toyofumi F; Hijiya, Kyoko; Motoyama, Hideki; Aoyama, Akihiro; Menju, Toshi; Sato, Toshihiko; Sonobe, Makoto; Date, Hiroshi

    2016-02-01

    Although bilateral lung transplantation is the procedure of choice internationally, single lung transplantation is preferred in Japan because of the severe donor shortage except in cases of contraindications to single lung transplantation. This study aimed to evaluate the clinical characteristics of single lung transplant recipients and outcomes of this procedure at one of the largest lung transplant centers in Japan. Between April 2002 and May 2015, 57 cadaveric lung transplantations (33 single and 24 bilateral) were performed in Kyoto University Hospital. The clinical characteristics of the lung transplant recipients and outcomes of these procedures, including overall survival and postoperative complications, were investigated. Overall, the 1-, 3-, and 5-year survival rates were 86, 77, and 72 %, respectively, with a median follow-up period of 1.9 years. There was no significant difference in survival between patients who underwent single lung transplantations and those who underwent bilateral lung transplantations (p = 0.92). The median waiting time was significantly shorter for single lung transplant patients than for bilateral lung transplant patients (p = 0.02). Native lung complications were seen in 14 out of 33 patients (42 %) who underwent single lung transplantation. There was no significant difference in survival between patients with and without postoperative native lung complications. Single lung transplantation has been performed with acceptable outcomes in our institution. In the current situation of severe donor shortage in Japan, single lung transplantation can remain the first choice of treatment except in cases of contraindications to single lung transplantation.

  20. To have and to hold: personnel shortage in a Finnish healthcare organisation.

    Science.gov (United States)

    Heilmann, Pia

    2010-07-01

    Retirements of baby boomers will create a talent shortage in Finnish health care. Concurrently, difficulties exist in recruiting new personnel. This paper provides an overview concerning the bottlenecks in talent management in a Finnish hospital, and finds solutions for recruitment and retention problems of healthcare professionals (nurses and physicians). Because the healthcare staffing shortage is worldwide, the results of this paper are also useful internationally. The research was a qualitative case study and the research method used was group interview. Background data was gathered from the public media and healthcare trade organisations. The bottlenecks of talent management in hospital organisation seem to relate to retaining actions of senior personnel. Concurrently, the organisation should develop new practices for attracting new personnel. Very few efforts on image marketing and recruitment have been done. The Internet has not been fully exploited and recruitment information has not been sent even to the neighbouring nursing college. Job rotation has not been used as a help in recruitment and competence development. Difficulties exist in transmitting tacit knowledge from a retiring nurse to a junior nurse. Leadership skills of the superior seem to be important when retaining and committing senior personnel. Recruitment and retention problems encourage organisations to develop new recruitment and commitment practices as well as management and leadership skills.

  1. Addressing a Yellow Fever Vaccine Shortage - United States, 2016-2017.

    Science.gov (United States)

    Gershman, Mark D; Angelo, Kristina M; Ritchey, Julian; Greenberg, David P; Muhammad, Riyadh D; Brunette, Gary; Cetron, Martin S; Sotir, Mark J

    2017-05-05

    Recent manufacturing problems resulted in a shortage of the only U.S.-licensed yellow fever vaccine. This shortage is expected to lead to a complete depletion of yellow fever vaccine available for the immunization of U.S. travelers by mid-2017. CDC, the Food and Drug Administration (FDA), and Sanofi Pasteur are collaborating to ensure a continuous yellow fever vaccine supply in the United States. As part of this collaboration, Sanofi Pasteur submitted an expanded access investigational new drug (eIND) application to FDA in September 2016 to allow for the importation and use of an alternative yellow fever vaccine manufactured by Sanofi Pasteur France, with safety and efficacy comparable to the U.S.-licensed vaccine; the eIND was accepted by FDA in October 2016. The implementation of this eIND protocol included developing a systematic process for selecting a limited number of clinic sites to provide the vaccine. CDC and Sanofi Pasteur will continue to communicate with the public and other stakeholders, and CDC will provide a list of locations that will be administering the replacement vaccine at a later date.

  2. The shortages of nurses in NSW: a motivation hygiene approach to identifying problems and solutions.

    Science.gov (United States)

    Carroll, E; Dwyer, L

    1988-01-01

    For a number of years public hospitals in NSW have experienced high turnover figures for nursing staff and have been unable to recruit sufficient numbers of registered nurses back into hospital employment. This paper outlines factors on both the demand and the supply side which contribute to the present shortage. It then goes on to argue that a greater appreciation of the causes of the shortage, and strategies for its resolution, can be gained by presenting the issues from the perspective of Herzberg's Motivation--Hygiene Theory. 'Motivation' factors, providing satisfaction to nurses, include achievement and recognition, the work itself, responsibility, advancement and potential for personal growth. 'Hygiene' factors, producing dissatisfaction, include physical working conditions, employer policies and administrative practices, interpersonal relations, salary. Discussion of the issues from this perspective indicates that strategies to resolve the crisis must proceed on two fronts. Continuing efforts must be made to promote job satisfaction among nurses while at the same time reducing the incidence of factors promoting job dissatisfaction.

  3. Reduce, reuse and recycle: a green solution to Canada's medical isotope shortage.

    Science.gov (United States)

    Galea, R; Ross, C; Wells, R G

    2014-05-01

    Due to the unforeseen maintenance issues at the National Research Universal (NRU) reactor at Chalk River and coincidental shutdowns of other international reactors, a global shortage of medical isotopes (in particular technetium-99m, Tc-99m) occurred in 2009. The operation of these research reactors is expensive, their age creates concerns about their continued maintenance and the process results in a large amount of long-lived nuclear waste, whose storage cost has been subsidized by governments. While the NRU has since revived its operations, it is scheduled to cease isotope production in 2016. The Canadian government created the Non-reactor based medical Isotope Supply Program (NISP) to promote research into alternative methods for producing medical isotopes. The NRC was a member of a collaboration looking into the use of electron linear accelerators (LINAC) to produce molybdenum-99 (Mo-99), the parent isotope of Tc-99m. This paper outlines NRC's involvement in every step of this process, from the production, chemical processing, recycling and preliminary animal studies to demonstrate the equivalence of LINAC Tc-99m with the existing supply. This process stems from reusing an old idea, reduces the nuclear waste to virtually zero and recycles material to create a green solution to Canada's medical isotope shortage. © 2013 Published by Elsevier Ltd.

  4. Successful importation of cytarabine into the United States during a critical national drug shortage.

    Science.gov (United States)

    Hunnisett-Dritz, Dee

    2012-08-15

    The importation of cytarabine into the United States during a critical national drug shortage is described. In March 2011, the hospital pharmacy team at an acute care hospital was struggling to supply cytarabine for four specific patients, all of whom needed critical maintenance therapy after induction. Cytarabine was not available from any source in the United States, and the team had no realistic projected release dates for back orders. Idis UK, a pharmaceutical distributor, was asked to identify available drug and eventually found an unrestricted source of cytarabine in Switzerland. Once available drug was identified, a price quote for the supply amount was written for our consideration. This was inspected carefully to ensure that the drug, strength, dosage form, and any other ingredients listed were indeed what were expected. The pharmacy department worked with the hospital's department of finance and accounting to submit the necessary financial paperwork. Payment was electronically sent to the distributor before the drug was shipped. Before the order for cytarabine was placed, the associated risks and benefits were assessed. The patients provided consent to treatment with the unapproved product. Acceptance of the price quote and instructions to order the drug were e-mailed to the distributor. The necessary documentation was completed and included with the shipment. The importation process, from initial inquiries to delivery, took 21 days. The importation of cytarabine amid a drug shortage required a complex process that involved the efforts of an overseas distributor, the cooperation of multiple health professionals, and meticulous attention to detail.

  5. Impact of canal water shortages on groundwater in the Lower Bari Doab Canal system in Pakistan

    International Nuclear Information System (INIS)

    Shakir, A.S.; Rehman, H.U.; Khan, N.M.; Qazi, A.U.

    2011-01-01

    This paper presents rigorous analysis of shortage of canal water supplies, crop water requirements, and groundwater use and its quality in the command of Lower Bari Doab Canal, Pakistan. The annual canal water supplies are 36% less than the crop water requirements. This shortage further increases to 56% if actual canal supplies (averaged over last ten years) are compared with the crop water requirement. The groundwater levels are depleting at the rate of 30 to 40 cm per year in most parts of the LBDC command and this tendency of lowering may increase in future due to further increase in crop water requirements. The analysis of data for the last seven years indicate that quality of groundwater in most parts of LBDC command is generally good (64% of the area) or marginally acceptable (28%) for irrigation use. However, declining trends in groundwater quality are visible and can create long term sustain ability problems if proper remedial actions are not taken well in time. (author)

  6. Coordinating vendor-buyer decisions for imperfect quality items considering trade credit and fully backlogged shortages

    Science.gov (United States)

    Khanna, Aditi; Gautam, Prerna; Jaggi, Chandra K.

    2016-03-01

    Supply chain management has become a critical issue for modern business environments. In today's world of cooperative decision-making, individual decisions in order to reduce inventory costs may not lead to an overall optimal solution. Coordination is necessary among participants of supply chain to achieve better performance. There are legitimate and important efforts from the vendor to enhance the relation with buyer; one such effort is offering trade credit which has been a driver of growth and development of business between them. The cost of financing is a core consideration in effective financial management, in general and in context of business. Also, due to imperfect production a vendor may produce defective items which results in shortages. Motivated with these aspects, an integrated vendor-buyer inventory model is developed for imperfect quality items with allowable shortages; in which the vendor offers credit period to the buyer for payment. The objective is to minimize the total joint annual costs incurred by the vendor and the buyer by using integrated decision making approach. The expected total annual integrated cost is derived and a solution procedure is provided to find the optimal solution. Numerical analysis shows that the integrated model gives an impressive cost reduction, in comparison to independent decision policies by the vendor and the buyer.

  7. Motivational indicators of protective behaviour in response to urban water shortage threat

    Science.gov (United States)

    Mankad, Aditi; Greenhill, Murni; Tucker, David; Tapsuwan, Sorada

    2013-05-01

    The present study examined the role of protection motivation variables in predicting rainwater tank adoption among urban householders. A regression analysis found that subjective knowledge, threat appraisal, response efficacy, response costs, subjective norms and social norms significantly predicted adaptive behavioural intentions (F(6, 399) = 50.769, p accounted for 43% of the variance in intentions to install a rainwater tank as a protective measure against future water shortages. Results further indicated that several variables uniquely contributed to the prediction of rainwater tank adoption (listed in order of relative contribution: response efficacy, threat appraisal, response costs, subjective knowledge and subjective norms). This suggests that people who perceive there is a real water shortage threat, and believe that rainwater tanks are effective in relieving the threat and require minimal or manageable effort to obtain, are more likely to install a tank on their property as a protective measure. Implications of these results are discussed from a research and policy perspective. Recommendations for future motivational research in the area of urban decentralised system acceptance and adoption are presented.

  8. Predicted shortage of vascular surgeons in the United Kingdom: A matter for debate?

    Science.gov (United States)

    Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

    2016-10-01

    Vascular surgery became a new independent surgical specialty in the United Kingdom (UK) in 2013. In this matter for debate we discuss the question, is there a "shortage of vascular surgeons in the United Kingdom?" We used data derived from the "Vascular Surgery United Kingdom Workforce Survey 2014", NHS Employers Electronic Staff Records (ESR), and the National Vascular Registry (NVR) surgeon-level public report to estimate current and predict future workforce requirements. We estimate there are approximately 458 Consultant Vascular Surgeons for the current UK population of 63 million, or 1 per 137,000 population. In several UK Regions there are a large number of relatively small teams (3 or less) of vascular surgeons working in separate NHS Trusts in close geographical proximity. In developed countries, both the number and complexity of vascular surgery procedures (open and endovascular) per capita population is increasing, and concerns have been raised that demand cannot be met without a significant expansion in numbers of vascular surgeons. Additional workforce demand arises from the impact of population growth and changes in surgical work-patterns with respect to gender, working-life-balance and 7-day services. We predict a future shortage of Consultant Vascular Surgeons in the UK and recommend an increase in training numbers and an expansion in the UK Consultant Vascular Surgeon workforce to accommodate population growth, facilitate changes in work-patterns and to create safe sustainable services. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  9. Pollution prevention: A regulatory update

    International Nuclear Information System (INIS)

    Walzer, A.E.; Maynard, J.W.

    1993-01-01

    Pollution prevention is the emphasis of the 1990s environmental philosophy. This new environmental era was ushered in when President Bush signed the Pollution Prevention Act in October 1990. This law, with its accompanying philosophy, was in response to the realization that end-of-the-pipe treatment, which frequently changed the media in which a pollutant or waste was discharged, was inadequate to protect the environment and human health. Pollution prevention advocates source reduction, where material substitutions and engineering solutions are sought to reduce the volume and toxicity of waste and pollutants. This proactive approach reduces environmental impacts such as those of former waste sites which have produced environmental legacies that will cost billions of dollars and take decades to remediate. This paper describes pollution prevention philosophy and summarizes regulatory pollution prevention requirements. It describes current regulatory trends in the area of pollution prevention, including voluntary programs and enforcement actions. The Pollution Prevention Act of 1990 is described, and pollution prevention initiatives embodied in other laws, including the Clean Air Act, the Clean Water Act, the Emergency Planning and Community Right-To-Know Act, the Resource Conservation and Recovery Act, and the Toxic Substances Control Act, are discussed. A historical overview of waste minimization initiatives within the Department of Energy is given, and other pollution prevention initiatives that affect federal facilities, such as Executive Order 12780, which mandates recycling and the procurement of recycled materials, are also outlined

  10. Land-Water-Food Nexus and indications of crop adjustment for water shortage solution.

    Science.gov (United States)

    Ren, Dandan; Yang, Yonghui; Yang, Yanmin; Richards, Keith; Zhou, Xinyao

    2018-06-01

    While agriculture places the greatest demand on water resources, increasing agricultural production is worsening a global water shortage. Reducing the cultivation of water-consuming crops may be the most effective way to reduce agricultural water use. However, when also taking food demand into consideration, sustaining the balance between regional water and food securities is a growing challenge. This paper addresses this task for regions where water is unsustainable for food production (Beijing-Tianjin-Hebei Region for example) by: (i) assessing the different effects of wheat and maize on water use; (ii) analyzing virtual water and virtual land flows associated with food imports and exports between Beijing-Tianjin-Hebei and elsewhere in China; (iii) identifying sub-regions where grain is produced using scarce water resources but exported to other regions; and (iv) analyzing the potentiality for mitigating water shortage via Land-Water-Food Nexus. In the Beijing-Tianjin-Hebei Region, the study reveals that 29.76 bn m 3 of virtual water (10.81 bn m 3 of blue virtual water) are used by wheat and maize production and 8.77 bn m 3 of virtual water used in nearly 2 million ha of cropland to overproduce 12 million ton of maize for external food consumption. As an importing-based sub-region with high population density, Beijing & Tianjin imported mostly grain (wheat and maize) from Shandong Province. Then, Hebei Province, as an exporting-based sub-region with severe water shortage, overproduced too much grain for other regions, which aggravated the water crisis. To achieve an integrated and sustainable development of the Beijing-Tianjin-Hebei Region, Hebei Province should stop undertaking the breadbasket role for Beijing & Tianjin and pay more attention to groundwater depletion. The analysis of the Land-Water-Food Nexus indicates how shifts in cultivated crops can potentially solve the overuse of water resources without adverse effects on food supply

  11. Addressing the primary care physician shortage in an evolving medical workforce

    Directory of Open Access Journals (Sweden)

    Lakhan Shaheen E

    2009-05-01

    Full Text Available Abstract Background Primary care physicians have been shown to play an important role in the general health of the communities in which they serve. In spite of their importance, however, there has been a decrease in the number of physicians interested in pursuing primary care fields, while the proportion of specialists continues to increase. The prediction of an overall physician shortage only augments this issue in the US, where this uneven distribution is particularly evident. As such, serious effort to increase the number of practicing primary care physicians is both necessary and beneficial for meeting this country's health care needs. Discussion There are several factors at play which contribute to the decrease in the number of practicing physicians in primary specialties. Lifestyle concerns, such as schedule and income, as well as the lack of prestige associated with this field seem to be among the most prevalent reasons cited for the diminishing interest. Multifaceted concerns such as these, however, are difficult to adequately invalidate; doing so would not only require a great deal research, but also a good deal of time – a resource which is in short supply given the current physician shortage being faced. Thus, a more immediate solution may lie in the increased recruitment and continued support of those individuals who are already associated with primary care service. This is particularly relevant given the Association of American Medical College's goal of increasing medical school enrollment by 15% over the next 10 years. Several groups have been shown to be large contributors to primary care in the US. Here, we focus on three such groups: minority students, International Medical Graduates (IMGs and Osteopathic Physicians (DOs. Although these groups are highly diverse individually, they all share the distinction of being underutilized in regard to the current primary care shortages faced. Thus, through more fully accentuating these

  12. Drug tendering: drug supply and shortage implications for the uptake of biosimilars

    Directory of Open Access Journals (Sweden)

    Dranitsaris G

    2017-09-01

    Full Text Available George Dranitsaris,1 Ira Jacobs,2 Carol Kirchhoff,3 Robert Popovian,4 Lesley G Shane5 1Augmentium Pharma Consulting Inc., Toronto, ON, Canada; 2Global Medical Affairs, Pfizer Inc, New York, NY, 3Global Technology Services, Biotechnology and Aseptic Sciences Group, Pfizer Inc, Chesterfield, MO, 4US Government Relations, Pfizer Inc, Washington, DC, 5Outcomes and Evidence, Global Health and Value, Pfizer Inc, New York, NY, USA Abstract: Due to the continued increase in global spending on health care, payers have introduced a number of programs, policies, and agreements on pharmaceutical pricing in order to control costs. While incentives to increase generic drug use have achieved significant savings, other cost-containment measures are required. Tendering is a formal procedure to purchase medications using competitive bidding for a particular contract. Although useful for cost containment, tendering can lead to decreased competition in a given market. Consequently, drug shortages can occur, resulting in changes to treatment plans to products that may have lower efficacy and/or an increased risk of adverse effects. Therefore, care must be taken to ensure that tendering does not negatively impact patient care or the health care system. A large and expanding portion of total pharmaceutical expenditure is for biologic therapies. These agents have revolutionized the treatment of many diseases, including cancer and inflammatory conditions; however, patient access to biologic drugs can be limited due to availability, insurance coverage, and cost. As branded biologic therapies reach the end of patent- and data-protection periods, biosimilars are being approved as lower-cost alternatives. Biosimilars are products that are highly similar to the originator product with no clinically meaningful differences in terms of safety, purity, or potency. As more biosimilars receive regulatory approval and adoption increases, these therapies are expected to have an

  13. Minding the gap: World Bank's assistance to power shortage mitigation in the developing world

    Energy Technology Data Exchange (ETDEWEB)

    Heffner, G.; Maurer, L.; Sarkar, A.; Wang, X. [The World Bank, 1818 H Street, NW, Washington DC 20433 (United States)

    2010-04-15

    This paper describes the World Bank's technical assistance and lending efforts in support of developing countries facing power shortages. The paper reviews the World Bank's experience in helping governments to mitigate power shortages in Africa, South Asia, East Asia, and Latin America regions. The paper stresses the need to consider each power ''crunch'' on an individual basis, and describes the process used in diagnosing a shortage situation and prescribing mitigation strategies. Several brief case studies are presented, including Botswana, Brazil, Uganda, and South Africa. The political and customer-centric dimensions of power shortage mitigation are briefly described, with suggestions for minimizing the socio-economic impacts of power shortages on the urban and rural poors. The paper concludes that an integrated supply-demand portfolio approach works best, and within the portfolio a mix of market-based rationing, emergency mobilization of customer-owned generation, interruptible rates, load control, and energy efficient lighting should be sought. Although the best formulation will vary according to market structure, demand composition, and nature of the crisis, World Bank practitioners have found one program that works almost everywhere to produce fast and effective results - mass market Compact Fluorescent Lamp (CFL) replacement programs. (author)

  14. Is there a 'pig cycle' in the labour supply of doctors? How training and immigration policies respond to physician shortages.

    Science.gov (United States)

    Chojnicki, Xavier; Moullan, Yasser

    2018-03-01

    Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004. By calculating panel fixed-effect estimates, we find that after a period of medical shortages, OECD governments produce more medical graduates in the long run but in the short term, they primarily recruit from abroad; however, at the same time, certain practising physicians choose to emigrate. Simulation results show the limits of recruiting only abroad in the long term but also highlight its appropriateness for the short term when there is a recurrent cycle of shortages/surpluses in the labour supply of physicians (pig cycle theory). Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Demonstration project: Load management on the user side at power shortages

    International Nuclear Information System (INIS)

    Lindskoug, Stefan

    2005-10-01

    The risk for power shortages during extreme cold weather has increased in Sweden. Comments are made that high electricity spot prices are important for holding down the demand. Through the consumers' higher price sensitivity, the electricity system can be operated with lower reserve capacity. The objective of the demonstration project is to show methods for reducing the electricity demand at the national level at high spot prices. An important prerequisite is that the measures must be profitable for all parties involved. Four separate studies were made, two concerning households, one industry and one for the district heating sector. The conclusion from the studies is that load management on the customer's side is an economic alternative to investment in new production capacity

  16. PS-109 Barriers and facilitators to implementing drug changes caused by drug tenders and shortages

    DEFF Research Database (Denmark)

    Rishøj, Rikke Mie; Christrup, Lona Louring; Clemmensen, Marianne H

    2015-01-01

    . Purpose To identify barriers and facilitators for implementing drug changes due to drug tenders and shortages in Danish public hospitals. Material and methods Six focus group interviews were conducted at three hospitals in different regions of the country. At each hospital two focus group interviews were...... thematically through content analysis. Results Barriers Identified included: frequent changes of labelling, packages and drug names. Furthermore, implementing drug changes requires extra resources and finance. Technologies such as computerised physician order entry and barcode scanning systems were perceived...... as potential facilitators, but also as barriers in cases where the quality and implementation of the systems were not adequate. Facilitators included: hospital pharmacy services and lower drug prices. Furthermore recommendations on generic prescription, optimisation of the tendering process and support...

