WorldWideScience

Sample records for survive resource shortages

  1. 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

  2. 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.

  3. 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.

  4. Model checking coalitional games in shortage resource scenarios

    Directory of Open Access Journals (Sweden)

    Dario Della Monica

    2013-07-01

    Full Text Available Verification of multi-agents systems (MAS has been recently studied taking into account the need of expressing resource bounds. Several logics for specifying properties of MAS have been presented in quite a variety of scenarios with bounded resources. In this paper, we study a different formalism, called Priced Resource-Bounded Alternating-time Temporal Logic (PRBATL, whose main novelty consists in moving the notion of resources from a syntactic level (part of the formula to a semantic one (part of the model. This allows us to track the evolution of the resource availability along the computations and provides us with a formalisms capable to model a number of real-world scenarios. Two relevant aspects are the notion of global availability of the resources on the market, that are shared by the agents, and the notion of price of resources, depending on their availability. In a previous work of ours, an initial step towards this new formalism was introduced, along with an EXPTIME algorithm for the model checking problem. In this paper we better analyze the features of the proposed formalism, also in comparison with previous approaches. The main technical contribution is the proof of the EXPTIME-hardness of the the model checking problem for PRBATL, based on a reduction from the acceptance problem for Linearly-Bounded Alternating Turing Machines. In particular, since the problem has multiple parameters, we show two fixed-parameter reductions.

  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. 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...

  7. 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

  8. 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.

  9. 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.

  10. Role of nuclear energy to a future society of shortage of energy resources and global warming

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Shinzo, E-mail: saito.shinzo@jaea.go.j [Japan Atomic Energy Research Institute (Japan)

    2010-03-15

    Human society entered into the society of large energy consumption since the industrial revolution and consumes more than 10 billion tons of oil equivalent energy a year in the world in the present time, in which over 80% is provided by fossil fuels such as coal, oil and natural gas. Total energy consumption is foreseen to increase year by year from now on due to significant economical and population growth in the developing countries such as China and India. However, fossil fuel resources are limited with conventional crude oil estimated to last about 40 years, and it is said that the peak oil production time has come now. On the other hand, global warming due to green house gases (GHG) emissions, especially carbon dioxide, has become a serious issue. Nuclear energy plays an important role as means to resolve energy security and global warming issues. Four hundred twenty-nine nuclear power plants are operating world widely producing 16% of the total electric power with total plant capacity of 386 GWe without emission of CO{sub 2} as of 2006. It is estimated that another 250 GWe nuclear power is needed to keep the same level contribution of electricity generation in 2030. On the other hand, the Japan Atomic Energy Research Institute (JAERI) developed the very high temperature gas-cooled reactor (HTGR) named high temperature gas-cooled engineering test reactor (HTTR) and carbon free hydrogen production process (IS process). Nuclear energy utilization will surely widen in, not only electricity generation, but also various industries such as steel making, chemical industries, together with hydrogen production for transportation by introduction of HTGRs. The details of development of the HTTR and IS process are also described.

  11. Survivable resource orchestration for optically interconnected data center networks.

    Science.gov (United States)

    Zhang, Qiong; She, Qingya; Zhu, Yi; Wang, Xi; Palacharla, Paparao; Sekiya, Motoyoshi

    2014-01-13

    We propose resource orchestration schemes in overlay networks enabled by optical network virtualization. Based on the information from underlying optical networks, our proposed schemes provision the fewest data centers to guarantee K-connect survivability, thus maintaining resource availability for cloud applications under any failure.

  12. 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.

  13. Survival and growth of epiphytic ferns depend on resource sharing

    Directory of Open Access Journals (Sweden)

    Hua-Zheng eLu

    2016-03-01

    Full Text Available Locally available resources can be shared within clonal plant systems through physiological integration, thus enhancing their survival and growth. Most epiphytes exhibit clonal growth habit, but few studies have tested effects of physiological integration (resource sharing on survival and growth of epiphytes and whether such effects vary with species. We conducted two experiments, one on individuals (single ramets and another on groups (several ramets within a plot, with severed and intact rhizome treatments (without and with physiological integration on two dominant epiphytic ferns (Polypodiodes subamoena and Lepisorus scolopendrium in a subtropical montane moist forest in Southwest China. Rhizome severing (preventing integration significantly reduced ramet survival in the individual experiment and number of surviving ramets in the group experiment, and it also decreased biomass of both species in both experiments. However, the magnitude of such integration effects did not vary significantly between the two species. We conclude that resource sharing may be a general strategy for clonal epiphytes to adapt to forest canopies where resources are limited and heterogeneously distributed in space and time.

  14. Relationships demand-supply of water and the rate of water shortage as tools for evaluating water resources in Colombia

    International Nuclear Information System (INIS)

    Dominguez Calle, Efrain Antonio; Gonzalo Rivera, Hebert; Vanegas, Sarmiento Raquel; Moreno, Pedro

    2008-01-01

    This paper shows updated results about Colombian water resources and their requirements by the economic sectors. Water demand water availability relationship is used as a pressure index on water resources. This relationship is expressed through the water scarcity index, which applies constraints over water availability; due to the runoff temporal variability and to the low levels of water during the dry season each year and for each geographic region to characterize average and low runoff years. Different water availability scenarios were building. One for modal runoff values and another for 95 percents for 2025 also were prepared. To the results call our attention to problems caused by the concentration of high density settlements and the presence of economics sectors in regions with low water availability. The infrastructure lag for management of a scarce high variable and over pressured resources emerges as a key factor to avoid a looming crisis in the process of water management

  15. 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

  16. Managing education/training resources to survive regulatory change

    International Nuclear Information System (INIS)

    Headley-Walker, L.; DeSain, G.

    1985-01-01

    The road to development of nuclear training and education programs that prepare operators to not only competently operate a commercial nuclear power plant under routine conditions but also acquire the knowledge, experience, and confidence necessary to perform under the rigors of a significant off-normal incident has been filled with speculative opinion, recommendations, disagreement, guidelines, and downright confusion. The US Nuclear Regulatory Commission (NRC) had not produced a regulation that specifically addresses the nature of education/training related to off-normal incidents. No one educational process currently offered fully addresses the ideal solution for those employed in the nuclear industry. The only practical solution must be the result of collaborative efforts between utilities and educational resources. The Regents College Degree Collaboration Model provides a worthy vehicle for positive movement toward this solution and survival of the ever-changing regulatory constraints in education

  17. 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.

  18. Energy Survival: entertainment as a resource for local energy actions

    Energy Technology Data Exchange (ETDEWEB)

    Elburg, Henk van; Moosdijk, Catelijne van de [SenterNovem (Netherlands)

    2007-07-01

    In 2005, SenterNovem, the Dutch Broadcasting Corporation, a publishing company and a consortium of local authorities launched 'Energy Survival'; a renewing energy marketing strategy for children to create a demand for local energy actions. New elements are powerful branding and the use of cross media techniques through national TV, internet, local events and primary education. Through entertainment, Energy Survival influences children's attitude towards energy consumption and its convincing relation with the environment. It aims at qualifying children to become 'energy ambassadors' in their own local environment: family, school and neighbourhood. Energy Survival has become a well tested energy game-concept for children in whom public and private partners cooperate under one brand name and with a clear division of roles and interests. However, the backbone of the concept is the local approach: local actions in municipalities and in primary schools, supported by television and internet where children learn to deal with the upcoming energy challenges of the planet they will inherit. By providing an internet-based teaching method, especially primary schools will be an effective multiplier to reach children. Broadcasting the energy game on national TV on the one hand, and local events and preliminaries on the other hand, ensure opportunities for widespread 'duplication' of the concept, adapted to local policy priorities regarding sustainable energy because each municipality is permitted to choose its own themes. Despite the fact that the project is still young and that the partners consider it as a 'long term-investment', the first independent monitoring results indicate that Energy Survival so far is quite successful. Ratings of the first TV-series show a national market share of 20 % in the age group 6-12 years and significantly more interaction between children and their parents on energy related issues. The website

  19. Resource Elasticity of Offspring Survival and the Optimal Evolution of Sex Ratios

    Science.gov (United States)

    Wang, Rui-Wu; Wang, Ya-Qiang; He, Jun-Zhou; Li, Yao-Tang

    2013-01-01

    The fitness of any organisms includes the survival and reproductive rate of adults and the survival of their offspring. Environmental selection pressures might not affect these two aspects of an organism equally. Assuming that an organism first allocates its limited resources to maintain its survival under environmental selection pressure, our model, based on the evolutionarily stable strategy theory, surprisingly shows that the sex ratio is greatly affected by the environmental pressure intensity and by the reproductive resource elasticity of offspring survival. Moreover, the concept of the resource elasticity of offspring survival intrinsically integrates the ecological concepts of K selection and r selection. The model shows that in a species with reproductive strategy K, increased environmental selection pressure will reduce resource allocation to the male function. By contrast, in a species with reproductive strategy r, harsher environmental selection pressure will increase allocation to the male function. The elasticity of offspring survival might vary not only across species, but also across many other factors affecting the same species (e.g., age structure, spatial heterogeneity), which explains sex ratio differences across species or age structures and spatial heterogeneity in the same species. PMID:23468826

  20. Reproduction and survival of a solitary bee along native and exotic floral resource gradients.

    Science.gov (United States)

    Palladini, Jennifer D; Maron, John L

    2014-11-01

    Native bee abundance has long been assumed to be limited by floral resources. This paradigm has been established in large measure because more bees are often found in areas supporting greater floral abundance. This could result from attraction to resource-rich sites as well as greater local demographic performance in sites supporting high floral abundance; however, demographic performance is usually unknown. Factors other than floral resources such as availability of nest sites, pressure from natural enemies, or whether floral resources are from a mixed native or mostly monodominant exotic assemblage might influence survival or fecundity and hence abundance. We examined how the survival and fecundity of the native solitary bee Osmia lignaria varied along a gradient in floral resource abundance. We released bees alongside a nest block at 27 grassland sites in Montana (USA) that varied in floral abundance and the extent of invasion by exotic forbs. We monitored nest construction and the fate of offspring within each nest. The number of nests established was positively related to native forb abundance and was negatively related to exotic forb species richness. Fecundity was positively related to native forb species richness; however, offspring mortality caused by the brood parasite Tricrania stansburyi was significantly greater in native-dominated sites. These results suggest that native floral resources can positively influence bee populations, but that the relationship between native floral resources and bee population performance is not straightforward. Rather, bees may face a trade-off between high offspring production and low offspring survival in native-dominated sites.

  1. Resource availability and competition shape the evolution of survival and growth ability in a bacterial community.

    Directory of Open Access Journals (Sweden)

    Minna Pekkonen

    Full Text Available Resource availability is one of the main factors determining the ecological dynamics of populations or species. Fluctuations in resource availability can increase or decrease the intensity of resource competition. Resource availability and competition can also cause evolutionary changes in life-history traits. We studied how community structure and resource fluctuations affect the evolution of fitness related traits using a two-species bacterial model system. Replicated populations of Serratia marcescens (copiotroph and Novosphingobium capsulatum (oligotroph were reared alone or together in environments with intergenerational, pulsed resource renewal. The comparison of ancestral and evolved bacterial clones with 1 or 13 weeks history in pulsed resource environment revealed species-specific changes in life-history traits. Co-evolution with S. marcescens caused N. capsulatum clones to grow faster. The evolved S. marcescens clones had higher survival and slower growth rate then their ancestor. The survival increased in all treatments after one week, and thereafter continued to increase only in the S. marcescens monocultures that experienced large resource pulses. Though adaptive radiation is often reported in evolution studies with bacteria, clonal variation increased only in N. capsulatum growth rate. Our results suggest that S. marcescens adapted to the resource renewal cycle whereas N. capsulatum was more affected by the interspecific competition. Our results exemplify species-specific evolutionary response to both competition and environmental variation.

  2. 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.

  3. Rapid Genetic Adaptation during the First Four Months of Survival under Resource Exhaustion.

    Science.gov (United States)

    Avrani, Sarit; Bolotin, Evgeni; Katz, Sophia; Hershberg, Ruth

    2017-07-01

    Many bacteria, including the model bacterium Escherichia coli can survive for years within spent media, following resource exhaustion. We carried out evolutionary experiments, followed by whole genome sequencing of hundreds of evolved clones to study the dynamics by which E. coli adapts during the first 4 months of survival under resource exhaustion. Our results reveal that bacteria evolving under resource exhaustion are subject to intense selection, manifesting in rapid mutation accumulation, enrichment in functional mutation categories and extremely convergent adaptation. In the most striking example of convergent adaptation, we found that across five independent populations adaptation to conditions of resource exhaustion occurs through mutations to the three same specific positions of the RNA polymerase core enzyme. Mutations to these three sites are strongly antagonistically pleiotropic, in that they sharply reduce exponential growth rates in fresh media. Such antagonistically pleiotropic mutations, combined with the accumulation of additional mutations, severely reduce the ability of bacteria surviving under resource exhaustion to grow exponentially in fresh media. We further demonstrate that the three positions at which these resource exhaustion mutations occur are conserved for the ancestral E. coli allele, across bacterial phyla, with the exception of nonculturable bacteria that carry the resource exhaustion allele at one of these positions, at very high frequencies. Finally, our results demonstrate that adaptation to resource exhaustion is not limited by mutational input and that bacteria are able to rapidly adapt under resource exhaustion in a temporally precise manner through allele frequency fluctuations. © The Author 2017. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

  4. 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.

  5. Partner resources and incidence and survival in two major causes of death

    Directory of Open Access Journals (Sweden)

    Jenny Torssander

    2018-04-01

    Full Text Available Because people tend to marry social equals – and possibly also because partners affect each other’s health – the social position of one partner is associated with the other partner’s health and mortality. Although this link is fairly well established, the underlying mechanisms are not fully identified. Analyzing disease incidence and survival separately may help us to assess when in the course of the disease a partner’s resources are of most significance. This article addresses the importance of partner’s education, income, employment status, and health for incidence and survival in two major causes of death: cancer and cardiovascular diseases (CVD. Based on a sample of Finnish middle-aged and older couples (around 200,000 individuals we show that a partner’s education is more often connected to incidence than to survival, in particular for CVD. Once ill, any direct effect of partner’s education seems to decline: The survival chances after being hospitalized for cancer or CVD are rather associated with partner’s employment status and/or income level when other individual and partner factors are adjusted for. In addition, a partner’s history of poor health predicted higher CVD incidence and, for women, lower cancer survival. The findings suggest that various partner’s characteristics may have different implications for disease and survival, respectively. A wider focus on social determinants of health at the household level, including partner’s social resources, is needed. Keywords: Marital/cohabiting partners, Education, Income, CVD, Cancer, Survival, Finland

  6. Optimal exploitation of a renewable resource with stochastic nonconvex technology: An analysis of extinction and survival

    International Nuclear Information System (INIS)

    Mitra, Tapan; Roy, Santanu

    1992-11-01

    This paper analyzes the possibilities of extinction and survival of a renewable resource whose technology of reproduction is both stochastic and nonconvex. In particular, the production function is subject to random shocks over time and is allowed to be nonconcave, though it eventually exhibits bounded growth. The existence of a minimum biomass below which the resource can only decrease, is allowed for. Society harvests a part of the current stock every time period over an infinite horizon so as to maximize the expected discounted sum of one period social utilities from the harvested resource. The social utility function is strictly concave. The stochastic process of optimal stocks generated by the optimal stationary policy is analyzed. The nonconvexity in the optimization problem implies that the optimal policy functions are not 'well behaved'. The behaviour of the probability of extinction (and the expected time to extinction), as a function of initial stock, is characterized for various possible configurations of the optimal policy and the technology. Sufficient conditions on the utility and production functions and the rate of impatience, are specified in order to ensure survival of the resource with probability one from some stock level (the minimum safe standard of conservation). Sufficient conditions for almost sure extinction and almost sure survival from all stock levels are also specified. These conditions are related to the corresponding conditions derived in models with deterministic and/or convex technology. 4 figs., 29 refs

  7. Optimal exploitation of a renewable resource with stochastic nonconvex technology: An analysis of extinction and survival

    Energy Technology Data Exchange (ETDEWEB)

    Mitra, Tapan [Department of Economics, Cornell University, Ithaca, NY (United States); Roy, Santanu [Econometric Institute, Erasmus University, Rotterdam (Netherlands)

    1992-11-01

    This paper analyzes the possibilities of extinction and survival of a renewable resource whose technology of reproduction is both stochastic and nonconvex. In particular, the production function is subject to random shocks over time and is allowed to be nonconcave, though it eventually exhibits bounded growth. The existence of a minimum biomass below which the resource can only decrease, is allowed for. Society harvests a part of the current stock every time period over an infinite horizon so as to maximize the expected discounted sum of one period social utilities from the harvested resource. The social utility function is strictly concave. The stochastic process of optimal stocks generated by the optimal stationary policy is analyzed. The nonconvexity in the optimization problem implies that the optimal policy functions are not `well behaved`. The behaviour of the probability of extinction (and the expected time to extinction), as a function of initial stock, is characterized for various possible configurations of the optimal policy and the technology. Sufficient conditions on the utility and production functions and the rate of impatience, are specified in order to ensure survival of the resource with probability one from some stock level (the minimum safe standard of conservation). Sufficient conditions for almost sure extinction and almost sure survival from all stock levels are also specified. These conditions are related to the corresponding conditions derived in models with deterministic and/or convex technology. 4 figs., 29 refs.

  8. 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

  9. Effects of microcosm scaling and food resources on growth and survival of larval Culex pipiens

    Directory of Open Access Journals (Sweden)

    Paradise Christopher J

    2001-08-01

    Full Text Available Abstract Background We used a simple experimental design to test for the effects of microcosm scaling on the growth and survival of the mosquito, Culex pipiens. Microcosm and mesocosm studies are commonly used in ecology, and there is often an assumption that scaling doesn't affect experimental outcomes. The assumption is implicit in the design; choice of mesocosms may be arbitrary or based on convenience or cost. We tested the hypothesis that scale would influence larvae due to depth and surface area effects. Larvae were predicted to perform poorly in microcosms that were both deep and had small openings, due to buildup of waste products, less exchange with the environment, and increased competition. To determine if the choice of scale affected responses to other factors, we independently varied leaf litter quantity, whose effects on mosquitoes are well known. Results We found adverse effects of both a lower wall surface area and lower horizontal surface area, but microcosm scale interacted with resources such that C. pipiens is affected by habitat size only when food resources are scarce. At low resource levels mosquitoes were fewer, but larger, in microcosms with smaller horizontal surface area and greater depth than in microcosms with greater horizontal surface area and shallower depth. Microcosms with more vertical surface area/volume often produced larger mosquitoes; more food may have been available since mosquitoes browse on walls and other substrates for food. Conclusions The interaction between habitat size and food abundance is consequential to aquatic animals, and choice of scale in experiments may affect results. Varying surface area and depth causes the scale effect, with small horizontal surface area and large depth decreasing matter exchange with the surrounding environment. In addition, fewer resources leads to less leaf surface area, and the effects of varying surface area will be greater under conditions of limiting resources

  10. Effects of maternal nutrition, resource use and multi-predator risk on neonatal white-tailed deer survival.

    Directory of Open Access Journals (Sweden)

    Jared F Duquette

    Full Text Available Growth of ungulate populations is typically most sensitive to survival of neonates, which in turn is influenced by maternal nutritional condition and trade-offs in resource selection and avoidance of predators. We assessed whether resource use, multi-predator risk, maternal nutritional effects, hiding cover, or interactions among these variables best explained variation in daily survival of free-ranging neonatal white-tailed deer (Odocoileus virginianus during their post-partum period (14 May-31 Aug in Michigan, USA. We used Cox proportional hazards mixed-effects models to assess survival related to covariates of resource use, composite predation risk of 4 mammalian predators, fawn body mass at birth, winter weather, and vegetation growth phenology. Predation, particularly from coyotes (Canis latrans, was the leading cause of mortality; however, an additive model of non-ideal resource use and maternal nutritional effects explained 71% of the variation in survival. This relationship suggested that dams selected areas where fawns had poor resources, while greater predation in these areas led to additive mortalities beyond those related to resource use alone. Also, maternal nutritional effects suggested that severe winters resulted in dams producing smaller fawns, which decreased their likelihood of survival. Fawn resource use appeared to reflect dam avoidance of lowland forests with poor forage and greater use by wolves (C. lupus, their primary predator. While this strategy led to greater fawn mortality, particularly by coyotes, it likely promoted the life-long reproductive success of dams because many reached late-age (>10 years old and could have produced multiple generations of fawns. Studies often link resource selection and survival of ungulates, but our results suggested that multiple factors can mediate that relationship, including multi-predator risk. We emphasize the importance of identifying interactions among biological and

  11. 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.

  12. 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

  13. 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....

  14. 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.

  15. Optimal resource allocation to survival and reproduction in parasitic wasps foraging in fragmented habitats.

    Directory of Open Access Journals (Sweden)

    Eric Wajnberg

    Full Text Available Expansion and intensification of human land use represents the major cause of habitat fragmentation. Such fragmentation can have dramatic consequences on species richness and trophic interactions within food webs. Although the associated ecological consequences have been studied by several authors, the evolutionary effects on interacting species have received little research attention. Using a genetic algorithm, we quantified how habitat fragmentation and environmental variability affect the optimal reproductive strategies of parasitic wasps foraging for hosts. As observed in real animal species, the model is based on the existence of a negative trade-off between survival and reproduction resulting from competitive allocation of resources to either somatic maintenance or egg production. We also asked to what degree plasticity along this trade-off would be optimal, when plasticity is costly. We found that habitat fragmentation can indeed have strong effects on the reproductive strategies adopted by parasitoids. With increasing habitat fragmentation animals should invest in greater longevity with lower fecundity; yet, especially in unpredictable environments, some level of phenotypic plasticity should be selected for. Other consequences in terms of learning ability of foraging animals were also observed. The evolutionary consequences of these results are discussed.

  16. 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

  17. Helping mothers survive bleeding after birth: an educational of simulation-based training in a low resource setting

    NARCIS (Netherlands)

    Nelissen, E.J.T.; Ersdal, H.; Ostergaard, D.; Mduma, E.; Broerse, J.E.W.; Evjen-Olsen, B.; van Roosmalen, J.; Stekelenburg, J.

    2014-01-01

    Objective To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. Design Educational intervention study. Setting Rural referral hospital in Northern Tanzania. Population Clinicians, nurse-midwives, medical attendants, and ambulance

  18. 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.

  19. Individual and Neighborhood Socioeconomic Status and Health care Resources in Relation to Black-White Breast Cancer Survival Disparities

    International Nuclear Information System (INIS)

    Akinyemiju, T. F.

    2013-01-01

    Breast cancer survival has improved significantly in the US in the past 10-15 years. However, disparities exist in breast cancer survival between black and white women. Purpose. To investigate the effect of county health care resources and SES as well as individual SES status on breast cancer survival disparities between black and white women. Methods. Data from 1,796 breast cancer cases were obtained from the Surveillance Epidemiology and End Results and the National Longitudinal Mortality Study dataset. Cox Proportional Hazards models were constructed accounting for clustering within counties. Three sequential Cox models were fit for each outcome including demographic variables; demographic and clinical variables; and finally demographic, clinical, and county-level variables. Results. In unadjusted analysis, black women had a 53% higher likelihood of dying of breast cancer and 32% higher likelihood of dying of any cause ( P < 0.05) compared with white women. Adjusting for demographic variables explained away the effect of race on breast cancer survival (HR, 1.40; 95% CI, 0.99-1.97), but not on all-cause mortality. The racial difference in all-cause survival disappeared only after adjusting for county-level variables (HR, 1.27; CI, 0.95-1.71). Conclusions. Improving equitable access to health care for all women in the US may help eliminate survival disparities between racial and socioeconomic groups.

  20. Individual and Neighborhood Socioeconomic Status and Healthcare Resources in Relation to Black-White Breast Cancer Survival Disparities

    Directory of Open Access Journals (Sweden)

    Tomi F. Akinyemiju

    2013-01-01

    Full Text Available Background. Breast cancer survival has improved significantly in the US in the past 10–15 years. However, disparities exist in breast cancer survival between black and white women. Purpose. To investigate the effect of county healthcare resources and SES as well as individual SES status on breast cancer survival disparities between black and white women. Methods. Data from 1,796 breast cancer cases were obtained from the Surveillance Epidemiology and End Results and the National Longitudinal Mortality Study dataset. Cox Proportional Hazards models were constructed accounting for clustering within counties. Three sequential Cox models were fit for each outcome including demographic variables; demographic and clinical variables; and finally demographic, clinical, and county-level variables. Results. In unadjusted analysis, black women had a 53% higher likelihood of dying of breast cancer and 32% higher likelihood of dying of any cause (P<0.05 compared with white women. Adjusting for demographic variables explained away the effect of race on breast cancer survival (HR, 1.40; 95% CI, 0.99–1.97, but not on all-cause mortality. The racial difference in all-cause survival disappeared only after adjusting for county-level variables (HR, 1.27; CI, 0.95–1.71. Conclusions. Improving equitable access to healthcare for all women in the US may help eliminate survival disparities between racial and socioeconomic groups.

  1. 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…

  2. Recovery and Resource Allocation Strategies to Maximize Mobile Network Survivability by Using Game Theories and Optimization Techniques

    Directory of Open Access Journals (Sweden)

    Pei-Yu Chen

    2013-01-01

    Full Text Available With more and more mobile device users, an increasingly important and critical issue is how to efficiently evaluate mobile network survivability. In this paper, a novel metric called Average Degree of Disconnectivity (Average DOD is proposed, in which the concept of probability is calculated by the contest success function. The DOD metric is used to evaluate the damage degree of the network, where the larger the value of the Average DOD, the more the damage degree of the network. A multiround network attack-defense scenario as a mathematical model is used to support network operators to predict all the strategies both cyber attacker and network defender would likely take. In addition, the Average DOD would be used to evaluate the damage degree of the network. In each round, the attacker could use the attack resources to launch attacks on the nodes of the target network. Meanwhile, the network defender could reallocate its existing resources to recover compromised nodes and allocate defense resources to protect the survival nodes of the network. In the approach to solving this problem, the “gradient method” and “game theory” are adopted to find the optimal resource allocation strategies for both the cyber attacker and mobile network defender.

  3. The survival of the conformist: social pressure and renewable resource management.

    Science.gov (United States)

    Tavoni, Alessandro; Schlüter, Maja; Levin, Simon

    2012-04-21

    This paper examines the role of other-regarding behavior as a mechanism for the establishment and maintenance of cooperation in resource use under variable social and environmental conditions. By coupling resource stock dynamics with social dynamics concerning compliance to a social norm prescribing non-excessive resource extraction in a common pool resource, we show that when reputational considerations matter and a sufficient level of social stigma affects the violators of a norm, sustainable outcomes are achieved. We find large parameter regions where norm-observing and norm-violating types coexist, and analyze to what extent such coexistence depends on the environment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. 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

  5. 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.

  6. A staff shortage in Canada?

    International Nuclear Information System (INIS)

    Stoll, P.

    1995-01-01

    Attrition of experienced staff, falling student enrolments and closure of university courses are symptoms of the contraction of the Canadian nuclear industry over the last two decades. It is not alone. A study carried out by Human Resources Development Canada, a government department, to forecast the demand for qualified nuclear staff in Canada over the next 15 years has reached similar conclusions to an OECD/NEA study of its members' future personnel requirements. (author)

  7. 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.

  8. Surviving in a marine desert: The sponge loop retains resources within coral reefs

    NARCIS (Netherlands)

    de Goeij, J.M.; van Oevelen, D.; Vermeij, M.J.A.; Osinga , R.; Middelburg, J.J.; de Goeij, A.F.P.M.; Admiraal, W.

    2013-01-01

    Ever since Darwin’s early descriptions of coral reefs, scientists have debated how one of the world’s most productive and diverse ecosystems can thrive in the marine equivalent of a desert. It is an enigma how the flux of dissolved organic matter (DOM), the largest resource produced on reefs, is

  9. Surviving in a marine desert: the sponge loop retains resources within coral reefs

    NARCIS (Netherlands)

    de Goei, J.M.; van Oevelen, D.; Vermeij, M.J.A.; Osinga, R.; Middelburg, J.J.; de Goei, A.F.P.M.; Admiraal, W.

    2013-01-01

    Ever since Darwin’s early descriptions of coral reefs, scientists have debated how one of the world’s most productive and diverse ecosystems can thrive in the marine equivalent of a desert. It is an enigma how the flux of dissolved organic matter (DOM), the largest resource produced on reefs, is

  10. Distributed Sharing of Functionalities and Resources in Survivable GMPLS-controlled WSONs

    DEFF Research Database (Denmark)

    Fagertun, Anna Manolova; Cerutti, I.; Muñoz, R.

    2012-01-01

    Sharing of functionalities and sharing of network resources are effective solutions for improving the cost-effectiveness of wavelength-switched optical networks (WSONs). Such cost-effectiveness should be pursued together with the objective of ensuring the requested level of performance at the phy...

  11. Surviving in a Marine Desert: The Sponge Loop Retains Resources Within Coral Reefs

    NARCIS (Netherlands)

    de Goeij, J.M.; van Oevelen, D.; Vermeij, M.J.A.; Osinga, R.; Middelburg, J.J.; de Goeij, A.F.P.M.; Admiraal, W.

    2013-01-01

    Ever since Darwin’s early descriptions of coral reefs, scientists have debated how one of the world’s most productive and diverse ecosystems can thrive in the marine equivalent of a desert. It is an enigma how the flux of dissolved organic matter (DOM), the largest resource produced on reefs, is

  12. 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.

  13. Inner resources for survival: integrating interpersonal psychotherapy with spiritual visualization with homeless youth.

    Science.gov (United States)

    Mastropieri, Biagio; Schussel, Lorne; Forbes, David; Miller, Lisa

    2015-06-01

    Homeless youth have particular need to develop inner resources to confront the stress, abusive environment of street life, and the paucity of external resources. Research suggests that treatment supporting spiritual awareness and growth may create a foundation for coping, relationships, and negotiating styles to mitigate distress. The current pilot study tests the feasibility, acceptability, and helpfulness of an interpersonal spiritual group psychotherapy, interpersonal psychotherapy (IPT) integrated with spiritual visualization (SV), offered through a homeless shelter, toward improving interpersonal coping and ameliorating symptoms of depression, distress, and anxiety in homeless youth. An exploratory pilot of integrative group psychotherapy (IPT + SV) for homeless young adults was conducted in a New York City on the residential floor of a shelter-based transitional living program. Thirteen young adult men (mean age 20.3 years, SD = 1.06) participated in a weekly evening psychotherapy group (55 % African-American, 18 % biracial, 18 % Hispanic, 9 % Caucasian). Measures of psychological functioning were assessed at pre-intervention and post-intervention using the General Health Questionnaire (GHQ-12), Patient Health Questionnaire (PHQ-9, GAD-7), and the Inventory of Interpersonal Problems (IIP-32). A semi-structured exit interview and a treatment satisfaction questionnaire were also employed to assess acceptability following treatment. Among homeless young adults to participate in the group treatment, significant decreases in symptoms of general distress and depression were found between baseline and termination of treatment, and at the level of a trend, improvement in overall interpersonal functioning and levels of general anxiety. High utilization and treatment satisfaction showed the intervention to be both feasible and acceptable. Offered as an adjunct to the services-as-usual model at homeless shelters serving young adults, interpersonal psychotherapy

  14. Effects of Anticipation in Individually Motivated Behaviour on Survival and Control in a Multi-Agent Scenario with Resource Constraints

    Directory of Open Access Journals (Sweden)

    Christian Guckelsberger

    2014-06-01

    Full Text Available Self-organization and survival are inextricably bound to an agent’s ability to control and anticipate its environment. Here we assess both skills when multiple agents compete for a scarce resource. Drawing on insights from psychology, microsociology and control theory, we examine how different assumptions about the behaviour of an agent’s peers in the anticipation process affect subjective control and survival strategies. To quantify control and drive behaviour, we use the recently developed information-theoretic quantity of empowerment with the principle of empowerment maximization. In two experiments involving extensive simulations, we show that agents develop risk-seeking, risk-averse and mixed strategies, which correspond to greedy, parsimonious and mixed behaviour. Although the principle of empowerment maximization is highly generic, the emerging strategies are consistent with what one would expect from rational individuals with dedicated utility models. Our results support empowerment maximization as a universal drive for guided self-organization in collective agent systems.

  15. "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)

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. Perinatal interventions and survival in resource-poor settings: which work, which don't, which have the jury out?

    Science.gov (United States)

    Osrin, David; Prost, Audrey

    2010-12-01

    Perinatal conditions make the largest contribution to the burden of disease in low-income countries. Although postneonatal mortality rates have declined, stillbirth and early neonatal mortality rates remain high in many countries in Africa and Asia, and there is a concentration of mortality around the time of birth. Our article begins by considering differences in the interpretation of 'intervention' to improve perinatal survival. We identify three types of a single action, a collection of actions delivered in a package and a broader social or system approach. We use this classification to summarise the findings of recent systematic reviews and meta-analyses. After describing the growing evidence base for the effectiveness of community-based perinatal care, we discuss current concerns about integration: of women's and children's health programmes, of community-based and institutional care, and of formal and informal sector human resources. We end with some thoughts on the complexity of choices confronting women and their families in low-income countries, particularly in view of the growth in non-government and private sector healthcare.

  3. 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...

  4. 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

  5. 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.

  6. 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.

  7. Ecophysiology of gelatinous Nostoc colonies: unprecedented slow growth and survival in resource-poor and harsh environments.

    Science.gov (United States)

    Sand-Jensen, Kaj

    2014-07-01

    structural substances in large Nostoc colonies cause lower quantum efficiency and assimilation number and higher light compensation points than in unicells and other aquatic macrophytes. Extremely low growth and mortality rates of N. zetterstedtii reflect stress-selected adaptation to nutrient- and DIC-poor temperate lakes, while N. pruniforme exhibits a mixed ruderal- and stress-selected strategy with slow growth and year-long survival prevailing in sub-Arctic lakes and faster growth and shorter longevity in temperate lakes. Nostoc commune and its close relative N. flagelliforme have a mixed stress-disturbance strategy not found among higher plants, with stress selection to limiting water and nutrients and disturbance selection in quiescent dry or frozen stages. Despite profound ecological differences between species, active growth of temperate specimens is mostly restricted to the same temperature range (0-35 °C; maximum at 25 °C). Future studies should aim to unravel the processes behind the extreme persistence and low metabolism of Nostoc species under ambient resource supply on sediment and soil surfaces. © The Author 2014. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. 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

  9. Aging as an evolvability-increasing program which can be switched off by organism to mobilize additional resources for survival.

    Science.gov (United States)

    Skulachev, Maxim V; Severin, Fedor F; Skulachev, Vladimir P

    2015-01-01

    During the last decade, several pieces of convincing evidence were published indicating that aging of living organisms is programmed, being a particular case of programmed death of organism (phenoptosis). Among them, the following observations can be mentioned. (1) Species were described that show negligible aging. In mammals, the naked mole rat is the most impressive example. This is a rodent of mouse size living at least 10-fold longer than a mouse and having fecundity higher than a mouse and no agerelated diseases. (2) In some species with high aging rate, genes responsible for active organization of aging by poisoning of the organism with endogenous metabolites have been identified. (3) In women, standard deviations divided by the mean are the same for age of menarche (an event controlled by the ontogenetic program) and for age of menopause (an aging-related event). (4) Inhibitors of programmed cell death (apoptosis and necrosis) retard and in certain cases even reverse the development of age-dependent pathologies. (5) In aging species, the rate of aging is regulated by the individual which responds by changes in this rate to changes in the environmental conditions. In this review, we consider point (5) in detail. Data are summarized suggesting that inhibition of aging rate by moderate food restriction can be explained assuming that such restriction is perceived by the organism as a signal of future starvation. In response to this dramatic signal, the organism switches off such an optional program as aging, mobilizing in such a way additional reserves for survival. A similar explanation is postulated for geroprotective effects of heavy muscle work, a lowering or a rise in the external temperature, small amounts of metabolic poisons (hormesis), low doses of radiation, and other deleterious events. On the contrary, sometimes certain positive signals can prolong life by inhibiting the aging program in individuals who are useful for the community (e

  10. Urate levels predict survival in amyotrophic lateral sclerosis: Analysis of the expanded Pooled Resource Open-Access ALS clinical trials database.

    Science.gov (United States)

    Paganoni, Sabrina; Nicholson, Katharine; Chan, James; Shui, Amy; Schoenfeld, David; Sherman, Alexander; Berry, James; Cudkowicz, Merit; Atassi, Nazem

    2018-03-01

    Urate has been identified as a predictor of amyotrophic lateral sclerosis (ALS) survival in some but not all studies. Here we leverage the recent expansion of the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database to study the association between urate levels and ALS survival. Pooled data of 1,736 ALS participants from the PRO-ACT database were analyzed. Cox proportional hazards regression models were used to evaluate associations between urate levels at trial entry and survival. After adjustment for potential confounders (i.e., creatinine and body mass index), there was an 11% reduction in risk of reaching a survival endpoint during the study with each 1-mg/dL increase in uric acid levels (adjusted hazard ratio 0.89, 95% confidence interval 0.82-0.97, P ALS and confirms the utility of the PRO-ACT database as a powerful resource for ALS epidemiological research. Muscle Nerve 57: 430-434, 2018. © 2017 Wiley Periodicals, Inc.

  11. 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...

  12. 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.

  13. 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.

  14. The Basin Water Resources Management System and Its Innovation in China

    Institute of Scientific and Technical Information of China (English)

    Xun; Pomponio

    2008-01-01

    Water provides the origin of human survival and prosperity,and the basic resource for the maintenance of terrestrial eco-systems,their biodiversity,productivity and ecological services.With China’s recent,rapid growth both in population and economic development,the water shortage has become one of the most constraints on its ecological restoration and socio-economic development,especially in the arid inland regions of northwest China.At first glance,this water shortage in China appears to be a resource crisis.But second,an in-depth analysis reveals that the water shortage crisis arises mainly resulting from the poor water management system and operating mechanism that cannot facilitate fair allocation and efficient utilization of water resources both regionally and nationally and thus is viewed as a crisis of water manage-ment.The solution of China’s water shortage and low-efficient utilization problem will,in particular,require a fundamen-tal and substantial reform or innovation of the existing water management system and operating mechanism.In this paper,we address explicitly the problems existed in the current water management system,explore the basic theory of water re-sources management and provide some insights into the way how to establish a river basin based integrated water re-sources management system in China.

  15. 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

  16. 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.

  17. 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)

  18. 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,…

  19. 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…

  20. A national survey of the impact of rapid scale-up of antiretroviral therapy on health-care workers in Malawi: effects on human resources and survival.

    Science.gov (United States)

    Makombe, Simon D; Jahn, Andreas; Tweya, Hannock; Chuka, Stuart; Yu, Joseph Kwong-Leung; Hochgesang, Mindy; Aberle-Grasse, John; Pasulani, Olesi; Schouten, Erik J; Kamoto, Kelita; Harries, Anthony D

    2007-11-01

    To assess the human resources impact of Malawis rapidly growing antiretroviral therapy (ART) programme and balance this against the survival benefit of health-care workers who have accessed ART themselves. We conducted a national cross-sectional survey of the human resource allocation in all public-sector health facilities providing ART in mid-2006. We also undertook a survival analysis of health-care workers who had accessed ART in public and private facilities by 30 June 2006, using data from the national ART monitoring and evaluation system. By 30 June 2006, 59 581 patients had accessed ART from 95 public and 28 private facilities. The public sites provided ART services on 2.4 days per week on average, requiring 7% of the clinician workforce, 3% of the nursing workforce and 24% of the ward clerk workforce available at the facilities. We identified 1024 health-care workers in the national ART-patient cohort (2% of all ART patients). The probabilities for survival on ART at 6 months, 12 months and 18 months were 85%, 81% and 78%, respectively. An estimated 250 health-care workers lives were saved 12 months after ART initiation. Their combined work-time of more than 1000 staff-days per week was equivalent to the human resources required to provide ART at the national level. A large number of ART patients in Malawi are managed by a small proportion of the health-care workforce. Many health-care workers have accessed ART with good treatment outcomes. Currently, staffing required for ART balances against health-care workers lives saved through treatment, although this may change in the future.

  1. 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.

  2. Conservation Genetic Resources for Effective Species Survival (ConGRESS): Bridging the divide between conservation research and practice

    Czech Academy of Sciences Publication Activity Database

    Hoban, S. M.; Arntzen, J. W.; Bertorelle, G.; Bryja, Josef; Fernandes, M.; Frith, K.; Gaggiotti, O. E.; Galbusera, P.; Godoy, J. A.; Hauffe, H. C.; Hoelzel, A. R.; Nichols, R. A.; Pérez-Espona, S.; Primmer, C. R.; Russo, I.-R.; Segelbacher, G.; Siegismund, H. R.; Sihvonen, M.; Sjögren-Gulve, P.; Vernesi, C.; Vila, C.; Bruford, M. W.

    2013-01-01

    Roč. 21, č. 6 (2013), s. 433-437 ISSN 1617-1381 Institutional support: RVO:68081766 Keywords : Capacity-building * Conservation planning * Data * Decision-making * Management * Online resource * Policy Subject RIV: EH - Ecology, Behaviour Impact factor: 1.833, year: 2013

  3. 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...

  4. 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.

  5. 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

  6. 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)

  7. Feasibility of modified surviving sepsis campaign guidelines in a resource-restricted setting based on a cohort study of severe S. aureus sepsis [corrected].

    Directory of Open Access Journals (Sweden)

    Weera Mahavanakul

    Full Text Available The Surviving Sepsis Campaign (SSC guidelines describe best practice for the management of severe sepsis and septic shock in developed countries, but most deaths from sepsis occur where healthcare is not sufficiently resourced to implement them. Our objective was to define the feasibility and basis for modified guidelines in a resource-restricted setting.We undertook a detailed assessment of sepsis management in a prospective cohort of patients with severe sepsis caused by a single pathogen in a 1,100-bed hospital in lower-middle income Thailand. We compared their management with the SSC guidelines to identify care bundles based on existing capabilities or additional activities that could be undertaken at zero or low cost. We identified 72 patients with severe sepsis or septic shock associated with S. aureus bacteraemia, 38 (53% of who died within 28 days. One third of patients were treated in intensive care units (ICUs. Numerous interventions described by the SSC guidelines fell within existing capabilities, but their implementation was highly variable. Care available to patients on general wards covered the fundamental principles of sepsis management, including non-invasive patient monitoring, antimicrobial administration and intravenous fluid resuscitation. We described two additive care bundles, one for general wards and the second for ICUs, that if consistently performed would be predicted to improve outcome from severe sepsis.It is feasible to implement modified sepsis guidelines that are scaled to resource availability, and that could save lives prior to the publication of international guidelines for developing countries.

  8. 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.

  9. 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.

  10. 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.

  11. Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact.

    Science.gov (United States)

    Kumar, Vishwajeet; Kumar, Aarti; Darmstadt, Gary L

    2010-12-01

    Despite an established evidence base of simple, affordable, and low-cost interventions to avert neonatal deaths, global progress in reducing neonatal mortality has stagnated in recent years. Under-recognition of the critical role played by behavior change in ensuring adoption and dissemination of innovations is a major reason for this gap between evidence and impact. A general lack of understanding of the mechanisms underlying behavior change at a population level coupled with an under-appreciation of the sociocultural context of newborn care behaviors has underscored ill-informed approaches towards behavior change that have met with limited success. This article draws upon available evidence from prevention-oriented, community-based newborn survival trials to derive insights into the role of behavior change in neonatal mortality reduction. We propose a simple model, the intervention-causation pathway, to explain the pathway through which behavior change interventions may lead to reductions in mortality. Further, we explore the unique nature of newborn care behaviors and their underlying sociocultural context, along with state-of-the-art advances in social, behavioral, and management sciences. These principles form the basis of the behavior change management framework that has successfully guided intervention design and implementation, leading to high impact on neonatal mortality reduction, in Uttar Pradesh, India. We describe how the behavior change management framework can be applied to inform the design of theoretically and empirically sound behavior change interventions with greater precision, predictability and pace towards reduction in neonatal mortality. We finally touch upon key overarching principles that should guide intervention execution for maximal impact. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. 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?

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. Nation-Scale Adoption of Shorter Breast Radiation Therapy Schedules Can Increase Survival in Resource Constrained Economies: Results From a Markov Chain Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Atif J., E-mail: atif.j.khan@rutgers.edu [Department of Radiation Oncology, Robert Wood Johnson Medical School/Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Rafique, Raza [Suleman Dawood School of Business, Lahore University of Management Sciences, Lahore (Pakistan); Zafar, Waleed [Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (Pakistan); Shah, Chirag [Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States); Haffty, Bruce G. [Department of Radiation Oncology, Robert Wood Johnson Medical School/Cancer Institute of New Jersey, New Brunswick, New Jersey (United States); Vicini, Frank [Michigan HealthCare Professionals, Farmington Hills, Michigan (United States); Jamshed, Arif [Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore (Pakistan); Zhao, Yao [Rutgers University School of Business, Newark, New Jersey (United States)

    2017-02-01

    Purpose: Hypofractionated whole breast irradiation and accelerated partial breast irradiation (APBI) offer women options for shorter courses of breast radiation therapy. The impact of these shorter schedules on the breast cancer populations of emerging economies with limited radiation therapy resources is unknown. We hypothesized that adoption of these schedules would improve throughput in the system and, by allowing more women access to life-saving treatments, improve patient survival within the system. Methods and Materials: We designed a Markov chain model to simulate the different health states that a postlumpectomy or postmastectomy patient could enter over the course of a 20-year follow-up period. Transition rates between health states were adapted from published data on recurrence rates. We used primary data from a tertiary care hospital in Lahore, Pakistan, to populate the model with proportional use of mastectomy versus breast conservation and to estimate the proportion of patients suitable for APBI. Sensitivity analyses on the use of APBI and relative efficacy of APBI were conducted to study the impact on the population. Results: The shorter schedule resulted in more women alive and more women remaining without evidence of disease (NED) compared with the conventional schedule, with an absolute difference of about 4% and 7% at 15 years, respectively. Among women who had lumpectomies, the chance of remaining alive and with an intact breast was 62% in the hypofractionation model and 54% in the conventional fractionation model. Conclusions: Increasing throughput in the system can result in improved survival, improved chances of remaining without evidence of disease, and improved chances of remaining alive with a breast. These findings are significant and suggest that adoption of hypofractionation in emerging economies is not simply a question of efficiency and cost but one of access to care and patient survivorship.