  17. Physical therapy workforce shortage for aging and aged societies in Thailand.

    Science.gov (United States)

    Kraiwong, Ratchanok; Vongsirinavarat, Mantana; Soonthorndhada, Kusol

    2014-07-01

    According to demographic changes, the size of the aging population has rapidly increased. Thailand has been facing the "aging society" since 2005 and the "aged society" has been projected to appear by the year 2025. Increased life expectancy is associated with health problems and risks, specifically chronic diseases and disability. Aging and aged societies and related specific conditions as stroke require the provision of services from health professionals. The shortage of the physical therapy workforce in Thailand has been reported. This study investigated the size of physical therapy workforce required for the approaching aging society of Thailand and estimated the number of needed physical therapists, specifically regarding stroke condition. Evidently, the issue of the physical therapy workforce to serve aging and aged societies in Thailand requires advocating and careful arranging.

  18. Medical isotope shortage 2009-2010 and future options NRU, SLOWPOKE and MAPLE

    Energy Technology Data Exchange (ETDEWEB)

    Hilborn, J. [Deep River, Ontario (Canada)

    2013-07-01

    The 15 month shutdown of NRU and the unexpected termination of the AECL/Nordion MAPLE project caused a world-wide shortage of medical isotopes. After the recent repair of NRU, AECL is confident that it could continue operating safely and reliably as a multi-purpose reactor until 2021 or longer. There is convincing evidence that the restoration of the MAPLE reactors is technically feasible, but it is highly improbable that a 10 MW MAPLE production reactor can ever be cost-effective. However, conversion of the present 10 MW reactors to 3 MW, without major changes to the structural hardware, warrants serious consideration. Finally, even the 20 kW SLOWPOKE reactor could produce useful quantities of Mo-99. If the present fuel rods were replaced with a small tank containing a solution of low-enriched uranyl sulphate in water, three of these liquid core reactors could supply all of Canada. (author)

  19. Medical isotope shortage 2009-2010 and future options NRU, SLOWPOKE and MAPLE

    International Nuclear Information System (INIS)

    Hilborn, J.

    2013-01-01

    The 15 month shutdown of NRU and the unexpected termination of the AECL/Nordion MAPLE project caused a world-wide shortage of medical isotopes. After the recent repair of NRU, AECL is confident that it could continue operating safely and reliably as a multi-purpose reactor until 2021 or longer. There is convincing evidence that the restoration of the MAPLE reactors is technically feasible, but it is highly improbable that a 10 MW MAPLE production reactor can ever be cost-effective. However, conversion of the present 10 MW reactors to 3 MW, without major changes to the structural hardware, warrants serious consideration. Finally, even the 20 kW SLOWPOKE reactor could produce useful quantities of Mo-99. If the present fuel rods were replaced with a small tank containing a solution of low-enriched uranyl sulphate in water, three of these liquid core reactors could supply all of Canada. (author)

  20. [Remedy for shortage or risk for national security? The search for oil in Switzerland].

    Science.gov (United States)

    Haller, Lea; Gisler, Monika

    2014-03-01

    Over several decades, geologists, entrepreneurs, politicians, and public authorities dealt with a potential petroleum occurrence in Switzerland. They provided scientific expertise, granted concessions, invested capital and sank bore holes. Although the endeavour was never successful economically, it reveals how closely related geopolitical situations and the exploitation of natural resources were. This article investigates the search for crude oil in Switzerland from the 1930s until the 1960s, combining a history of science and technology perspective with a history of the political regulations and economic considerations concerning the extractive industry. It traces the changing fears and hopes about potential oil occurrences in Switzerland: From an investment to overcome future shortages, to the risk of imperial desires if oil would be found in abundance.

  1. EOQ Model for Delayed Deteriorating Items with Shortages and Trade Credit Policy

    Directory of Open Access Journals (Sweden)

    R Sundararajan

    2015-08-01

    Full Text Available This paper deals with a deterministic inventory model for deteriorating items under the condition of permissible delay in payments with constant demand rate is a function of time which differs from before and after deterioration for a single item. Shortages are allowed and completely backlogged which is a function of time. Under these assumptions, this paper develops a retailer's model for obtaining an optimal cycle length and ordering quantity in deteriorating items of an inventory model. Thus, our objective is retailer's cost minimization problem to nd an optimal replenishment policy under various parameters. The convexity of the objective function is derived and the numerical examples are provided to support the proposed model. Sensitivity analysis of the optimal solution with respect to major parameters of the model is included and the implications are discussed.

  2. The global health workforce shortage: role of surgeons and other providers.

    Science.gov (United States)

    Sheldon, George F; Ricketts, Thomas C; Charles, Anthony; King, Jennifer; Fraher, Erin P; Meyer, Anthony

    2008-01-01

    The debate over the status of the physician workforce seems to be concluded. It now is clear that a shortage of physicians exists and is likely to worsen. In retrospect it seems obvious that a static annual production of physicians, coupled with a population growth of 25 million persons each decade, would result in a progressively lower physician to population ratio. Moreover, Cooper has demonstrated convincingly that the robust economy of the past 50 years correlates with demand for physician services. The aging physician workforce is an additional problem: one third of physicians are over 55 years of age, and the population over the age of 65 years is expected to double by 2030. Signs of a physician and surgeon shortage are becoming apparent. The largest organization of physicians in the world (119,000 members), the American College of Physicians, published a white paper in 2006 titled, "The Impending Collapse of Primary Care Medicine and Its Implications for the State of the Nation's Health Care" [37]. The American College of Surgeons, the largest organization of surgeons, has published an article on access to emergency surgery [38], and the Institute of Medicine of the National Academies of Science has published a book on the future of emergency care (Fig. 10). The reports document diminished involvement and availability of emergency care by general surgeons, neurologic surgeons, orthopedists, hand surgeons, plastic surgeons, and others. The emergency room has become the primary care physician after 5 PM for much of the population. A survey done by the Commonwealth Fund revealed that less than half of primary care practices have an on-call arrangement for after-hours care. Other evidence of evolving shortage are reports of long wait times for appointments, the hospitalist movement, and others. The policies for the future should move beyond dispute over whether or not a shortage exists. The immediate need is for the United States, as a society, to commit to

  3. Future global manpower shortages in nuclear industries with special reference to india including remedial measures

    International Nuclear Information System (INIS)

    Ghosh Hazra, G.S.

    2008-01-01

    Full text: The Radiation Protection Program of the Environmental Protection Agencies of countries employ scientists, engineers, statisticians, economists, lawyers, policy analysts, and public affairs professionals amongst others. These professionals aim to protect workers, the general public, and the environment from harmful radiation exposures and to provide the technical basis for radiation protection policies and regulations. Professionals include Health physicists, Bio statistician, Radio chemist, Radio ecologist, Radio biologist etc. With a large proportion of the population of the nuclear workforce of many countries now approaching retirement age, existing power plants of these countries will be hard pressed to find enough qualified professionals to support their operations. The potential shortage of skilled manpower not only affects utilities, but also impacts the entire nuclear infrastructure, including national laboratories, federal and state agencies, nuclear technology vendors and manufacturing companies, nuclear construction companies, and university nuclear engineering departments. Manpower requirements exist in the nuclear power industry, universities and research establishments, hospitals, government departments, general industry e.g. radiography, transport, instrumentation etc., specialist contractors, agencies and consultancies serving radiation protection. India is no exception. India has the world's 12 th largest economy. Assuming India's average growth rate p.a. of more than 5%, total GDP by 2050 will increase substantially which will require proportionate increase of manpower for all industries. Also chance of brain drain is very high from developing countries e.g. from India to developed countries because of much higher pay and better lifestyle as there will be shortage of manpower in developed countries as explained above. With population growth to be stabilized in future in India, the working age population may not increase in the year 2030

  4. Fatty liver disease and lifestyle in youngsters: diet, food intake frequency, exercise, sleep shortage and fashion.

    Science.gov (United States)

    Trovato, Francesca M; Martines, Giuseppe Fabio; Brischetto, Daniela; Catalano, Daniela; Musumeci, Giuseppe; Trovato, Guglielmo M

    2016-03-01

    Fatty liver is associated with alcohol habits and/or overweight/obesity. We challenged several lifestyle features associated with fatty liver and, particularly, with non-alcoholic fatty liver disease (NAFLD). Among them, sleep shortage as a result of nightlife habits and a preference for plus-size fashion were assessed. The latter consists of fashionable plus-sized clothing for actual individuals' size and reflects a frequent attitude of some social or age groups, conceivably indicating more global and widespread trend and behaviour. We studied a group of 708 non-diabetic youngsters, 458 women and 250 men, 21.72 ± 3.71 years old (range 15-35 years), referred for minor digestive ailments for clinical assessment, ultrasound detection of fatty liver and nutritional counselling. Details of personal history regarding lifestyle, food intake frequency and alcohol intake, dietary and physical exercise profile, sleep duration and clothing preferences were recorded. The prevalence of NAFLD in this cohort of youngsters is 67/708 (9.4%). Even if it is quantitatively very low in both groups, the average alcohol intake, always below 20 g/day, is greater in NAFLD subjects (5.83 ± 4.32 g) vs. subjects with normal liver (2.02 ± 3.20 g). The number of meals/day and adherence to a Mediterranean diet profile are smaller in NAFLD subjects. By multiple regression, BMI, sedentary life, plus-sized clothing for their actual size, sleep shortage and lower frequency of daily food intake are associated with the presence of NAFLD. Onset and continuation of fatty liver disease, beyond food and exercise quantity and quality, with their effects on obesity, may also be associated with other aspects of lifestyle. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services.

    Science.gov (United States)

    Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances

    2011-02-26

    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011

  6. Reduce, reuse and recycle: A green solution to Canada's medical isotope shortage

    International Nuclear Information System (INIS)

    Galea, R.; Ross, C.; Wells, R.G.

    2014-01-01

    Due to the unforeseen maintenance issues at the National Research Universal (NRU) reactor at Chalk River and coincidental shutdowns of other international reactors, a global shortage of medical isotopes (in particular technetium-99m, Tc-99m) occurred in 2009. The operation of these research reactors is expensive, their age creates concerns about their continued maintenance and the process results in a large amount of long-lived nuclear waste, whose storage cost has been subsidized by governments. While the NRU has since revived its operations, it is scheduled to cease isotope production in 2016. The Canadian government created the Non-reactor based medical Isotope Supply Program (NISP) to promote research into alternative methods for producing medical isotopes. The NRC was a member of a collaboration looking into the use of electron linear accelerators (LINAC) to produce molybdenum-99 (Mo-99), the parent isotope of Tc-99m. This paper outlines NRC’s involvement in every step of this process, from the production, chemical processing, recycling and preliminary animal studies to demonstrate the equivalence of LINAC Tc-99m with the existing supply. This process stems from reusing an old idea, reduces the nuclear waste to virtually zero and recycles material to create a green solution to Canada's medical isotope shortage. - Highlights: • Commercial power electron accelerators are realistic option to produce 99 Mo. • Could cover national demand of Canada. • Demonstrate LINAC- 99 Mo as environmental and economical solution to isotope crisis. • Demonstrate LINAC- 99m Tc to be clinically equivalent to current fission- 99m Tc supply

  7. Effective Factors on Shortage of Breastfeeding According to Iranian Traditional Medicine.

    Science.gov (United States)

    Ghorat, Fereshteh; Nejatbakhsh, Fatemeh; Ahmadi, Mohammad; Namazi, Nazli

    2016-05-01

    Support for breastfeeding is a public health priority. One of the major factors that can negatively affect breastfeeding is the lack of breast milk. There are many instructions on the subject of breast milk in Iranian traditional medicine resources. This article attempts to investigate causes and reasons for the lack of breast milk from the perspective of the great scholars in this field. This study reviews the literature based on the Iranian traditional medicine. The literature review included traditional medicine resources and a survey of reputable databases using keywords such as "morzae", "sady", "pestan", "sheer", "sheerkhar", and "hifzossehhe". The content analysis was used after collecting data. According to the viewpoint stated in traditional medicine literature, the primary substance for milk production is blood that transforms to milk after crossing the breast glandular tissue. The main causes of milk shortage can be classified into four categories, namely food-related factors, factors related to blood impaired, factors related to breast tissue and psychological and physical factors. One of the main reasons for milk shortage is the impaired quality and quantity of food. Appropriate mizaj of breast tissue is required for adequate milk production as it develops sufficient ability to absorb and transform the substance into milk. On the other hand, the ability of breast tissue is greatly influenced by the main organs of the body, particularly the heart; being the core of understanding psychological factors. Thus, psychological factors can have a significant effect on the process of milk production. Due to the importance of breastfeeding, reflection on other viewpoints, such as those mentioned in Iranian traditional medicine, could pave the way towards new research areas. It could also steer policies towards an extra focus on breastfeeding by mothers.

  8. Engaging rural preceptors in new longitudinal community clerkships during workforce shortage: a qualitative study

    Directory of Open Access Journals (Sweden)

    Weston Kathryn M

    2011-09-01

    Full Text Available Abstract Background In keeping with its mission to produce doctors for rural and regional Australia, the University of Wollongong, Graduate School of Medicine has established an innovative model of clinical education. This includes a 12-month integrated community-based clerkship in a regional or rural setting, offering senior students longitudinal participation in a 'community of practice' with access to continuity of patient care experiences, continuity of supervision and curriculum, and individualised personal and professional development. This required developing new teaching sites, based on attracting preceptors and providing them with educational and physical infrastructure. A major challenge was severe health workforce shortages. Methods Before the new clerkship started, we interviewed 28 general practitioners to determine why they engaged as clerkship preceptors. Independent researchers conducted semi-structured interviews. Responses were transcribed for inductive qualitative content analysis. Results The new model motivated preceptors to engage because it enhanced their opportunities to contribute to authentic learning when compared with the perceived limitations of short-term attachments. Preceptors appreciated the significant recognition of the value of general practice teaching and the honour of major involvement in the university. They predicted that the initiative would have positive effects on general practitioner morale and improve the quality of their practice. Other themes included the doctors' commitment to their profession, 'handing on' to the next generation and helping their community to attract doctors in the future. Conclusions Supervisors perceive that new models of clinical education offer alternative solutions to health care education, delivery and workforce. The longitudinal relationship between preceptor, student and community was seen as offering reciprocal benefits. General practitioners are committed to refining

  9. [Predicting spread of new pandemic swine-origin influenza A (H1N1) in local mid-size city: evaluation of hospital bed shortage and effectiveness of vaccination].

    Science.gov (United States)

    Takeuchi, Shouhei; Kuroda, Yoshiki

    2010-01-01

    On April 24th, 2009, a new swine-origin influenza A (H1N1) was first reported in Mexico. Japan confirmed cases of the flu on May 9th, and the pandemic in Japan has become full-scale. The Ministry of Health, Labor and Welfare of Japan announced that the first peak of this pandemic was predicted to occur in October, 2009. Therefore, it is most important to predict the progress of this pandemic to be able to use medical resources effectively in Japan. We used a modified susceptible-exposed-infected-recovered (SEIR) model to calculate the number of infected people and hospital bed shortage during this pandemic. In this model, available medical resources were investigated on the basis of four vaccination scenarios. Our model showed that it would take a further six months for the pandemic to peak than was predicted by the Ministry of Health, Labor and Welfare of Japan. Without vaccination, at the peak of the pandemic 23,689 out of 400,000 people would be infected and the hospital bed shortage would reach 7,349 in total. We suggest that mathematical models are strong tools to predict the spread of infectious diseases. According to our model, it is possible to prevent hospital bed shortage by vaccination.

  10. Addressing Canada's Commercialization Crisis and Shortage of Venture Capital: Will the Federal Government’s Solution Work?

    Directory of Open Access Journals (Sweden)

    Stephen A. Hurwitz

    2013-09-01

    Full Text Available Lack of funding is a major challenge to innovation in Canada’s emerging technology industry. This article will focus on this supply-side challenge within the complex venture capital ecosystem and discuss: i the current shortage of venture capital available to commercialize Canada’s R&D; ii the causes and consequences of that venture capital shortage; iii how the federal government will address this shortage through its innovative 2013 Venture Capital Action Plan, which commits $400 million and seeks to raise at least another $800 million from outside investors; and iv how a separate decision in the federal 2013 budget to phase out federal tax credits for labour-sponsored venture capital funds could imperil the 2013 Venture Capital Action Plan.

  11. 78 FR 22604 - Privacy Act of 1974, as Amended; System of Records

    Science.gov (United States)

    2013-04-16

    ... Compensation Act for medical expenses, lost wages, leave buy- back, and scheduled awards continuation of pay or... clearance requests; Case files; Bank shortage letters; Contractor files; Currency discrepancy reports; Intelligence files; Stamp discrepancy reports; Case records; Correspondence from the public concerning security...

  12. 77 FR 69445 - Privacy Act of 1974; System of Records

    Science.gov (United States)

    2012-11-19

    ... records of the Military Police Report are maintained in the Centralized Operations Police Suite (COPS... Violence Prevention Act; 28 U.S.C. 534, Uniform Federal Crime Reporting Act of 1988; 42 U.S.C. 5119 et seq... complying with mandatory background checks, i.e., Brady Handgun Violence Prevention Act (18 U.S.C. 922) and...

  13. Effects of a power shortage in the Tokyo metropolitan area on awareness of nuclear power generation and power savings behavior

    International Nuclear Information System (INIS)

    Kitada, Atsuko

    2004-01-01

    The shutdown of a number of nuclear power stations of the Tokyo Electric Power Company in the summer of 2003 caused a power shortage problem in the Tokyo Metropolitan area. To examine the effects of the power shortage, in September 2003 a survey was conducted in the service areas of the Kansai Electric Power Company (Kansai region) and the Tokyo Electric Power Company (Kanto region). This survey was part of a wider opinion survey begun in 1993 concerning nuclear power generation. The results of the September 2003 survey are as follows: The degree of recognition of the power shortage problem in the Metropolitan area was high, with 40% of respondents in the Kansai region and nearly 70% in the Kanto region understanding that the shortage was caused by the shutdown of several nuclear power station. The overall awareness of nuclear power generation was little affected in both the Kansai and Kanto regions, though the sense of a shortage of the generating capacity had been raised slightly. Once respondents knew about the power shortage problem, they estimated the likelihood of an occurrence of large-scale service interruption to be low, nearly at an even chance, and they had been only slightly worried about it, essentially viewing the problem optimistically. In the Kanto region, where public relations activities for power savings had been actively pursued, the frequency of experiencing exposure to such public relations activities was remarkably higher than in the Kansai region. The relation between exposure to public relations activities for power savings and power savings behavior was analyzed using quantification method II. Analysis results suggest that public relations activities for power savings in the Kanto region had the effect of urging power savings behavior. However, the difference in the rate of putting power savings behavior into practice was small between the Kanto and Kansai regions, indicating that public relation activities for power savings in the Kanto

  14. Affordable Care Act and Women

    Science.gov (United States)

    ... quality care for older women, and ends the gender discrimination that requires women to pay more for the same insurance coverage ... the Affordable Care Act and 13 million more women will gain coverage by 2016. Maternity Coverage Preventive ... Expanded Insurance Coverage Endnotes Download "rb. ...

  15. The implication of the shortage of health workforce specialist on universal health coverage in Kenya.

    Science.gov (United States)

    Miseda, Mumbo Hazel; Were, Samuel Odhiambo; Murianki, Cirindi Anne; Mutuku, Milo Peter; Mutwiwa, Stephen N

    2017-12-01

    Globally, there is an acute shortage of human resources for health (HRH), and the greatest burden is borne by low-income countries especially in sub-Saharan Africa and some parts of Asia. This shortage has not only considerably constrained the achievement of health-related development goals but also impeded accelerated progress towards universal health coverage (UHC). Like any other low-income country, Kenya is experiencing health workforce shortage particularly in specialized healthcare workers to cater for the rapidly growing need for specialized health care (MOH Training Needs Assessment report (2015)). Efficient use of the existing health workforce including task shifting is under consideration as a short-term stop gap measure while deliberate efforts are being put on retention policies and increased production of HRH. The Ministry of Health (MOH) with support from the United States Agency for International Development-funded FUNZOKenya project and MOH/Japan International Cooperation Agency (JICA) project conducted a country-wide training needs assessment (TNA) to identify skill gaps in the provision of specialized health care in private and public hospitals in 46 out of Kenya's 47 counties between April and June 2015. A total of 99 respondents participated in the TNA. Structured questionnaires were used to undertake this assessment. The assessment sought to determine the extent of skill gaps on the basis of the national guidelines and as perceived by the County Directors of Health (CDH). The questionnaires were posted to and received by all the respondents a week prior to a face-to-face interview with the respondents for familiarization. Data analysis was done using SPSS statistical package. Overall, the findings revealed average skill gaps on selected specialists (healthcare professional whose practice is limited to a particular area, such as a branch of medicine, surgery, or nursing, especially, one who by virtue of advanced training is certified by a

  16. The role of the uncertainty in assessing future scenarios of water shortage in alluvial aquifers

    Science.gov (United States)

    Romano, Emanuele; Camici, Stefania; Brocca, Luca; Moramarco, Tommaso; Guyennon, Nicolas; Preziosi, Elisabetta

    2015-04-01

    There are many evidences that the combined effects of variations in precipitation and temperature due to climate change can result in a significant change of the recharge to groundwater at different time scales. A possible reduction of effective infiltration can result in a significant decrease, temporary or permanent, of the availability of the resource and, consequently, the sustainable pumping rate should be reassessed. In addition to this, one should also consider the so called indirect impacts of climate change, resulting from human intervention (e.g. augmentation of abstractions) which are feared to be even more important than the direct ones in the medium term: thus, a possible increase of episodes of shortage (i.e. the inability of the groundwater system to completely supply the water demand) can result both from change in the climate forcing and change in the demand. In order to assess future scenarios of water shortage a modelling chain is often used. It includes: 1) the use of General Circulation Models to estimate changes in temperature and precipitation; 2) downscaling procedures to match modeling scenarios to the observed meteorological time series; 3) soil-atmosphere modelling to estimate the time variation of the recharge to the aquifer; 4) groundwater flow models to simulate the water budget and piezometric head evolution; 5) future scenarios of groundwater quantitative status that include scenarios of demand variation. It is well known that each of these processing steps is affected by an intrinsic uncertainty that propagates through the whole chain leading to a final uncertainty on the piezometric head scenarios. The estimate of such an uncertainty is a key point for a correct management of groundwater resources, in case of water shortage due to prolonged droughts as well as for planning purposes. This study analyzes the uncertainty of the processing chain from GCM scenarios to its impact on an alluvial aquifer in terms of exploitation

  17. Strong Internal Controls at Service Delivery Level Will Help Prevent CETA-Type Fraud and Abuse in Job Training Partnership Act Programs. Report to Senator Sam Nunn, Ranking Minority Member, Permanent Subcommittee on Investigations, Senate Committee on Governmental Affairs.

    Science.gov (United States)

    General Accounting Office, Washington, DC.

    The Government Accounting Office (GAO) conducted an examination of patterns and causes of fraud in Comprehensive Employment and Training Act (CETA) programs to determine how implementation of Job Training Partnership Act (JTPA) programs might be made less vulnerable to exploitation. GAO's investigation found that fraud and abuse in CETA programs…

  18. ¿Puede el ejercicio físico moderado durante el embarazo actuar como un factor de prevención de la Diabetes Gestacional? (Can moderate physical exercise during pregnancy act as a factor in preventing Gestational Diabetes?

    Directory of Open Access Journals (Sweden)

    Yaiza Cordero Rodríguez

    2012-01-01

    Full Text Available The aim of the present study was to know the effectiveness of exercise of a moderate program developed during pregnancy in the excessive maternal weight gain and development of Gestational Diabetes (GD. We performed a clinical trial, randomized, unmatched, not masked by mean the collaboration between the Department of Gynecology and Obstetrics of Health Center of Torrelodones (Madrid and the Polytechnic University of Madrid. 55 pregnant women without obstetric contraindications were studied, (age= 32,9±3,9 years, all of them caucasian, 25 in the treatment group and 30 in the control group. A physical exercise program was developed (land/water three times per week during pregnancy. According to our resultats, treatment group showed a lower maternal weight gain than in the control group (12.820±3.682 g and 14.780 g ± 3.427 g respectively, p=0.03. The values in the O'Sullivan test are lower in the treatment group than in the control group (102,9±17,7 gr/dL vs 125,6±30,8 gr/dL respectively, p=0,002. Not diagnosed any cases of GD in the treatment group while the control group 2 cases were diagnosed. The exercise done during the pregnancy reduces maternal weight gain, values of O’Sullivan score and apparently acts as a preventive factor of the GD.ResumenEl presente trabajo pretende conocer la eficacia de un programa de ejercicio f��sico moderado desarrollado durante todo el embarazo en la excesiva ganancia de peso materno y el desarrollo de la Diabetes Gestacional (DG. Se realizó un ensayo clínico, aleatorizado, no apareado, no enmascarado mediante una colaboración entre el Servicio de Ginecología y Obstetricia del Centro de Salud de Torrelodones y la Universidad Politécnica de Madrid. 55 gestantes sin contraindicaciones obstétricas fueron estudiadas, (edad=32,9±3,9 años, todas ellas caucásicas, 25 en el grupo de tratamiento y 30 en el de control. Se desarrolló un programa de ejercicio físico (seco/agua durante todo el embarazo

  19. The nursing shortage ... will we become an endangered species or near extinction in the new millennium.

    Science.gov (United States)

    Lanford, A; Hardesty, P

    1998-12-01

    In conclusion, it is obvious to each of us that the nursing shortage issue is complex. There are no simple solutions. In the acute care arena we can expect to see the usual recruitment wars using sign-on bonuses, increased salaries for per diem staff, internship programs and all sorts of methods used in the past to recruit needed staff. It is that sort of crisis management and short term thinking that has plagued the profession in the past. These are bandaid efforts especially in light of the factors of supply vs demand with short-term quick fixes. There must be, however, more efforts towards addressing the long-term issues such as wage compression, differentiated practice and pay, effective models of care delivery, educating the public about nursing, and public/government funding more nursing education and research at all levels. There may need to be a federal subsidy for nursing education and recruitment included to affect the magnitude of this potential societal problem. The profession is at a crossroads. One thing is certain however, this nursing shortage is different and will get worse before it gets better. Let's not let the demand for nurses become so large and supply become so small that we are an endangered species or near extinction in the new millennium. What will be the scenario for nurses in 2050? Are we, as the largest healthcare profession, so complacent about our continued existence that we are at a point of paralysis? Are we in such a state of deep depression in response to current changing environment that we will allow ourselves to be devoured by our predators. Are we cannibalistic as we eat our young and chew on our own unresolved internal issues with a lack of action? Are we septic as a result of our own self-inflicted professional wounds? Our profession must become immediately aware of our possibly tenuous future. We must work together as a community of nurses to strategically address the areas of recruitment, education, retention and

  20. Preventing recurrence of endometriosis by means of long-acting progestogen therapy (PRE-EMPT): report of an internal pilot, multi-arm, randomised controlled trial incorporating flexible entry design and adaption of design based on feasibility of recruitment.

    Science.gov (United States)

    Middleton, Lee J; Daniels, Jane P; Weckesser, Annalise; Bhattacharya, Siladitya

    2017-03-11

    Endometriosis is associated with the growth of endometrium in ectopic sites mainly within the pelvis. This results in inflammation and scarring, causing pain and impaired quality of life. Endometriotic lesions can be excised or ablated surgically, but the risk of recurrence is high. A Heath Technology Assessment commissioning call in 2011 sought applications for trials aimed at evaluating long-term effectiveness of postoperative, long-acting, reversible contraceptives (LARCs) in preventing recurrence of endometriosis. A survey of gynaecologists indicated that there was no consensus about which LARC (Levonorgestrel Intrauterine System (LNG-IUS) or depot medroxyprogesterone acetate injection (DMPA)) or comparator (combined oral contraceptive pill (COCP) or no treatment) should be evaluated. Hence, we designed a 'flexible-entry' internal pilot to assess whether a four-arm trial was feasible including a possible design adaption based on pilot findings. In this pilot, women could be randomised to two, three or four treatment options provided that one was a LARC and one was a non-LARC. An assessment of feasibility based on recruitment to these options and a revised substantive trial design was considered by an independent oversight committee. The study ran for 1 year from April 2014 and 77 women were randomised. Only 5 (6%) women accepted randomisation to all groups, with 63 (82%) having a LARC preference and 55 (71%) a non-LARC preference. Four-way and three-way designs were ruled out with a two-way LARC versus COCP design, stratified by prerandomisation choice of LARC and optional subrandomisation to LNG-IUS versus DMPA considered a feasible substantive study. Multi-arm studies are potentially efficient as they can answer multiple questions simultaneously but are difficult to recruit to if there are strong patient or clinician preferences. A flexible approach to randomisation in a pilot phase can be used to assess feasibility of such studies and modify a trial design

  1. Interim Canadian recommendations for the use of a fractional dose of yellow fever vaccine during a vaccine shortage

    Science.gov (United States)

    2016-01-01

    Summary This statement outlines interim recommendations intended for use during yellow fever vaccine shortages only. The recommendations differ from the standard recommendations for yellow fever vaccination in the Canadian Immunization Guide and in the Committee to Advise on Tropical Medicine and Travel (CATMAT) Statement for Travellers and Yellow Fever. PMID:29770023

  2. Teacher Shortages in Urban Schools: The Role of Traditional and Alternative Certification Routes in Filling the Voids.

    Science.gov (United States)

    Ng, Jennifer C.

    2003-01-01

    Examines the impact of teacher recruitment approaches via university-based and alternative certification programs. Asserts that traditional and alternative certification efforts are by themselves limited in their potential to address the problem of teacher shortages in urban schools. Suggests that an organizational view of schools, which looks…

  3. Assessing the Special Education Faculty Shortage: The Crisis in California--A Statewide Study of the Professoriate

    Science.gov (United States)

    Evans, Susan; Eliot, Michael; Hood, Jolene; Driggs, Max; Mori, Ayako; Johnson, Theresa

    2005-01-01

    This article examines several questions related to the faculty shortage in special education. Using California as a case, the authors address these questions: (1) What were the personal and professional characteristics of current special education faculty preparing special education credential and doctoral candidates?; (2) What were the…

  4. 42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

    Science.gov (United States)

    2010-10-01

    ... of Pharmacy Professional(s) F Appendix F to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. F Appendix F to Part 5—Criteria for Designation of Areas Having Shortages of Pharmacy... of pharmacy professional(s) if the following three criteria are met: 1. The area is a rational area...

  5. Vulnerability of U.S. water supply to shortage: a technical document supporting the Forest Service 2010 RPA Assessment

    Science.gov (United States)

    Romano Foti; Jorge A. Ramirez; Thomas C. Brown

    2012-01-01

    Comparison of projected future water demand and supply across the conterminous United States indicates that, due to improving efficiency in water use, expected increases in population and economic activity do not by themselves pose a serious threat of large-scale water shortages. However, climate change can increase water demand and decrease water supply to the extent...

  6. Trafficking in human beings as an enterprise: : Highlighting key questions about data shortage on the business side

    NARCIS (Netherlands)

    Muraszkiewicz, J.; Watson, H; Wadwa, K.; de Hert, Paul

    2015-01-01

    Researchers and policymakers face a shortage of data on the business side of human trafficking. This inevitably leads to problems when trying to combat this crime. Questions such as: who is involved in trafficking, how do they operate, what is their relationship with organised crime groups (or other

  7. Reduce shortage with self-reservation policy for a manufacturer paying both fixed and variable stockout expenditure

    NARCIS (Netherlands)

    Huang, B.; Wu, A.

    2017-01-01

    This study considers a single item make-to-stock system with continuous-time production and inventory controls to meet bulk demand with an exponential inter-arrival time. A key issue in this system is the non-convex shortage cost consisting of fixed and variable expenditures when the demand is not

  8. Is physical water scarcity a new phenomenon? Global assessment of water shortage over the last two millennia

    NARCIS (Netherlands)

    Kummu, M.S.; Ward, P.J.; de Moel, H.; Varis, O.

    2010-01-01

    In this letter we analyse the temporal development of physical population-driven water scarcity, i.e. water shortage, over the period 0 AD to 2005 AD. This was done using population data derived from the HYDE dataset, and water resource availability based on the WaterGAP model results for the period

  9. Metaphorical expressions used in Swedish news media narratives to portray the shortage of nurses and their working conditions.

    Science.gov (United States)

    Blomberg, Helena; Stier, Jonas

    2016-02-01

    The aim of the study is to uncover and reveal how nurses as a profession and their working conditions are dramatized and portrayed in Swedish media narratives about the shortage of nurses. The media is an arena where stakeholders can air their views of the healthcare sector in general and the situation for nurses in particular. The focus in this study is the debate in Sweden on the shortage of nurses. Qualitative discursive study. A discourse analysis of media narratives about nurses and their working conditions published in several Swedish newspapers from 2009-2014. 1779 articles were included in the study. A selection (113 articles) of these articles was further analysed using a qualitative discursive psychological approach. Nurses are portrayed as being good, concerned about and critical of healthcare managers and politicians for not taking action. The accused actors justify their actions by partially accepting or displacing responsibility. The shortage of nurses is framed as a social problem - a threat to patients' safety. Seven different types of metaphorical expression frame the problem as inevitable, beyond control, abstract, an individual and collegial problem and nurses as replaceable. In addition, nurses and patients are dehumanized and no-one is held responsible. This study analyses the role of the media in emphasizing the seriousness or obscurity of the problem and possible solutions to it. Alternative narratives are needed to re-frame the nursing shortage and to find sustainable solutions. © 2015 John Wiley & Sons Ltd.

  10. The Nature of the Current and Anticipated Shortage of Professional Skills and Qualities of Workers in the Russian Labor Market

    Science.gov (United States)

    Bondarenko, Natal'ia

    2015-01-01

    This article analyzes the characteristics of the existing and expected deficit of professional skills and qualities of workers employed by Russian companies. Analyzed factors include generic skills, soft or behavioral skills, the influence of the qualification, and shortage on the effectiveness of the companies as a whole. The data is based on a…

  11. Decree no 90-918 of 11 october 1990 on exercising rights to information on major risks, in implementation of Section 21 of act no 87-565 of 22 july 1987 on the organisation of public safety measures, forestry protection against fires and prevention of major risks

    International Nuclear Information System (INIS)

    1990-01-01

    This Decree specifies the content and type of information to which persons likely to be exposed to major risks must have access, in accordance with the 1987 Act. These provisions apply in the communes for which a special action plan has been prepared. The information includes a description of the risks and their foreseeable consequences for persons, property and the environment, and a statement on the preventive measures to limit their effects. A summary record of this information is established [fr

  12. Are health professionals responsible for the shortage of organs from deceased donors in Malaysia?

    Science.gov (United States)

    Abidin, Zada L Zainal; Ming, Wee Tong; Loch, Alexander; Hilmi, Ida; Hautmann, Oliver

    2013-02-01

    The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia. © 2012 The Authors Transplant International © 2012 European Society for Organ Transplantation. Published by Blackwell Publishing Ltd.

  13. Exploring incentives for RNs to return to practice: a partial solution to the nursing shortage.

    Science.gov (United States)

    Langan, Joanne C; Tadych, Rita A; Kao, Chia-Chan

    2007-01-01

    Although many have suggested strategies to resolve the nursing shortage, few have considered inactive RNs. This pilot study investigated reasons why nurses leave the practice, the type of work environment and resources necessary to entice RNs to return to practice, and the specific skills required to assist RNs in feeling confident and competent to return to practice. Herzberg's Two-Factor Theory was used to study motivation and hygiene factors enticing RNs to practice. A screening questionnaire was sent to 1,004 randomly selected RNs in Missouri to determine who were licensed but not practicing. Fifty-two full questionnaires were mailed and 33 (63%) were returned. Quantitative data were analyzed using SPSS, whereas qualitative data were coded and analyzed using manifest content analysis. The lack of motivators such as recognition of one's work and achievements was one reason why RNs left the practice. The hygiene factors of money, improved working conditions, refresher courses, and health insurance would motivate RNs to return to practice. Those wishing to entice inactive nurses to practice will need to offer sign-on bonuses or make the hourly wages and benefits package very competitive. This study indicates that nurses value flexible working hours, part-time opportunities, consideration of family lives, and positive relationships with administrators.

  14. Enhancing nurse satisfaction: an exploration of specialty nurse shortage in a region of NHS England.

    Science.gov (United States)

    Gray, Keith; Wilde, Rebecca; Shutes, Karl

    2018-03-22

    This article offers nurse managers guidance on analysing, managing and addressing a potentially dissatisfied nursing workforce, focusing on three priority shortage specialties: emergency care, paediatrics and cardiology. The aim of the study was to explore to what extent registered nurses and healthcare assistants, referred to collectively here as 'nursing staff', are satisfied with teamworking opportunities, continuing professional development (CPD) opportunities and workplace autonomy. A survey questionnaire was developed to evaluate three derived determinants of nurse satisfaction: team working, CPD and autonomy. The NHS West Midlands region was the focus given that it is among the poorest performing regions outside London in filling nursing posts. Overall, nursing staff respondents were satisfied with teamworking, CPD and autonomy, which challenges the perception that nurses in NHS England are dissatisfied with these satisfaction determinants. The findings give a complex picture of nurse satisfaction; for example a large minority of respondents were dissatisfied with their ability to carry out duties as they see fit. When developing management systems to investigate, manage and enhance nurse satisfaction, nurse managers must recognise the complexity and subtleties of determining factors. This will increase as nursing becomes more specialised. Subsequently, nurse managers need to work closely with staff at higher education institutions and other professional agencies to commission appropriate professional development. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  15. Optimal replenishment policy for fuzzy inventory model with deteriorating items and allowable shortages under inflationary conditions

    Directory of Open Access Journals (Sweden)

    Jaggi Chandra K.

    2016-01-01

    Full Text Available This study develops an inventory model to determine ordering policy for deteriorating items with constant demand rate under inflationary condition over a fixed planning horizon. Shortages are allowed and are partially backlogged. In today’s wobbling economy, especially for long term investment, the effects of inflation cannot be disregarded as uncertainty about future inflation may influence the ordering policy. Therefore, in this paper a fuzzy model is developed that fuzzify the inflation rate, discount rate, deterioration rate, and backlogging parameter by using triangular fuzzy numbers to represent the uncertainty. For Defuzzification, the well known signed distance method is employed to find the total profit over the planning horizon. The objective of the study is to derive the optimal number of cycles and their optimal length so to maximize the net present value of the total profit over a fixed planning horizon. The necessary and sufficient conditions for an optimal solution are characterized. An algorithm is proposed to find the optimal solution. Finally, the proposed model has been validated with numerical example. Sensitivity analysis has been performed to study the impact of various parameters on the optimal solution, and some important managerial implications are presented.

  16. The workforce for health in a globalized context--global shortages and international migration.

    Science.gov (United States)

    Aluttis, Christoph; Bishaw, Tewabech; Frank, Martina W

    2014-01-01

    The 'crisis in human resources' in the health sector has been described as one of the most pressing global health issues of our time. The World Health Organization (WHO) estimates that the world faces a global shortage of almost 4.3 million doctors, midwives, nurses, and other healthcare professionals. A global undersupply of these threatens the quality and sustainability of health systems worldwide. This undersupply is concurrent with globalization and the resulting liberalization of markets, which allow health workers to offer their services in countries other than those of their origin. The opportunities of health workers to seek employment abroad has led to a complex migration pattern, characterized by a flow of health professionals from low- to high-income countries. This global migration pattern has sparked a broad international debate about the consequences for health systems worldwide, including questions about sustainability, justice, and global social accountabilities. This article provides a review of this phenomenon and gives an overview of the current scope of health workforce migration patterns. It further focuses on the scientific discourse regarding health workforce migration and its effects on both high- and low-income countries in an interdependent world. The article also reviews the internal and external factors that fuel health worker migration and illustrates how health workforce migration is a classic global health issue of our time. Accordingly, it elaborates on the international community's approach to solving the workforce crisis, focusing in particular on the WHO Code of Practice, established in 2010.

  17. Economic benefits of sharing and redistributing influenza vaccines when shortages occurred.

    Science.gov (United States)

    Chen, Sheng-I

    2017-01-01

    Recurrent influenza outbreak has been a concern for government health institutions in Taiwan. Over 10% of the population is infected by influenza viruses every year, and the infection has caused losses to both health and the economy. Approximately three million free vaccine doses are ordered and administered to high-risk populations at the beginning of flu season to control the disease. The government recommends sharing and redistributing vaccine inventories when shortages occur. While this policy intends to increase inventory flexibility, and has been proven as widely valuable, its impact on vaccine availability has not been previously reported. This study developed an inventory model adapted to vaccination protocols to evaluate government recommended polices under different levels of vaccine production. Demands were uncertain and stratified by ages and locations according to the demographic data in Taiwan. When vaccine supply is sufficient, sharing pediatric vaccine reduced vaccine unavailability by 43% and overstock by 54%, and sharing adult vaccine reduced vaccine unavailability by 9% and overstock by 15%. Redistributing vaccines obtained greater gains for both pediatrics and adults (by 75%). When the vaccine supply is in short, only sharing pediatric vaccine yielded a 48% reduction of unused inventory, while other polices do not improve performances. When implementing vaccination activities for seasonal influenza intervention, it is important to consider mismatches of demand and vaccine inventory. Our model confirmed that sharing and redistributing vaccines can substantially increase availability and reduce unused vaccines.

  18. The workforce for health in a globalized context – global shortages and international migration

    Science.gov (United States)

    Aluttis, Christoph; Bishaw, Tewabech; Frank, Martina W.