  19. Nation-Scale Adoption of Shorter Breast Radiation Therapy Schedules Can Increase Survival in Resource Constrained Economies: Results From a Markov Chain Analysis

    International Nuclear Information System (INIS)

    Khan, Atif J.; Rafique, Raza; Zafar, Waleed; Shah, Chirag; Haffty, Bruce G.; Vicini, Frank; Jamshed, Arif; Zhao, Yao

    2017-01-01

    Purpose: Hypofractionated whole breast irradiation and accelerated partial breast irradiation (APBI) offer women options for shorter courses of breast radiation therapy. The impact of these shorter schedules on the breast cancer populations of emerging economies with limited radiation therapy resources is unknown. We hypothesized that adoption of these schedules would improve throughput in the system and, by allowing more women access to life-saving treatments, improve patient survival within the system. Methods and Materials: We designed a Markov chain model to simulate the different health states that a postlumpectomy or postmastectomy patient could enter over the course of a 20-year follow-up period. Transition rates between health states were adapted from published data on recurrence rates. We used primary data from a tertiary care hospital in Lahore, Pakistan, to populate the model with proportional use of mastectomy versus breast conservation and to estimate the proportion of patients suitable for APBI. Sensitivity analyses on the use of APBI and relative efficacy of APBI were conducted to study the impact on the population. Results: The shorter schedule resulted in more women alive and more women remaining without evidence of disease (NED) compared with the conventional schedule, with an absolute difference of about 4% and 7% at 15 years, respectively. Among women who had lumpectomies, the chance of remaining alive and with an intact breast was 62% in the hypofractionation model and 54% in the conventional fractionation model. Conclusions: Increasing throughput in the system can result in improved survival, improved chances of remaining without evidence of disease, and improved chances of remaining alive with a breast. These findings are significant and suggest that adoption of hypofractionation in emerging economies is not simply a question of efficiency and cost but one of access to care and patient survivorship.

  20. 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.

  1. 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…

  2. 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…

  3. 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...

  4. 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.

  5. 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 ...

  6. 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 ...

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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...

  16. 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

  17. 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

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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...

  3. [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.

  4. 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)

  5. 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

  6. 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.

  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. 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

  9. The Use of Restoring Resources of the Survival Roles and Reflex Patterns in MNRI® (Reflex Integration Interactive Training of Personality Growth and Interpersonal Relations

    Directory of Open Access Journals (Sweden)

    Masgutova S.K.

    2017-12-01

    Full Text Available Personality growth as a socio-psychological problem is a multi-complex phenomenon that targets Self-identity, Self-actualization, and other areas. During the last decade scientists started studying other factors limiting the personality growth, such as stress and post-trauma. However, the Survival Roles, the socio-individual patterns based on neurophysiological and psychological defense mechanisms blocking the personality Self-actualization, social interaction and professional business qualities, are rarely discussed. Thus this study based on Survival Roles may extend the personality growth oriented concepts and therapy modality tools. This study showed a correlation between Survival Role patterns, stress resilience, and survival reflexes (integrative units of the nervous system functions. Comparative data on 464 business professionals from high management jobs (Study Group — n=340, and Control Group — n=124 participated in this research which found 70.9 % (n=329 of the total group was in stress. This stress activated socio-individual Survival Roles and protective reflex patterns which responded with reactivity, over-protection, non-constructive interactions with others and limited business strategies. The MNRI® reflex integrative training used in this study demonstrated improvement of functions of the protective reflex patterns effected positively the survival mechanisms including increased stress resilience, and decreased negative effect of Survival Roles. MNRI® proposes a new paradigm in the realm of personality growth and socio-interpersonal activity, and supports the neurophysiological aspects to optimize the overall quality of life of business professionals from a variety of high management business areas.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    The General Unified Threshold model for Survival (GUTS) integrates previously published toxicokinetic-toxicodynamic models and estimates survival with explicitly defined assumptions. Importantly, GUTS accounts for time-variable exposure to the stressor. We performed three studies to test...

  17. Survival analysis

    International Nuclear Information System (INIS)

    Badwe, R.A.

    1999-01-01

    The primary endpoint in the majority of the studies has been either disease recurrence or death. This kind of analysis requires a special method since all patients in the study experience the endpoint. The standard method for estimating such survival distribution is Kaplan Meier method. The survival function is defined as the proportion of individuals who survive beyond certain time. Multi-variate comparison for survival has been carried out with Cox's proportional hazard model

  18. 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.

  19. 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...

  20. Patterns of hospital resource utilization of children with leukemia and CNS tumors: a comparison of children who survive and those who die within 3 years of diagnosis.

    Science.gov (United States)

    Hendrickson, Karrie Cummings; Rimar, Joan

    2009-01-01

    Hospital admissions for children with cancer tend to be longer than admissions for adults with cancer and longer, more frequent, and more costly than other pediatric admissions. The two childhood cancers most commonly requiring hospitalization are leukemia and tumors of the central nervous system (CNS tumors). Determining the best use of limited financial resources and preparing children and their parents for what to expect requires a better understanding of the patterns and cost of hospital resource utilization by children with cancer. Both hospital administrators and third-party payers can use this understanding to better allocate resources and plan the care of children with cancer in the future. Because many parents of children with cancer struggle financially due to the high cost of treatments, time off of work, and other non-medical expenses, more education in this area may help parents to prepare, thus alleviating some of the uncertainty and unexpected financial costs associated with childhood cancer.

  1. 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

  2. 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.

  3. 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.

  4. 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.

  5. 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)

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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

    -2050. Service sector in India accounts for about 50% of GDP which will continue to increase further and will provide more jobs and better paid jobs than core industries and there will be continued shift of choice of employment towards service sector creating deep gap of manpower resource requirement in basic and core industries. There are reports that some countries may have to abandon some future projects because of non availability skilled manpower in core industries. The installed capacity of nuclear power in India in the year 2052 will be about 200 G We from the present about 4 G We which will be a manifold increase. This will need about estimated 1,30,000 skilled manpower from the present about 12,000 persons in nuclear industries. Moreover, the need for competent persons in nuclear industries because of high safety requirements of nuclear installations will further add to the problem. The following short-term strategies to retain and attract new employees in nuclear industries may be envisaged amongst others: - Recruit employees prior to the departure of experienced technical staff to facilitate knowledge transfer in time. - Increase compensation and the number of higher level positions. - Increase permanent entry-level intake of skilled manpower taking into account historical turn-over rate. - Implement attractive student loan repayment programs by tying up with banks and financial institutions. - Implement well researched strategies and measures including reassessing the practical capacity which nations including India can achieve in power generation in future taking practical aspects of manpower shortage. - Implement advanced technology which requires lesser manpower. - Implement higher level of automation in nuclear industries. The paper aims to highlight the acute problems of future manpower shortages in nuclear industries globally with special reference to India and discusses some remedial measures which may be taken to address the issue. (author)

  11. 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.

  12. Pollution protection and resource conservation in the economic aid of developing countries: a contribution to survival. Umwelt- und Ressourcenschutz in der Entwicklungshilfe: Beihilfe zum Ueberleben

    Energy Technology Data Exchange (ETDEWEB)

    Hartje, V J

    1982-01-01

    The contribution of the bilateral economic aid of the F.R. of Germany for diminishing the pollution and resource problems of the Third World is investigated. Not only the imported air and water pollution are considered the reasons for these problems but the specific aspects of environmental deterioration in developing countries as deforestation, desertification and ground erosion caused primarily by the poverty of the Third World are also included.

  13. 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.

  14. 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…

  15. 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…

  16. 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...

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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

  5. Water resources

    International Nuclear Information System (INIS)

    2002-01-01

    The report entitled Climate Change Impacts and Adaptation : A Canadian Perspective, presents a summary of research regarding the impacts of climate change on key sectors over the past five years as it relates to Canada. This chapter on water resources describes how climate change will affect the supply of water in Canada. Water is one of Canada's greatest resources, which contributes about $7.5 to 23 billion per year to the Canadian economy. The decisions taken to adapt to climate change within the water resources sector will have profound implications in many other areas such as agriculture, human health, transportation and industry. The water related problems include water quality issues that relate to water shortages from droughts, or excesses from floods. The Intergovernmental Panel on Climate Change forecasts an increase in global average surface air temperatures of 1.4 to 5.8 degrees C by 2100. Such a change would impact the hydrological cycle, affecting runoff, evaporation patterns, and the amount of water stored in glaciers, lakes, wetlands and groundwater. The uncertainty as to the magnitude of these changes is due to the difficulty that climate models have in projecting future changes in regional precipitation patterns and extreme events. This chapter presents potential impacts of climate change on water resources in the Yukon, British Columbia, the Prairies, the Great Lakes basin, the Atlantic provinces, and the Arctic and Subarctic. The associated concerns for each region were highlighted. Adaptation research has focused on the impacts of supply and demand, and on options to adapt to these impacts. 60 refs., 2 tabs., 1 fig

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. [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.

  16. 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.

  17. 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…

  18. 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

  19. 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...

  20. 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.

  1. 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...

  2. [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.

  3. Survival Analysis

    CERN Document Server

    Miller, Rupert G

    2011-01-01

    A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.

  4. 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

  5. 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

  6. Nuclear scientists and engineers in Canada - A coming shortage?

    International Nuclear Information System (INIS)

    Stoll, P.

    1995-01-01

    A survey of large Canadian employers was used to identify the current level of employment of engineers and scientists in applications of nuclear technology. The survey assessed the labour market implications of three alternative future scenarios for the industry over the period 1994-2009 to determine the capability of the industry to maintain a competitive Canadian presence in domestic and international markets for nuclear generating facilities. The study found that under the nuclear phase-out and no-growth scenarios the requirements for nuclear experts decline from present levels of employment, but the Canadian industry retains to ability to meet an eventual renewed demand for CANDU generating systems. Under the growth scenario, requirements for nuclear scientists and engineers increase, although at a rate which can be met from domestic sources. The Canadian situation was compared with that in other OECD countries, as assessed by a study conducted by the OECD/NEA. According to this source, labour market conditions for nuclear qualified human resources in most participating OECD member countries resemble those of Canada. (author). 3 refs, 2 figs, 4 tabs

  7. Will Science and Technique Head Off Energy Shortage?

    International Nuclear Information System (INIS)

    Papon, P.

    2008-01-01

    Fluctuations in the price of the standard barrel of oil have been making headlines for several years now. In remaining at a high level in 2008 (with a peak of 150 US dollars in July), it seems to have left a marked impression on consumers, sensitizing them to the ever more imminent advent of a new energy era. Unless there is something approaching a technical revolution in this field, there is a danger that the increasing scarcity of fossil resources will appreciably raise energy costs and changed consumer habits will ensue. Is the prospect of such a revolution plausible? Can there be scientific and technical breakthroughs in the coming years that produce improvements or new paths in energy production? Pierre Papon has examined this question. After briefly summing up the current energy situation (in a context, we should remember, of climate change), he offers a detailed overview of the various options for the exploration and use of fossil fuels, bio-fuels, hydrogen etc. He also demonstrates the potential and limits of renewable, together with the prospects for the nuclear industry. In all these fields there seems little hope of a revolution before 2030: adaptation to a context of growing scarcity of energy supplies remains, then, a pressing question. However, as Pierre Papon reminds us, we cannot rule out the emergence of a new paradigm in physics that could radically alter the situation (such as occurred, for example, with the theory of relativity); hence the indispensable research effort that must be put in by both scientists and founders. (author)

  8. 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

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. [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.

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. Governance and human resources for health

    NARCIS (Netherlands)

    Dieleman, Marjolein; Hilhorst, Thea

    2011-01-01

    Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic

  19. 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

  20. 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

  1. 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

  2. 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...

  3. 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…

  4. 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...

  5. 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.

  6. 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…

  7. 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…

  8. 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...

  9. 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.

  10. 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"…

  11. 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…

  12. 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.

  13. 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...

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. Implementing Human Resources Management (HRM) within Dutch VET schools: Examining the fostering and hindering factors

    NARCIS (Netherlands)

    Runhaar, P.R.; Sanders, K.

    2013-01-01

    Vocational Education and Training (VET) Institutions face serious challenges, like the implementation of competence-based education and upcoming teacher shortages, which urge them to implement Human Resources Management policy and practices (HRM). The implementation of HRM, however, often stagnates.

  19. Birth asphyxia and perinatal outcome in a low resourced setting in ...

    African Journals Online (AJOL)

    The main administrative problem was a delay in caesarean section due to an inadequate ... Conclusion: This audit identifies resource deficiencies. ... The hospital management must be involved in delays in CS due to staff shortages and ...

  20. [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

  1. 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)

  2. 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

  3. Surviving Sengstaken.

    Science.gov (United States)

    Jayakumar, S; Odulaja, A; Patel, S; Davenport, M; Ade-Ajayi, N

    2015-07-01

    To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis. Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). 19 children [10 male, age 1 (0.4-16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula. Varices were secondary to: biliary atresia (n=8), portal vein thrombosis (n=5), alpha-1-anti-trypsin deficiency (n=1), cystic fibrosis (n=1), intrahepatic cholestasis (n=1), sclerosing cholangitis (n=1) and nodular hyperplasia with arterio-portal shunt (n=1). Three children deteriorated rapidly and did not survive to have post-SBT endoscopy. The child with an aortooesophageal fistula underwent aortic stent insertion and subsequently oesophageal replacement. Complications included gastric mucosal ulceration (n=3, 16%), pressure necrosis at lips and cheeks (n=6, 31%) and SBT dislodgment (n=1, 6%). Six (31%) children died. The remaining 13 have been followed up for 62 (2-165) months; five required liver transplantation, two underwent a mesocaval shunt procedure and 6 have completed endoscopic variceal obliteration and are under surveillance. SBT can be an effective, albeit temporary, life-saving manoeuvre in children with catastrophic haematemesis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Helping mothers survive bleeding after birth

    DEFF Research Database (Denmark)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris

    2014-01-01

    OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants, and ambul......OBJECTIVE: To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. DESIGN: Educational intervention study. SETTING: Rural referral hospital in Northern Tanzania. POPULATION: Clinicians, nurse-midwives, medical attendants...

  5. 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

  6. 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...

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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...

  14. 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)

  15. 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.

  16. 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...

  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.

    2016-01-01

    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

  18. 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.

  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. 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.

  2. 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.

  3. Online Resources

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Online Resources. Journal of Genetics. Online Resources. Volume 97. 2018 | Online resources. Volume 96. 2017 | Online resources. Volume 95. 2016 | Online resources. Volume 94. 2015 | Online resources. Volume 93. 2014 | Online resources. Volume 92. 2013 | Online resources ...

  4. 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.

  5. What to think about the shortage of oil resources and of the evolution of crude oil price?

    International Nuclear Information System (INIS)

    Babusiaux, Denis; Bauquis, Pierre-Rene

    2007-09-01

    Produced by the 'Oil' work-group of the French Academy of Technologies, this report first proposes a synthesis of different points of view (optimistic, pessimistic, public bodies) on the issue of oil reserves and of oil world peak production. A second part analyzes the mechanisms of oil pricing while highlighting the long term dimension, but without addressing the market short-term operation. The last part discusses various possible evolution scenarios for production and price profiles on a middle and on a long term

  6. 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

  7. Canadian gas resource

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    Canadian exports of gas to the United States are a critical component of EMF-9 (North American Gas Supplies). However, it has been noted that there are differences between US expectations for imports and Canadian forecasts of export supply capacity. Recent studies by the National Petroleum Council (NPC) and the US Department of Energy (DOE) indicate that 1.8 to 2.4 Tcf of imports may be required in the mid to late 1990's; A recent study by Canada's National Energy Board (NEB) indicates that the conventional resource base may not be able to provide continued gas exports to the US after the mid 1990's and that frontier sources would need to be developed to meet US expectations. The discrepancies between US expectations and Canadian estimates of capacity are of great concern to US policymakers because they call into question the availability of secure supplies of natural gas and suggest that the cost of imports (if available) will be high. By implication, if shortages are to be averted, massive investment may be required to bring these higher cost sources to market. Since the long-term supply picture will be determined by the underlying resource base, EMF-9 participants have been asked to provide estimates of critical components of the Canadian resource base. This paper provides a summary of ICF-Lewin's recent investigation of both the Conventional and Tight Gas resource in Canada's Western Sedimentary Basin, which includes both quantitative estimates and a brief sketch of the analysis methodology

  8. Uranium resources, production and demand in South Africa

    International Nuclear Information System (INIS)

    Brynard, H.J.; Ainslie, L.C.

    1990-01-01

    This paper provides a review of the historical development of the South African uranium market and the current status of uranium exploration, resources and production. A prognosticated view of possible future demand for uranium in South Africa is attempted, taking cognisance of the finite nature of the country's coal resources and estimated world uranium demand. Although well endowed with uranium resources, South Africa could face a shortage of this commodity in the next century, should the predicted electricity growth materials. (author)

  9. Uranium resources, production and demand in South Africa

    Energy Technology Data Exchange (ETDEWEB)

    Brynard, H J; Ainslie, L C [Atomic Energy Corporation of South Africa Ltd., Pretoria (South Africa)

    1990-06-01

    This paper provides a review of the historical development of the South African uranium market and the current status of uranium exploration, resources and production. A prognosticated view of possible future demand for uranium in South Africa is attempted, taking cognisance of the finite nature of the country's coal resources and estimated world uranium demand. Although well endowed with uranium resources, South Africa could face a shortage of this commodity in the next century, should the predicted electricity growth materials. (author)

  10. Water resources for Africa

    International Nuclear Information System (INIS)

    2003-01-01

    Water scarcity is a matter of urgent, national, regional and international concern. For those people, usually women, who are responsible for the daily task of obtaining sufficient water for household use, water shortages are a perpetual worry. It is a situation which affects many individual families and communities throughout the arid and semi-arid regions of Africa. The isotope studies conducted thus far have proved that the majority of regional groundwater systems in northern Africa and the Sahel zone are paleowaters, replenished thousands of years ago, without the possibility of significant replenishment under present climatic conditions. Therefore, removal from such underground reservoirs will eventually deplete the resource. Mapping these paleowaters, and estimating their reservoir sizes, is a priority. (IAEA)

  11. [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.

  12. Herpes - resources

    Science.gov (United States)

    Genital herpes - resources; Resources - genital herpes ... following organizations are good resources for information on genital herpes : March of Dimes -- www.marchofdimes.org/complications/sexually- ...

  13. 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.

  14. 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.

  15. 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]).

  16. 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.

  17. 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

  18. 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)

  19. Dealing with Dwindling Resources.

    Science.gov (United States)

    Martorana, S. V.

    Factors contributing to the struggle for survival faced by postsecondary institutions and ways to deal with dwindling resources, in particular by regionalism and regionalization, are considered. Among the contributing factors are the leveling off of the college-age population (18-21-year-olds), the declining status of advanced learning in American…

  20. The Challenges and Countermeasures of Human Resources on Nuclear Power in the 21st Century

    International Nuclear Information System (INIS)

    Zheng Mingguang; Ye Cheng; Han Xu

    2011-01-01

    The paper addresses the situations of nuclear power development and nuclear industry human resources and points out that the development and supply of human resources are becoming the big challenges in the effective and sustainable development of nuclear power. At the same time, the paper analyzes the root causes of human resources shortage and recommends several countermeasures to confront human resources problems. At last, the paper introduces what SNPTC and SNERDI do to overcome the human resources problem and give conclusions. (author)

  1. Electricity sector human resources review

    Energy Technology Data Exchange (ETDEWEB)

    Facette, J. [Canadian Association of Technicians and Technologists (Canada)

    2005-07-01

    The electricity industry is expanding, with new supply and infrastructure development equivalent to 35 per cent of existing capacity over the next 20 years. This paper examines the preliminary results of a human resources sector review providing industry specific labor force data. The key objectives of the review were to develop detailed industry profiles, identify root causes of human resources issues, identify industry best practices and develop a human resources strategy for the Canadian electricity sector. Estimates of current employment were provided, with age of employees, retirement projections, regional projections and estimated supply/demand gaps. Current shortages were identified, including wind energy technicians. The paper also identified a declining Canadian born labor force and a concurrent dependence on immigrants. A project research methodology was provided with a list of participating major employers. tabs., figs.

  2. The shortage of superhero comic books in academic libraries: Case study of the Library System of the University of Puerto Rico at Río Piedras

    Directory of Open Access Journals (Sweden)

    Manuel Martínez Nazario

    2015-07-01

    Full Text Available Objective. The objective of this article has been to prove the findings about the lack of superhero comic books in an academic library in Puerto Rico, as in to demostrate its academic value of this bibliographical resource, and the possibility of integration. Method. For this qualitative study, it has been consulted the related literature, and it has been used interviews, with the intention to explore the reasons of this phenomenon. Results. The shortage of superhero comic books is connected with the lack of curricular justification and the absence of recommendations for acquisition. Conclusions. The superhero comic books have demostrated a great popularity among the readers and have comfirmed their potential in the academic researches. The scope of this information source has surpassed the boundaries of entertainment and has been incorporated to school libraries, public libraries and academic libraries.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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)

  9. 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.

  10. 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.

  11. 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.

  12. Human Resource Development for Health in Ethiopia: Challenges of ...

    African Journals Online (AJOL)

    Review of different documents on human resource for health was undertaken. Particular attention was given to documents from Ethiopia. Generally there is shortage in number of different groups of professionals, mal distribution of professionals between regions, urban and rural setting, and governmental and non ...

  13. 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

  14. Survival pathways under stress

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Survival pathways under stress. Bacteria survive by changing gene expression. pattern. Three important pathways will be discussed: Stringent response. Quorum sensing. Proteins performing function to control oxidative damage.