    2014-01-01

    The ‘crisis in human resources’ in the health sector has been described as one of the most pressing global health issues of our time. The World Health Organization (WHO) estimates that the world faces a global shortage of almost 4.3 million doctors, midwives, nurses, and other healthcare professionals. A global undersupply of these threatens the quality and sustainability of health systems worldwide. This undersupply is concurrent with globalization and the resulting liberalization of markets, which allow health workers to offer their services in countries other than those of their origin. The opportunities of health workers to seek employment abroad has led to a complex migration pattern, characterized by a flow of health professionals from low- to high-income countries. This global migration pattern has sparked a broad international debate about the consequences for health systems worldwide, including questions about sustainability, justice, and global social accountabilities. This article provides a review of this phenomenon and gives an overview of the current scope of health workforce migration patterns. It further focuses on the scientific discourse regarding health workforce migration and its effects on both high- and low-income countries in an interdependent world. The article also reviews the internal and external factors that fuel health worker migration and illustrates how health workforce migration is a classic global health issue of our time. Accordingly, it elaborates on the international community's approach to solving the workforce crisis, focusing in particular on the WHO Code of Practice, established in 2010. PMID:24560265

  19. Economic benefits of sharing and redistributing influenza vaccines when shortages occurred.

    Directory of Open Access Journals (Sweden)

    Sheng-I Chen

    Full Text Available Recurrent influenza outbreak has been a concern for government health institutions in Taiwan. Over 10% of the population is infected by influenza viruses every year, and the infection has caused losses to both health and the economy. Approximately three million free vaccine doses are ordered and administered to high-risk populations at the beginning of flu season to control the disease. The government recommends sharing and redistributing vaccine inventories when shortages occur. While this policy intends to increase inventory flexibility, and has been proven as widely valuable, its impact on vaccine availability has not been previously reported.This study developed an inventory model adapted to vaccination protocols to evaluate government recommended polices under different levels of vaccine production. Demands were uncertain and stratified by ages and locations according to the demographic data in Taiwan.When vaccine supply is sufficient, sharing pediatric vaccine reduced vaccine unavailability by 43% and overstock by 54%, and sharing adult vaccine reduced vaccine unavailability by 9% and overstock by 15%. Redistributing vaccines obtained greater gains for both pediatrics and adults (by 75%. When the vaccine supply is in short, only sharing pediatric vaccine yielded a 48% reduction of unused inventory, while other polices do not improve performances.When implementing vaccination activities for seasonal influenza intervention, it is important to consider mismatches of demand and vaccine inventory. Our model confirmed that sharing and redistributing vaccines can substantially increase availability and reduce unused vaccines.

  20. 78 FR 25414 - Privacy Act of 1974, System of Records

    Science.gov (United States)

    2013-05-01

    ... communication cables; facility access authorizations/restrictions; photographs, fingerprints; financial records... Reinvestigating Individuals in Positions of Public Trust; and the Intelligence Reform and Terrorism Prevention Act...

  1. Forecasting Japan's Physician Shortage in 2035 as the First Full-Fledged Aged Society

    Science.gov (United States)

    Yamaguchi, Rui; Matsumura, Tomoko; Murashige, Naoko; Kodama, Yuko; Minayo, Satoru; Imai, Kohzoh; Kami, Masahiro

    2012-01-01

    Introduction Japan is rapidly becoming a full-fledged aged society, and physician shortage is a significant concern. The Japanese government has increased the number of medical school enrollments since 2008, but some researchers warn that this increase could lead to physician surplus in the future. It is unknown how many physicians will be required to accommodate future healthcare needs. Materials and Methods We simulated changes in age/sex composition of the population, fatalities (the number of fatalities for the consecutive five years), and number of physicians from 2010 to 2035. Two indicators were defined: fatalities per physician and fatalities by physician working hour, based on the data of the working hours of physicians for each tuple of sex and age groups. We estimated the necessary number of physicians in 2035 and the number of new physicians to maintain the indicator levels in 2010. Results The number of physicians per 1,000 population is predicted to rise from 2·00 in 2010 to 3·14 in 2035. The number of physicians aged 60 years or older is expected to increase from 55,375 (20% of physicians) to 141,711 (36%). In 2010 and 2035, fatalities per physician were 23·1 and 24·0 for the total population, and 13·9 and 19·2 for 75 years or older, respectively. Fatalities per physician working hour are predicted to rise from 0·128 to 0·138. If working hours are limited to 48 hours per week in 2035, the number of fatalities per physician working hour is expected to be 0·196, and the number of new physicians must be increased by 53% over the current pace. Discussion The number of physicians per population continues to rise, but the estimated supply will not fulfill the demand for healthcare in the aging society. Strategies to increase the number of physicians and improve working conditions are urgently needed. PMID:23233868

  2. The basic construction materials industry and today’s vast housing shortage

    Directory of Open Access Journals (Sweden)

    Oteiza, I.

    2008-12-01

    Full Text Available This paper documents some of the aspects of the major challenge facing world-wide building: humanity's daunting shortage of basic housing, monographically focusing on what this means for the basic building materials industry. These needs have created the greatest demand ever for ex-novo solutions and an exponential increase in slum rehabilitation and improvement, translated here into the need for construction materials and more specifically, cement, as the emblematic component of buildings.El trabajo aborda en forma documentada, algunos aspectos del mayor de los retos que tiene planteado a nivel cosmopolita el sector de la edificación: las ingentes necesidades de habitabilidad básica que padece la humanidad, centrándose en forma monográfica en lo que ello supone para la industria de materiales básicos de edificación. Necesidades que se traducen en la mayor demanda histórica de soluciones ex-novo y en el aumento exponencial de rehabilitación y mejora de tugurios, que los autores traducen en necesidades de materiales de construcción, y de forma más concreta, de cemento, como material emblemático de la edificación.El trabajo, mediante el análisis de casos, muestra la muy diferente repercusión que tienen los materiales sobre los presupuestos finales de lo ejecutado, según se trate del mundo desarrollado (MD o de países en vías de desarrollo (PVD. Por otra parte, estudia la incidencia general del sector 'informal' de la construcción, concluyendo que éste, en muchos países, es el consumidor mayoritario de materiales -specialmente cemento-y que a nivel mundial los PVD lo son tanto en producción como en consumo.

  3. University versus Practice: A Pilot Study to Identify Skills Shortages That Exist in First-Year Trainee Accountants in South Africa

    Science.gov (United States)

    van Romburgh, Henriëtte; van der Merwe, Nico

    2015-01-01

    This study aims to determine the skills shortages in first-year trainee accountants entering practice in South Africa and to recommend ways to address and overcome those shortages. Questionnaires were administered to registered audit firms in Gauteng Province to gather the perceptions of senior trainees, managers and partners on the skills…

  4. Correcting India’s Chronic Shortage of Drug Inspectors to Ensure the Production and Distribution of Safe, High-Quality Medicines

    Science.gov (United States)

    Kadam, Abhay B.; Maigetter, Karen; Jeffery, Roger; Mistry, Nerges F.; Weiss, Mitchell G.; Pollock, Allyson M.

    2016-01-01

    Background: Good drug regulation requires an effective system for monitoring and inspection of manufacturing and sales units. In India, despite widespread agreement on this principle, ongoing shortages of drug inspectors have been identified by national committees since 1975. The growth of India’s pharmaceutical industry and its large export market makes the problem more acute. Methods: The focus of this study is a case study of Maharashtra, which has 29% of India’s manufacturing units and 38% of its medicines exports. India’s regulations were reviewed, comparing international, national and state inspection norms with the actual number of inspectors and inspections. Twenty-six key informant interviews were conducted to ascertain the causes of the shortfall. Results: In 2009-2010, 55% of the sanctioned posts of drug inspectors in Maharashtra were vacant. This resulted in a shortfall of 83%, based on the Mashelkar Committee’s recommendations. Less than a quarter of the required inspections of manufacturing and sales units were undertaken. The Indian Drugs and Cosmetics Act and its Rules and Regulations make no provisions for drug inspectors and workforce planning norms, despite the growth and increasing complexity of India’s pharmaceutical industry. Conclusion: The Maharashtra Food and Drug Administration (FDA) falls short of the Mashelkar Committee’s recommended workforce planning norms. Legislation and political and operational support are required to produce needed changes PMID:27694680

  5. Skilled labour supply in the South African construction industry: The nexus between certification, quality of work output and shortages

    Directory of Open Access Journals (Sweden)

    Abimbola O. Windapo

    2016-06-01

    Full Text Available Orientation: Construction human resource management. Research purpose: The study examines the skilled labour supply in the South African construction industry and determines whether there is a relationship between trade certification, quality of work output and scarce labour skills. Motivation for the study: The rationale for the investigation is based on the view of scholars that a skilled labour shortage is preponderant in the South African construction industry even though there is a high level of youth unemployment in South Africa and that the perceived skills shortage contributes to a decrease in productivity and product quality. Research design, approach and method: The paper reviews relevant literature and employs a mixed method research approach in collecting empirical data from contracting companies within the Western Cape Province of South Africa that are listed on the Construction Industry Development Board contractor register. Main findings: The study demonstrated that there is no shortage of manpower, but there is a shortage of qualified or skilled tradesmen, such as electricians, plumbers, welders, fitters and carpenters, whose professions are more technical and require formal training and certification. The level of supply of skilled tradesmen is attributed to the lack of high-quality basic education, the state of the economy, compulsory certification of tradesmen and an ageing workforce. It was also found that there is a significant relationship between skilled labour shortages and the requirement that labour be certified and that work output is unsatisfactory when there is no certification requirement. Practical/managerial implications: Based on these findings, the study concludes that skilled labour shortages and poor work output quality continue to be experienced in the South African construction industry when workers are unable to obtain formal certification for informal work experience acquired through years of practice on

  6. Prevention of COPD exacerbations

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Lange, Peter

    2015-01-01

    Exacerbations have significant impact on the morbidity and mortality of patients with chronic obstructive pulmonary disease. Most guidelines emphasise prevention of exacerbations by treatment with long-acting bronchodilators and/or anti-inflammatory drugs. Whereas most of this treatment is eviden...

  7. Vaccines for preventing Japanese encephalitis

    DEFF Research Database (Denmark)

    Schiøler, Karin Linda; Samuel, Miny; Wai, Kim Lay

    2007-01-01

    BACKGROUND: Vaccination is recognized as the only practical measure for preventing Japanese encephalitis. Production shortage, costs, and issues of licensure impair vaccination programmes in many affected countries. Concerns over vaccine effectiveness and safety also have a negative impact...... on acceptance and uptake. OBJECTIVES: To evaluate vaccines for preventing Japanese encephalitis in terms of effectiveness, adverse events, and immunogenicity. SEARCH STRATEGY: In March 2007, we searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library 2007, Issue 1......), MEDLINE, EMBASE, LILACS, BIOSIS, and reference lists. We also attempted to contact corresponding authors and vaccine companies. SELECTION CRITERIA: Randomized controlled trials (RCTs), including cluster-RCTs, comparing Japanese encephalitis vaccines with placebo (inert agent or unrelated vaccine...

  8. 76 FR 80878 - Solicitation of Veterinary Shortage Situation Nominations for the Veterinary Medicine Loan...

    Science.gov (United States)

    2011-12-27

    ... INFORMATION CONTACT: Gary Sherman; National Program Leader, Veterinary Science; National Institute of Food and... of Consultation 3. Rationale for Capping Nominations and State Allocation Method 4. State Allocation... adding section 1415A to the National Agricultural Research, Extension, and Teaching Policy Act of 1997...

  9. 32 CFR 989.31 - Pollution prevention.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Pollution prevention. 989.31 Section 989.31... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.31 Pollution prevention. The Pollution Prevention Act of 1990..., whenever feasible. Pollution prevention approaches should be applied to all pollution-generating activities...

  10. Sustaining supply of senior academic leadership skills in a shortage environment: a short review of a decade of dental experience.

    Science.gov (United States)

    Kruger, Estie; Heitz-Mayfield, Lisa; Tennant, Marc

    2014-06-01

    For the past decade, and expected for the next decade, Australia faces a significant health workforce shortage and an acute maldistribution of health workforce. Against this background the governments at both national and state level have been increasing the training places for all health practitioners and trying to redress the imbalance through a strong regional focus on these developments. Dentistry has been an active participant in these workforce initiatives. This study examines the increasing demand for academics and discusses the existing pathways for increase, and also examines in detail the advantages of a sustainable, shared-model approach, using dentistry as a model for other disciplines. Three non-exclusive pathways for reform are considered: importation of academics, delayed retirement and the shared resource approach. Of the various solutions outlined in this review a detailed explanation of a cost-effective shared model of senior academic leadership is highlighted as a viable, sustainable model for ameliorating the shortage.

  11. The crisis in leadership in the context of the nursing shortage and the increasing prevalence of nursing unions

    Directory of Open Access Journals (Sweden)

    Balogh-Robinson LL

    2012-10-01

    Full Text Available Latisha L Balogh-RobinsonMarist College, School of Global and Professional Programs, Poughkeepsie, NY, USAAbstract: Developing nurse leaders in a unionized environment presents unique challenges that are beyond those traditionally experienced in nonunion settings. This literature review examines multiple factors contributing to increasing nursing union membership, including population aging, the nursing shortage, and the relationship between leadership and staff engagement. Current trends in succession planning and leadership development are also highlighted. Job dissatisfaction related to the inability to provide quality care in the context of a protracted nursing shortage and current health care trends is identified as the driver in nursing union growth. The discussion that follows assumes current trends in nursing unionization will continue and proposes that adversarial relationships between management and union nurses will further amplify the dearth in leadership by reducing the pool of nurses willing to leave the union for nonunion leadership roles.Keywords: succession planning, baby boomer, staff engagement, population aging

  12. Water shortage and drought monitoring in Bačka region (Vojvodina, North Serbia: Setting-up measurement stations network

    Directory of Open Access Journals (Sweden)

    Jovanović Mlađen

    2013-01-01

    Full Text Available Water shortage and drought, as the most important hydro-climatic hazards, cause significant damages in case of most continents including SE Europe. An experimental field established in Bačka region (Vojvodina Autonomous Province, North Serbia for the purpose of droughts/water shortage monitoring and remote sensing under ongoing IPA project 'Water shortage hazard and adaptive water management strategies in the Hungarian-Serbian cross-border region' (WAHASTRAT. The main objective of this project is to determine water shortage con­flicts on a local and regional level, and to reveal the frequency, extent and severity of future hydro-cli­matic hazards. The locations of eight measurement stations selected on the principle of representativeness in term of terrain configuration and soil cover. An area in which measurement stations were placed, covers about 1000 km2 (12% of total area of Bačka and includes geomorphic units which reliable represent the relief of the whole Bačka region. Measurement stations were placed on 4 out of 5 most common soil types in the Bačka and Vojvodina: chernozem, alluvial soils, smonitza and saline and alkali soils. A measurement equipment system was constructed for the requirements of the WAHASTRAT project. The aim was to design a user-friendly and affordable IT solution, which would enable continuous re­mote monitoring of meteorological parameters and soil moisture. Independent solar-powered meas­urement stations are able to automatically measure air temperature, air humidity, wind speed, wind di­rection, precipitation and soil moisture.

  13. Extent and effects of recurrent shortages of purified-protein derivative tuberculin skin test antigen solutions - United States, 2013.

    Science.gov (United States)

    2013-12-13

    Two purified-protein derivative (PPD) tuberculin skin test (TST) antigen solutions are approved by the U.S. Food and Drug Administration (FDA): Tubersol (Sanofi Pasteur Limited) and Aplisol (JHP Pharmaceuticals, LLC). Tubersol was out of production in late 2012 through April 2013. Shortages of Aplisol have resulted from increased demand as practitioners have sought a substitute for Tubersol. Tubersol production resumed in May 2013, and supplies had been nearly restored by early June. However, in mid-July, state tuberculosis (TB) control officials notified CDC of difficulty obtaining Tubersol and Aplisol. Sanofi Pasteur notified FDA of a temporary delay in the availability of tuberculin in the 10-dose and 50-dose presentations. In mid-October, the 10-dose presentation was being returned to market, on allocation, which means that historical purchasing practices determine the amount that customers are allotted. In late October, the 50-dose presentation was being returned to market, also on allocation, one vial per historical customer per month. Supplies are forecast to approach normal during January 2014, after distributors have restored their supply chains. A compensatory surge in testing after deferment of testing during the periods of shortage might cause further temporary instability of supplies. In mid-August 2013, officials in 29 of 52 U.S. jurisdictions noted a shortage of at least one PPD TST antigen solution in health departments to the extent that it interrupted activities. This report includes a summary of the extent and effects of the shortages and a reiteration of advice on how to adapt to them.

  14. UTILIZATION OF ACUTE CARE NURSE PRACTITIONERS TO COMBAT PHYSICIAN SHORTAGES IN THE MILITARY TRAUMA SYSTEM: WORKING TOWARDS IMPROVED OUTCOMES

    Science.gov (United States)

    2016-10-01

    repeatedly deployed, potentially leading to burnout or difficulties with post-traumatic stress .36 Some of this burden could be relieved with the use of an...1 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY UTILIZATION OF ACUTE CARE NURSE PRACTITIONERS TO COMBAT PHYSICIAN SHORTAGES IN THE...providers such as nurse practitioners to aid in achieving patient care goals, there is little published to support their use in the military

  15. The analysis on the extreme water shortage event in Hangzhou in 1247 AD and its natural and social backgrounds

    Science.gov (United States)

    Liu, Haolong

    2017-04-01

    Yangtze River Delta locating in the north subtropics of China, is famous for numerous rivers and lakes. Because of East Asian monsoon rainfall, flood is always the most primary disaster in this area during the past 2000 years. However, there were also several extreme water shortage events in the history. Example in Hangzhou in 1247 AD was such a typical year in the area. In the paper, the severity of this extreme event and the closely tied spatiotemporal variation of drought in Yangtze River Delta was quantitatively analyzed on the basis of documentary records during Southern Song Dynasty. Furtherly, its natural and social backgrounds was discussed. The result s are summarized as follows: 1) Wells, canals and West Lake of Hangzhou dried up in 1247 AD. The water level of canals was about 1.32-2.64 m lower than that in the normal year. The reduction of storage capacity in West Lake was 21 million stere or so. 2) The droughts in Yangtze River Delta was moderate on the whole, but that in the west of Zhejiang Province was severe. The drought in Hangzhou lasted from the 2nd lunar month to the end of this year. 3) The water shortage event was closely related to the quick going north and farther northern location of summer rain belt. The descending sea-level weakening the tide in Qiantang River, can also reduce the supply of water resources. 4) The quick growth of urban population, excessive aquaculture, and ineffective government supervision played an important social role in the process of this event. In the all, this extreme water shortage event was the result of both natural and social factors. This research is very helpful for the futuristic water resource forecast in Yangtze River Delta, and it also affords us lessons on the risk management and heritage conservation that merit attention. Key Words: Hangzhou, 1247 AD, water shortage, canal, West Lake, natural factors, social factors

  16. Development of a novel information and communication technology system to compensate for a sudden shortage of emergency department physicians.

    Science.gov (United States)

    Tanaka, Kumiko; Nakada, Taka-Aki; Fukuma, Hiroshi; Nakao, Shota; Masunaga, Naohisa; Tomita, Keisuke; Matsumura, Yosuke; Mizushima, Yasuaki; Matsuoka, Tetsuya

    2017-01-23

    A sudden shortage of physician resources due to overwhelming patient needs can affect the quality of care in the emergency department (ED). Developing effective response strategies remains a challenging research area. We created a novel system using information and communication technology (ICT) to respond to a sudden shortage, and tested the system to determine whether it would compensate for a shortage. Patients (n = 4890) transferred to a level I trauma center in Japan during 2012-2015 were studied. We assessed whether the system secured the necessary physicians without using other means such as phone or pager, and calculated fulfillment rate by the system as a primary outcome variable. We tested for the difference in probability of multiple casualties among total casualties transferred to the ED as an indicator of ability to respond to excessive patient needs, in a secondary analysis before and after system introduction. The system was activated 24 times (stand-by request [n = 12], attendance request [n = 12]) in 24 months, and secured the necessary physicians without using other means; fulfillment rate was 100%. There was no significant difference in the probability of multiple casualties during daytime weekdays hours before and after system introduction, while the probability of multiple casualties during night or weekend hours after system introduction significantly increased compared to before system introduction (4.8% vs. 12.9%, P improvement in the ability to respond to sudden excessive patient needs in multiple causalities. A novel system using ICT successfully secured immediate responses from needed physicians outside the hospital without increasing user workload, and increased the ability to respond to excessive patient needs. The system appears to be able to compensate for a shortage of physician in the ED due to excessive patient transfers, particularly during off-hours.

  17. Path Toward Economic Resilience for Family Caregivers: Mitigating Household Deprivation and the Health Care Talent Shortage at the Same Time

    OpenAIRE

    Simon, Melissa A.; Gunia, Brian; Martin, Emily J.; Foucar, Charles E.; Kundu, Tapas; Ragas, Daiva M.; Emanuel, Linda L.

    2013-01-01

    Rising costs and a workforce talent shortage are two of the health care industry’s most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness–poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As the...

  18. Avoiding a Pilot Retention Death Spiral: The Pilot Shortage and DOD’s Challenge to Maintain an Effective Fighting Force

    Science.gov (United States)

    2018-04-09

    public oversight.”79 His comments apply equally well to the Air Force or the Navy. Anecdotal evidence provided by an anonymous survey on social media ...Master’s Thesis 31 July 2017- 09 APRIL 2018 Avoiding a Pilot Retention Death Spiral: The Pilot Shortage and DOD’s Challenge to Maintain an Effective ...DOD’S CHALLENGE TO MAINTAIN AN EFFECTIVE FIGHTING FORCE by Nathan Thompson Lieutenant Colonel, United States Air Force

  19. System Schema Analysis of County Economy Talents Shortages Based on the Perspective of Returning-home Entrepreneurship

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    According to the discussion of domestic scholars on county talents,we know that the researches concerning county human resources mainly focus on discussing the problems such as the total amount,distribution,quality and introduction of county talents though the analysis of coordination between talents and county economic development,and the research of relationship between industry adjustment and talents need.However,there have no relevant documents about the analysis and discussion of county talents problems based on system schema theory.In view of this reality,on the basis of the introduction of the system schema theory propounded by management guru Peter Senge,we conduct the feedback schema analysis of the restricted factors of talents shortages during county economic development;establish the growth limits schema of county talents system;analyze the functioning mechanism of the total amount,distribution,quality and introduction of county talents on the development of county economy;discuss the relationship between the individual quality,social relation and emotional need of returning-home start-up,and talents resource shortage;propose the countermeasures and suggestions to mitigate the shortage of county talents,in order to optimize the allocation of county human resources,and promote the county’s economic development.

  20. Supply shortage forecast in Ontario: The significance of demand-side management (DSM); its tools and techniques

    International Nuclear Information System (INIS)

    Saini, S.

    2004-01-01

    Aspects of the recent report by the Ontario Electricity Conservation and Supply Task Force and Independent Market Operator which forecasts acute power supply shortages in Ontario, are discussed. Immediate action is recommended to avert the problem. The principal recommendation concerns the adoption of Demand Side Management as a tool to reduce the widening gap between supply and demand, citing supply shortage, imports, high prices, deregulated market and environmental concerns as the driving forces which push for the adoption of DSM. It is claimed that DSM, through its tools such as Demand/Load Response Programs and Time-of-Use rates has the capacity to create the necessary balance between supply and demand more efficiently, and in a more timely fashion than supply side management. The demand for adoption of DSM is justified on the basis of a careful examination of the magnitude and significance of each of the driving forces affecting the electricity supply in Ontario, as well as the benefits and techniques of DSM designed to manage power shortages. Energy Conservation and Efficiency and Demand/Load Response Programs are discussed as the principal DSM techniques, while Dynamic/Real Time Pricing, Time-of-Use Rates, Automated /Smart Metering, Web-based/Communication Systems, Reliability-based Programs, Market/Price-based programs, and Types of Load Control are described as the principal tools used by DSM. DSM program approaches and strategies are also reviewed, along with a brief list of successful examples of DSM applications. 3 figs

  1. Supply shortage forecast in Ontario: The significance of demand-side management (DSM); its tools and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Saini, S.

    2004-06-01

    Aspects of the recent report by the Ontario Electricity Conservation and Supply Task Force and Independent Market Operator which forecasts acute power supply shortages in Ontario, are discussed. Immediate action is recommended to avert the problem. The principal recommendation concerns the adoption of Demand Side Management as a tool to reduce the widening gap between supply and demand, citing supply shortage, imports, high prices, deregulated market and environmental concerns as the driving forces which push for the adoption of DSM. It is claimed that DSM, through its tools such as Demand/Load Response Programs and Time-of-Use rates has the capacity to create the necessary balance between supply and demand more efficiently, and in a more timely fashion than supply side management. The demand for adoption of DSM is justified on the basis of a careful examination of the magnitude and significance of each of the driving forces affecting the electricity supply in Ontario, as well as the benefits and techniques of DSM designed to manage power shortages. Energy Conservation and Efficiency and Demand/Load Response Programs are discussed as the principal DSM techniques, while Dynamic/Real Time Pricing, Time-of-Use Rates, Automated /Smart Metering, Web-based/Communication Systems, Reliability-based Programs, Market/Price-based programs, and Types of Load Control are described as the principal tools used by DSM. DSM program approaches and strategies are also reviewed, along with a brief list of successful examples of DSM applications. 3 figs.

  2. Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

    Science.gov (United States)

    Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

    2018-06-01

    The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

  3. Model of inventory replenishment in periodic review accounting for the occurrence of shortages

    Directory of Open Access Journals (Sweden)

    Stanisław Krzyżaniak

    2014-03-01

    Full Text Available Background: Despite the development of alternative concepts of goods flow management, the inventory management under conditions of random variations of demand is still an important issue, both from the point of view of inventory keeping and replenishment costs and the service level measured as the level of inventory availability. There is a number of inventory replenishment systems used in these conditions, but they are mostly developments of two basic systems: reorder point-based and periodic review-based. The paper deals with the latter system. Numerous researches indicate the need to improve the classical models describing that system, the reason being mainly the necessity to adapt the model better to the actual conditions. This allows a correct selection of parameters that control the used inventory replenishment system and - as a result - to obtain expected economic effects. Methods: This research aimed at building a model of the periodic review system to reflect the relations (observed during simulation tests between the volume of inventory shortages and the degree of accounting for so-called deferred demand, and the service level expressed as the probability of satisfying the demand in the review and the inventory replenishment cycle. The following model building and testing method has been applied: numerical simulation of inventory replenishment - detailed analysis of simulation results - construction of the model taking into account the regularities observed during the simulations - determination of principles of solving the system of relations creating the model - verification of the results obtained from the model using the results from simulation. Results: Presented are selected results of calculations based on classical formulas and using the developed model, which describe the relations between the service level and the parameters controlling the discussed inventory replenishment system. The results are compared to the simulation

  4. Wilted cucumber plants infected by Fusarium oxysporum f. sp. cucumerinum do not suffer from water shortage.

    Science.gov (United States)

    Sun, Yuming; Wang, Min; Li, Yingrui; Gu, Zechen; Ling, Ning; Shen, Qirong; Guo, Shiwei

    2017-09-01

    Fusarium wilt is primarily a soil-borne disease and results in yield loss and quality decline in cucumber (Cucumis sativus). The main symptom of fusarium wilt is the wilting of entire plant, which could be caused by a fungal toxin(s) or blockage of water transport. To investigate whether this wilt arises from water shortage, the physiological responses of hydroponically grown cucumber plants subjected to water stress using polyethylene glycol (PEG, 6000) were compared with those of plants infected with Fusarium oxysporum f. sp. cucumerinum (FOC). Parameters reflecting plant water status were measured 8d after the start of treatment. Leaf gas exchange parameters and temperature were measured with a LI-COR portable open photosynthesis system and by thermal imaging. Chlorophyll fluorescence and chloroplast structures were assessed by imaging pulse amplitude-modulated fluorometry and transmission electron microscopy, respectively. Cucumber water balance was altered after FOC infection, with decreased water absorption and hydraulic conductivity. However, the responses of cucumber leaves to FOC and PEG differed in leaf regions. Under water stress, measures of lipid peroxidation (malondialdehyde) and chlorophyll fluorescence indicated that the leaf edge was more seriously injured, with a higher leaf temperature and disrupted leaf water status compared with the centre. Here, abscisic acid (ABA) and proline were negatively correlated with water potential. In contrast, under FOC infection, membrane damage and a higher temperature were observed in the leaf centre while ABA and proline did not vary with water potential. Cytologically, FOC-infected cucumber leaves exhibited circular chloroplasts and swelled starch grains in the leaf centre, in which they again differed from PEG-stressed cucumber leaves. This study illustrates the non-causal relationship between fusarium wilt and water transport blockage. Although leaf wilt occurred in both water stress and FOC infection, the

  5. Nursing around the world: a perspective on growing concerns and the shortage of care

    Directory of Open Access Journals (Sweden)

    Vance DE

    2011-11-01

    some of these problems are. As such, questions and possible solutions are considered.Keywords: nursing shortage, aging, HIV, lifelong learning, exponential knowledge growth, limited resources, burnout

  6. Atomic Energy Commission Act, 2000 (Act 588)

    International Nuclear Information System (INIS)

    2000-01-01

    Act 588 of the Republic of Ghana entitled, Atomic Energy Commission Act, 2000, amends and consolidates the Atomic Energy Commission Act, 204 of 1963 relating to the establishment of the Atomic Energy Commission. Act 588 makes provision for the Ghana Atomic Energy Commission to establish more institutes for the purpose of research in furtherance of its functions and also promote the commercialization of its research and development results. (E.A.A.)

  7. 1984 Act on nuclear activities (1984:3)

    International Nuclear Information System (INIS)

    1984-01-01

    This 1984 Act on Nuclear Activities (1984:3) replaces the 1956 Atomic Energy Act as well as the 1977 Act on special permits to charge nuclear reactors with nuclear fuel and the 1980 Act on Public Insight into the Safety Work at Nuclear Power Plants. Like the 1956 Act, the 1984 Act in a safety legislation, which is based on a system of licensing conditions and supervision. According to the fundamental provisions of the 1984 Act, nuclear activities should be conducted in such a way as to meet safety requirements and fulfil the obligations that follow from Sweden's international agreements for the purpose of preventing the proliferation of nuclear weapons. (NEA) [fr

  8. Pay Equity Act, 17 May 1988.

    Science.gov (United States)

    1988-01-01

    This document contains major provisions of the 1988 Pay Equity Act of Prince Edward Island, Canada. (Nova Scotia enacted similar legislation in 1988.) This act defines "female-dominated class" or "male-dominated class" as a class with 60% or more female or male incumbents, respectively. The objective of this act is to achieve pay equity among public sector employers and employees by identifying systemic gender discrimination through a comparison of the relative wages and value of the work performed by female- and male-dominated classes. The value of work is to be determined by considering the skill, effort, and responsibility required by the work as well as the conditions under which it is performed. A difference in wages between a female- and male-dominated class performing work of equal or comparable value can be justified by a formal performance appraisal system or formal seniority system that does not discriminate on the basis of gender or by a skills shortage which requires a temporary inflation in wages to attract workers for a certain position. No wages shall be reduced to implement pay equity. Implementation of pay equity will include the work of bargaining agents to achieve agreement on salient points. Pay equity may be implemented in four stages over a period of 24 months.

  9. Act No. 11/87 of 7 april - Basic environment act

    International Nuclear Information System (INIS)

    1987-04-01

    The purpose of this Act is to provide the basis for an environmental policy in Portugal. Section 25 of the Act deals with radioactive substances. It provides that any contamination likely to be caused by these substances should be controlled with a view to preventing its effects on the health and welfare of the population and specifies the methods for such control [fr

  10. Indian Child Welfare Act of 1978. S.1214 to Establish Standards for the Placement of Indian Children in Foster or Adoptive Homes, to Prevent the Breakup of Indian Families, and for Other Purposes. Hearings before the Subcommittee on Indian Affairs and Public Lands of the Committee on Interior and Insular Affairs. House of Representatives, Ninety-Fifth Congress, Second Session (February 9 and March 9, 1978).

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Committee on Interior and Insular Affairs.

    Testimonies were heard by the Subcommittee on Indian Affairs and Public Lands in reference to the Indian Child Welfare Act of 1978, which establishes standards for the placement of Indian children in foster or adoptive homes to prevent the breakup of Indian families. Representatives from the following organizations testified: Administration for…

  11. Health Care in Mozambique: Wartime clinics confront shortages, parasites, and terror

    OpenAIRE

    Williams, Betsy

    1992-01-01

    Mozambique has been in a state of near civil war since 1980, which has prevented the country from providing any health care at all to most of its rural citizens. Medications are scarce, and the range of diagnostic tools is limited. The health clinics treat illnesses that include severe anemia, tuberculosis, malnutrition, sexually transmitted diseases, and injuries that are a result of the war, but the biggest killer of all remains malaria.

  12. Nuclear Regulatory Authority Act, 2015 (Act 895)

    International Nuclear Information System (INIS)

    2015-04-01

    An Act to establish a Nuclear Regulatory Authority in Ghana. This Act provides for the regulation and management of activities and practices for the peaceful use of nuclear material or energy, and to provide for the protection of persons and the environment against the harmful effects of radiation; and to ensure the effective implementation of the country’s international obligations and for related matters. This Act replaced the Radiation Protection Instrument, of 1993 (LI 1559).

  13. Exploring primary care activities in ACT teams.

    Science.gov (United States)

    Vanderlip, Erik R; Williams, Nancy A; Fiedorowicz, Jess G; Katon, Wayne

    2014-05-01

    People with serious mental illness often receive inadequate primary and preventive care services. Federal healthcare reform endorses team-based care that provides high quality primary and preventive care to at risk populations. Assertive community treatment (ACT) teams offer a proven, standardized treatment approach effective in improving mental health outcomes for the seriously mentally ill. Much is known about the effectiveness of ACT teams in improving mental health outcomes, but the degree to which medical care needs are addressed is not established. The purpose of this study was to explore the extent to which ACT teams address the physical health of the population they serve. ACT team leaders were invited to complete an anonymous, web-based survey to explore attitudes and activities involving the primary care needs of their clients. Information was collected regarding the use of health screening tools, physical health assessments, provision of medical care and collaboration with primary care systems. Data was analyzed from 127 team leaders across the country, of which 55 completed the entire survey. Nearly every ACT team leader believed ACT teams have a role in identifying and managing the medical co-morbidities of their clientele. ACT teams report participation in many primary care activities. ACT teams are providing a substantial amount of primary and preventive services to their population. The survey suggests standardization of physical health identification, management or referral processes within ACT teams may result in improved quality of medical care. ACT teams are in a unique position to improve physical health care by virtue of having medically trained staff and frequent, close contact with their clients.

  14. Guidelines for prevention in psychology.

    Science.gov (United States)

    2014-04-01

    The effectiveness of prevention to enhance human functioning and reduce psychological distress has been demonstrated. From infancy through adulthood, access to preventive services and interventions is important to improve the quality of life and human functioning and reduce illness and premature death. The importance of prevention is consistent with the Patient Protection and Affordable Care Act of 2010. Even with the increased focus on prevention, psychology training programs rarely require specific courses on prevention. In particular, conceptualizations about best practices in prevention, particularly at the environmental level, are lacking. Therefore, psychologists engaged in prevention can benefit from a set of guidelines that address and inform prevention practices. Accordingly, the Guidelines for Prevention in Psychology are intended to "inform psychologists, the public, and other interested parties regarding desirable professional practices" in prevention. The Prevention Guidelines are recommended based on their potential benefits to the public and the professional practice of psychology. They support prevention as an important area of practice, research, and training for psychologists. The Guidelines give increased attention to prevention within APA, encouraging psychologists to become involved with preventive activities relevant to their area of practice. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  15. Technetium99m shortage: Practical solutions to manage lack of the radio-isotope in nuclear medicine departments

    International Nuclear Information System (INIS)

    Biechlin-Chassel, M.L.; Francois-Joubert, A.; Bolot, C.; Desruet, M.D.; Bourrel, F.; Pelegrin, M.; Couret, I.; Lao, S.; Quelven, I.

    2010-01-01

    Technetium 99m ( 99m Tc) shortage crisis regularly affect nuclear medicine activity and oblige the community to find solutions in order to perform most of the prescribed exams and avoid systematic substitutions by other non-nuclear medicine techniques. Firstly, some practical solutions can be set up in radiopharmacy departments such as using more than two generators together, realizing fractionated elutions, preparing radiopharmaceuticals with elutions providing from different generators.. Then, it could be interesting to have a reflexion in nuclear medicine departments to convene patients the days when 99m Tc supply is sufficient, to pool some exams or to make substitutions with more available isotopes. (authors)

  16. Outcomes analysis of an alternative formulation of PEGylated liposomal doxorubicin in recurrent epithelial ovarian carcinoma during the drug shortage era

    Directory of Open Access Journals (Sweden)

    Berger JL

    2014-08-01

    Full Text Available Jessica L Berger, Ashlee Smith, Kristin K Zorn, Paniti Sukumvanich, Alexander B Olawaiye, Joseph Kelley, Thomas C Krivak Magee-Womens Hospital, University of Pittsburgh Medical Center, Division of Gynecologic Oncology, Pittsburgh, PA, USA Background: In response to the critical shortage of Doxil®, the US Food and Drug Administration (FDA allowed temporary importation of non-FDA-approved second-generation liposomal doxorubicin, Lipo-Dox®. Lipo-Dox utilizes a different liposomal particle than Doxil and demonstrates different pharmacokinetic properties. Its use has never been evaluated in a North American population. The objective of this study was to evaluate the efficacy and tolerability of Lipo-Dox at Magee-Womens Hospital, University of Pittsburgh Medical Center, for patients with recurrent epithelial ovarian cancer who were treated during the Doxil shortage. Methods: Patients treated with Lipo-Dox from January 2012 to December 2012 were identified retrospectively. Disease response was defined radiographically by RECIST (Response Evaluation Criteria in Solid Tumors or biochemically by CA-125 level if measurable disease was not present. Survival was defined from the start date of Lipo-Dox until the date of progression or death. Toxicity was assessed by the Gynecologic Oncology Group common toxicity criteria. Results: Eighteen patients with recurrent epithelial ovarian cancer who received Lipo-Dox were identified. These patients had a median of three prior treatment regimens. The median number of Lipo-Dox cycles given was 3.5 (range 1–8. No patients had a complete or partial response. Two patients had stable disease over a mean follow-up of 144.5 days. Fourteen patients had progressive disease, with a median time to progression of 82 days. Progression was based on CA-125 in four patients and RECIST in the remainder. Nine patients died from the disease. Conclusion: Although this represents a small, pretreated population, there were no clinical

  17. Interference with the clinical independence of doctors in hospitals faced with a shortage of resources: what should doctors do?

    Science.gov (United States)

    McQuoid-Mason, D J

    2014-11-01

    In the face of interference with their clinical independence in hospitals with a shortage of resources, what should doctors do? The question can be answered by considering: (i) the constitutional right to healthcare and emergency treatment; (ii) the common-law position regarding unlawful homicide and the doctrine of 'superior orders'; (iii) the ethical rules of the Health Professions Council of South Africa; and (iv) whether there is any protection for doctors who refuse to carry out unprofessional, unethical or unlawful directives from their superiors. While this article focuses on the public sector, some of the legal principles, where relevant, apply equally to doctors in the private sector.

  18. Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products.

    Science.gov (United States)

    Palm, Eric; Dotson, Bryan

    2015-11-01

    Drug shortages in the United States, including parenteral nutrition (PN) components, have been common in recent years and can adversely affect patient care. Here we report a case of copper and zinc deficiency in a patient receiving PN during a shortage of parenteral trace element products. The management of the patient's deficiencies, including the use of an imported parenteral multi-trace element product, is described. © 2014 American Society for Parenteral and Enteral Nutrition.

  19. Shortage and surplus of water in the socio-hydrological context

    Science.gov (United States)

    Schumann, A.; Nijssen, d.

    2014-09-01

    Balancing the temporal variability of hydrological conditions in the long- and short-term is often essential for steady socio-economic conditions. However, this equilibrium is very fragile in many cases. Hydrological changes or socio-economic changes may destroy it in a short time. If we extend the bearing capacity of socio-hydrological systems we increase, in many cases, the harmful consequences of failures. Here, two case studies are discussed to illustrate these problems. The limited success at adapting water resources to increasing human requirements without consideration of the natural capacities will be discussed with the example of water use for irrigation in northeastern China. The demand for a new planning approach, which is based on a combination of monitoring, model-based impact assessments and spatial distributed planning, is demonstrated. The problems of water surplus, which becomes evident during floods, are discussed in a second case study. It is shown that flood protection depends strongly on expectations of flood characteristics. The gap between the social requirement for complete flood prevention and the remaining risk of flood damage becomes obvious. An increase of risk-awareness would be more sustainable than promises of flood protection, which are the basis for technical measures to affect floods and (or) to prevent flood damages.

  20. Shortage and surplus of water in the socio-hydrological context

    Directory of Open Access Journals (Sweden)

    A. Schumann

    2014-09-01

    Full Text Available Balancing the temporal variability of hydrological conditions in the long- and short-term is often essential for steady socio-economic conditions. However, this equilibrium is very fragile in many cases. Hydrological changes or socio-economic changes may destroy it in a short time. If we extend the bearing capacity of socio-hydrological systems we increase, in many cases, the harmful consequences of failures. Here, two case studies are discussed to illustrate these problems. The limited success at adapting water resources to increasing human requirements without consideration of the natural capacities will be discussed with the example of water use for irrigation in northeastern China. The demand for a new planning approach, which is based on a combination of monitoring, model-based impact assessments and spatial distributed planning, is demonstrated. The problems of water surplus, which becomes evident during floods, are discussed in a second case study. It is shown that flood protection depends strongly on expectations of flood characteristics. The gap between the social requirement for complete flood prevention and the remaining risk of flood damage becomes obvious. An increase of risk-awareness would be more sustainable than promises of flood protection, which are the basis for technical measures to affect floods and (or to prevent flood damages.

  1. Salmonella Prevention

    Science.gov (United States)

    ... and in vegetable and fruit harvesting and packing operations may help prevent salmonellosis caused by contaminated foods. Better education of food industry workers in basic food safety and restaurant inspection procedures may prevent cross-contamination and other ...

  2. Atomic Act amended

    International Nuclear Information System (INIS)

    Drabova, D.

    2002-01-01

    In the paper by the chairwoman of the Czech nuclear regulatory authority, the history of Czech nuclear legislation is outlined, the reasons for the amendment of the Atomic Act (Act No. 18/1997) are explained, and the amendments themselves are highlighted. The Act No. 13/2002 of 18 December 2001 is reproduced from the official Collection of Acts of the Czech Republic in the facsimile form. The following acts were thereby amended: Atomic Act No. 18/1997, Metrology Act No. 505/1990, Public Health Protection Act No. 258/2000, and Act No. 2/1969 on the Establishment of Ministries and Other Governmental Agencies of the Czech Republic. (P.A.)