  15. Is Fly in/Fly out (FIFO) a viable interim solution to address remote medical workforce shortages?

    Science.gov (United States)

    Margolis, Stephen A

    2012-01-01

    Geographically remote regions of Australia experience a higher degree of socioeconomic inequality and health inequity, amid poor resourcing and extreme climatic conditions, when compared with their more urban counterparts. Doctors with the knowledge, skills and interest in remote work remain a scarce resource, with only 58 practitioners per 100,000 people versus 196/100,000 in metropolitan areas. Pending the arrival of the full complement of long-term remote medical workforce, an alternative solution that has so far received little attention but could provide near equivalence to resident doctors is the 'fly in/fly out' (FIFO) model. Specifically, where one doctor has a continuous relationship with one town or community, albeit spending their rostered time off away from this location, rather than continuity of service with different doctors each time. In this model, doctors spend a fixed number of days at work geographically remote from their home and families, with logistical support (eg housing, transport) provided, followed by a fixed number of days back at home not working. This provides a the doctor with the benefits of remote clinical work plus guaranteed time off at home, a more acceptable roster than in many remote locations at present. This also avoids the complex issue of experienced doctors having to leave remote areas mid-career for the well-documented reasons of spouse employment and children's education, as well as providing easier access to professional development activities. The author followed this path and remains a FIFO doctor after 7 years of continuous service. For FIFO to be effective, there needs to be a commitment from the sponsoring organisation for short, balanced, flexible, family friendly rosters and a positive organizational structure with effective communication between management and front line staff. Evidence shows that families and children with healthy family functioning, who are able to balance separateness and togetherness and

  16. 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)

  17. 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.

  18. 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

  19. 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.

  20. 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)

  1. 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)

  2. 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.

  3. 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

  4. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... (HPSAs) as of April 1, 2012, available on the Health Resources and Services Administration (HRSA) Web... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, Department of Health and Human Services. ACTION: Notice. SUMMARY...

  5. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ..., available on the Health Resources and Services Administration (HRSA) Web site at http://bhpr.hrsa.gov... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: This notice advises the public of the...

  6. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ..., available on the Health Resources and Services Administration (HRSA) Web site at http://www.hrsa.gov... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Lists of... Resources and Services Administration, HHS. ACTION: Notice. SUMMARY: This notice advises the public of the...

  7. 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.

  8. 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

  9. 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

  10. Niche expansion, body size, and survival in Galápagos marine iguanas.

    Science.gov (United States)

    Wikelski, M; Wrege, Peter H

    2000-07-01

    Foraging theory predicts that dietary niche breadth should expand as resource availability decreases. However, Galápagos marine iguanas often die during algae shortages (El Niños) although land plants abound where they rest and reproduce. On Seymour Norte island, a subpopulation of iguanas exhibited unique foraging behavior: they consistently included the succulent beach plant B. maritima in their diet. We investigated the consequences of land-plant feeding for body size and survival. Batis-eaters supplemented their algae diet both before and after intertidal zone foraging, and more Batis was eaten during tides unfavorable for intertidal zone foraging (dawn and dusk). Larger, energy-constrained iguanas fed more on land than did smaller animals. Compared to intertidal zone algae, Batis was 39% lower in caloric content (1.6 vs. 2.6 kcal g -1 dry mass), 56% lower in protein (8.3 vs. 18.9% dry mass) and 57% lower in nitrogen (1.3 vs. 3.0% dry mass). In spite of its lower nutrient value, iguanas that supplemented their diet with this plant were able to attain nearly twice the body size of other iguanas on the island. Age estimates indicate that many Batis-eaters survived repeated El Niño episodes during which animals of their relative size-class experienced high mortality on other islands. The larger animals were, however, completely dependent upon this supplementary source of food to maintain condition, and all perished in the 1997-1998 El Niño when high tides inundated and killed Batis on Seymour Norte Island. We hypothesize that Batis feeding developed as a local foraging tradition, and that dietary conservatism and strong foraging site fidelity explain why the inclusion of land plants in the diet has been observed in only a single population. Ultimately, a unique algae-adapted hindgut morphology and physiology may limit a switch from marine to terrestrial diet.

  11. Managing water resources in Malaysia: the use of isotope technique and its potential

    International Nuclear Information System (INIS)

    Keizrul Abdullah

    2006-01-01

    This keynote address discusses the following subjects; state of Malaysia water resources, water related problem i.e floods, water shortage (droughts), water quality, river sedimentation, water resources management and the ongoing and potential application of isotope techniques in river management

  12. Optimal Allocation of Water Resources Based on Water Supply Security

    Directory of Open Access Journals (Sweden)

    Jianhua Wang

    2016-06-01

    Full Text Available Under the combined impacts of climate change and human activities, a series of water issues, such as water shortages, have arisen all over the world. According to current studies in Science and Nature, water security has become a frontier critical topic. Water supply security (WSS, which is the state of water resources and their capacity and their capacity to meet the demand of water users by water supply systems, is an important part of water security. Currently, WSS is affected by the amount of water resources, water supply projects, water quality and water management. Water shortages have also led to water supply insecurity. WSS is now evaluated based on the balance of the supply and demand under a single water resources condition without considering the dynamics of the varying conditions of water resources each year. This paper developed an optimal allocation model for water resources that can realize the optimal allocation of regional water resources and comprehensively evaluate WSS. The objective of this model is to minimize the duration of water shortages in the long term, as characterized by the Water Supply Security Index (WSSI, which is the assessment value of WSS, a larger WSSI value indicates better results. In addition, the simulation results of the model can determine the change process and dynamic evolution of the WSS. Quanzhou, a city in China with serious water shortage problems, was selected as a case study. The allocation results of the current year and target year of planning demonstrated that the level of regional comprehensive WSS was significantly influenced by the capacity of water supply projects and the conditions of the natural water resources. The varying conditions of the water resources allocation results in the same year demonstrated that the allocation results and WSSI were significantly affected by reductions in precipitation, decreases in the water yield coefficient, and changes in the underlying surface.

  13. Industrial Performance of the Renewable Resources Industry in China

    OpenAIRE

    Dong Zhou; Xingang Zhao

    2015-01-01

    Promoting the development of renewable resources industry is an effective way to solve the problems of resources shortage and environmental pollution in China. In this paper, studies have found that “market structure” and “ownership structure”, namely “double structure”, is an important explanatory variable that affects industrial performance according to the “structure-conduct-performance” paradigm. Literature reviews have shown that large state-owned enterprises are playing an important rol...

  14. Key challenges of human resources for health in India

    OpenAIRE

    Priya Sinha

    2016-01-01

    Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all le...

  15. Planning ahead : although Canada could experience a shortage of some 300,000 workers within the next 20 years, long-term strategies can help companies cope : part 1

    Energy Technology Data Exchange (ETDEWEB)

    Cook, D.

    2006-12-15

    This article is the first in a 2-part series examining the current labour shortage in the energy industry. Factors that are expected to exacerbate the shortage were reviewed, as well as some of the steps that the petroleum industry is now taking to manage labour challenges in the future. A critical talent crisis is expected to occur in the next 5 to 10 years as baby boomers plan to retire, and fewer graduates are expected to enter the marketplace. While some organizations have responded to shortages by merely offering high salaries to employees, many oil and gas companies are now looking to develop the skills and capabilities of employees in order to retain them. In addition, employers are attempting to strengthen social networks within their organizations by providing coaching and mentoring programs. A recent report published by the Conference Board of Canada has suggested that the oil and gas industry can improve manpower shortages by improving training programs; attracting more immigrants; and creating better mechanisms for recognizing foreign credentials and prior learning assessments. Many organizations are successfully using internal referral programs to hire employees with the appropriate skill levels. Petro-Canada is now using electronic recruiting methods to draw upon a wider resource pool and is currently building relationships with key post-secondary institutions as well as providing programs to give educational awards to students. Devon Canada has recently implemented an employee referral program and has also focused on improving conditions at its Jackfish steam assisted gravity drainage (SAGD) project at Fort McMurray by hiring certified chefs, installing satellite televisions and providing top-notch recreation facilities. 2 figs.

  16. 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.

  17. Network survivability performance

    Science.gov (United States)

    1993-11-01

    This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunications networks to user expectations for network survivability and a foundation for continuing industry activities in the subject area. This report focuses on the survivability of both public and private networks and covers a wide range of users. Two frameworks are established for quantifying and categorizing service outages, and for classifying network survivability techniques and measures. The performance of the network survivability techniques is considered; however, recommended objectives are not established for network survivability performance.

  18. 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

  19. Survival Processing and the Stroop Task

    Directory of Open Access Journals (Sweden)

    Stephanie A. Kazanas

    2015-11-01

    Full Text Available This study was designed to investigate the impact of survival processing with a novel task for this paradigm: the Stroop color-naming task. As the literature is mixed with regard to task generalizability, with survival processing promoting better memory for words, but not better memory for faces or paired associates, these types of task investigations are important to a growing field of research. Using the Stroop task provides a unique contribution, as identifying items by color is an important evolutionary adaptation and not specific to humans as is the case with word recall. Our results indicate that survival processing, with its accompanying survival-relevance rating task, remains the best mnemonic strategy for word memory. However, our results also indicate that presenting the survival passage does not motivate better color-naming performance than color-naming alone. In addition, survival processing led to a larger amount of Stroop interference, though not significantly larger than the other conditions. Together, these findings suggest that considering one’s survival when performing memory and attention-based tasks does not enhance cognitive performance generally, although greater allocation of attentional resources to color-incongruent concrete objects could be considered adaptive. These findings support the notion that engaging in deeper processing via survival-relevance ratings may preserve these words across a variety of experimental manipulations.

  20. The Challenge and Countermeasure of Human Resources on Nuclear Power for China in the 21st Century

    International Nuclear Information System (INIS)

    Zheng Mingguang

    2011-01-01

    The paper addresses the situations of nuclear power development and nuclear industry human resources and points out that the development and supply of human resources are becoming the big challenges in the effective and sustainable development of nuclear power. At the same time, the paper analyzes the root causes of human resources shortage and recommends several countermeasures to confront human resources problems. At last, the paper introduces what SNPTC and SNERDI do to overcome the human resources problem and give conclusions. (author)

  1. The Classroom Teacher's Technology Survival Guide

    Science.gov (United States)

    Johnson, Doug

    2012-01-01

    This is a must-have resource for all K-12 teachers and administrators who want to really make the best use of available technologies. Written by Doug Johnson, an expert in educational technology, "The Classroom Teacher's Technology Survival Guide" is replete with practical tips teachers can easily use to engage their students and make their…

  2. Multinationals and plant survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2010-01-01

    The aim of this paper is twofold: first, to investigate how different ownership structures affect plant survival, and second, to analyze how the presence of foreign multinational enterprises (MNEs) affects domestic plants’ survival. Using a unique and detailed data set on the Swedish manufacturing...... sector, I am able to separate plants into those owned by foreign MNEs, domestic MNEs, exporting non-MNEs, and purely domestic firms. In line with previous findings, the result, when conditioned on other factors affecting survival, shows that foreign MNE plants have lower survival rates than non......-MNE plants. However, separating the non-MNEs into exporters and non-exporters, the result shows that foreign MNE plants have higher survival rates than non-exporting non-MNEs, while the survival rates of foreign MNE plants and exporting non-MNE plants do not seem to differ. Moreover, the simple non...

  3. 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

  4. Italian regional health system structure and expected cancer survival.

    Science.gov (United States)

    Vercelli, Marina; Lillini, Roberto; Quaglia, Alberto; Capocaccia, Riccardo

    2014-01-01

    Few studies deal with the association of socioeconomic and health system resource variables with cancer survival at the Italian regional level, where the greatest number of decisions about social and health policies and resource allocations are taken. The present study aimed to describe the causal relationships between socioeconomic and health system resource factors and regional cancer survival and to compute the expected cancer survival at provincial, regional and area levels. Age-standardized relative survival at 5 years from diagnosis of cases incident in 1995-1998 and followed up to 2004 were derived by gender for 11 sites from the Italian Association of Cancer Registries data bank. The socioeconomic and health system resource variables, describing at a regional level the macro-economy, demography, labor market, and health resources for 1995-2005, came from the Health for All database. A principal components factor analysis was applied to the socioeconomic and health system resource variables. For every site, linear regression models were computed considering the relative survival at 5 years as a dependent variable and the principal components factor analysis factors as independent variables. The factors described the socioeconomic and health-related features of the regional systems and were causally related to the characteristics of the patient taken in charge. The models built by the factors allowed computation of the expected relative survival at 5 years with very good concordance with those observed at regional, macro-regional and national levels. In the regions without any cancer registry, survival was coherent with that of neighboring regions with similar socioeconomic and health system resources characteristics. The models highlighted the causal correlations between socioeconomic and health system resources and cancer survival, suggesting that they could be good evaluation tools for the efficiency of the resources allocation and use.

  5. 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

  6. 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…

  7. 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…

  8. 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...

  9. 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...

  10. 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

  11. 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

  12. 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.

  13. 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…

  14. 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.

  15. 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.

  16. [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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. Substitute energy resource policy in Japan

    International Nuclear Information System (INIS)

    Umehara, Katsuhiko

    1980-01-01

    Japan depends 88% of energy resources and 99.8% of petroleum on imports. The solution of energy problems is now made internationally. As the means for Japan, there are the substitution of other resources for petroleum and its promotion. However, this involves the considerable funds for the development and utilization, which must be borne by the people in the form of tax. For governmental financing, a special account must be set up for the particular purpose. In the research and development of new energy resources, new institution is required. The following matters are described: petroleum shortage coming even in 1980s, the international need of substitute energy development, the need for establishing measures for substitute energy resources, acquisition of the funds, special-account governmental financing, and an institute of new energy development. (author)

  2. ASURV: Astronomical SURVival Statistics

    Science.gov (United States)

    Feigelson, E. D.; Nelson, P. I.; Isobe, T.; LaValley, M.

    2014-06-01

    ASURV (Astronomical SURVival Statistics) provides astronomy survival analysis for right- and left-censored data including the maximum-likelihood Kaplan-Meier estimator and several univariate two-sample tests, bivariate correlation measures, and linear regressions. ASURV is written in FORTRAN 77, and is stand-alone and does not call any specialized libraries.

  3. Policy for securing human resources in the nuclear industry of Japan

    International Nuclear Information System (INIS)

    Takeuchi, S.

    1993-01-01

    The shortage of human resources in the field of nuclear industry in Japan is due to: structural difficulty resulting from the prevailing labor shortage in Japan, difficulties from the ever-intensifying adverse wind against nuclear power, and difficulties specific to R and D organizations. A practical plan is proposed for securing qualified personnel: approach to be directly made on campuses; effective/advanced management of human resources; better treatment and fringe benefit; promoting the nuclear industry attractiveness; expanding the scope of basic and fundamental researches; regaining the public confidence; closer cooperation between the government and the nuclear power groups. 6 figs

  4. The survival advantage of olfaction in a competitive environment.

    Science.gov (United States)

    Asahina, Kenta; Pavlenkovich, Viktoryia; Vosshall, Leslie B

    2008-08-05

    Olfaction is generally assumed to be critical for survival because this sense allows animals to detect food and pheromonal cues. Although the ability to sense sex pheromones [1, 2, 3] is likely to be important for insects, the contribution of general odor detection to survival is unknown. We investigated the extent to which the olfactory system confers a survival advantage on Drosophila larvae foraging for food under conditions of limited resources and competition from other larvae.

  5. Long-term logistic analysis of FBR introduction strategy: avoiding both uranium and plutonium shortage

    International Nuclear Information System (INIS)

    Suzuki, T.

    1995-01-01

    Despite comfortable predictions on short to mid-term uranium resources, there is still a concern about long-term availability of competitive uranium resources. In order to achieve substantial uranium saving, early introduction of Fast Breeder Reactor (FBR) is desirable. But it is also known that rapid introduction of FBR could result in plutonium storage. Will there be enough plutonium on a global scale to sustain fast FBR growth? is there any other way to save uranium resource? This paper concludes that multi-option strategies to achieve flexible long-term strategy to avoid both uranium and plutonium storage are desirable. (authors)

  6. Daylight Management in Mediterranean Cities: When Shortage Is Not the Issue

    OpenAIRE

    Judit Lopez-Besora; Glòria Serra-Coch; Helena Coch; Antonio Isalgue

    2016-01-01

    Natural resources such as daylight and sunlight are highly appreciated in countries with prevailing overcast skies. Taking advantage of this scarce resource contributes to saving energy on artificial lighting. In contrast to northern, southern European cities are distinguished by a large number of days with direct sunlight caused by a propitious climate condition. While it is a positive issue in terms of energy availability, the abundance of it can be counterproductive if management measures ...

  7. 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

  8. 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.

  9. 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…

  10. Marketing child survival.

    Science.gov (United States)

    Grant, J P

    1984-01-01

    Growth monitoring charts, packets of oral rehydration salts (ORS), and vaccines, are inexpensive, life-saving, growth-protecting technologies which can enable parents to protect their children against the worst effects of poverty. Similarly, a matrix of current and easily understandable information about pregnancy, breast feeding, weaning, feeding during and immediately after illness, child spacing, and preparing and using home-made oral rehydration solutions, also could empower parents to protect the lives and the health of their children. The question arises as to how can these technologies and this information be put at the disposal of millions of families in the low-income world. The initial task of the Child Survival and Development Revolution is the communication of what is now possible, yet little is known about how to communicate information whose principal value is to the poor. There are 2 large-scale precedents: the Green Revolution, which in many instances succeeded in putting into the hands of thousands of small and large farmers the techniques and the knowledge which enabled them to double and treble the yields from their lands; and the campaign to put the knowledge and the means of family planning at the disposal of many millions of people. There are 2 lessons to be learned from these precedents: they have shown that the way to promote a people's technology and to put information at the disposal of the majority is by mobilizing all possible resources and working through all possible channels both to create the demand and to meet it; and neither the Green Revolution nor the family planning movement rally took off until they were viewed as political and economic priorities and given the full support of the nation's political leadership. Nowhere are these 2 lessons more clearly illustrated than in present-day Indonesia. Because the campaign for family planning was given high personal and political priority by the President, and because 85% of all family

  11. 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

  12. Superficial Water Resource at Tempisque River Watershed, Costa Rica: Availability and Requirement Perspective

    OpenAIRE

    Guzmán-Arias, Isabel

    2014-01-01

    This paper describes the status of water resources availability and demand in the upper and middle Tempisque watershed projected up to 2030 and the proposed actions to start a planning process. The resource availability scenarios incorporate the modifications inwater flows due to land use and cli­mate changes; these combined effects increases the problems of water shortages during the dry season. The resource demand scenarios include projections provided by the major users in the watershed, o...

  13. Superficial Water Resource at Tempisque River Watershed, Costa Rica: Availability and Requirement Perspective

    OpenAIRE

    Isabel Guzmán-Arias

    2014-01-01

    This paper describes the status of water resources availability and demand in the upper and middle Tempisque watershed projected up to 2030 and the proposed actions to start a planning process. The resource availability scenarios incorporate the modifications inwater flows due to land use and cli­mate changes; these combined effects increases the problems of water shortages during the dry season. The resource demand scenarios include projections provided by the major users in the watershe...

  14. Issues about Human Resources Recruitment

    OpenAIRE

    Aurel Manolescu

    2008-01-01

    As to ensure its success or even for surviving, organizations must settle accordingly some issues regarding the human resources enlistment, presented in great details within the article, whose success settlement ensure, concomitantly, the success of the entire assurance process with personnel, process extremely important, if there are taken into consideration, especially, the effects of some possible errors or hire errors. Therefore, the human resources recruitment tends to become a complex a...

  15. Network ties and survival

    DEFF Research Database (Denmark)

    Acheampong, George; Narteh, Bedman; Rand, John

    2017-01-01

    Poultry farming has been touted as one of the major ways by which poverty can be reduced in low-income economies like Ghana. Yet, anecdotally there is a high failure rate among these poultry farms. This current study seeks to understand the relationship between network ties and survival chances...... of small commercial poultry farms (SCPFs). We utilize data from a 2-year network survey of SCPFs in rural Ghana. The survival of these poultry farms are modelled using a lagged probit model of farms that persisted from 2014 into 2015. We find that network ties are important to the survival chances...... but this probability reduces as the number of industry ties increases but moderation with dynamic capability of the firm reverses this trend. Our findings show that not all network ties aid survival and therefore small commercial poultry farmers need to be circumspect in the network ties they cultivate and develop....

  16. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-01-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  17. Survivability and Hope

    Science.gov (United States)

    ... Current Issue Past Issues Special Section Survivability and Hope Past Issues / Spring 2007 Table of Contents For ... cure or long-term survivorship." This message of hope is a hallmark of the latest advances in ...

  18. Survival of falling robots

    Science.gov (United States)

    Cameron, Jonathan M.; Arkin, Ronald C.

    1992-02-01

    As mobile robots are used in more uncertain and dangerous environments, it will become important to design them so that they can survive falls. In this paper, we examine a number of mechanisms and strategies that animals use to withstand these potentially catastrophic events and extend them to the design of robots. A brief survey of several aspects of how common cats survive falls provides an understanding of the issues involved in preventing traumatic injury during a falling event. After outlining situations in which robots might fall, a number of factors affecting their survival are described. From this background, several robot design guidelines are derived. These include recommendations for the physical structure of the robot as well as requirements for the robot control architecture. A control architecture is proposed based on reactive control techniques and action-oriented perception that is geared to support this form of survival behavior.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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...

  4. 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

  5. Water Resources

    International Nuclear Information System (INIS)

    Abira, M.A.

    1997-01-01

    Water is essential for life and ecological sustenance; its availability is essential component of national welfare and productivity.The country's socio-economic activities are largely dependent on the natural endowment of water resources. Kenya's water resources comprises of surface waters (rivers, lakes and wetlands) and ground water. Surface water forms 86% of total water resources while the rest is ground water Geological, topographical and climatic factors influence the natural availability and distribution of water with the rainfall distribution having the major influence. Water resources in Kenya are continuously under threat of depletion and quality degradation owing to rising population, industrialization, changing land use and settlement activities as well as natural changes. However, the anticipated climate change is likely to exacerbate the situation resulting in increased conflict over water use rights in particular, and, natural resource utilisation in general. The impacts of climate change on the water resources would lead to other impacts on environmental and socio-economic systems

  6. 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

  7. 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.

  8. 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.

  9. 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

  10. 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

  11. Groundwater resources in Southern and Eastern Africa

    International Nuclear Information System (INIS)

    2003-01-01

    Water shortage, water quality, and the protection of investments in water supply, are of continuing concern to countries in Africa. As more countries join those already short of water, sound management of groundwater resources becomes more critical. Isotope techniques provide information that is unobtainable by other means and help to achieve a better understanding of mechanisms and processes through which water resources can be managed. The International Atomic Energy Agency is sponsoring a regional technical co-operation project addressing practical issues related to water resources assessment and development in Kenya, Madagascar, Namibia, South Africa, Tanzania, Uganda and Zimbabwe. The project also seeks to strengthen isotope hydrology capacity in the sub-region. (IAEA)

  12. Marine and Maritime Sector Skills Shortages in the South West of England: Developing Regional Training Provision

    Science.gov (United States)

    Beer, Julian; Meethan, Kevin

    2007-01-01

    Clustering theory assumes that companies gravitate towards each other on the basis of locally and regionally specific resources and supply chain characteristics, which lead in turn to innovation and high-value economic development. In line with such thinking, UK government policy has devolved certain functions to regional development agencies such…

  13. A Matter of Definition: Is There Truly a Shortage of School Principals?

    Science.gov (United States)

    Roza, Marguerite

    Although some districts and areas have experienced difficulty finding good principals, there are far more candidates certified to be principals than there are principal vacancies to fill. This report describes a study based on a written indepth survey of human-resource directors supplemented by formal survey questions to school superintendents and…

  14. An Ameliorative Whale Optimization Algorithm for Multi-Objective Optimal Allocation of Water Resources in Handan, China

    Directory of Open Access Journals (Sweden)

    Zhihong Yan

    2018-01-01

    Full Text Available With the deepening discrepancy between water supply and demand caused by water shortages, alleviating water shortages by optimizing water resource allocation has received extensive attention. How to allocate water resources optimally, rapidly, and effectively has become a challenging problem. Thus, this study employs a meta-heuristic swarm-based algorithm, the whale optimization algorithm (WOA. To overcome drawbacks like relatively low convergence precision and convergence rates, when applying the WOA algorithm to complex optimization problems, logistic mapping is used to initialize swarm location, and inertia weighting is employed to improve the algorithm. The resulting ameliorative whale optimization algorithm (AWOA shows substantially enhanced convergence rates and precision than the WOA and particle swarm optimization algorithms, demonstrating relatively high reliability and applicability. A water resource allocation optimization model with optimal economic efficiency and least total water shortage volume is established for Handan, China, and solved by the AWOA. The allocation results better reflect actual water usage in Handan. In 2030, the p = 50% total water shortage is forecast as 404.34 × 106 m3 or 14.8%. The shortage is mainly in the primary agricultural sector. The allocation results provide a reference for regional water resources management.

  15. Rapid diagnostic test supply chain and consumption study in Cabo Delgado, Mozambique: estimating stock shortages and identifying drivers of stock-outs.

    Science.gov (United States)

    Hasselback, Leah; Crawford, Jessica; Chaluco, Timoteo; Rajagopal, Sharanya; Prosser, Wendy; Watson, Noel

    2014-08-02

    Malaria rapid diagnostic tests (RDTs) are particularly useful in low-resource settings where follow-through on traditional laboratory diagnosis is challenging or lacking. The availability of these tests depends on supply chain processes within the distribution system. In Mozambique, stock-outs of malaria RDTs are fairly common at health facilities. A longitudinal cross-sectional study was conducted to evaluate drivers of stock shortages in the Cabo Delgado province. Data were collected from purposively sampled health facilities, using monthly cross-sectional surveys between October 2011 and May 2012. Estimates of lost consumption (consumption not met due to stock-outs) served as the primary quantitative indicator of stock shortages. This is a better measure of the magnitude of stock-outs than binary indicators that only measure frequency of stock-outs at a given facility. Using a case study based methodology, distribution system characteristics were qualitatively analysed to examine causes of stock-outs at the provincial, district and health centre levels. 15 health facilities were surveyed over 120 time points. Stock-out patterns varied by data source; average monthly proportions of 59%, 17% and 17% of health centres reported a stock-out on stock cards, laboratory and pharmacy forms, respectively. Estimates of lost consumption percentage were significantly high; ranging from 0% to 149%; with a weighted average of 78%. Each ten-unit increase in monthly-observed consumption was associated with a nine-unit increase in lost consumption percentage indicating that higher rates of stock-outs occurred at higher levels of observed consumption. Causes of stock-outs included inaccurate tracking of lost consumption, insufficient sophistication in inventory management and replenishment, and poor process compliance by facility workers, all arguably stemming from inadequate attention to the design and implementation of the distribution system. Substantially high levels of RDT

  16. Key challenges of human resources for health in India

    Directory of Open Access Journals (Sweden)

    Priya Sinha

    2016-01-01

    Full Text Available Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all levels in the healthcare delivery system. The article aimed at understanding the current status of human resources for health and initiatives adopted to deal with existing shortage and to highlight factors leading to further shortage and to bring to notice the use of talent management strategy as a retention tool. Review Methodology The review used descriptive research design using secondary sources from journals-articles using key words. The study also used exclusion and inclusion criteria to select the articles. The study was done using extensive review of literature on health sector, health workforce, its availability and scarcity due to attrition/emigration in India. The critical review helped in setting objective for the study. Findings The review of articles provided insight into the current status of health workforce in India. The earlier studies emphasized that gap between demand and supply of human resource for health is mainly due to increasing population and burden of diseases. Studies have now identified other factors leading to further shortage as attrition/emigration of skilled health workforce. Most of the initiatives are mainly directed towards increasing supply of human resources for health to deal with the scarcity and less emphasis to control attrition. Few studies highlighted the use of talent management strategy to deal with the challenges of attrition and emigration that helps in retention and controlling further shortage. Recommendations

  17. Managing talent flow : 2006 energy and resources talent pulse survey report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-08-15

    The Canadian energy sector is experiencing a labour shortage. It is expected that by 2025, the province of Alberta could face a shortfall of 332,000 workers. The impending shortage has already caused concern among energy sector organizations. This survey was conducted among 55 Canadian oil and gas, utilities, and mining organizations to better understand the extent of the talent crisis. The survey examined specific resources shortages, talent issues and their impacts on performance. Efforts on behalf of organizations to address the labour shortage were also reviewed. Respondents to the survey identified a clear link between talent management and organizational performance. Nearly 80 per cent of the respondents indicated that the talent shortage has limited productivity and efficiency in their organization. Fifty-five per cent indicated that the talent shortage will limit the ability to meet production requirements and customer demand, while 47 per cent said that the lack of skilled workers will affect their organization's ability to innovate. Attracting specific types of labour was seen as one of the top 3 issues facing organizations. The survey indicated that some organizations have increased their investment in recruiting experienced staff, but are relying on old recruiting tactics to meet changing needs. It was also noted that employees are now placing greater importance on opportunities for growth, development and communication, rather than on pay alone. It was stated that Deloitte's model for talent management was designed to optimize the employee experience in an environment where employees expect opportunities for personal growth. It was concluded that the future success of Canada's energy and resources sector will rely on how well organizations address the talent shortage. 8 figs.

  18. Managing talent flow : 2006 energy and resources talent pulse survey report

    International Nuclear Information System (INIS)

    2006-08-01

    The Canadian energy sector is experiencing a labour shortage. It is expected that by 2025, the province of Alberta could face a shortfall of 332,000 workers. The impending shortage has already caused concern among energy sector organizations. This survey was conducted among 55 Canadian oil and gas, utilities, and mining organizations to better understand the extent of the talent crisis. The survey examined specific resources shortages, talent issues and their impacts on performance. Efforts on behalf of organizations to address the labour shortage were also reviewed. Respondents to the survey identified a clear link between talent management and organizational performance. Nearly 80 per cent of the respondents indicated that the talent shortage has limited productivity and efficiency in their organization. Fifty-five per cent indicated that the talent shortage will limit the ability to meet production requirements and customer demand, while 47 per cent said that the lack of skilled workers will affect their organization's ability to innovate. Attracting specific types of labour was seen as one of the top 3 issues facing organizations. The survey indicated that some organizations have increased their investment in recruiting experienced staff, but are relying on old recruiting tactics to meet changing needs. It was also noted that employees are now placing greater importance on opportunities for growth, development and communication, rather than on pay alone. It was stated that Deloitte's model for talent management was designed to optimize the employee experience in an environment where employees expect opportunities for personal growth. It was concluded that the future success of Canada's energy and resources sector will rely on how well organizations address the talent shortage. 8 figs

  19. Human Resources and Innovative Behaviour : Improving Nursing Performance

    OpenAIRE

    Xerri, Matthew; Reid, Stuart

    2017-01-01

    This study examines, using the social exchange theory, the mediating effect of employees’ perception of wellbeing on the relationship between two human resource (HR) management factors (satisfaction with teamwork and satisfaction with training opportunities) and innovative behaviour of nurses working in Australian public and private hospitals. Current nurse shortages and limited budgets have increased the need for hospitals to improve their efficiency and cost-effectiveness. It is proposed th...

  20. Managing Water Resources for Environmentally Sustainable Irrigated Agriculture in Pakistan

    OpenAIRE

    Muhammad Afzal

    1996-01-01

    Pakistan’s agriculture is almost wholly dependent on irrigation and irrigated land supplies more than 90 percent of agricultural production. Irrigation is central to Pakistan’s economy. Massive investments in irrigation contributed to the development of one of the largest Indus Basin Irrigation System. Despite heavy budgetary inputs in irrigation system, it is facing shortage of resources and suffering from operational problems. The sustainability of irrigated agriculture is threatened due to...

  1. Report on the EMBER Project--A European Multimedia Bioinformatics Educational Resource

    Science.gov (United States)

    Attwood, Terri K.; Selimas, Ioannis; Buis, Rob; Altenburg, Ruud; Herzog, Robert; Ledent, Valerie; Ghita, Viorica; Fernandes, Pedro; Marques, Isabel; Brugman, Marc

    2005-01-01

    EMBER was a European project aiming to develop bioinformatics teaching materials on the Web and CD-ROM to help address the recognised skills shortage in bioinformatics. The project grew out of pilot work on the development of an interactive web-based bioinformatics tutorial and the desire to repackage that resource with the help of a professional…

  2. Resourceful Thinking about Printing and Related Industries: Economic Considerations and Environmental Sustainability

    Science.gov (United States)

    Wikina, Suanu Bliss; Thompson, Cynthia Carlton; Blackwell, Elinor

    2010-01-01

    Increasing population, total economic volume, and human consumption levels have resulted in problems of resource shortages, climate change, ozone layer depletion, land regression, and deteriorating environmental pollution. Printing and related industries constitute one of the major sources of environmental pollution due to heavy energy and…

  3. Workshop: Towards an integrative European perspective on health human resources policy: how and why?

    NARCIS (Netherlands)

    Batenburg, R.; Kuhlmann, E.

    2013-01-01

    Background: Across many countries, shortages and inefficient use of qualified healthcare staff – together with changes in the composition of the health professional workforce by age, gender and citizenship – have created an urgent call for health human resources policy, planning and management. In

  4. Implementing Human Resources Management (HRM) within Dutch VET Institutions: Examining the Fostering and Hindering Factors

    Science.gov (United States)

    Runhaar, Piety; Sanders, Karin

    2013-01-01

    Vocational Education and Training (VET) Institutions face serious challenges, like the implementation of competence-based education and upcoming teacher shortages, which urge them to implement Human Resources Management policy and practices (HRM). The implementation of HRM, however, often stagnates. This paper describes a qualitative study--in…

  5. The cellulose resource matrix.

    Science.gov (United States)

    Keijsers, Edwin R P; Yılmaz, Gülden; van Dam, Jan E G

    2013-03-01

    The emerging biobased economy is causing shifts from mineral fossil oil based resources towards renewable resources. Because of market mechanisms, current and new industries utilising renewable commodities, will attempt to secure their supply of resources. Cellulose is among these commodities, where large scale competition can be expected and already is observed for the traditional industries such as the paper industry. Cellulose and lignocellulosic raw materials (like wood and non-wood fibre crops) are being utilised in many industrial sectors. Due to the initiated transition towards biobased economy, these raw materials are intensively investigated also for new applications such as 2nd generation biofuels and 'green' chemicals and materials production (Clark, 2007; Lange, 2007; Petrus & Noordermeer, 2006; Ragauskas et al., 2006; Regalbuto, 2009). As lignocellulosic raw materials are available in variable quantities and qualities, unnecessary competition can be avoided via the choice of suitable raw materials for a target application. For example, utilisation of cellulose as carbohydrate source for ethanol production (Kabir Kazi et al., 2010) avoids the discussed competition with easier digestible carbohydrates (sugars, starch) deprived from the food supply chain. Also for cellulose use as a biopolymer several different competing markets can be distinguished. It is clear that these applications and markets will be influenced by large volume shifts. The world will have to reckon with the increase of competition and feedstock shortage (land use/biodiversity) (van Dam, de Klerk-Engels, Struik, & Rabbinge, 2005). It is of interest - in the context of sustainable development of the bioeconomy - to categorize the already available and emerging lignocellulosic resources in a matrix structure. When composing such "cellulose resource matrix" attention should be given to the quality aspects as well as to the available quantities and practical possibilities of processing the

  6. Uranium resources

    International Nuclear Information System (INIS)

    Gangloff, A.

    1978-01-01

    It is first indicated how to evaluate the mining resources as a function of the cost of production and the degree of certainty in the knowledge of the deposit. A table is given of the world resources (at the beginning 1977) and resources and reserves are compared. There is a concordance between requirements and possible production until 1990. The case of France is examined: known reserves, present and future prospection, present production (In 1978 2200 T of U metal will be produced from 3 French processing plants), production coming from Cogema. A total production of 2000 T in 1980 and 10.000 in 1985 is expected [fr

  7. CHARACTERISTICS OF HUMAN RESOURCE PLANNING IN HEALTHCARE

    Directory of Open Access Journals (Sweden)

    Tsvetelina Mihaylova

    2018-03-01

    Full Text Available The planning may be determined as prediction and prognosis making of human resources in a long-term plan, in conformity with the aims of the particular healthcare institution. It is prepared by the medical manager based on different analyses and prognoses with the purpose of ensuring the needed number of human resources. The aim of the study is an exploration of some of the reasons for the shortage of human resources in the healthcare system. In order to be achieved the realization of the aim set, a task was assigned for analysis of the main aspects of human resource planning in the healthcare system. Data from available scientific sources on the subject were used; they were published in different scientific issues. The results from the study demonstrate that the human resource planning is usually determined by the volume of work, however, due to the specificity of the activities in the health care system, it is usually determined by the type of labour functions – basic, governing, assisting. The future needs of personnel are fully determined by the mission, strategy, and aims of the organization. A conclusion may be drawn that the human resource planning is a necessary condition for effective management of human resources, and it has a significant and decisive role in the prosperity of the particular hospital.

  8. Surviving After Suicide

    Science.gov (United States)

    ... fewer tools for communicating their feelings. Surviving After Suicide Fact Sheet 3 Children are especially vulnerable to feelings of guilt and ... to take care of them. Secrecy about the suicide in the hopes of protecting children may cause further complications. Explain the situation and ...

  9. Survivability via Control Objectives

    Energy Technology Data Exchange (ETDEWEB)

    CAMPBELL,PHILIP L.

    2000-08-11

    Control objectives open an additional front in the survivability battle. A given set of control objectives is valuable if it represents good practices, it is complete (it covers all the necessary areas), and it is auditable. CobiT and BS 7799 are two examples of control objective sets.

  10. Education for Survival.

    Science.gov (United States)

    Allen, James E., Jr.

    In this address, James E. Allen, Jr., Assistant Secretary for Education and U.S. Commissioner of Education, discusses the relationship of education to the problem of ecological destruction. He states that the solutions to the problems of air, water, and soil pollution may be found in redirected education. This "education for survival" can serve to…

  11. Artists’ Survival Rate

    DEFF Research Database (Denmark)

    Bille, Trine; Jensen, Søren

    2017-01-01

    The literature of cultural economics generally finds that an artistic education has no significant impact on artists’ income and careers in the arts. In our research, we have readdressed this question by looking at the artists’ survival in the arts occupations. The results show that an artistic...... education has a significant impact on artists’ careers in the arts and we find important industry differences....

  12. Seaweed resources

    Digital Repository Service at National Institute of Oceanography (India)

    Deshmukhe, G.V.; Dhargalkar, V.K.; Untawale, A.G.

    The chapter summarizes our present knowledge of the seaweed resources of the Indian Ocean region with regard to the phytogeographical distribution, composition, biomass, utilization, cultivation, conservation and management. The voluminous data...

  13. Arthritis - resources

    Science.gov (United States)

    Resources - arthritis ... The following organizations provide more information on arthritis : American Academy of Orthopaedic Surgeons -- orthoinfo.aaos.org/menus/arthritis.cfm Arthritis Foundation -- www.arthritis.org Centers for Disease Control and Prevention -- www. ...

  14. Mineral resources

    Digital Repository Service at National Institute of Oceanography (India)

    Valsangkar, A.B.

    (placers), biogenous (ooze, limestone) or chemogenous (phosphorites and polymetallic nodules) type. In recent years, hydrothermal deposits, cobalt crust and methane gas hydrates are considered as frontier resources. Their distribution depends upon proximity...

  15. Depression - resources

    Science.gov (United States)

    Resources - depression ... Depression is a medical condition. If you think you may be depressed, see a health care provider. ... following organizations are good sources of information on depression : American Psychological Association -- www.apa.org/topics/depression/ ...

  16. Hemophilia - resources

    Science.gov (United States)

    Resources - hemophilia ... The following organizations provide further information on hemophilia : Centers for Disease Control and Prevention -- www.cdc.gov/ncbddd/hemophilia/index.html National Heart, Lung, and Blood Institute -- www.nhlbi.nih.gov/ ...

  17. Diabetes - resources

    Science.gov (United States)

    Resources - diabetes ... The following sites provide further information on diabetes: American Diabetes Association -- www.diabetes.org Juvenile Diabetes Research Foundation International -- www.jdrf.org National Center for Chronic Disease Prevention and Health Promotion -- ...

  18. Forest Resources

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-06-01

    Forest biomass is an abundant biomass feedstock that complements the conventional forest use of wood for paper and wood materials. It may be utilized for bioenergy production, such as heat and electricity, as well as for biofuels and a variety of bioproducts, such as industrial chemicals, textiles, and other renewable materials. The resources within the 2016 Billion-Ton Report include primary forest resources, which are taken directly from timberland-only forests, removed from the land, and taken to the roadside.

  19. Overcoming the challenges of the skilled labour shortage through energy industry cooperation

    Energy Technology Data Exchange (ETDEWEB)

    Massitti, P. [Baker Hughes INTEQ, Calgary, AB (Canada); Goodman, G. [Goodman McDougall and Associates Ltd., Calgary, AB (Canada); Dalik, A.; Richardson, S. [RainTree Consulting, Calgary, AB (Canada); Gurevitch, J. [Halliburton, Calgary, AB (Canada)

    2004-07-01

    This presentation described the unique workforce planning and recruitment challenges currently facing the petroleum services industry, and how they are being managed. It offered suggestions as to how energy companies can work more effectively with petroleum industry service providers to ensure that projects have the necessary human resources to staff projects. In particular, the paper referred to the challenge and feasibility of smoothing out drilling cycles throughout the year. The challenge facing the service and supply industry in planning and managing a workforce for Arctic development was also discussed.

  20. 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)

  1. 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.

  2. Daylight Management in Mediterranean Cities: When Shortage Is Not the Issue

    Directory of Open Access Journals (Sweden)

    Judit Lopez-Besora

    2016-09-01

    Full Text Available Natural resources such as daylight and sunlight are highly appreciated in countries with prevailing overcast skies. Taking advantage of this scarce resource contributes to saving energy on artificial lighting. In contrast to northern, southern European cities are distinguished by a large number of days with direct sunlight caused by a propitious climate condition. While it is a positive issue in terms of energy availability, the abundance of it can be counterproductive if management measures are not taken. Apart from the thermal consequences, lighting penetration into buildings causes a great contrast between inside and outside. This is especially critical when the visual system does not have enough time to adapt, as happens at entrance areas. The aim of this study is to analyze the light contrast between these areas and the urban outside in sunny conditions. To attain this objective, light data from five entrance spaces and their contiguous streets were analyzed and measured. The results were divided into three zones in the visual scene, showing an increasing contrast from top to bottom of the visual field. It may be concluded that interventions applied to urban areas and building pavements can improve visual adaptation in the transition zone.

  3. Impact of forest maintenance on water shortages: Hydrologic modeling and effects of climate change.

    Science.gov (United States)

    Luo, Pingping; Zhou, Meimei; Deng, Hongzhang; Lyu, Jiqiang; Cao, Wenqiang; Takara, Kaoru; Nover, Daniel; Geoffrey Schladow, S

    2018-02-15

    The importance of water quantity for domestic and industrial water supply, agriculture, and the economy more broadly has led to the development of many water quantity assessment methods. In this study, surface flow and soil water in the forested upper reaches of the Yoshino River are compared using a distributed hydrological model with Forest Maintenance Module under two scenarios; before and after forest maintenance. We also examine the impact of forest maintenance on these variables during extreme droughts. Results show that surface flow and soil water increased after forest maintenance. In addition, projections of future water resources were estimated using a hydrological model and the output from a 20km mesh Global Climate Model (GCM20). River discharge for the near-future (2015-2039) is similar to that of the present (1979-2003). Estimated river discharge for the future (2075-2099) was found to be substantially more extreme than in the current period, with 12m 3 /s higher peak discharge in August and 7m 3 /s lower in July compared to the discharges of the present period. Soil water for the future is estimated to be lower than for the present and near future in May. The methods discussed in this study can be applied in other regions and the results help elucidate the impact of forests and climate change on water resources. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.

    Science.gov (United States)

    Mackey, Timothy Ken; Liang, Bryan Albert

    2012-09-01

    Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This "brain drain" results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations and effectiveness of global health interventions. Current structural imbalances in resource allocation and global incentive structures have resulted in 57 countries identified by WHO as having a "critical shortage" of health workers. Yet current efforts to strengthen domestic health systems have fallen short in addressing this issue. Instead, global solutions should focus on sustainable forms of equitable resource sharing. This can be accomplished by adoption of mandatory global resource and staff-sharing programs in conjunction with implementation of state-based health services corps. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Radiobilogical cell survival models

    International Nuclear Information System (INIS)

    Zackrisson, B.

    1992-01-01

    A central issue in clinical radiobiological research is the prediction of responses to different radiation qualities. The choice of cell survival and dose-response model greatly influences the results. In this context the relationship between theory and model is emphasized. Generally, the interpretations of experimental data depend on the model. Cell survival models are systematized with respect to their relations to radiobiological theories of cell kill. The growing knowlegde of biological, physical, and chemical mechanisms is reflected in the formulation of new models. The present overview shows that recent modelling has been more oriented towards the stochastic fluctuations connected to radiation energy deposition. This implies that the traditional cell surivival models ought to be complemented by models of stochastic energy deposition processes and repair processes at the intracellular level. (orig.)

  6. Practices implemented by a Texas charter school system to overcome science teacher shortage

    Science.gov (United States)

    Yasar, Bilgehan M.

    The purpose of this study was to examine practices used by a charter school system to hire and retain science teachers. The research design for this study was a qualitative case study. This single instrumental case study explored the issue within a bounded system. Purposeful sampling strategy was used to identify the participants who were interviewed individually. Findings of the case study supported that using online resources, advertising in the newspaper, attending job fairs, using alternative certification programs, attracting alumni, contacting the college of educations and hiring internationally helped the charter school system with hiring science teachers. Improving teacher salary scale, implementing teacher mentorship programs, reimbursing teachers for certification and master's programs, providing professional development and supporting teachers helped to retain science teachers. Therefore, this study contributes to determining strategies and techniques, selecting methods and programs, training administrators, and monitoring for successful hiring and retaining science teacher implementation.