  3. Selection of an evaluation index for water ecological civilizations of water-shortage cities based on the grey rough set

    Science.gov (United States)

    Zhang, X. Y.; Zhu, J. W.; Xie, J. C.; Liu, J. L.; Jiang, R. G.

    2017-08-01

    According to the characteristics and existing problems of water ecological civilization of water-shortage cities, the evaluation index system of water ecological civilization was established using a grey rough set. From six aspects of water resources, water security, water environment, water ecology, water culture and water management, this study established the prime frame of the evaluation system, including 28 items, and used rough set theory to undertake optimal selection of the index system. Grey correlation theory then was used for weightings in order that the integrated evaluation index system for water ecology civilization of water-shortage cities could be constituted. Xi’an City was taken as an example, for which the results showed that 20 evaluation indexes could be obtained after optimal selection of the preliminary framework of evaluation index. The most influential indices were the water-resource category index and water environment category index. The leakage rate of the public water supply pipe network, as well as the disposal, treatment and usage rate of polluted water, urban water surface area ratio, the water quality of the main rivers, and so on also are important. It was demonstrated that the evaluation index could provide an objectively reflection of regional features and key points for the development of water ecology civilization for cities with scarce water resources. It is considered that the application example has universal applicability.

  4. 76 FR 55915 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-09-09

    ... type 2 diabetes DPRP Application Form........ 120 1 1 prevention programs. DPRP Evaluation Data... mechanism for recognizing organizations that deliver effective, community-based type 2 diabetes prevention...] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...

  5. 77 FR 70781 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-11-27

    ... comments should be received within 30 days of this notice. Proposed Project Workplace Violence Prevention... prevention programs. However, little is understood about how effective these laws are in reducing violence... facility compliance with the New Jersey Violence Prevention in Health Care Facilities Act, (2) to evaluate...

  6. Immediate and longer term impact of the varicella shortage on children 18 and 24 months of age in a community population

    Directory of Open Access Journals (Sweden)

    Zimmerman Rick

    2006-08-01

    Full Text Available Abstract Background Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. Methods Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. Results Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30 received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%. Conclusion The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but

  7. How urban societies can adapt to resource shortage and climate change

    Energy Technology Data Exchange (ETDEWEB)

    Satterthwaite, David

    2011-04-15

    With more than half the world's population now living in urban areas and with much of the world still urbanizing, there are concerns that urbanization is a key driver of unsustainable resource demands. Urbanization also appears to contribute to ever-growing levels of greenhouse gas (GHG) emissions. Meanwhile, in much of Africa and Asia and many nations in Latin America and the Caribbean, urbanization has long outstripped local governments' capacities or willingness to act as can be seen in the high proportion of the urban population living in poor quality, overcrowded, illegal housing lacking provision for water, sanitation, drainage, healthcare and schools. But there is good evidence that urban areas can combine high living standards with relatively low GHG emissions and lower resource demands. This paper draws on some examples of this and considers what these imply for urban policies in a resource-constrained world. These suggest that cities can allow high living standards to be combined with levels of GHG emissions that are much lower than those that are common in affluent cities today. This can be achieved not with an over-extended optimism on what new technologies can bring but mostly by a wider application of what already has been shown to work.

  8. Single acting translational/rotational brake

    Science.gov (United States)

    Allred, Johnny W. (Inventor); Fleck, Jr., Vincent J. (Inventor)

    1996-01-01

    A brake system is provided that applies braking forces on surfaces in both the translational and rotational directions using a single acting self-contained actuator that travels with the translational mechanism. The brake engages a mechanical lock and creates a frictional force on the translational structure preventing translation while simultaneously creating a frictional torque that prevents rotation of the vertical support. The system may include serrations on the braking surfaces to provide increased braking forces.

  9. Limiting financial disincentives in live organ donation: a rational solution to the kidney shortage.

    Science.gov (United States)

    Gaston, R S; Danovitch, G M; Epstein, R A; Kahn, J P; Matas, A J; Schnitzler, M A

    2006-11-01

    Availability of kidney transplantation is limited by an inadequate supply of organs, with no apparent remedy on the immediate horizon and increasing reliance on living donors (LDs). While some have advocated financial remuneration to stimulate donation, the National Organ Transplant Act (NOTA) of 1984 expressly forbids the offer of 'valuable consideration.' However, recent developments indicate some fluidity in the definition of valuable consideration while evolving international standards highlight deficiencies (particularly regarding long-term care and follow-up) in the current American system. Recognizing that substantial financial and physical disincentives exist for LDs, we propose a policy change that offers the potential to enhance organ availability as well as address concerns regarding long-term care. Donors assume much greater risk than is widely acknowledged, risk that can be approximated for the purpose of determining appropriate compensation. Our proposal offsets donor risk via a package of specific benefits (life insurance, health insurance and a small amount of cash) to minimize hazard and ensure donor interests are protected after as well as before nephrectomy. It will fund medical follow-up and enable data collection so that long-term risk can be accurately assessed. The proposal should be cost effective with only a small increase in the number of LDs, and the net benefit will become greater if removal of disincentives stimulates even further growth. As importantly, by directly linking compensation to risk, we believe it preserves the essence of kidney donation as a gift, consistent with NOTA and implementable in the United States without altering current legal statutes.

  10. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Therapeutics Lab Developing New Treatments The CF Foundation offers a number of resources for learning about clinical ... her father: Demonstrate and discuss common ACT therapies Offer their tips for fitting ACTs into daily life ...

  11. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Treatments and Therapies Airway Clearance Airway Clearance Techniques (ACTs) There are different ways to clear your airways. ... or caregiver. Older kids and adults can choose ACTs that they can do on their own. Share ...

  12. Nuclear Installations Act 1965

    International Nuclear Information System (INIS)

    1965-01-01

    This Act governs all activities related to nuclear installations in the United Kingdom. It provides for the licensing procedure for nuclear installations, the duties of licensees, the competent authorities and carriers of nuclear material in respect of nuclear occurrences, as well as for the system of third party liability and compensation for nuclear damage. The Act repeals the Nuclear Installations (Licensing and Insurance) Act 1959 and the Nuclear Installations (Amendment Act) 1965 except for its Section 17(2). (NEA) [fr

  13. Collaborative ReTek exchange - An innovative solution to the skills and resource shortage in the nuclear industry - 16396

    International Nuclear Information System (INIS)

    Parr, Corhyn

    2009-01-01

    A Different Approach to the Skills and Resource Shortage The Nuclear Industry has for many years been concerned about a skills and resource shortage. This has been due to a poor perception of the industry by those on the outside, highly competitive industries vying for the same resource pool, a steep retirement curve for highly qualified staff and a lack of graduates entering industry. Here in the UK the creation of the National Skill Academy for Nuclear (NSAN) has put in place a framework to record skills and look to accredit the training providers in the nuclear industry to ensure that the correct skills for the future are available. This has gone some way to solving the skills problem and developing a well recognised accredited system but what about resource - where are the additional qualified resources going to be found? Part of the Solution - A Resource Exchange. How do we solve the skills shortage? We come together as an industry and share the available resource through a collaborative resource exchange. It has been done before in the IT industry when rates for specialists hit Pounds 1500 per day and recruitment agencies were charging extortionate fees for providing temporary resource. ReTek Consulting have developed the ReTek Resource Exchange to provide a neutral collaborative platform across the supply chain; from large scale infrastructure companies and joint venture platforms through to small companies and independent consultants. Using the ReTek Exchange permanent staff are made available to work for others during periods of under-utilisation. Links with similar highly regulated industries enable further management of peaks and troughs and a growth in experienced nuclear professionals through focused training and development. The Benefits of the ReTek Exchange are: - Increased utilisation of your current workforce. - Shared cost of permanent staff. - Speedy access to staff available in your region. - Reduced need for contract or agency staff. - Access

  14. Risk Assessment in Relation to the Effect of Climate Change on Water Shortage in the Taichung Area

    Science.gov (United States)

    Hsiao, J.; Chang, L.; Ho, C.; Niu, M.

    2010-12-01

    Rapid economic development has stimulated a worldwide greenhouse effect and induced global climate change. Global climate change has increased the range of variation in the quantity of regional river flows between wet and dry seasons, which effects the management of regional water resources. Consequently, the influence of climate change has become an important issue in the management of regional water resources. In this study, the Monte Carlo simulation method was applied to risk analysis of shortage of water supply in the Taichung area. This study proposed a simulation model that integrated three models: weather generator model, surface runoff model, and water distribution model. The proposed model was used to evaluate the efficiency of the current water supply system and the potential effectiveness of two additional plans for water supply: the “artificial lakes” plan and the “cross-basin water transport” plan. A first-order Markov Chain method and two probability distribution models, exponential distribution and normal distribution, were used in the weather generator model. In the surface runoff model, researchers selected the Generalized Watershed Loading Function model (GWLF) to simulate the relationship between quantity of rainfall and basin outflow. A system dynamics model (SD) was applied to the water distribution model. Results of the simulation indicated that climate change could increase the annual quantity of river flow in the Dachia River and Daan River basins. However, climate change could also increase the difference in the quantity of river flow between wet and dry seasons. Simulation results showed that in current system case or in the additional plan cases, shortage status of water for both public and agricultural uses with conditions of climate change will be mostly worse than that without conditions of climate change except for the shortage status for the public use in the current system case. With or without considering the effect of

  15. An EOQ model of time quadratic and inventory dependent demand for deteriorated items with partially backlogged shortages under trade credit

    Science.gov (United States)

    Singh, Pushpinder; Mishra, Nitin Kumar; Singh, Vikramjeet; Saxena, Seema

    2017-07-01

    In this paper a single buyer, single supplier inventory model with time quadratic and stock dependent demand for a finite planning horizon has been studied. Single deteriorating item which suffers shortage, with partial backlogging and some lost sales is considered. Model is divided into two scenarios, one with non permissible delay in payment and other with permissible delay in payment. Latter is called, centralized system, where supplier offers trade credit to retailer. In the centralized system cost saving is shared amongst the two. The objective is to study the difference in minimum costs borne by retailer and supplier, under two scenarios including the above mentioned parameters. To obtain optimal solution of the problem the model is solved analytically. Numerical example and a comparative study are then discussed supported by sensitivity analysis of each parameter.

  16. A Simple Way to Overcome the Shortage of {sup 3}He Detectors in the IPEN/MB-01 Nuclear Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Gonnelli, E.; Diniz, R.; Dos Santos, A.; Jerez, R.; Landim, H.R. [Nuclear and Energy Research Institute, Nuclear Engineering Center, Nuclear Reactor Division - IPEN/CNEN, Cidade Universitaria, Av. Lineu Prestes 2242, CEP 05508-000, Sao Paulo, SP (Brazil)

    2015-07-01

    The presented work shows the preliminary results of an experimental procedure to overcome the helium-3 detectors shortage in the IPEN/MB-01 nuclear reactor and be feasible the study of the high subcritical states with less sensitivity detectors. The main principle was employing the input logic nuclear module which was possible to execute logic operations with the neutron signals. Though these signals was possible to construct the Auto Power Spectral Densities (APSD) and obtain the Prompt Neutron Constant Decay (α). Two different kinds of thermal neutron detectors were used ({sup 3}He and BF{sub 3}). The arrangement was initially constituted by one of each type detector and, posteriorly, for a more complete data acquisition, in groups of two detectors for all subcritical configurations. The experiment was carried out using the control banks (BC-1 and BC-2) insertion to achieve all the subcritical states studied in this work. (authors)

  17. Aggregate resource availability in the conterminous United States, including suggestions for addressing shortages, quality, and environmental concerns

    Science.gov (United States)

    Langer, William H.

    2011-01-01

    One-third of America's major roads are in poor or mediocre condition, and over one-quarter of the bridges are either structurally deficient or functionally obsolete. A 70-percent increase in annual aggregate production may be required to upgrade the transportation infrastructure. Natural aggregate is widespread throughout the conterminous United States, but the location of aggregate is determined by geology and is non-negotiable. Natural aggregate is in short supply in the Coastal Plain and Mississippi embayment, Colorado Plateau and Wyoming Basin, glaciated Midwest, High Plains, and the non-glaciated Northern Plains. A variety of techniques have been used to overcome local shortages, such as the use of substitute materials, recycling, and importing high-quality aggregates from more distant locations.

  18. Prevention: Exercise

    Medline Plus

    Full Text Available ... Steroid Injections Lumbar Zygapophysical (Facet) Joint Injections PREVENTION Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen ...

  19. Preventative Maintenance.

    Science.gov (United States)

    Migliorino, James

    Boards of education must be convinced that spending money up front for preventive maintenance will, in the long run, save districts' tax dollars. A good program of preventive maintenance can minimize disruption of service; reduce repair costs, energy consumption, and overtime; improve labor productivity and system equipment reliability; handle…

  20. Risk Management Programs under Clean Air Act Section 112(r): Guidance for Implementing Agencies

    Science.gov (United States)

    Accidental release prevention programs under section 112(r) of the Clean Air Act (CAA) are related to and build on activities under the Emergency Planning and Community Right-to-Know Act, and Occupational Safety and Health Administration standards.

  1. National and international capital shortages slowing, perhaps preventing, American economic growth and leading to a decline in the domestic standard of living

    Science.gov (United States)

    1975-01-01

    It is shown that many of the basic industries that the U.S. has relied upon in the past for economic growth and development are now so obsolete, so old, and so technologically inferior to that of foreign competitors that the U.S. is losing its international competitive position. The most conservative estimate suggests that it will require $325 billion between now and 1982 merely to meet existing and currently anticipated pollution requirements and that it would take an additional $197 billion to replace outmoded existing facilities.

  2. Know Stroke: Know the Signs, Act in Time Video

    Medline Plus

    Full Text Available ... history of stroke. Dr. Galen Henderson, Harvard Medical School, Brigham and Women's Hospital: "Strokes are preventable, they ... University of Maryland Medical Center University of Maryland School of Medicine Know Stroke: Know the Signs. Act ...

  3. Radioactive Substances Act 1960

    International Nuclear Information System (INIS)

    1960-01-01

    This Act regulates the keeping and use of radioactive material and makes provision for the disposal and storage of radioactive waste in the United Kingdom. It provides for a licensing system for such activities and for exemptions therefrom, in particular as concerns the United Kingdom Atomic Energy Authority. The Act repeals Section 4(5) of the Atomic Energy Authority Act, 1954 which made temporary provision for discharge of waste on or from premises occupied by the Authority. (NEA) [fr

  4. Learning dialog act processing

    OpenAIRE

    Wermter, Stefan; Löchel, Matthias

    1996-01-01

    In this paper we describe a new approach for learning dialog act processing. In this approach we integrate a symbolic semantic segmentation parser with a learning dialog act network. In order to support the unforeseeable errors and variations of spoken language we have concentrated on robust data-driven learning. This approach already compares favorably with the statistical average plausibility method, produces a segmentation and dialog act assignment for all utterances in a robust manner,...

  5. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements Advocacy News Briefings, Testimonies, and Regulatory ...

  6. Radiological Protection Act 1970

    International Nuclear Information System (INIS)

    1970-01-01

    This Act provides for the establishment of a Radiological Protection Board to undertake research and advise on protection from radiation hazards. Its functions include provision of advice to Government departments with responsibilities in relation to protection of sectors of the community or the community as a whole against the hazards of ionizing radiation. The Act, which lays down that the Board shall replace certain departments concerned with radiation protection, repeals several Sections of the Radioactive Substances Act 1948 and the Science and Technology Act 1965. (NEA) [fr

  7. Preventive analgesia

    DEFF Research Database (Denmark)

    Dahl, Jørgen B; Kehlet, Henrik

    2011-01-01

    This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...

  8. 25 CFR 700.33 - Act (The Act).

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false Act (The Act). 700.33 Section 700.33 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION OPERATIONS AND RELOCATION PROCEDURES General Policies and Instructions Definitions § 700.33 Act (The Act). (a) The Act. The Act is Pub. L. 93-531, (88 Stat...

  9. 16 CFR 1700.15 - Poison prevention packaging standards.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Poison prevention packaging standards. 1700.15 Section 1700.15 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION POISON PREVENTION PACKAGING ACT OF 1970 REGULATIONS POISON PREVENTION PACKAGING § 1700.15 Poison prevention packaging...

  10. A review of strategies to address the shortage of science and mathematics educators in grades 10-12

    Science.gov (United States)

    Magano, Florence Lesedi

    For an education system to function effectively it is important that its planning functions are executed effectively and efficiently. Among others this implies that the system must know what the teacher supply and demand is and how it will change in time. If the teacher supply and demand is known it could result in sound intervention strategies being developed and implemented. Education planners will be able to plan for the number of bursaries to be awarded and in which subject fields; it will be known how many foreign teachers to employ and for which subjects. This is the basic rationale that underpins this study. This study explored the problem of teacher demand and supply in the Further Education and Training (FET) phase (Grades 10 to 12) in South Africa and offers a critical analysis of strategies adopted by Provincial Education Departments in an endeavour to diminish the demand for teachers, specifically for Mathematics and Science, in rural and poor schools. Initially the study involved a secondary data analysis to extrapolate the demand and supply of teachers in Mathematics and Science over the next ten years. The first key finding of the study was that the data needed for such an analysis does not exist in any reliable form that would facilitate the development of such a projection. What the study had to rely on was anecdotal evidence that suggests that a shortage of Mathematics and Science teachers does exist and that posts are often filled by unqualified and under-qualified staff. In the second phase of the research in which the study explored the effectiveness of strategies developed to address the shortage of Mathematics and Science teachers, a qualitative research approach was adopted within a descriptive interpretive design. The views and opinions of human resource managers responsible for post provisioning in schools were explored through in-depth interviews to understand the types of strategy adopted by the provinces, their potential to alleviate

  11. Prevention: Exercise

    Medline Plus

    Full Text Available ... Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic ... Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain ...

  12. Preventing Rejection

    Science.gov (United States)

    ... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

  13. Prevent Cyberbullying

    Science.gov (United States)

    ... Tips for Teachers Report Cyberbullying Print Share Prevent Cyberbullying Be Aware of What Your Kids are Doing ... Signs a Child is Being Cyberbullied or is Cyberbullying Others Many of the warning signs that cyberbullying ...

  14. Preventing Suicide

    Science.gov (United States)

    ... protective factors listed below: Skills in problem solving, conflict resolution, and nonviolent ways of handling disputes Effective ... 2017 Page last updated: August 9, 2017 Content source: National Center for Injury Prevention and Control, Division ...

  15. Prevention: Exercise

    Medline Plus

    Full Text Available ... A SPECIALIST Prevention Strengthening Exercise Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ... acute pain, you should stop doing it. Transverse Core Strengthening This strengthens the muscles that cross from ...

  16. Prevention: Exercise

    Medline Plus

    Full Text Available ... Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain Basics ... increases your back pain after five repetitions, or causes acute pain, you should stop doing it. Transverse ...

  17. Preventing accidents

    Science.gov (United States)

    2005-08-01

    As the most effective strategy for improving safety is to prevent accidents from occurring at all, the Volpe Center applies a broad range of research techniques and capabilities to determine causes and consequences of accidents and to identify, asses...

  18. Prevention: Exercise

    Medline Plus

    Full Text Available ... 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility ... Pain Preventing Osteoporosis Back Pain Basics Book RESOURCES Patient Information Feature Articles Patient Q&A Success Stories ...

  19. Prevention: Exercise

    Medline Plus

    Full Text Available ... Preventing Osteoporosis Back Pain Basics Book RESOURCES Patient Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 ...

  20. HIV Prevention

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about steps people can take to protect their health from HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  1. Preventive measures for emergencies?

    International Nuclear Information System (INIS)

    Calliess, J.

    1990-01-01

    The meeting discussed the new provisions for civil defense on account of the amended Disaster Control Act which had been recently adopted by the Lower House of Parliament. In 6 working groups it was discussed how appropriate and sensible the attempt is to make provisions for civil defence in order to protect the population, and how adequate legislative measures are in the face of true threat and var scenarios. Ethical aspects and aspects of international law were considered, as well as the role of public health and free charitable institutions concering preventive measures in emergencies. (orig. HSCH) [de

  2. Health system's response for physician workforce shortages and the upcoming crisis in Ethiopia: a grounded theory research.

    Science.gov (United States)

    Assefa, Tsion; Haile Mariam, Damen; Mekonnen, Wubegzier; Derbew, Miliard

    2017-12-28

    A rapid transition from severe physician workforce shortage to massive production to ensure the physician workforce demand puts the Ethiopian health care system in a variety of challenges. Therefore, this study discovered how the health system response for physician workforce shortage using the so-called flooding strategy was viewed by different stakeholders. The study adopted the grounded theory research approach to explore the causes, contexts, and consequences (at the present, in the short and long term) of massive medical student admission to the medical schools on patient care, medical education workforce, and medical students. Forty-three purposively selected individuals were involved in a semi-structured interview from different settings: academics, government health care system, and non-governmental organizations (NGOs). Data coding, classification, and categorization were assisted using ATLAs.ti qualitative data analysis scientific software. In relation to the health system response, eight main categories were emerged: (1) reasons for rapid medical education expansion; (2) preparation for medical education expansion; (3) the consequences of rapid medical education expansion; (4) massive production/flooding as human resources for health (HRH) development strategy; (5) cooperation on HRH development; (6) HRH strategies and planning; (7) capacity of system for HRH development; and (8) institutional continuity for HRH development. The demand for physician workforce and gaining political acceptance were cited as main reasons which motivated the government to scale up the medical education rapidly. However, the rapid expansion was beyond the capacity of medical schools' human resources, patient flow, and size of teaching hospitals. As a result, there were potential adverse consequences in clinical service delivery, and teaching learning process at the present: "the number should consider the available resources such as number of classrooms, patient flows

  3. 76 FR 10874 - Implementation of Revised Lacey Act Provisions

    Science.gov (United States)

    2011-02-28

    ... Lacey Act to expand its protections to a broader range of plant species, extended its reach to encompass... 8204, Prevention of Illegal Logging Practices). As amended, the Lacey Act now makes it unlawful to... plant, with some limited exceptions, taken in violation of any Federal, State, Tribal, or foreign law...