  7. Carbonaceous Survivability on Impact

    Science.gov (United States)

    Bunch, T. E.; Becker, Luann; Morrison, David (Technical Monitor)

    1994-01-01

    In order to gain knowledge about the potential contributions of comets and cosmic dust to the origin of life on Earth, we need to explore the survivability of their potential organic compounds on impact and the formation of secondary products that may have arisen from the chaotic events sustained by the carriers as they fell to Earth. We have performed a series of hypervelocity impact experiments using carbon-bearing impactors (diamond, graphite, kerogens, PAH crystals, and Murchison and Nogoya meteorites) into Al plate targets at velocities - 6 km/s. Estimated peak shock pressures probably did not exceed 120 GPa and peak shock temperatures were probably less than 4000 K for times of nano- to microsecs. Nominal crater dia. are less than one mm. The most significant results of these experiments are the preservation of the higher mass PAHs (e. g., pyrene relative to napthalene) and the formation of additional alkylated PAHs. We have also examined the residues of polystyrene projectiles impacted by a microparticle accelerator into targets at velocities up to 15 km/s. This talk will discuss the results of these experiments and their implications with respect to the survival of carbonaceous deliverables to early Earth. The prospects of survivability of organic molecules on "intact" capture of cosmic dust in space via soft: and hard cosmic dust collectors will also be discussed.

  8. Survival analysis models and applications

    CERN Document Server

    Liu, Xian

    2012-01-01

    Survival analysis concerns sequential occurrences of events governed by probabilistic laws.  Recent decades have witnessed many applications of survival analysis in various disciplines. This book introduces both classic survival models and theories along with newly developed techniques. Readers will learn how to perform analysis of survival data by following numerous empirical illustrations in SAS. Survival Analysis: Models and Applications: Presents basic techniques before leading onto some of the most advanced topics in survival analysis.Assumes only a minimal knowledge of SAS whilst enablin

  9. 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

  10. 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

  11. Water resources trends in Middle East and North Africa towards 2050

    Directory of Open Access Journals (Sweden)

    P. Droogers

    2012-09-01

    Full Text Available Changes in water resources availability can be expected as consequences of climate change, population growth, economic development and environmental considerations. A two-stage modeling approach is used to explore the impact of these changes in the Middle East and North Africa (MENA region. An advanced, physically based, distributed, hydrological model is applied to determine the internal and external renewable water resources for the current situation and under future changes. Subsequently, a water allocation model is used to combine the renewable water resources with sectoral water demands. Results show that total demand in the region will increase to 393 km3 yr−1 in 2050, while total water shortage will grow to 199 km3 yr−1 in 2050 for the average climate change projection, an increase of 157 km3 yr−1. This increase in shortage is the combined impact of an increase in water demand by 50% with a decrease in water supply by 12%. Uncertainty, based on the output of the nine GCMs applied, reveals that expected water shortage ranges from 85 km3 yr−1 to 283 km3 yr−1~in 2050. The analysis shows that 22% of the water shortage can be attributed to climate change and 78% to changes in socio-economic factors.

  12. Teaching Resources

    Science.gov (United States)

    Physics?" Poster Pamphlets/Books/SPIN-UP Resources Making and Sustaining Changes in Undergraduate AAPT.org - American Association of Physics Teachers Skip to content Skip to navigation Skip to local navigation AAPT - American Association of Physics Teachers Go Sign In / Online Services Join

  13. Resource Mobilization

    International Development Research Centre (IDRC) Digital Library (Canada)

    constitute endorsement of the product and is given only for information. ..... point where they could significantly impact an organization's financial viability. This alternative ... putting in place internal systems and processes that enable the resource .... control over the incorporation of non-profit organizations. ..... Accounting.

  14. Resource Mobilization

    International Development Research Centre (IDRC) Digital Library (Canada)

    Annex 1: The Scoping Study on Donor Funding for. Development Research in ... publication of the Resource Mobilization: A Practical Guide for Research .... applied the concept or technique, which validates the practical application of ... some other staff member would write up a grant application addressed to one, two, or a ...

  15. 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.

  16. 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.

  17. Spatial risk modelling for water shortage and nitrate pollution in the lower Jordan valley

    International Nuclear Information System (INIS)

    Loibl, W.; Orthofer, R.

    2002-02-01

    This report summarizes the results of the spatial risk modeling activities (work package WP-4.4, 'GIS Risk Modeling') of the INCO-DC project 'Developing Sustainable Water Management in the Jordan Valley'. The project was funded by European Commission's INCO-DC research program. The main objective of the project was to develop the scientific basis for an integral management plan of water resources and their use in the Lower Jordan Valley. The outputs of the project were expected to allow a better understanding of the water management situation, and to provide a sound basis for a better future water management - not only separately in the three countries, but in the overall valley region. The risk modeling was done by the ARCS Seibersdorf research (ARCS), based on information and data provided by the regional partners from Israel (Hebrew University, Jerusalem, HUJ), Palestine (Applied Research Institute, Jerusalem, Bethlehem, ARIJ) and Jordan (EnviroConsult Office, Amman, ECO). The land use classification has been established through a cooperation between ARCS and the Yale University Center for Earth Observation (YUCEO). As a result of the work, the spatial patterns of agricultural and domestic water demand in the Lower Jordan Valley were established, and the spatial dimension of driving forces for water usage and water supply was analyzed. Furthermore, a conceptual model for nitrate leakage (established by HUJ) was translated into a GIS system, and the risks for nitrate pollution of groundwater were quantified. (author)

  18. Effect of donor age on long-term survival following cardiac transplantation.

    Science.gov (United States)

    Topkara, Veli K; Cheema, Faisal H; Kesavaramanujam, Satish; Mercando, Michelle L; Forster, Catherine S; Argenziano, Michael; Esrig, Barry C; Oz, Mehmet C; Naka, Yoshifumi

    2006-01-01

    The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age or =40 years (Group B, n = 264). Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.

  19. Applied survival analysis using R

    CERN Document Server

    Moore, Dirk F

    2016-01-01

    Applied Survival Analysis Using R covers the main principles of survival analysis, gives examples of how it is applied, and teaches how to put those principles to use to analyze data using R as a vehicle. Survival data, where the primary outcome is time to a specific event, arise in many areas of biomedical research, including clinical trials, epidemiological studies, and studies of animals. Many survival methods are extensions of techniques used in linear regression and categorical data, while other aspects of this field are unique to survival data. This text employs numerous actual examples to illustrate survival curve estimation, comparison of survivals of different groups, proper accounting for censoring and truncation, model variable selection, and residual analysis. Because explaining survival analysis requires more advanced mathematics than many other statistical topics, this book is organized with basic concepts and most frequently used procedures covered in earlier chapters, with more advanced topics...

  20. Issues about Human Resources Recruitment

    Directory of Open Access Journals (Sweden)

    Aurel Manolescu

    2008-04-01

    Full Text Available As to ensure its success or even for surviving, organizations must settle accordingly some issues regarding the human resources enlistment, presented in great details within the article, whose success settlement ensure, concomitantly, the success of the entire assurance process with personnel, process extremely important, if there are taken into consideration, especially, the effects of some possible errors or hire errors. Therefore, the human resources recruitment tends to become a complex and expensive activity and, concomitantly, an independent activity, sustained both through the necessary work volume as well as through its importance for the organization.

  1. Evaluating the link between human resource management decisions and patient satisfaction with quality of care.

    Science.gov (United States)

    Oppel, Eva-Maria; Winter, Vera; Schreyögg, Jonas

    Patient satisfaction with quality of care is becoming increasingly important in the competitive hospital market. Simultaneously, the growing shortage of clinical staff poses a considerable challenge to ensuring a high quality of care. In this context, a question emerges regarding whether and how human resource management (HRM) might serve as a means to reduce staff shortage problems and to increase patient satisfaction. Although considerable efforts have been devoted to understanding the concepts of patient satisfaction and HRM, little is known about the interrelationships between these concepts or about the link between staff shortage problems and patients' satisfaction with quality of care. The aim of this study was to investigate the relationship between strategic human resource management (SHRM), staff shortage problems, and patients' satisfaction with care. Furthermore, we analyze how the HRM decision to fill short-term vacancies through temporary staffing affects patient satisfaction. We differentiate between physicians and nurses. We develop and empirically test a theoretical model. The data (n = 165) are derived from a survey on SHRM that was sent to 732 German hospitals and from a survey on patient satisfaction that comprises 436,848 patient satisfaction ratings. We use a structural equation modeling approach to test the model. The results indicate that SHRM significantly reduces staff shortage problems for both occupational groups. Having fewer physician shortage problems is significantly associated with higher levels of patient satisfaction, whereas this effect is not significant for nurses. Furthermore, the use of temporary staffing considerably reduces patients' satisfaction with care. Hospital managers are advised to consider the effects of HRM decisions on patients' satisfaction with care. In particular, investments in SHRM targeted at physicians have significantly positive effects on patient satisfaction, whereas the temporary staffing of physicians

  2. The Will to Survive

    Science.gov (United States)

    Katz, Robert

    1975-01-01

    Bangladesh could achieve self-sufficiency despite natural and man-made catastrophies. It contains rich alluvial soils and abundant groundwater. The country also possesses energy resources needed for development. By combining agrarian reform with population control and small industry development the Bangladesh government hopes to restructure its…

  3. Nuclear War Survival Skills

    Energy Technology Data Exchange (ETDEWEB)

    Kearny, C.H.

    2002-06-24

    The purpose of this book is to provide Americans with information and instructions that will significantly increase their chances of surviving a possible nuclear attack. It brings together field-tested instructions that, if followed by a large fraction of Americans during a crisis that preceded an attack, could save millions of lives. The author is convinced that the vulnerability of our country to nuclear threat or attack must be reduced and that the wide dissemination of the information contained in this book would help achieve that objective of our overall defense strategy.

  4. Survival after blood transfusion

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Ahlgren, Martin; Rostgaard, Klaus

    2008-01-01

    of transfusion recipients in Denmark and Sweden followed for up to 20 years after their first blood transfusion. Main outcome measure was all-cause mortality. RESULTS: A total of 1,118,261 transfusion recipients were identified, of whom 62.0 percent were aged 65 years or older at the time of their first...... the SMR remained significantly 1.3-fold increased. CONCLUSION: The survival and relative mortality patterns among blood transfusion recipients were characterized with unprecedented detail and precision. Our results are relevant to assessments of the consequences of possible transfusion-transmitted disease...... as well as for cost-benefit estimation of new blood safety interventions....

  5. Survival curves for irradiated cells

    International Nuclear Information System (INIS)

    Gibson, D.K.

    1975-01-01

    The subject of the lecture is the probability of survival of biological cells which have been subjected to ionising radiation. The basic mathematical theories of cell survival as a function of radiation dose are developed. A brief comparison with observed survival curves is made. (author)

  6. Chemical dependence - resources

    Science.gov (United States)

    Substance use - resources, Drug abuse - resources; Resources - chemical dependence ... are a good resource for information on drug dependence: National Council on Alcoholism and Drug Dependence -- ncadd. ...

  7. Avoiding shortage of radio-chemists with the NAMP radiochemistry webinars

    International Nuclear Information System (INIS)

    Paviet-Hartmann, P.; Akbarzadeh, M.; Griggs, J.

    2013-01-01

    The U.S. Department of Energy originally created the National Analytical Management Program (NAMP) to help coordinate its analytical capabilities and to address national needs in technology and resources. In support of this mission, the NAMP established a subcommittee to promote training and education in radiochemistry to avert the predicted loss in expertise. In cooperation with the U.S. Environmental Protection Agency and university partners, the NAMP developed a series of two-hour webinar presentations by experts on different topics relevant to radiochemistry. These webinars are intended to be of interest to those already in the workforce who may need a refresher course or a better understanding of specific radiochemistry topics. The live webinars include slides presentation, and engage the attendees by giving them the opportunity to ask questions during the live event through the web-cast interface. Certificates may be given for attendance during the live webinar. The success of these webinars relies not only on the presenters who are internationally recognized experts but also on how we promote them: we advertised them through a dedicated web site, social networks or flyers. Another important point is that they are free are accessible online in 2 formats: audio-video recording and pdf files. Recorded and archived versions comprise a library vital to future generations of radio-chemists and scientists interested in radiochemistry. The first webinar, An Overview of Actinide Chemistry, was presented on April 20, 2012. The overwhelmingly positive feedback from participants clearly demonstrates that the NAMP webinars are making a difference by providing unique educational opportunities in radiochemistry

  8. Avoiding shortage of radio-chemists with the NAMP radiochemistry webinars

    Energy Technology Data Exchange (ETDEWEB)

    Paviet-Hartmann, P. [Idaho National Laboratory, 995 University Blvd, Idaho Falls, ID 83402 (United States); Akbarzadeh, M. [Nuclear Waste Partnership, LLC, 1400 university Dr, Carlsbad, NM 88220 (United States); Griggs, J. [US Environmental Protection Agency, NAREL, 540 S. Morris Ave, Montgomery, AL 36115-2601 (United States)

    2013-07-01

    The U.S. Department of Energy originally created the National Analytical Management Program (NAMP) to help coordinate its analytical capabilities and to address national needs in technology and resources. In support of this mission, the NAMP established a subcommittee to promote training and education in radiochemistry to avert the predicted loss in expertise. In cooperation with the U.S. Environmental Protection Agency and university partners, the NAMP developed a series of two-hour webinar presentations by experts on different topics relevant to radiochemistry. These webinars are intended to be of interest to those already in the workforce who may need a refresher course or a better understanding of specific radiochemistry topics. The live webinars include slides presentation, and engage the attendees by giving them the opportunity to ask questions during the live event through the web-cast interface. Certificates may be given for attendance during the live webinar. The success of these webinars relies not only on the presenters who are internationally recognized experts but also on how we promote them: we advertised them through a dedicated web site, social networks or flyers. Another important point is that they are free are accessible online in 2 formats: audio-video recording and pdf files. Recorded and archived versions comprise a library vital to future generations of radio-chemists and scientists interested in radiochemistry. The first webinar, An Overview of Actinide Chemistry, was presented on April 20, 2012. The overwhelmingly positive feedback from participants clearly demonstrates that the NAMP webinars are making a difference by providing unique educational opportunities in radiochemistry.

  9. Survival of the relocated population of the U. S. after a nuclear attack. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Haaland, C.M.; Chester, C.V.; Wigner, E.P.

    1976-06-01

    The feasibility of continued survival after a hypothetical nuclear attack is evaluated for people relocated from high-risk areas during the crisis period before the attack. The attack consists of 6559 MT, of which 5951 MT are ground bursts on military, industrial, and urban targets. Relocated people are assumed to be adequately protected from fallout radiation by shelters of various kinds. The major problems in the postattack situation will be the control of exposure to fallout radiation, and prevention of severe food shortages to several tens of millions of people.

  10. Algae Resources

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-06-01

    Algae are highly efficient at producing biomass, and they can be found all over the planet. Many use sunlight and nutrients to create biomass, which contain key components—including lipids, proteins, and carbohydrates— that can be converted and upgraded to a variety of biofuels and products. A functional algal biofuels production system requires resources such as suitable land and climate, sustainable management of water resources, a supplemental carbon dioxide (CO2) supply, and other nutrients (e.g., nitrogen and phosphorus). Algae can be an attractive feedstock for many locations in the United States because their diversity allows for highpotential biomass yields in a variety of climates and environments. Depending on the strain, algae can grow by using fresh, saline, or brackish water from surface water sources, groundwater, or seawater. Additionally, they can grow in water from second-use sources such as treated industrial wastewater; municipal, agricultural, or aquaculture wastewater; or produced water generated from oil and gas drilling operations.

  11. Uranium resources

    International Nuclear Information System (INIS)

    1976-01-01

    This is a press release issued by the OECD on 9th March 1976. It is stated that the steep increases in demand for uranium foreseen in and beyond the 1980's, with doubling times of the order of six to seven years, will inevitably create formidable problems for the industry. Further substantial efforts will be needed in prospecting for new uranium reserves. Information is given in tabular or graphical form on the following: reasonably assured resources, country by country; uranium production capacities, country by country; world nuclear power growth; world annual uranium requirements; world annual separative requirements; world annual light water reactor fuel reprocessing requirements; distribution of reactor types (LWR, SGHWR, AGR, HWR, HJR, GG, FBR); and world fuel cycle capital requirements. The information is based on the latest report on Uranium Resources Production and Demand, jointly issued by the OECD's Nuclear Energy Agency (NEA) and the International Atomic Energy Agency. (U.K.)

  12. Nuclear war survival skills

    International Nuclear Information System (INIS)

    Kearney, C.H.

    1979-09-01

    This book includes chapters on psychological preparations, warning and communications, and evacuation. It describes the building of expedient shelters, their ventilation and cooling, the purification and storage of adequate water, the processing and cooking of whole grains and legumes, fallout meters, protection against fires and carbon monoxide, and expedient furnishings for shelters. Other chapters cover sanitation and preventive medicine, medical advice for nuclear survivors lacking the help of doctors, improvised footwear and clothing, and advice on minimum preparations that can be made at low cost and should be made before a crisis arises. One appendix of the handbook gives detailed, field-tested instructions for building six types of earth-covered expedient fallout shelters, with criteria to guide the choice of which shelter to build. Others contain instructions for making an efficient shelter-ventilating pump and a homemade fallout meter that is accurate and dependable with inexpensive materials found in most households. This report is primarily a compilation and summary of civil defense measures and inventions developed at ORNL over the past 14 years and field-tested in six states, from Florida to Utah. It is the first comprehensive handbook of survival information for use by untrained citizens who want to improve their chances of surviving a possible nuclear attack. Sections may be easily excerpted and reproduced for mass distribution through news media

  13. Resource Abundance and Resource Dependence in China

    NARCIS (Netherlands)

    Ji, K.; Magnus, J.R.; Wang, W.

    2010-01-01

    This paper reconsiders the ‘curse of resources’ hypothesis for the case of China, and distinguishes between resource abundance, resource rents, and resource dependence. Resource abundance and resource rents are shown to be approximately equivalent, and their association with resource dependence

  14. Simulation of Integrated Qualitative and Quantitative Allocation of Surafce and Underground Water Resources to Drinking Water Demand in Mashhad

    Directory of Open Access Journals (Sweden)

    Mansoureh Atashi

    2015-12-01

    Full Text Available Despite the fact that both surface and groundwater resources inside and outside the city of Mashhad have been already exploited to their maximum capacity and that the large water transfer Doosti Dam Project has been already implemented to transfer a considerable quanity of water to Mashhad, the city will be encountering a daily water shortage of about 1.7 m3/s by 2021. The problem would be even worse if the quality of the water resources are taken into account, in which case, the shortage would start even sooner in 2011 when the water deficit will be about 0.9 m3/s. As a result, it is essential to develop short- and medium-term strategies for secure adequate water supplies for the city's domestic water demand. The present study aims to carry out a qualitative and quantitative modeling of surface and groundwater resources supplying Mashhad domestic water. The qualitative model is based on the quality indices of surface and groundwater resources according to which the resources are classified in the three quality categories of resources with no limitation, those with moderate limitations, and those with high limitations for use as domestic water supplies. The pressure zones are then examined with respect to the potable water demand and supply to be simulated in the MODSIM environment. The model thus developed is verified for the 2012 data based on the measures affecting water resources in the region and various scenarios are finally evaluated for a long-term 30-year period. Results show that the peak hourdaily water shortage in 2042for the zone supplied from no limitation resources will be 38%. However, this value will drop to 28% if limitations due to resource quality are also taken into account. Finally, dilution is suggested as a solution for exploiting the maximum quantitative and qualitative potential of the resources used as domestic water supplies. In this situation, the daily peak hour water shortage will be equal to 31%.

  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. Underground coal gasification with extended CO2 utilization as economic and carbon neutral approach to address energy and fertilizer supply shortages in Bangladesh

    Science.gov (United States)

    Nakaten, Natalie; Islam, Rafiqul; Kempka, Thomas

    2014-05-01

    The application of underground coal gasification (UCG) with proven carbon mitigation techniques may provide a carbon neutral approach to tackle electricity and fertilizer supply shortages in Bangladesh. UCG facilitates the utilization of deep-seated coal seams, not economically exploitable by conventional coal mining. The high-calorific synthesis gas produced by UCG can be used for e.g. electricity generation or as chemical raw material for hydrogen, methanol and fertilizer production. Kempka et al. (2010) carried out an integrated assessment of UCG operation, demonstrating that about 19 % of the CO2 produced during UCG may be mitigated by CO2 utilization in fertilizer production. In the present study, we investigated an extension of the UCG system by introducing excess CO2 storage in the gas deposit of the Bahkrabad gas field (40 km east of Dhaka, Bangladesh). This gas field still holds natural gas resources of 12.8 million tons of LNG equivalent, but is close to abandonment due to a low reservoir pressure. Consequently, applying enhanced gas recovery (EGR) by injection of excess carbon dioxide from the coupled UCG-urea process may mitigate carbon emissions and support natural gas production from the Bahkrabad gas field. To carry out an integrated techno-economic assessment of the coupled system, we adapted the techno-economic UCG-CCS model developed by Nakaten et al. (2014) to consider the urea and EGR processes. Reservoir simulations addressing EGR in the Bakhrabad gas field by utilization of excess carbon dioxide from the UCG process were carried out to account for the induced pressure increase in the reservoir, and thus additional gas recovery potentials. The Jamalganj coal field in Northwest Bangladesh provides favorable geological and infrastructural conditions for a UCG operation at coal seam depths of 640 m to 1,158 m. Excess CO2 can be transported via existing pipeline networks to the Bahkrabad gas field (about 300 km distance from the coal deposit) to be

  18. Sustainable River Basin Management under the European Water Framework Directive: an Effective Protection of Drinking-Water Resources

    NARCIS (Netherlands)

    van Rijswick, H.F.M.W.|info:eu-repo/dai/nl/099909189; Wuijts, Susanne

    2016-01-01

    In the Netherlands drinking water is produced both from surface water and groundwater. Due to the shortage of space, resources are often found in combination with other activities, such as those pertaining to industry or agriculture, in the same neighbourhood. These combinations impose strong

  19. Uranium resource processing. Secondary resources

    International Nuclear Information System (INIS)

    Gupta, C.K.; Singh, H.

    2003-01-01

    This book concentrates on the processing of secondary sources for recovering uranium, a field which has gained in importance in recent years as it is environmental-friendly and economically in tune with the philosophy of sustainable development. Special mention is made of rock phosphate, copper and gold tailings, uranium scrap materials (both natural and enriched) and sea water. This volume includes related area of ore mineralogy, resource classification, processing principles involved in solubilization followed by separation and safety aspects

  20. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012." DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings...... (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups......, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low...

  1. Surviving Sepsis Campaign

    DEFF Research Database (Denmark)

    Rhodes, Andrew; Evans, Laura E; Alhazzani, Waleed

    2017-01-01

    OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings...... (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups......, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low...

  2. Surviving relatives after suicide

    DEFF Research Database (Denmark)

    Nørrelykke, Helle; Cohrt, Pernille

    and that suicide has become a subject of research, prevention and treatment. Auxiliary Strategies In the 1990s there have been established the Centre for Suicide Research and the Centre for Prevention of Suicide in Denmark and there has been drafted a national policy document which focuses on the need......We would like to focus on the surviving relatives after suicides, because it is generally accepted that it is especially difficult to recover after the loss from suicide and because we know as a fact that one suicide affects five persons on average. Every year approximately 700 people commit...... suicide in Denmark. This means that at least 400 people undergo the trauma it is when one of their near relatives commits suicide. We also know that the loss from suicide involves a lot of conflicting feelings - like anger, shame, guilt and loss and that the lack of therapy/treatment of these difficult...

  3. The impact of resource tax reform on China's coal industry

    International Nuclear Information System (INIS)

    Liu, Huihui; Chen, ZhanMing; Wang, Jianliang; Fan, Jihong

    2017-01-01

    Contributing to approximately two-thirds of primary energy consumption, coal usage is the focus of China's energy policies. To regulate the resource taxation system and reduce the burden of coal enterprises, the Chinese government launched a reform of its resource tax system in 2014 for coal, introducing the ad valorem system to replace the volume-based system that had been in place for the preceding thirty years. To assess the impact of the tax reform, this paper constructs two-stage dynamic game models by taking the coal and coal-fired power industries as the players. The market situations of shortage and oversupply are investigated separately. Empirical data are collected to estimate the model parameters for numerical simulations. The model results suggest that the tax reform will reduce both coal prices and the coal industry profitability if the tax levied on each ton of coal is maintained at the same level as before the reform, regardless of whether the market is in a shortage or an oversupply situation. However, the increased buyer's power will amplify the effect of the tax reform. The numerical simulations also provide an estimation of the tax rate of the ad valorem system that maintains the profit of the coal industry. Considering the demand and supply situations in China's coal market, policy recommendations are provided to guide further reform of China's resource tax system. - Highlights: • The paper examines the influence of resource tax reform on China's coal industry. • We construct two-stage game models between coal and coal-fired power industries. • Market situations of shortage and oversupply are studied in two taxation systems. • Coal price will decrease if maintaining the tax levied on each ton of coal the same. • To achieve the reform objective, the ad valorem tax rate should not be set too high.

  4. Energy resources

    CERN Document Server

    Simon, Andrew L

    1975-01-01

    Energy Resources mainly focuses on energy, including its definition, historical perspective, sources, utilization, and conservation. This text first explains what energy is and what its uses are. This book then explains coal, oil, and natural gas, which are some of the common energy sources used by various industries. Other energy sources such as wind, solar, geothermal, water, and nuclear energy sources are also tackled. This text also looks into fusion energy and techniques of energy conversion. This book concludes by explaining the energy allocation and utilization crisis. This publ

  5. Water Conservation Resource List.

    Science.gov (United States)

    NJEA Review, 1981

    1981-01-01

    Alarmed by the growing water shortage, the New Jersey State Office of Dissemination has prepared this annotated list of free or inexpensive instructional materials for teaching about water conservation, K-l2. A tipsheet for home water conservation is appended. (Editor/SJL)

  6. Water application rate and frequency affect seedling survival and ...

    African Journals Online (AJOL)

    Adequate amount of water is critical to successful tree nursery operation among resource-constrained smallholder farmers in Africa. Two experiments were undertaken with the objectives of evaluating effects of water application rate and frequency on seedling growth and survival of Persea americana and Vangueria ...

  7. Survival of extremely low-birth-weight infants

    African Journals Online (AJOL)

    Survival of extremely low-birth-weight (ELBW) infants in a resource-limited public hospital setting is still low in South. Africa. is study aimed ... Mortality as a result of prematurity is the major contributor to .... reported from a large cohort study that.

  8. Network survivability performance (computer diskette)

    Science.gov (United States)

    1993-11-01

    File characteristics: Data file; 1 file. Physical description: 1 computer diskette; 3 1/2 in.; high density; 2.0MB. System requirements: Mac; Word. This technical report has been developed to address the survivability of telecommunications networks including services. It responds to the need for a common understanding of, and assessment techniques for network survivability, availability, integrity, and reliability. It provides a basis for designing and operating telecommunication networks to user expectations for network survivability.

  9. Resource consumption, sustainability, and cancer.

    Science.gov (United States)

    Kareva, Irina; Morin, Benjamin; Castillo-Chavez, Carlos

    2015-02-01

    Preserving a system's viability in the presence of diversity erosion is critical if the goal is to sustainably support biodiversity. Reduction in population heterogeneity, whether inter- or intraspecies, may increase population fragility, either decreasing its ability to adapt effectively to environmental changes or facilitating the survival and success of ordinarily rare phenotypes. The latter may result in over-representation of individuals who may participate in resource utilization patterns that can lead to over-exploitation, exhaustion, and, ultimately, collapse of both the resource and the population that depends on it. Here, we aim to identify regimes that can signal whether a consumer-resource system is capable of supporting viable degrees of heterogeneity. The framework used here is an expansion of a previously introduced consumer-resource type system of a population of individuals classified by their resource consumption. Application of the Reduction Theorem to the system enables us to evaluate the health of the system through tracking both the mean value of the parameter of resource (over)consumption, and the population variance, as both change over time. The article concludes with a discussion that highlights applicability of the proposed system to investigation of systems that are affected by particularly devastating overly adapted populations, namely cancerous cells. Potential intervention approaches for system management are discussed in the context of cancer therapies.

  10. Mineral resources

    International Nuclear Information System (INIS)

    1991-09-01

    This paper reports that to prevent the concentration of control over federal oil and gas resources in a few companies or individuals, Congress has limited the number of acres of oil and gas leases that one party may control in a single state. An exception to this limitation involves lease acreage within the boundaries of development contracts. These contracts permit oil and gas lease operators and pipeline companies to contract with enough lessees to economically justify large-scale drilling operations for the production and transportation of oil and gas, subject to approval by the Secretary of the Interior, who must find that such contracts are in the public interest. Since 1986 Interior has entered into or approved 10 contracts with 12 lease operators for exploration of largely unleased federal lands-ranging from about 180,000 to 3.5 million acres in four western states-and has designated them as developmental contracts. GAO believes that the 10 contracts do not satisfy the legal requirements for development contracts because they are for oil and gas exploration on largely unleased federal lands, rather than for developing existing leases. By designating the 10 contracts as development contracts, Interior has enabled nine of the 12 contract parties to accumulate lease acreage that vastly exceeds the statutory acreage limitation. All nine of the contract parties were major or large independent oil companies. As a result, other parties who wish to participate in developing federal oil and gas resources within the four states may be adversely affected because the parties to Interior's contracts have been able to compete for and obtain lease acreage beyond the statutory acreage limitation. Although Interior believes that the Secretary has the discretion under law to use development contracts in the current manner, in April 1989 it ceased issuing these contracts pending completion of GAO's review

  11. Depression and Liver Transplant Survival.

    Science.gov (United States)

    Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

    Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  12. Ship Systems Survivability Test Site

    Data.gov (United States)

    Federal Laboratory Consortium — Area for testing survivability of shipboard systems to include electrical, communications, and fire suppression. Multipurpose test range for supporting gun firing,...

  13. Surviving a Suicide Attempt

    Directory of Open Access Journals (Sweden)

    Ahmed Al-Harrasi

    2016-09-01

    Full Text Available Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors and protective factors (like religious affiliation and family support. All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.

  14. Survival and weak chaos.

    Science.gov (United States)

    Nee, Sean

    2018-05-01

    Survival analysis in biology and reliability theory in engineering concern the dynamical functioning of bio/electro/mechanical units. Here we incorporate effects of chaotic dynamics into the classical theory. Dynamical systems theory now distinguishes strong and weak chaos. Strong chaos generates Type II survivorship curves entirely as a result of the internal operation of the system, without any age-independent, external, random forces of mortality. Weak chaos exhibits (a) intermittency and (b) Type III survivorship, defined as a decreasing per capita mortality rate: engineering explicitly defines this pattern of decreasing hazard as 'infant mortality'. Weak chaos generates two phenomena from the normal functioning of the same system. First, infant mortality- sensu engineering-without any external explanatory factors, such as manufacturing defects, which is followed by increased average longevity of survivors. Second, sudden failure of units during their normal period of operation, before the onset of age-dependent mortality arising from senescence. The relevance of these phenomena encompasses, for example: no-fault-found failure of electronic devices; high rates of human early spontaneous miscarriage/abortion; runaway pacemakers; sudden cardiac death in young adults; bipolar disorder; and epilepsy.

  15. A survival programme

    International Nuclear Information System (INIS)

    Vester, F.

    1978-01-01

    The book is a non-speculative information source on ecological problems and their possible solutions. It is a 'programme' from a twofold point of view: it determines political and scientific-technological objectives and it transfers knowledge by mental steps with techniques of programmed instruction. Thus emphasis is laid on detailed problems, especially by conscionsly challenged redundancies, and, on the other hand, a greater context is presented. Selected facts are examined under their different aspects, interactions and control circuits are described. Each chapter will speak for itself after the introduction has been read but is related to other chapters by cross references, illustrative material, a glossary and a comprehensive list of references. The 'Survival Programme' is a realistic and challenging discussion with the problem of 'Ecology in the Industrial Age'. It adresses scientists from various disciplines but also offers itself as a compendium to laymen in search of information, members of citizens initiatives and responsible representants of the political and industrial world. (orig./HP) [de

  16. Emergence and Evolution of Cooperation Under Resource Pressure

    Science.gov (United States)

    Pereda, María; Zurro, Débora; Santos, José I.; Briz I Godino, Ivan; Álvarez, Myrian; Caro, Jorge; Galán, José M.

    2017-03-01

    We study the influence that resource availability has on cooperation in the context of hunter-gatherer societies. This paper proposes a model based on archaeological and ethnographic research on resource stress episodes, which exposes three different cooperative regimes according to the relationship between resource availability in the environment and population size. The most interesting regime represents moderate survival stress in which individuals coordinate in an evolutionary way to increase the probabilities of survival and reduce the risk of failing to meet the minimum needs for survival. Populations self-organise in an indirect reciprocity system in which the norm that emerges is to share the part of the resource that is not strictly necessary for survival, thereby collectively lowering the chances of starving. Our findings shed further light on the emergence and evolution of cooperation in hunter-gatherer societies.

  17. Stochastic population dynamics under resource constraints

    Energy Technology Data Exchange (ETDEWEB)

    Gavane, Ajinkya S., E-mail: ajinkyagavane@gmail.com; Nigam, Rahul, E-mail: rahul.nigam@hyderabad.bits-pilani.ac.in [BITS Pilani Hyderabad Campus, Shameerpet, Hyd - 500078 (India)

    2016-06-02

    This paper investigates the population growth of a certain species in which every generation reproduces thrice over a period of predefined time, under certain constraints of resources needed for survival of population. We study the survival period of a species by randomizing the reproduction probabilities within a window at same predefined ages and the resources are being produced by the working force of the population at a variable rate. This randomness in the reproduction rate makes the population growth stochastic in nature and one cannot predict the exact form of evolution. Hence we study the growth by running simulations for such a population and taking an ensemble averaged over 500 to 5000 such simulations as per the need. While the population reproduces in a stochastic manner, we have implemented a constraint on the amount of resources available for the population. This is important to make the simulations more realistic. The rate of resource production then is tuned to find the rate which suits the survival of the species. We also compute the mean life time of the species corresponding to different resource production rate. Study for these outcomes in the parameter space defined by the reproduction probabilities and rate of resource production is carried out.

  18. Ecosystem Services Insights into Water Resources Management in China: A Case of Xi’an City

    Science.gov (United States)

    Liu, Jingya; Li, Jing; Gao, Ziyi; Yang, Min; Qin, Keyu; Yang, Xiaonan

    2016-01-01

    Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi’an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index’s weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem’s service capability is closely related to water resources, providing a method for managing water resources. Using Xi’an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers. PMID:27886137

  19. Ecosystem Services Insights into Water Resources Management in China: A Case of Xi'an City.

    Science.gov (United States)

    Liu, Jingya; Li, Jing; Gao, Ziyi; Yang, Min; Qin, Keyu; Yang, Xiaonan

    2016-11-24

    Global climate and environmental changes are endangering global water resources; and several approaches have been tested to manage and reduce the pressure on these decreasing resources. This study uses the case study of Xi'an City in China to test reasonable and effective methods to address water resource shortages. The study generated a framework combining ecosystem services and water resource management. Seven ecosystem indicators were classified as supply services, regulating services, or cultural services. Index values for each indicator were calculated, and based on questionnaire results, each index's weight was calculated. Using the Likert method, we calculated ecosystem service supplies in every region of the city. We found that the ecosystem's service capability is closely related to water resources, providing a method for managing water resources. Using Xi'an City as an example, we apply the ecosystem services concept to water resources management, providing a method for decision makers.

  20. 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...

  1. 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…

  2. 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,…

  3. Global variations in cancer survival. Study Group on Cancer Survival in Developing Countries.

    Science.gov (United States)

    Sankaranarayanan, R; Swaminathan, R; Black, R J

    1996-12-15

    Population-based cancer registries from Algeria, China, Costa Rica, Cuba, India, the Philippines, and Thailand are collaborating with the International Agency for Research on Cancer in a study of cancer survival in developing countries. Comparisons with the SEER program results of the National Cancer Institute in the United States, and the EUROCARE study of survival in European countries revealed considerable differences in the survival of patients with certain tumors associated with intensive chemotherapeutic treatment regimes (Hodgkin's disease and testicular tumors), more modest differences in the survival of patients with tumors for which early diagnosis and treatment confer an improved prognosis (carcinomas of the large bowel, breast, and cervix), and only slight differences for tumors associated with poor prognosis (carcinomas of the stomach, pancreas, and lung). With limited resources to meet the challenge of the increasing incidence of cancer expected in the next few decades, health authorities in developing countries should be aware of the importance of investing in a range of cancer control activities, including primary prevention and early detection programs as well as treatment.

  4. 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

  5. Information resources

    Science.gov (United States)

    Friend, Milton; Franson, J. Christian; Friend, Milton; Gibbs, Samantha E.J.; Wild, Margaret A.

    2015-10-19

    During recent decades, natural resources agency personnel and others involved with the management and stewardship of wildlife have experienced an increasing need to access information and obtain technical assistance for addressing a diverse array of wildlife disease issues. This Chapter provides a broad overview of selected sources for obtaining supplemental information and technical assistance for addressing wildlife disease issues in North America. Specifically, examples of existing major wildlife disease programs focusing on free-ranging wildlife populations are highlighted; training opportunities for enhancing within-agency wildlife disease response are identified; a selected reading list of wildlife disease references is provided; and selected Web sites providing timely information on wildlife disease are highlighted. No attempt is made to detail all the North American programs and capabilities that address disease in free-ranging wildlife populations. Instead, this Chapter is focused on enhancing awareness of the types of capabilities that exist as potential sources for assistance and collaboration between wildlife conservation agency personnel and others in addressing wildlife disease issues.

  6. Global Activities and Plant Survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2014-01-01

    the highest exit rates. Moreover, the exit rates of globally engaged plants seem to be unaffected by increased foreign presence, whereas there appears to be a negative impact on the survival rates of non-exporting non-MNE plants. Finally, the result reveals that the survival ratio of plants of acquired...

  7. Radionuclide blood cell survival studies

    International Nuclear Information System (INIS)

    Bentley, S.A.; Miller, D.T.

    1986-01-01

    Platelet and red cell survival studies are reviewed. The use of 51 Cr and di-isopropylfluoridate labelled with tritium or 32 P is discussed for red cell survival study and 51 Cr and 111 In-oxine are considered as platelet labels. (UK)

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. The nursing human resource planning best practice toolkit: creating a best practice resource for nursing managers.

    Science.gov (United States)

    Vincent, Leslie; Beduz, Mary Agnes

    2010-05-01

    Evidence of acute nursing shortages in urban hospitals has been surfacing since 2000. Further, new graduate nurses account for more than 50% of total nurse turnover in some hospitals and between 35% and 60% of new graduates change workplace during the first year. Critical to organizational success, first line nurse managers must have the knowledge and skills to ensure the accurate projection of nursing resource requirements and to develop proactive recruitment and retention programs that are effective, promote positive nursing socialization, and provide early exposure to the clinical setting. The Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a network of teaching and community hospitals to develop a best practice toolkit in nursing human resource planning targeted at first line nursing managers. The toolkit includes the development of a framework including the conceptual building blocks of planning tools, manager interventions, retention and recruitment and professional practice models. The development of the toolkit involved conducting a review of the literature for best practices in nursing human resource planning, using a mixed method approach to data collection including a survey and extensive interviews of managers and completing a comprehensive scan of human resource practices in the participating organizations. This paper will provide an overview of the process used to develop the toolkit, a description of the toolkit contents and a reflection on the outcomes of the project.

  13. 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

  14. Discharge Fee Policy Analysis: A Computable General Equilibrium (CGE) Model of Water Resources and Water Environments

    OpenAIRE

    Guohua Fang; Ting Wang; Xinyi Si; Xin Wen; Yu Liu

    2016-01-01

    To alleviate increasingly serious water pollution and shortages in developing countries, various kinds of policies have been implemented by local governments. It is vital to quantify and evaluate the performance and potential economic impacts of these policies. This study develops a Computable General Equilibrium (CGE) model to simulate the regional economic and environmental effects of discharge fees. Firstly, water resources and water environment factors are separated from the input and out...

  15. Disparities in cervical cancer survival among Asian-American women.

    Science.gov (United States)

    Nghiem, Van T; Davies, Kalatu R; Chan, Wenyaw; Mulla, Zuber D; Cantor, Scott B

    2016-01-01

    We compared overall survival and influencing factors between Asian-American women as a whole and by subgroup with white women with cervical cancer. Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with and/or without age stratification). Being 3.3 years older than white women at diagnosis (P Asian-American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared to white women. Asian-American women had higher 36- and 60-month survival rates (P = .004 and P = .013, respectively), higher overall survival rates (P = .049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio = 0.77, 95% confidence interval: 0.68-0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian-American women grouped by geographic origin had better overall survival than white women. Although Asian-American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Disparities in cervical cancer survival among Asian American women

    Science.gov (United States)

    Nghiem, Van T.; Davies, Kalatu R.; Chan, Wenyaw; Mulla, Zuber D.; Cantor, Scott B.

    2015-01-01

    Purpose We compared overall survival and influencing factors between Asian American women as a whole and by subgroup with white women with cervical cancer. Methods Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with/without age-stratification). Results Being 3.3 years older than white women at diagnosis (pAsian American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared with white women. Asian American women had higher 36- and 60-month survival rates (p=0.004 and p=0.013, respectively), higher overall survival rates (p=0.049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio=0.77, 95% confidence interval: 0.68–0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian American women grouped by geographic origin had better overall survival than white women. Conclusions Although Asian American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. PMID:26552330

  17. Cardiovascular disease incidence and survival

    DEFF Research Database (Denmark)

    Byberg, Stine; Agyemang, Charles; Zwisler, Ann Dorthe

    2016-01-01

    Studies on cardiovascular disease (CVD) incidence and survival show varying results between different ethnic groups. Our aim was to add a new dimension by exploring the role of migrant status in combination with ethnic background on incidence of-and survival from-CVD and more specifically acute...... of some types of cardiovascular disease compared to Danish-born. Family-reunified migrants on the other hand had lower rates of CVD. All migrants had better survival than Danish-born indicating that migrants may not always be disadvantaged in health....

  18. Stimulated human fibroblast cell survival

    International Nuclear Information System (INIS)

    Smith, B.P.; Gale, K.L.; Einspenner, M.; Greenstock, C.L.; Gentner, N.E.

    1992-01-01

    Techniques for cloning cultured mammalian cells have supported the most universally-accepted method for measuring the induction of lethality by geno-toxicants such as ionizing radiation: the 'survival of colony-forming ability (CFA)' assay. Since most cultured human cell lines exhibit plating efficiency (i.e. the percentage of cells that are capable of reproductively surviving and dividing to form visible colonies) well below 100%, such assays are in essence 'survival of plating efficiency' assays, since they are referred to the plating (or cloning) efficiency of control (i.e. unirradiated) cells. (author). 8 refs., 2 figs

  19. Food security and sustainable resource management

    Science.gov (United States)

    McLaughlin, Dennis; Kinzelbach, Wolfgang

    2015-07-01

    The projected growth in global food demand until mid-century will challenge our ability to continue recent increases in crop yield and will have a significant impact on natural resources. The water and land requirements of current agriculture are significantly less than global reserves but local shortages are common and have serious impacts on food security. Recent increases in global trade have mitigated some of the effects of spatial and temporal variability. However, trade has a limited impact on low-income populations who remain dependent on subsistence agriculture and local resources. Potential adverse environmental impacts of increased agricultural production include unsustainable depletion of water and soil resources, major changes in the global nitrogen and phosphorous cycles, human health problems related to excessive nutrient and pesticide use, and loss of habitats that contribute to agricultural productivity. Some typical case studies from China illustrate the connections between the need for increased food production and environmental stress. Sustainable options for decreasing food demand and for increasing production include reduction of food losses on both the producer and consumer ends, elimination of unsustainable practices such as prolonged groundwater overdraft, closing of yield gaps with controlled expansions of fertilizer application, increases in crop yield and pest resistance through advances in biotechnology, and moderate expansion of rain fed and irrigated cropland. Calculations based on reasonable assumptions suggest that such measures could meet the food needs of an increasing global population while protecting the environment.

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. WE-FG-201-00: High Impact Technologies for Low Resource Environments

    International Nuclear Information System (INIS)

    2016-01-01

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd

  5. WE-FG-201-00: High Impact Technologies for Low Resource Environments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd.

  6. WE-FG-201-02: Automated Treatment Planning for Low-Resource Settings

    Energy Technology Data Exchange (ETDEWEB)

    Court, L. [UT MD Anderson Cancer Center (United States)

    2016-06-15

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd.

  7. Analyzing climate change impacts on water resources under uncertainty using an integrated simulation-optimization approach

    Science.gov (United States)

    Zhuang, X. W.; Li, Y. P.; Nie, S.; Fan, Y. R.; Huang, G. H.

    2018-01-01

    An integrated simulation-optimization (ISO) approach is developed for assessing climate change impacts on water resources. In the ISO, uncertainties presented as both interval numbers and probability distributions can be reflected. Moreover, ISO permits in-depth analyses of various policy scenarios that are associated with different levels of economic consequences when the promised water-allocation targets are violated. A snowmelt-precipitation-driven watershed (Kaidu watershed) in northwest China is selected as the study case for demonstrating the applicability of the proposed method. Results of meteorological projections disclose that the incremental trend of temperature (e.g., minimum and maximum values) and precipitation exist. Results also reveal that (i) the system uncertainties would significantly affect water resources allocation pattern (including target and shortage); (ii) water shortage would be enhanced from 2016 to 2070; and (iii) the more the inflow amount decreases, the higher estimated water shortage rates are. The ISO method is useful for evaluating climate change impacts within a watershed system with complicated uncertainties and helping identify appropriate water resources management strategies hedging against drought.