  4. Marine Mammal Protection Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Marine Mammal Protection Act (MMPA or Act) prohibits, with certain exceptions, the "take" of marine mammals in U.S. waters and by U.S. citizens on the high seas,...

  5. Collective speech acts

    NARCIS (Netherlands)

    Meijers, A.W.M.; Tsohatzidis, S.L.

    2007-01-01

    From its early development in the 1960s, speech act theory always had an individualistic orientation. It focused exclusively on speech acts performed by individual agents. Paradigmatic examples are ‘I promise that p’, ‘I order that p’, and ‘I declare that p’. There is a single speaker and a single

  6. Americans with Disabilities Act.

    Science.gov (United States)

    Kaesberg, Mary Ann; Murray, Kenneth T.

    1994-01-01

    Presents a 35-item checklist of practical activities for school district compliance with the Americans with Disabilities Act (ADA). The checklist is based on ADA statutes, other civil rights legislation and litigation, as well as pertinent regulations and the legislative history of the act contained in the Congressional Record. (MLF)

  7. Radiation emitting devices act

    International Nuclear Information System (INIS)

    1970-01-01

    This Act, entitled the Radiation Emitting Devices Act, is concerned with the sale and importation of radiation emitting devices. Laws relating to the sale, lease or import, labelling, advertising, packaging, safety standards and inspection of these devices are listed as well as penalties for any person who is convicted of breaking these laws

  8. Nuclear Installations Act 1969

    International Nuclear Information System (INIS)

    1969-01-01

    The purpose of this Act is to amend the Nuclear Installations Act 1965 to bring it into full compliance with the international conventions on nuclear third party liability to which the United Kingdom is a Signatory, namely, the Paris Convention, the Brussels Supplementary Convention and the Vienna Convention. (NEA) [fr

  9. 42 CFR Appendix A to Part 5 - Criteria for Designation of Areas Having Shortages of Primary Medical Care Professional(s)

    Science.gov (United States)

    2010-10-01

    ... above.) 2. Determination of Degree of Shortage. Designated correctional institutions will be assigned to... metropolitan areas which display a strong self-identity (as indicated by a homogeneous socioeconomic or... population for the differing health service requirements of various age-sex population groups will be...

  10. Hospital Staff Shortage after the 2011 Triple Disaster in Fukushima, Japan-An Earthquake, Tsunamis, and Nuclear Power Plant Accident: A Case of the Soso District.

    Science.gov (United States)

    Ochi, Sae; Tsubokura, Masaharu; Kato, Shigeaki; Iwamoto, Shuichi; Ogata, Shinichi; Morita, Tomohiro; Hori, Arinobu; Oikawa, Tomoyoshi; Kikuchi, Antoku; Watanabe, Zenjiro; Kanazawa, Yukio; Kumakawa, Hiromi; Kuma, Yoshinobu; Kumakura, Tetsuo; Inomata, Yoshimitsu; Kami, Masahiro; Shineha, Ryuzaburo; Saito, Yasutoshi

    2016-01-01

    In 2011, Fukushima was struck by a triple disaster: an earthquake, tsunamis, and a nuclear accident. In the aftermath, there was much fear among hospital staff members about radiation exposure and many staff members failed to report to work. One objective is to measure this shortage in hospital staff and another is to compare the difference in recovery by hospital types and by categories of hospital staff. The monthly records of the number of staff members from May 2011 to September 2012 were extracted anonymously from the records of 7 local hospitals in the Soso district in Fukushima. Change in the number of staff was analyzed. Staff shortages at hospitals reached a maximum within one month after the disaster (47% reported to work). The shortage of clerks was the most severe (38% reported to work), followed by nurses (48% reported to work). The shortages remained even 18 months after the disaster. After a disaster in which the damage to hospital functions surpasses the structural damage, massive support of human resources in the acute phase and a smaller volume of support in the mid-term phase appear to be required, particularly for non-medical staff.

  11. Nursing Workforce: Emerging Nurse Shortages Due to Multiple Factors. Report to the Chairman, Subcommittee on Health, Committee on Ways and Means, House of Representatives.

    Science.gov (United States)

    Heinrich, Janet

    Current evidence suggests emerging shortages of nurses available or willing to fill some vacant positions in hospitals, nursing homes, and home care. Total employment of registered nurses (RNs) per capita and the national unemployment rate for RNs have declined, and providers from around the country report growing difficulty recruiting and…

  12. Doctoring up the Nursing Profession: Several Factors Are Contributing to the National Nursing Shortage, but Initiatives, Perceptions and College Programs Can Nurture Industry's Growth

    Science.gov (United States)

    Keels, Crystal L.

    2004-01-01

    For all the baby boomers who've embraced and adopted healthier lifestyles, including proper diet and exercise, there may be an even more compelling reason. If you get sick or become hospitalized, you may not have the critically needed services of a well-trained nurse. It's been widely reported that there is a nursing shortage in the United States,…

  13. Addressing the impact of economic sanctions on Iranian drug shortages in the joint comprehensive plan of action: promoting access to medicines and health diplomacy.

    Science.gov (United States)

    Setayesh, Sogol; Mackey, Tim K

    2016-06-08

    The U.S Congress initiated sanctions against Iran after the 1979 U.S. Embassy hostage crisis in Tehran, and since then the scope of multilateral sanctions imposed by the United States, the European Union, and the United Nations Security Council have progressively expanded throughout the intervening years. Though primarily targeted at Iran's nuclear proliferation activities, sanctions have nevertheless resulted in negative public health outcomes for ordinary Iranian citizens. This includes creating vital domestic shortages to life-saving medicines, leaving an estimated 6 million Iranian patients with limited treatment access for a host of diseases. Sanctions have also crippled Iran's domestic pharmaceutical industry, leading to the disruption of generic medicines production and forcing the country to import medicines and raw materials that are of lower or questionable quality. Countries such as the United States have responded to this medical crisis by implementing export control exemptions with the aim of easing the trade of humanitarian goods (including certain pharmaceuticals and medical devices). However, despite these efforts, pharmaceutical firms and international banking institutions remain cautious about doing business with Iran, leaving the country faced with continuing shortages. We conducted a review of key characteristics of the Iranian drug shortage that identified 73 shortage drugs that closely tracked with the disease burden in the country. Additionally, 44 % of these drugs were also classified as essential medicines by the World Health Organization. A vast majority of these drugs were also covered under export control exemptions that theoretically should make them easier to procure, but nevertheless will still in shortage. Based on our review of the sanctions regulatory framework and key characteristics of the Iranian drug shortage, we propose policy intervention leveraging the recently negotiated P5 + 1 agreement that begins the process of

  14. The world’s road to water scarcity: shortage and stress in the 20th century and pathways towards sustainability

    Science.gov (United States)

    Kummu, M.; Guillaume, J. H. A.; de Moel, H.; Eisner, S.; Flörke, M.; Porkka, M.; Siebert, S.; Veldkamp, T. I. E.; Ward, P. J.

    2016-01-01

    Water scarcity is a rapidly growing concern around the globe, but little is known about how it has developed over time. This study provides a first assessment of continuous sub-national trajectories of blue water consumption, renewable freshwater availability, and water scarcity for the entire 20th century. Water scarcity is analysed using the fundamental concepts of shortage (impacts due to low availability per capita) and stress (impacts due to high consumption relative to availability) which indicate difficulties in satisfying the needs of a population and overuse of resources respectively. While water consumption increased fourfold within the study period, the population under water scarcity increased from 0.24 billion (14% of global population) in the 1900s to 3.8 billion (58%) in the 2000s. Nearly all sub-national trajectories show an increasing trend in water scarcity. The concept of scarcity trajectory archetypes and shapes is introduced to characterize the historical development of water scarcity and suggest measures for alleviating water scarcity and increasing sustainability. Linking the scarcity trajectories to other datasets may help further deepen understanding of how trajectories relate to historical and future drivers, and hence help tackle these evolving challenges. PMID:27934888

  15. Rural and remote dental services shortages: filling the gaps through geo-spatial analysis evidence-based targeting.

    Science.gov (United States)

    Shiika, Yulia; Kruger, Estie; Tennant, Marc

    Australia has a significant mal-distribution of its limited dental workforce. Outside the major capital cities, the distribution of accessible dental care is at best patchy. This study applied geo-spatial analysis technology to locate gaps in dental service accessibility for rural and remote dwelling Australians, in order to test the hypothesis that there are a few key location points in Australia where further dental services could make a significant contribution to ameliorating the immediate shortage crisis. A total of 2,086 dental practices were located in country areas, covering a combined catchment area of 1.84 million square kilometers, based on 50 km catchment zones around each clinic. Geo-spatial analysis technology was used to identify gaps in the accessibility of dental services for rural and remote dwelling Australians. An extraction of data was obtained to analyse the integrated geographically-aligned database. Results: Resolution of the lack of dental practices for 74 townships (of greater than 500 residents) across Australia could potentially address access for 104,000 people. An examination of the socio-economic mix found that the majority of the dental practices (84%) are located in areas classified as less disadvantaged. Output from the study provided a cohesive national map that has identified locations that could have health improvement via the targeting of dental services to that location. The study identified potential location sites for dental clinics, to address the current inequity in accessing dental services in rural and remote Australia.

  16. Hematoxylin shortages: their causes and duration, and other dyes that can replace hemalum in routine hematoxylin and eosin staining.

    Science.gov (United States)

    Dapson, R; Horobin, R W; Kiernan, J

    2010-02-01

    The origins of repeated hematoxylin shortages are outlined. Lack of integration in the hematoxylin trade exacerbates the problems inherent in using a natural product. Separate corporations are engaged in tree growth and harvesting, dye extraction, processing of extracts to yield hematoxylin, and formulation and sale of hematoxylin staining solutions to the end users in biomedical laboratories. Hematoxylin has many uses in biological staining and no single dye can replace it for all applications. Probably, the most satisfactory substitutes for aluminum-hematoxylin (hemalum) are the ferric complexes of celestine blue (CI 51050; mordant blue 14) and eriochrome cyanine R (CI 43820; mordant blue 3, also known as chromoxane cyanine R and solochrome cyanine R). The iron-celestine blue complex is a cationic dye that binds to nucleic acids and other polyanions, such as those of cartilage matrix and mast cell granules. Complexes of iron with eriochrome cyanine R are anionic and give selective nuclear staining similar to that obtained with acidic hemalum solutions. Iron complexes of gallein (CI 45445; mordant violet 25), a hydroxyxanthene dye, can replace iron-hematoxylin in formulations for staining nuclei, myelin, and protozoa.

  17. The world's road to water scarcity: shortage and stress in the 20th century and pathways towards sustainability.

    Science.gov (United States)

    Kummu, M; Guillaume, J H A; de Moel, H; Eisner, S; Flörke, M; Porkka, M; Siebert, S; Veldkamp, T I E; Ward, P J

    2016-12-09

    Water scarcity is a rapidly growing concern around the globe, but little is known about how it has developed over time. This study provides a first assessment of continuous sub-national trajectories of blue water consumption, renewable freshwater availability, and water scarcity for the entire 20 th century. Water scarcity is analysed using the fundamental concepts of shortage (impacts due to low availability per capita) and stress (impacts due to high consumption relative to availability) which indicate difficulties in satisfying the needs of a population and overuse of resources respectively. While water consumption increased fourfold within the study period, the population under water scarcity increased from 0.24 billion (14% of global population) in the 1900s to 3.8 billion (58%) in the 2000s. Nearly all sub-national trajectories show an increasing trend in water scarcity. The concept of scarcity trajectory archetypes and shapes is introduced to characterize the historical development of water scarcity and suggest measures for alleviating water scarcity and increasing sustainability. Linking the scarcity trajectories to other datasets may help further deepen understanding of how trajectories relate to historical and future drivers, and hence help tackle these evolving challenges.

  18. Strategies for laboratory cost containment and for pathologist shortage: centralised pathology laboratories with microwave-stimulated histoprocessing and telepathology.

    Science.gov (United States)

    Leong, Anthony S Y; Leong, F Joel W M

    2005-02-01

    The imposition of laboratory cost containment, often from external forces, dictates the necessity to develop strategies to meet laboratory cost savings. In addition, the national and worldwide shortage of anatomical pathologists makes it imperative to examine our current practice and laboratory set-ups. Some of the strategies employed in other areas of pathology and laboratory medicine include improvements in staff productivity and the adoption of technological developments that reduce manual intervention. However, such opportunities in anatomical pathology are few and far between. Centralisation has been an effective approach in bringing economies of scale, the adoption of 'best practices' and the consolidation of pathologists, but this has not been possible in anatomical pathology because conventional histoprocessing takes a minimum of 14 hours and clinical turnaround time requirements necessitate that the laboratory and pathologist be in proximity and on site. While centralisation of laboratories for clinical chemistry, haematology and even microbiology has been successful in Australia and other countries, the essential requirements for anatomical pathology laboratories are different. In addition to efficient synchronised courier networks, a method of ultra-rapid tissue processing and some expedient system of returning the prepared tissue sections to the remote laboratory are essential to maintain the turnaround times mandatory for optimal clinical management. The advent of microwave-stimulated tissue processing that can be completed in 30-60 minutes and the immediate availability of compressed digital images of entire tissue sections via telepathology completes the final components of the equation necessary for making centralised anatomical pathology laboratories a reality.

  19. A Response to the Commentary Entitled: “Addressing the Shortage of Health Professionals in Rural China: Issues and Progress”

    Directory of Open Access Journals (Sweden)

    Qian Yang

    2015-05-01

    Full Text Available The principal problems of healthcare services in China are “difficulty in seeing a doctor”and “high expense of getting medical service” (commonly known in Chinese as “kan bing nan, kan bing gui”. The central Chinese government has already launched the bottom-up cascading medical system and two-way referral system recently in order to solve these problems (1. Only when patients go to medical institutions in an orderly fashion, can we see the hope of breaking the kan bing nan, kan bing gui (2. However, we face a number of obstacles when implementing the referral policies. The biggest obstacle is the lack of Human Resource (HR for primary care both in capacity and volume (3. The central Chinese government has launched a series of policies to deal with the shortage of HRs in rural areas. Profound measurements involve postgraduate training for General Practitioner (GP (a three-year plan beginning in 2010 for producing health professionals for rural areas and improving rural retention, “3+2” medical education model (3-year diploma education and 2-year postgraduate GP training, and in-service training for physicians in rural areas (4. It is not the time to assess their effectiveness, however, these measurements are certain to improve the capacity of Community Health Service (CHS institutions.

  20. [Strategies to Cope with the Shortage of Technologists: Facing the Mass-Retirement of the 'Baby-Boomer' Generation].

    Science.gov (United States)

    Morikane, Keita; Yamada, Miyuki

    2015-03-01

    In Japan, the primary 'baby-boomer' generation, born between 1947 and 1949, is now in its retirement. This has caused a marked shortage of human resources nationwide. Clinical laboratory technologists are no exception, and many clinical laboratories in Japanese healthcare facilities are struggling with management because the number of new graduates, i.e., newly licensed technologists, is mostly fixed and, therefore, their recruitment is becoming more and more competitive. Our laboratory is now facing a wave of mass-retirement associated with our history. In addition, in the early 2000s, there was almost no position for new graduates replacing those retiring because of the change in the social healthcare system as well as our hospital's policy. This resulted in uneven numbers of technologists in generations, and it seemed to be getting worse. Fortunately, five years ago, the direction of social health care was changed and lots of positions became available as a result. We have been trying to recruit new graduates and experienced technologists as well, and were able to hire 18 people. Among them, 8 were non-freshmen. The generation gap has been mostly resolved. We will continue to make our laboratory more attractive not just to new graduates but also to experienced technologists, especially those who wish to return to work after a several-year absence to raise their children. We believe that this will energize our laboratory.

  1. Path toward economic resilience for family caregivers: mitigating household deprivation and the health care talent shortage at the same time.

    Science.gov (United States)

    Simon, Melissa A; Gunia, Brian; Martin, Emily J; Foucar, Charles E; Kundu, Tapas; Ragas, Daiva M; Emanuel, Linda L

    2013-10-01

    Rising costs and a workforce talent shortage are two of the health care industry's most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness-poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As these skills are marketable and could be paired with many existing medical certifications, this article describes a possible "path toward economic resilience" (PER) through a program whereby family caregivers could find meaningful employment using their new skills. The proposed program would identify ideal program candidates, assess and supplement their competencies, and connect them to the health care industry. We provide a set of practical steps and recommended tools for implementation, discuss pilot data on the program's appeal and feasibility, and raise several considerations for program development and future research. Our analysis suggests that this PER program could appeal to family caregivers and the health care industry alike, possibly helping to address two of our health care system's most pressing challenges with one solution.

  2. Cancer prevention.

    Science.gov (United States)

    Tubiana, M

    1999-01-01

    Over 70% of human cancers are associated with lifestyle and about half of cancer deaths could be prevented by relatively simple individual actions: no smoking, moderate consumption of alcohol, increased consumption of fruit and vegetables, avoidance of sunbathing, obesity and a too high consumption of saturated lipids. Most of these efforts would also markedly decrease the incidence of cardiovascular and respiratory diseases. However, the concept of prevention is currently neither well accepted nor understood by the medical community and the general public. It is often felt that it restricts freedom, imposes a choice between pleasure and duty, and that passing judgement on lifestyle is a form of intolerance. The case of tobacco illustrates the difficulties encountered by prevention, notably among adolescents. The fight against smoking requires information, a societal approach (ban on advertising, increase in price), and a reduction of the example given by adult smoking (parents, peers, teachers, physicians, TV presenters, movie stars, have a great influence on adolescents), while tobacco cessation programs must be promoted. The various approaches should be integrated into a global program of health prevention, including health education at school from 5 to 12 years of age. The efficacy of each of the global program's components should be evaluated. Misconceptions such as overestimation of the impact of pollution on health should also be corrected. Health is created and experienced by people within the setting of their daily lives, in particular during childhood. Prevention is the responsibility of individual members of the community but also of the community as a whole.

  3. A long shortage

    NARCIS (Netherlands)

    Jean Marie Wildeboer Schut; Stella Hoff

    2016-01-01

    Original title: Een lang tekort The economic recession of recent years has led to a sharp increase in poverty in the Netherlands. There are also indications that a growing number of people spend at least three years living below the poverty line. This group of long-term poor are the focus of

  4. The Radiation Protection Act

    International Nuclear Information System (INIS)

    Persson, L.

    1989-01-01

    The new Radiation Protection Act (1988:220) entered into force in Sweden on July 1st, 1988. This book presents the Act as well as certain regulations connected to it. As previously, the main responsibility for public radiation protection will rest with one central radiation protection authority. According to the 1988 Act, the general obligations with regard to radiation protection will place a greater responsibility than in the past on persons carrying out activities involving radiation. Under the act, it is possible to adjust the licensing and supervisory procedures to the level of danger of the radiation source and the need for adequate competence, etc. The Act recognises standardised approval procedures combined with technical regulations for areas where the risks are well known. The Act contains several rules providing for more effective supervision. The supervising authority may in particular decide on the necessary regulations and prohibitions for each individual case. The possibilities of using penal provisions have been extended and a rule on the mandatory execution of orders has been introduced. The Ordinance on Radiation Protection (1988:293) designates the National Institute of Radiation Protection (SSI) as the central authority referred to in the Radiation Protection Act. The book also gives a historic review of radiation protection laws in Sweden, lists regulations issued by SSI and presents explanations of radiation effects and international norms in the area. (author)

  5. Canada's Clean Air Act

    International Nuclear Information System (INIS)

    2006-01-01

    This paper provided an outline of Canada's Clean Air Act and examined some of the regulatory changes that will occur as a result of its implementation. The Act is being introduced to strengthen the legislative basis for taking action on reducing air pollution and GHGs, and will allow the government to regulate both indoor and outdoor air pollutants and GHGs. The Act will require the Ministers of the Environment and Health to establish national air quality objectives, as well as to monitor and report on their attainment. The Canadian Environmental Protection Act will be amended to enable the government to regulate the blending of fuels and their components. The Motor Vehicle Fuel Consumption Standards Act will also be amended to enhance the government's authority to regulate vehicle fuel efficiency. The Energy Efficiency Act will also be expanded to allow the government to set energy efficiency standards and labelling requirements for a wider range of consumer and commercial products. The Act will commit to short, medium and long-term industrial air pollution targets. Regulations will be proposed for emissions from industry; on-road and off-road vehicles and engines; and consumer and commercial products. It was concluded that the Government of Canada will continue to consult with provinces, territories, industries and Canadians to set and reach targets for the reduction of both indoor and outdoor air pollutants and GHG emissions. 6 figs

  6. 75 FR 6671 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-02-10

    ... programs implemented a new consent form. This form asked participants for permission for CDC to contact...] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention... prevention behaviors, CDC will conduct telephone interviews of 425 Matter of Balance program participants six...

  7. 76 FR 5377 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2011-01-31

    ... Budget (OMB) in compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of... Project Developing a Sexual Consent Norms Instrument--New--National Center for Injury Prevention and... violence prevention strategies are increasingly focusing on promoting positive behavioral norms such as...

  8. 77 FR 76045 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-12-26

    ... case classification (disease staging system). Recommendations for revisions in the case definition were... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30Day-13-0573] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...

  9. 77 FR 40363 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-07-09

    ... Methicillin-resistant Staphylococcus aureus (MRSA) among Patients Recently Discharged from Acute Care... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day-12-12II] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...

  10. 78 FR 40151 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-07-03

    ... resistant Staphylococcus aureus ABCs Case Report Form. ABCs Invasive Pneumococcal 10 41 10/60 Disease in... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30-Day 13-13DB] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...

  11. 75 FR 20601 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2010-04-20

    .... Proposed Project Asthma Information Reporting System (AIRS)--New--Air Pollution and Respiratory Health... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30Day-10-09CK] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and prevention...

  12. 78 FR 24422 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2013-04-25

    ... System (AIRS) (0920-0853, Expiration 06/30/2013)--Extension--Air Pollution and Respiratory Health Branch... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [30Day-13-0853] Agency Forms Undergoing Paperwork Reduction Act Review The Centers for Disease Control and Prevention...

  13. The Energy Act 1983

    International Nuclear Information System (INIS)

    1983-01-01

    Part II of This Act came into force on 1 September 1983 and is concerned with nuclear installations. Its main purpose is to amend the Nuclear Installations Act 1965 to give effect to the provisions of two Protocols amending the Paris Convention on nuclear third party liability and the Brussels Convention Supplementary to the Paris Convention respectively. The principal effect of these modifications is to increase the sums available to meet claims for nuclear damage. The United Kingdom is a Party to both Conventions and the provisions of the 1983 Act will enable it to ratify the Protocols. (NEA) [fr

  14. Safeguarding the Dignity of Women under the Criminal Law Amendment Act 2013-A Critical Analysis

    OpenAIRE

    R C Borpatragohain

    2013-01-01

    This viewpoint aims to analyse the Criminal Law Amendment Act 2013 from a legal perspective. In doing so, it discusses the statutory safeguards of rights to a dignified life of a woman by analysing the various existing laws, which have been significantly amended to build the Criminal Act, 2013. These laws are: Indian Penal Code (IPC) 1860; Indian Evidence Act 1872, Code of Criminal Procedure as amended in 1973, Immoral Trafficking Prevention Act 1956, Information Technology Act 2000, The Juve...

  15. 75 FR 63703 - Privacy Act of 1974; Privacy Act Regulation

    Science.gov (United States)

    2010-10-18

    ... FEDERAL RESERVE SYSTEM 12 CFR Part 261a [Docket No. R-1313] Privacy Act of 1974; Privacy Act... implementing the Privacy Act of 1974 (Privacy Act). The primary changes concern the waiver of copying fees... records under the Privacy Act; the amendment of special procedures for the release of medical records to...

  16. Abandoned Shipwreck Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data represents the extent of the Abandoned Shipwreck Act (ASA). The ASA allows states to manage a broad range of resources within submerged lands, including...

  17. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy ... the value of tapping into the expertise that only people with CF and their families have. We invite you to share insights to ...

  18. Energy Policy Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Energy Policy Act (EPA) addresses energy production in the United States, including: (1) energy efficiency; (2) renewable energy; (3) oil and gas; (4) coal; (5)...

  19. ACTS – SUCCESS STORY

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. ACTS – SUCCESS STORY. Totally 103 experiments were conducted and the programme succeeded in the areas. Medicine; Education; Defence; Emergency Response; Maritime and Aeronautical Mobile Communications; Science and Astronomy.

  20. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... There are different ways to clear your airways. Most are easy to do. Infants and toddlers will ... best ACT is the one that you are most likely to perform as part of your daily ...

  1. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... to loosen mucus from airway walls. See how different airway clearance techniques work to help you clear the thick, sticky mucus ... Offer their tips for fitting ACTs into daily life Airway Clearance Techniques | Webcast ... Facebook Twitter ...

  2. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... CF Community in Health Care Reform Milestones in Health Care Reform How Tax Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements ...

  3. Clean Water Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data represent geographic terms used within the Clean Water Act (CWA). The CWA establishes the basic structure for regulating the addition of pollutants...

  4. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... toddlers will need help from a parent or caregiver. Older kids and adults can choose ACTs that ... into the smaller airways to attack bacteria. Choose What's Best for You Your respiratory therapist or another ...

  5. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... that help thin and move the mucus, and antibiotics. Bronchodilators should be inhaled before you start ACTs. This medication helps to widen your airways (bronchi) by relaxing the ...

  6. Endangered Species Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The purpose of the Endangered Species Act (ESA) is to protect and recover imperiled species and the ecosystems upon which they depend. The U.S. Fish and Wildlife...

  7. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements ... on their own. Share Facebook Twitter Email More options Print Share Facebook Twitter Email Print Permalink All ...

  8. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... 3-D Structure Consortium CFTR Folding Consortium Epithelial Stem Cell Consortium Mucociliary Clearance Consortium SUCCESS WITH THERAPIES RESEARCH ... ACTs involve coughing or huffing . Many of them use percussion (clapping) or vibration to loosen mucus from ...

  9. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... today. ANNUAL FUND Become a Corporate Supporter Cause Marketing Make a Charitable Gift Our Corporate Supporters Workplace ... Clearance Airway Clearance Techniques (ACTs) There are different ways to clear your airways. Most are easy to ...

  10. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... CF Community in Health Care Reform Milestones in Health Care Reform How Tax Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements Advocacy News Briefings, Testimonies, and Regulatory ...

  11. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Contraception and Protection How Does CF Affect the Female Reproductive System? How Does CF Affect the Male ... Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements ...

  12. ACT250 Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — The ACT 250 Districts layer is part of a larger dataset that contains administrative boundaries for Vermont's Agency of Natural Resources. The dataset includes...

  13. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... ACTs involve coughing or huffing . Many of them use percussion (clapping) or vibration to loosen mucus from airway walls. See how different airway clearance techniques work to help you clear the thick, sticky mucus ...

  14. Acts of Research

    DEFF Research Database (Denmark)

    Nelund, Sidsel

    place mostly in seminars and articles, in which knowledge is often discussed as an intrinsic quality of the artwork. Acts of Research, however, is devoted to studying the rise of knowledge production in contemporary art from the perspective of artistic, curatorial and educational research...... described as knowledge producers and exhibitions and art works as instances of knowledge production. Acts of Research: Knowledge Production in Contemporary Arts between Knowledge Economy and Critical Practices analyses this development. The academic discussion of knowledge production in the arts has taken...... with an awareness of larger political, economic, geographical and art-related aspects. The concept of ‘acts of research’ is suggested as a way to understand knowledge production as a creative act in which research carried out in relation to a specific material challenges and resists the protocols of conventional...

  15. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Congressional Cystic Fibrosis Caucus Our Policy Agenda Policy Principles SIGN UP FOR ADVOCACY ACTION ALERTS Community We ... options Print Share Facebook Twitter Email Print Permalink All ACTs involve coughing or huffing . Many of them ...

  16. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... How Does CF Affect the Male Reproductive System? Sex and CF: Some Practical Advice Family Planning and ... need help from a parent or caregiver. Older kids and adults can choose ACTs that they can ...

  17. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... FOR ADVOCACY ACTION ALERTS Community We recognize the value of tapping into the expertise that only people ... ACTs involve coughing or huffing . Many of them use percussion (clapping) or vibration to loosen mucus from ...

  18. National Environmental Policy Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Environmental Policy Act (NEPA) was the first major environmental law in the United States and established national environmental policies for the...

  19. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... Reform Could Impact People With CF The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements ... Board of Trustees Our Leadership Careers Reports and Financials Contact Us Governance and Policies What is CF? ...

  20. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... own. Share Facebook Twitter Email More options Print Share Facebook Twitter Email Print Permalink All ACTs involve ... CF Care Team Research About Our Research Developing New Treatments Researcher Resources Assistance Services Find Resources: CF ...

  1. Affordable Care Act (ACA)

    Data.gov (United States)

    Social Security Administration — The Affordable Care Act (ACA) is a federal statute enacted with a goal of increasing the quality and affordability of health insurance. Through a web service, CMS...

  2. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements Advocacy News Briefings, Testimonies, and Regulatory Comments Congressional Cystic Fibrosis Caucus Our Policy Agenda Policy Principles SIGN UP FOR ADVOCACY ACTION ...

  3. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... people with cystic fibrosis so that they make smart decisions about CF-related research, treatment, and access ... The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements Advocacy News Briefings, Testimonies, and Regulatory ...

  4. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... What to Consider Regarding a Lung Transplant Medications Antibiotics Bronchodilators CFTR Modulator Therapies Mucus Thinners Nebulizer Care ... that help thin and move the mucus, and antibiotics. Bronchodilators should be inhaled before you start ACTs. ...

  5. Airway Clearance Techniques (ACTs)

    Medline Plus

    Full Text Available ... resources you need to continuously build upon this work. Awards and Grants Career Development Awards Research Awards ... The Preserving Employee Wellness Programs Act Our Advocacy Work Advocacy Achievements Advocacy News Briefings, Testimonies, and Regulatory ...

  6. Prevent Pneumonia

    Centers for Disease Control (CDC) Podcasts

    2015-08-06

    CDC’s Matthew Westercamp explains what pneumonia is, its symptoms, and how to prevent it.  Created: 8/6/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Respiratory Diseases Branch (RDB).   Date Released: 8/6/2015.

  7. Prevention: Exercise

    Medline Plus

    Full Text Available ... Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 for Spine Epidural Steroid Injections Exercise: The Backbone of Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Prevention ...

  8. Suicide Prevention

    Science.gov (United States)

    ... corresponding to World Suicide Prevention Day, to celebrate life, hope, and reasons to live. SAMHSA is committed to ... members, and helping people navigate the struggles of life to find a sustainable sense of hope, meaning, and purpose. For information about how you ...

  9. Bullying Prevention

    Science.gov (United States)

    Kemp, Patrice

    2016-01-01

    The focus of the milestone project is to focus on bridging the gap of bullying and classroom instruction methods. There has to be a defined expectations and level of accountability that has to be defined when supporting and implementing a plan linked to bullying prevention. All individuals involved in the student's learning have to be aware of…

  10. Contraceptive Coverage and the Affordable Care Act.

    Science.gov (United States)

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. The Corporations Act 2001

    OpenAIRE

    Bostock, Tom

    2002-01-01

    The author outlines reforms made in Australia in the area of company law with an analysis of the Corporations Act 2001, which along with the Australian Securities and Investments Commission Act 2001 comprises Corporations legislation in Australia. Article by Tom Bostock (a partner in the law firm Mallesons Stephen Jaques, Melbourne, Australia). Published in Amicus Curiae - Journal of the Institute of Advanced Legal Studies and its Society for Advanced Legal Studies. The Journal is produced by...

  12. 78 FR 32257 - Privacy Act of 1974; Report of a New Routine Use for Selected CMS Systems of Records

    Science.gov (United States)

    2013-05-29

    ... systems of records to assist in preventing and detecting fraud, waste and abuse. The new routine use will... for the purpose of preventing and detecting fraud, waste and abuse, pursuant to section 1128C(a)(2) of the Social Security Act (``the Act''). At section 1128C(c) of the Act, a health plan is defined as a...

  13. Will the new Consumer Protection Act prevent harm to nutritional ...

    African Journals Online (AJOL)

    ... in South Africa can be attributed to aggressive marketing by manufacturers whose claims are not always ... Control Council, which is charged with ensuring the safety, quality and effectiveness of medicines, ... Metrics powered by PLOS ALM.

  14. Hydrological Regime and Water Shortage as Drivers of the Seasonal Incidence of Diarrheal Diseases in a Tropical Montane Environment.

    Directory of Open Access Journals (Sweden)

    Laurie Boithias

    2016-12-01

    Full Text Available The global burden of diarrhea is a leading cause of morbidity and mortality worldwide. In montane areas of South-East Asia such as northern Laos, recent changes in land use have induced increased runoff, soil erosion and in-stream suspended sediment loads, and potential pathogen dissemination. To our knowledge, few studies have related diarrhea incidences to catchment scale hydrological factors such as river discharge, and loads of suspended sediment and of Fecal Indicator Bacteria (FIB such as Escherichia coli, together with sociological factors such as hygiene practices. We hypothesized that climate factors combined with human behavior control diarrhea incidence, either because higher rainfall, leading to higher stream discharges, suspended sediment loads and FIB counts, are associated with higher numbers of reported diarrhea cases during the rainy season, or because water shortage leads to the use of less safe water sources during the dry season. Using E. coli as a FIB, the objectives of this study were thus (1 to characterize the epidemiological dynamics of diarrhea in Northern Laos, and (2 to identify which hydro-meteorological and sociological risk factors were associated with diarrhea epidemics.Considering two unconnected river catchments of 22 and 7,448 km2, respectively, we conducted a retrospective time series analysis of meteorological variables (rainfall, air temperature, hydrological variables (discharge, suspended sediments, FIB counts, water temperature, and the number of diarrheal disease cases reported at 6 health centers located in the 5 southern districts of the Luang Prabang Province, Lao PDR. We also examined the socio-demographic factors potentially affecting vulnerability to the effect of the climate factors, such as drinking water sources, hygiene habits, and recreational water exposure.Using thus a mixed methods approach, we found E. coli to be present all year long (100-1,000 Most Probable Number or MPN 100 mL-1

  15. Two-warehouse inventory model for deteriorating items with price-sensitive demand and partially backlogged shortages under inflationary conditions

    Directory of Open Access Journals (Sweden)

    Chandra K. Jaggi

    2015-01-01

    Full Text Available In today’s competition inherited business world, managing inventory of goods is a major challenge in all the sectors of economy. The demand of an item plays a significant role while managing the stock of goods, as it may depend on several factors viz., inflation, selling price, advertisement, etc. Among these, selling price of an item is a decisive factor for the organization; because in this competitive world of business one is constantly on the lookout for the ways to beat the competition. It is a well-known accepted fact that keeping a reasonable price helps in attracting more customers, which in turn increases the aggregate demand. Thus in order to improve efficiency of business performance organization needs to stock a higher inventory, which needs an additional storage space. Moreover, in today’s unstable global economy there is consequent decline in the real value of money, because the general level of prices of goods and services is rising (i.e., inflation. And since inventories represent a considerable investment for every organization, it is inevitable to consider the effects of inflation and time value of money while determining the optimal inventory policy. With this motivation, this paper is aimed at developing a two-warehouse inventory model for deteriorating items where the demand rate is a decreasing function of the selling price under inflationary conditions. In addition, shortages are allowed and partially backlogged, and the backlogging rate has been considered as an exponentially decreasing function of the waiting time. The model jointly optimizes the initial inventory and the price for the product, so as to maximize the total average profit. Finally, the model is analysed and validated with the help of numerical examples, and a comprehensive sensitivity analysis has been performed which provides some important managerial implications.

  16. Specific leaf areas of the tank bromeliad Guzmania monostachia perform distinct functions in response to water shortage.

    Science.gov (United States)

    Freschi, Luciano; Takahashi, Cassia Ayumi; Cambui, Camila Aguetoni; Semprebom, Thais Ribeiro; Cruz, Aline Bertinatto; Mioto, Paulo Tamoso; de Melo Versieux, Leonardo; Calvente, Alice; Latansio-Aidar, Sabrina Ribeiro; Aidar, Marcos Pereira Marinho; Mercier, Helenice

    2010-05-01

    Leaves comprise most of the vegetative body of tank bromeliads and are usually subjected to strong longitudinal gradients. For instance, while the leaf base is in contact with the water accumulated in the tank, the more light-exposed middle and upper leaf sections have no direct access to this water reservoir. Therefore, the present study attempted to investigate whether different leaf portions of Guzmania monostachia, a tank-forming C(3)-CAM bromeliad, play distinct physiological roles in response to water shortage, which is a major abiotic constraint in the epiphytic habitat. Internal and external morphological features, relative water content, pigment composition and the degree of CAM expression were evaluated in basal, middle and apical leaf portions in order to allow the establishment of correlations between the structure and the functional importance of each leaf region. Results indicated that besides marked structural differences, a high level of functional specialization is also present along the leaves of this bromeliad. When the tank water was depleted, the abundant hydrenchyma of basal leaf portions was the main reservoir for maintaining a stable water status in the photosynthetic tissues of the apical region. In contrast, the CAM pathway was intensified specifically in the upper leaf section, which is in agreement with the presence of features more suitable for the occurrence of photosynthesis at this portion. Gas exchange data indicated that internal recycling of respiratory CO(2) accounted for virtually all nighttime acid accumulation, characterizing a typical CAM-idling pathway in the drought-exposed plants. Altogether, these data reveal a remarkable physiological complexity along the leaves of G. monostachia, which might be a key adaptation to the intermittent water supply of the epiphytic niche. Copyright 2009 Elsevier GmbH. All rights reserved.

  17. Effects of inflation and time value of money on an inventory system with deteriorating items and partially backlogged shortages

    Directory of Open Access Journals (Sweden)

    Chandra K. Jaggi

    2016-04-01

    Full Text Available As the long arm of the grinding, deep financial crisis continues to haunt the global economy, the effects of inflation and time value of money cannot be oblivious to an inventory system. Inflation, defined as a general rise in the prices of goods and services over a period of time, has monetary depreciation as one of its major side effects. And, since inventories correspond to substantial investment in capital for any organization, it would be unethical if the effects of inflation and time value of money are not considered while determining the optimal inventory policy. Moreover, deterioration of items is a phenomenon which cannot be ignored, as it may yield misleading results. Further, under the inflationary conditions, the different cost parameters including the price are bound to vary from cycle to cycle over the planning horizon. Another important factor is shortages which no retailer would prefer, and in practice are partially backlogged and partially lost. In order to convert the lost sales into sales, the retailer offers such customers an incentive, by charging them the price prevailing at the time of placing an order, instead of the current inflated price. Therefore, bearing in mind these facts, the present paper develops an inventory model for a retailer dealing with deteriorating items under inflationary conditions over a fixed planning horizon. The objective is to derive the optimal number of cycles and cycle length that maximizes the net present value of the total profit over a fixed planning horizon. An appropriate algorithm has been proposed to obtain the optimal solution. Finally, a numerical example is provided to illustrate the proposed model. Sensitivity analysis of the optimal solution with respect to major parameters is carried out and some managerial inferences have been presented.

  18. Politics of prevention: The emergence of prevention science.

    Science.gov (United States)

    Roumeliotis, Filip

    2015-08-01

    This article critically examines the political dimension of prevention science by asking how it constructs the problems for which prevention is seen as the solution and how it enables the monitoring and control of these problems. It also seeks to examine how prevention science has established a sphere for legitimate political deliberation and which kinds of statements are accepted as legitimate within this sphere. The material consists of 14 publications describing and discussing the goals, concepts, promises and problems of prevention science. The analysis covers the period from 1993 to 2012. The analysis shows that prevention science has established a narrow definition of "prevention", including only interventions aimed at the reduction of risks for clinical disorders. In publications from the U.S. National Institute of Drug Abuse, the principles of prevention science have enabled a commitment to a zero-tolerance policy on drugs. The drug using subject has been constructed as a rational choice actor lacking in skills in exerting self-control in regard to drug use. Prevention science has also enabled the monitoring and control of expertise, risk groups and individuals through specific forms of data gathering. Through the juxtaposition of the concepts of "objectivity" and "morality", prevention science has constituted a principle of delineation, disqualifying statements not adhering to the principles of prevention science from the political field, rendering ethical and conflictual dimensions of problem representations invisible. The valorisation of scientific accounts of drugs has acted to naturalise specific political ideals. It simultaneously marginalises the public from the public policy process, giving precedence to experts who are able to provide information that policy-makers are demanding. Alternative accounts, such as those based on marginalisation, poverty or discrimination are silenced within prevention science. Copyright © 2015 Elsevier B.V. All rights

  19. Trifluoromethyl acting as stopper in [2]rotaxane

    KAUST Repository

    Dasgupta, Suvankar; Huang, Kuo-Wei; Wu, Jishan

    2012-01-01

    A modified dumbbell obtained by replacing one of the phenyl groups of the dibenzylammonium with a strong electron-withdrawing trifluoromethyl group templated the synthesis of the smallest [2]rotaxane reported so far. The trifluoromethyl group not only enhances the templating effect of the dumbbell but also acts as the stopper to prevent dethreading of a [20]crown ether macrocycle. © 2012 The Royal Society of Chemistry.

  20. Trifluoromethyl acting as stopper in [2]rotaxane

    KAUST Repository

    Dasgupta, Suvankar

    2012-07-24

    A modified dumbbell obtained by replacing one of the phenyl groups of the dibenzylammonium with a strong electron-withdrawing trifluoromethyl group templated the synthesis of the smallest [2]rotaxane reported so far. The trifluoromethyl group not only enhances the templating effect of the dumbbell but also acts as the stopper to prevent dethreading of a [20]crown ether macrocycle. © 2012 The Royal Society of Chemistry.