  8. WE-FG-201-02: Automated Treatment Planning for Low-Resource Settings

    International Nuclear Information System (INIS)

    Court, L.

    2016-01-01

    Many low- and middle-income countries lack the resources and services to manage cancer, from screening and diagnosis to radiation therapy planning, treatment and quality assurance. The challenges in upgrading or introducing the needed services are enormous, and include severe shortages in equipment and trained staff. In this symposium, we will describe examples of technology and scientific research that have the potential to impact all these areas. These include: (1) the development of high-quality/low-cost colposcopes for cervical cancer screening, (2) the application of automated radiotherapy treatment planning to reduce staffing shortages, (3) the development of a novel radiotherapy treatment unit, and (4) utilizing a cloud-based infrastructure to facilitate collaboration and QA. Learning Objectives: Understand some of the issues in cancer care in low- resource environments, including shortages in staff and equipment, and inadequate physical infrastructure for advanced radiotherapy. Understand the challenges in developing and deploying diagnostic and treatment devices and services for low-resource environments. Understand some of the emerging technological solutions for cancer management in LMICs. NCI; L. Court, NIH, Varian, Elekta; I. Feain, Ilana Feain is founder and CTO of Nano-X Pty Ltd

  9. A resource-based view of partnership strategies in health care organizations.

    Science.gov (United States)

    Yarbrough, Amy K; Powers, Thomas L

    2006-01-01

    The distribution of management structures in health care has been shifting from independent ownership to interorganizational relationships with other firms. A shortage of resources has been cited as one cause for such collaboration among health care entities. The resource- based view of the firm suggests that organizations differentiate between strategic alliances and acquisition strategies based on a firm's internal resources and the types of resources a potential partner organization possesses. This paper provides a review of the literature using the resource-based theory of the firm to understand what conditions foster different types of health care partnerships. A model of partnership alliances using the resource-based view is presented, strategic linkages are presented, managerial implications are outlined, and directions for future research are given.

  10. Probabilistic Survivability Versus Time Modeling

    Science.gov (United States)

    Joyner, James J., Sr.

    2016-01-01

    This presentation documents Kennedy Space Center's Independent Assessment work completed on three assessments for the Ground Systems Development and Operations (GSDO) Program to assist the Chief Safety and Mission Assurance Officer during key programmatic reviews and provided the GSDO Program with analyses of how egress time affects the likelihood of astronaut and ground worker survival during an emergency. For each assessment, a team developed probability distributions for hazard scenarios to address statistical uncertainty, resulting in survivability plots over time. The first assessment developed a mathematical model of probabilistic survivability versus time to reach a safe location using an ideal Emergency Egress System at Launch Complex 39B (LC-39B); the second used the first model to evaluate and compare various egress systems under consideration at LC-39B. The third used a modified LC-39B model to determine if a specific hazard decreased survivability more rapidly than other events during flight hardware processing in Kennedy's Vehicle Assembly Building.

  11. The Survival of the Wisest

    Science.gov (United States)

    Salk, Jonas

    1975-01-01

    Suggests that humans differ from other living organisms in the ability to exercise learned behavior and the individual will, which may allow people to make the changes in values necessary to survive on this planet. (DW)

  12. A hybrid system dynamics and optimization approach for supporting sustainable water resources planning in Zhengzhou City, China

    Science.gov (United States)

    Li, Zhi; Li, Chunhui; Wang, Xuan; Peng, Cong; Cai, Yanpeng; Huang, Weichen

    2018-01-01

    Problems with water resources restrict the sustainable development of a city with water shortages. Based on system dynamics (SD) theory, a model of sustainable utilization of water resources using the STELLA software has been established. This model consists of four subsystems: population system, economic system, water supply system and water demand system. The boundaries of the four subsystems are vague, but they are closely related and interdependent. The model is applied to Zhengzhou City, China, which has a serious water shortage. The difference between the water supply and demand is very prominent in Zhengzhou City. The model was verified with data from 2009 to 2013. The results show that water demand of Zhengzhou City will reach 2.57 billion m3 in 2020. A water resources optimization model is developed based on interval-parameter two-stage stochastic programming. The objective of the model is to allocate water resources to each water sector and make the lowest cost under the minimum water demand. Using the simulation results, decision makers can easily weigh the costs of the system, the water allocation objectives, and the system risk. The hybrid system dynamics method and optimization model is a rational try to support water resources management in many cities, particularly for cities with potential water shortage and it is solidly supported with previous studies and collected data.

  13. [From personnel administration to human resource management : demographic risk management in hospitals].

    Science.gov (United States)

    Schmidt, C E; Gerbershagen, M U; Salehin, J; Weib, M; Schmidt, K; Wolff, F; Wappler, F

    2011-06-01

    The healthcare market is facing a serious shortage of qualified personnel in 2020. Aging of staff members is one important driver of this human resource deficit but current planning periods of 1-2 years cannot compensate the demographic effects on staff portfolio early enough. Therefore, prospective human resource planning is important to avoid loss of competence. The long range development (10 years) of human resources in the hospitals of the City of Cologne was analyzed. The basis for the analysis was a simulation model that included fluctuation of staff, retirement, maternity leave, status of employee illness, partial retirement and fresh engagements per department and profession. The model was matched with the staff requirements for each department. The results showed a capacity analysis which was used to convey strategic measures for staff recruitment and retention. The greatest risk for shortage of qualified staff was found in the fluctuation of doctors and in the aging work force. Without strategic human resource management the hospitals would face a 50% reduction of the work force within 10 years and after 2 years there would be a 25% deficit of anesthesiologists with impact on the function of operation rooms (OR) and intensive care units. Qualification and continuous training of staff members as well as process optimization are the most important spheres of activity for human resource management in order to recruit and retain qualified staff members. Prospective human resource planning for the OR and intensive care units can help to detect shortage of staff and loss of competence early enough to apply effective personnel development measures. A growing number of companies have started to plan ahead of the current demand of human resources. Hospitals should follow this example because the competition for qualified staff members is increasing rapidly.

  14. Customer service skills for survival.

    Science.gov (United States)

    McAtee, L F

    1999-11-01

    As APICS practitioners, we all must share a common goal. How can we contribute to our company's success? Success can be measured in positive terms of market share, growth, profitability, return on investment, or some combination thereof. Each company must establish its own definition of success. For the purposes of this article, success will be equated to one word that we can all readily identify with: survival. What skills do we need to survive in the marketplace of the next millennium?

  15. Prolongation of islet allograft survival

    International Nuclear Information System (INIS)

    Lacy, P.E.; Davie, J.M.; Finke, E.H.; Scharp, D.W.

    1979-01-01

    Pretreatment of donor rats with irradiation and silica followed by in vitro culture of the islets for 1 to 2 days prolonged survival of allografts across a minor histocompatibility barrier if hand-picked, clean islets were used for transplantation. Pretreatment of donor rats with irradiation and silica in conjunction with a single injection of antilymphocyte serum (ALS) into the recipient produced a prolongation of survival of hand-picked islets transplanted across a major histocompatibility barrier

  16. Operational slack and venture survival

    OpenAIRE

    Azadegan, Arash; Patel, Pankaj; Parida, Vinit

    2013-01-01

    Slack can act as a double-edged sword. While it can buffer against environmental threats to help ensure business continuity, slack canalso be costly and reduce profitability. In this study, we focus on operational slack, the form related to the firm’s production processes. We investigate the role of operational slack on firm survival during its venture stage, when its survival is significantly challenged by environmental threats. Specifically, we explore how change in three types of environme...

  17. The health care market: can hospitals survive?

    Science.gov (United States)

    Goldsmith, J C

    1980-01-01

    Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations.

  18. On the Applicability of Resources Optimization Model for Mitigating ...

    African Journals Online (AJOL)

    The survival of peer-to-peer systems depends on the contribution of resources by all the participating peers. Selfish behavior of some peers that do not contribute resources inhibits the expected level of service delivery. Free riding has been found to seriously affect the performance and negates the sharing principle of ...

  19. Caspian energy: Oil and gas resources and the global market

    NARCIS (Netherlands)

    Amineh, M.P.; Houweling, H.

    2003-01-01

    his article develops several concepts of critical geopolitics and relates them to the energy resources of the Caspian Region. Energy resources beyond borders may be accessed by trade, respectively by conquest, domination and changing property rights. These are the survival strategies of human groups

  20. A systematic review on the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.

    Science.gov (United States)

    Gi, Toh Shir; Devi, Kamala M; Neo Kim, Emily Ang

    2011-01-01

    Nursing shortage is a global issue that which affects oncology nursing. Oncology nurses are more prone to experience job dissatisfaction, stress and burnout when they work in units with poor staffing. There is thus a need for greater understanding of the relationship between the nursing shortage and nursing outcomes in oncology/haematology settings. This review aimed to establish the best available evidence concerning the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings; and to make recommendations for practice and future research. Types of participants: This review considered studies that included oncology registered nurses (RNs) who were more than 18 years of age and worked in either inpatient or outpatient oncology/haematology wards or units for the adult or paediatric patients.Types of intervention: This review considered studies that evaluated the relationship between the nursing shortage and nurses' job satisfaction, stress and burnout levels in oncology/haematology settings.Types of outcomes: This review included studies that measured job satisfaction, stress and burnout levels using different outcomes measures. Job satisfaction was determined by the Measure of Job Satisfaction scale, the Misener Nurse Practitioner Job Satisfaction Scale and the Likert scale, stress by the Pediatric Oncology Nurse Stressor Questionnaire and burnout by the Maslash Burnout Inventory scale.Types of studies: This review included descriptive/descriptive-correlational studies which were published in English. The search strategy sought to identify published and unpublished studies conducted between 1990 and 2010. Using a three-step search strategy, the following databases were accessed: CINAHL, Medline, Scopus, ScienceDirect, PsycInfo, PsycArticles, Web of Science, The Cochrane Library, Proquest and Mednar. Two independent reviewers assessed each paper for methodological validity prior to inclusion in

  1. Child survival and the demographic "trap".

    Science.gov (United States)

    Kalish, S

    1992-02-01

    A debate within the UK public health community has centered around the feasibility of campaigns to improve child survival rates in Africa in the absence of equally aggressive efforts to increase family planning acceptance. The central spokesperson in this debate, Maurice King of the University of Leeds, has argued that population growth in sub-Saharan countries is undermining the carrying capacity of available resources and threatening ecological collapse. These countries are not exhibiting the characteristic demographic transition pattern, in which declining death rates eventually create conditions conducive to lower birth rates. Instead, they have fallen into a "demographic trap " in which population increases are outstripping growth in food production. To remedy this situation, King advocates the introduction of the concept of sustainability of the ecological foundations of health into the World Health Organizations's official definition of health. Richard Jolly of UNICEF has countered King's articles with the insistence that UNICEF has long supported child survival within the broader context of family planning provision and advocacy of birth spacing.

  2. Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review

    Directory of Open Access Journals (Sweden)

    Wouters Edwin

    2012-07-01

    Full Text Available Abstract Background Task-shifting to lay community health providers is increasingly suggested as a potential strategy to overcome the barriers to sustainable antiretroviral treatment (ART scale-up in high-HIV-prevalence, resource-limited settings. The dearth of systematic scientific evidence on the contributory role and function of these forms of community mobilisation has rendered a formal evaluation of the published results of existing community support programmes a research priority. Methods We reviewed the relevant published work for the period from November 2003 to December 2011 in accordance with the guidelines for a synthetic review. ISI Web of Knowledge, Science Direct, BioMed Central, OVID Medline, PubMed, Social Services Abstracts, and Sociological Abstracts and a number of relevant websites were searched. Results The reviewed literature reported an unambiguous positive impact of community support on a wide range of aspects, including access, coverage, adherence, virological and immunological outcomes, patient retention and survival. Looking at the mechanisms through which community support can impact ART programmes, the review indicates that community support initiatives are a promising strategy to address five often cited challenges to ART scale-up, namely (1 the lack of integration of ART services into the general health system; (2 the growing need for comprehensive care, (3 patient empowerment, (4 and defaulter tracing; and (5 the crippling shortage in human resources for health. The literature indicates that by linking HIV/AIDS-care to other primary health care programmes, by providing psychosocial care in addition to the technical-medical care from nurses and doctors, by empowering patients towards self-management and by tracing defaulters, well-organised community support initiatives are a vital part of any sustainable public-sector ART programme. Conclusions The review demonstrates that community support initiatives are a

  3. Biomass energy resource enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Grover, P D [Indian Institute of Technology, New Delhi (India)

    1995-12-01

    The demand for energy in developing countries is expected to increase to at least three times its present level within the next 25 years. If this demand is to be met by fossil fuels, an additional 2 billion tonnes of crude oil or 3 billion tonnes of coal would be needed every year. This consumption pattern, if allowed to proceed, would add 10 billion tonnes of CO{sub 2}, to the global atmosphere each year, with its attendant risk of global warming. Therefore, just for our survival, it is imperative to progressively replace fossil fuels by biomass energy resources and to enhance the efficiency of use of the latter. Biomass is not only environmentally benign but is also abundant. It is being photosynthesised at the rate of 200 billion tonnes of carbon every year, which is equivalent to 10 times the world`s present demand for energy. Presently, biomass energy resources are highly under-utilised in developing countries; when they are used it is through combustion, which is inefficient and causes widespread environmental pollution with its associated health hazards. Owing to the low bulk density and high moisture content of biomass, which make it difficult to collect, transport and store, as well as its ash-related thermochemical properties, its biodegradability and seasonal availability, the industrial use of biomass is limited to small and (some) medium-scale industries, most of which are unable to afford efficient but often costly energy conversion systems. Considering these constraints and the need to enhance the use base, biomass energy technologies appropriate to developing countries have been identified. Technologies such as briquetting and densification to upgrade biomass fuels are being adopted as conventional measures in some developing countries. The biomass energy base can be enhanced only once these technologies have been shown to be viable under local conditions and with local raw materials, after which they will multiply on their own, as has been the case

  4. Biomass energy resource enhancement

    International Nuclear Information System (INIS)

    Grover, P.D.

    1995-01-01

    The demand for energy in developing countries is expected to increase to at least three times its present level within the next 25 years. If this demand is to be met by fossil fuels, an additional 2 billion tonnes of crude oil or 3 billion tonnes of coal would be needed every year. This consumption pattern, if allowed to proceed, would add 10 billion tonnes of CO 2 , to the global atmosphere each year, with its attendant risk of global warming. Therefore, just for our survival, it is imperative to progressively replace fossil fuels by biomass energy resources and to enhance the efficiency of use of the latter. Biomass is not only environmentally benign but is also abundant. It is being photosynthesised at the rate of 200 billion tonnes of carbon every year, which is equivalent to 10 times the world's present demand for energy. Presently, biomass energy resources are highly under-utilised in developing countries; when they are used it is through combustion, which is inefficient and causes widespread environmental pollution with its associated health hazards. Owing to the low bulk density and high moisture content of biomass, which make it difficult to collect, transport and store, as well as its ash-related thermochemical properties, its biodegradability and seasonal availability, the industrial use of biomass is limited to small and (some) medium-scale industries, most of which are unable to afford efficient but often costly energy conversion systems. Considering these constraints and the need to enhance the use base, biomass energy technologies appropriate to developing countries have been identified. Technologies such as briquetting and densification to upgrade biomass fuels are being adopted as conventional measures in some developing countries. The biomass energy base can be enhanced only once these technologies have been shown to be viable under local conditions and with local raw materials, after which they will multiply on their own, as has been the case

  5. Medical students and physical education students as CPR instructors: an appropriate solution to the CPR-instructor shortage in secondary schools?

    OpenAIRE

    Cuijpers, P. J. P. M.; Bookelman, G.; Kicken, W.; de Vries, W.; Gorgels, A. P. M.

    2016-01-01

    Background Integrating cardiopulmonary resuscitation (CPR) training in secondary schools will increase the number of potential CPR providers. However, currently too few certified instructors are available for this purpose. Training medical students and physical education student teachers to become CPR instructors could decrease this shortage. Aim Examine whether medical students and physical education student teachers can provide CPR training for secondary school pupils as well as (i.?e., non...

  6. 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...

  7. Assessing the relationship between total factor productivity and foreign direct investment in an economy with a skills shortage: the case of South Africa

    OpenAIRE

    Bonga-Bonga, Lumengo; Phume, Maphelane

    2017-01-01

    This paper assesses the relationship between total factor productivity (TFP) and foreign direct investment (FDI) in a country with skills shortage. South Africa is used as a case study. Literature is inconclusive on how FDI should affect TFP. This paper shows that it is important to account for the interactivity between FDI and human capital when assessing the effects of FDI on TFP. Moreover, the empirical results show that, contrary to countries with abundance of skills, in countries with sk...

  8. Revisiting double kidney transplantation: two kidneys provide better graft survival than one.

    Science.gov (United States)

    Cruzado, J M; Fernandez, L; Riera, L; Bestard, O; Carrera, M; Torras, J; Gil Vernet, S; Melilli, E; Ngango, L; Grinyó, J M

    2011-01-01

    Double kidney transplantation is an accepted strategy to increase the donor pool. Regarding older donor kidneys, protocols for deciding to perform a dual or a single transplantation are mainly based on preimplantation biopsies. The aim of our study was to evaluate the long-term graft and patient survivals of our "Dual Kidney Transplant program." Patients who lost one of their grafts peritransplantation were used as controls. A total of 203 patients underwent kidney transplantation from December 1996 to January 2008 in our "old for old" renal transplantation program. We excluded 21 patients because of a nonfunctioning kidney, hyperacute rejection, or patient death with a functioning graft within the first month. Seventy-nine among 182 kidney transplantation the "old for old" program were dual kidney transplantation (DKT). Fifteen of 79 patients lost one of their kidney grafts (the uninephrectomized (UNX) UNX group). At 1 year, renal function was lower and proteinuria greater among the UNX than the DKT group. Patient survival was similar in both groups. However, death-censored graft survival was lower in UNX than DKT patients. The 5-year graft survival rate was 70% in UNX versus 93% in DKT cohorts (P = .04). In conclusion, taking into account the kidney shortage, our results may question whether the excellent transplant outcomes with DKT counter balance the reduced donor pool obviating acceptable transplant outcomes for more patients with single kidney transplantation. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Meeting the Challenge of Instructor Shortages: A Blended Teaching and Learning Model for a Neuroscience Course in a Doctor of Physical Therapy Program.

    Science.gov (United States)

    Ge, Weiqing

    2018-01-01

    Physical therapy workforce shortages are expected to increase for all 50 states through 2030. There is a recognized nationwide unprecedented shortage of well-prepared physical therapy instructors. One practical solution can be to share instructors among Doctor of Physical Therapy (DPT) programs using a blended teaching and learning model. The purpose of this project was to evaluate the effectiveness of a blended teaching and learning model for a neuroscience course in a DPT program. Faculty members from two DPT programs collaborated to develop, implement, and evaluate a blended teaching and learning model. The Blackboard Learning Management System (LMS) was available at both institutions and chosen as the learning platform. The design of this research study was retrospective nonexperimental observational. The overall feedback from the students was positive. Most students (91.6%) strongly agreed or agreed that the content of the course was appropriate for learning neuroscience. The students taking this blended course performed slightly better than the students taking the traditional course, though there was no significant difference (p=0.06). The results support the use of a blended teaching and learning model to meet faculty shortage challenges. Future research with a larger sample size is necessary.

  10. The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce.

    Science.gov (United States)

    Takata, Hideaki; Nagata, Hiroshi; Nogawa, Hiroki; Tanaka, Hiroshi

    2011-05-27

    Starting in the late 1980s, the Japanese government decreased the number of students accepted into medical school each year in order to reduce healthcare spending. The result of this policy is a serious shortage of doctors in Japan today, which has become a social problem in recent years. In an attempt to solve this problem, the Japanese government decided in 2007 to increase the medical student quota from 7625 to 8848. Furthermore, the Democratic Party of Japan (DPJ), Japan's ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. It should be noted, however, that this rapid increase in the medical student quota may bring about a serious doctor surplus in the future, especially because the population of Japan is decreasing.The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus. Simulation modeling of the Japanese medical workforce. Even if the additional increase in the medical student quota promised by the DPJ fails, the number of practitioners is projected to increase from 286 699 (2.25 per 1000 persons) in 2008 to 365 533 (over the national numerical goal of 3.0 per 1000) in 2024. The number of practitioners per 1000 persons is projected to further increase to 3.10 in 2025, to 3.71 in 2035, and to 4.69 in 2050. If the additional increase in the medical student quota promised by the DPJ is realized, the total workforce is projected to rise to 392 331 (3.29 per 1000 persons) in 2025, 464 296 (4.20 per 1,000 persons) in 2035, and 545 230 (5.73 per 1000 persons) in 2050. The plan to increase the medical student quota will bring about a serious doctor surplus in the long run.

  11. World resources: engineering solutions

    Energy Technology Data Exchange (ETDEWEB)

    1976-01-01

    The proceedings include 10 papers that contribute to population environment; fossil fuel resources and energy conservation; nuclear and solar power; production of ores and manufacture and use of metallic resources; resources of manufactured and natural nonmetallic materials; water as a reusable resource; and timber as a replaceable resource.

  12. Analyses on Water Vapor Resource in Chengdu City

    Science.gov (United States)

    Liu, B.; Xiao, T.; Wang, C.; Chen, D.

    2017-12-01

    Chengdu is located in the Sichuan basin, and it is the most famous inland city in China. With suitable temperatures and rainfall, Chengdu is the most livable cities in China. With the development of urban economy and society, the population has now risen to 16 million, and it will up to 22 million in 2030. This will cause the city water resources demand, and the carrying capacity of water resources become more and more serious. In order to improve the contradiction between urban waterlogging and water shortage, sponge city planning was proposed by Chengdu government, and this is of great practical significance for promoting the healthy development of the city. Base on the reanalysis data from NCEP during 2007-2016, the characters of Water Vapor Resources was analyzed, and the main contents of this research are summarized as follows: The water vapor resource in Chengdu plain is more than that in Southeast China and less in Northwest China. The annual average water vapor resource is approximately 160 mm -320 mm, and the water vapor resource in summer can reach 3 times in winter. But the annual average precipitation in Chengdu is about 800 mm -1200 mm and it is far greater than the water vapor resource, this is because of the transport of water vapor. Using the formula of water vapor flux, the water vapor in Chengdu is comes from the west and the south, and the value is around 50kg/(ms). Base on the calculation of boundary vapor budget, the water vapor transport under 500hPa accounted for 97% of the total. Consider the water vapor transport, transformation and urban humidification effect, the Water Vapor Resource in Chengdu is 2500mm, and it can be used by artificial precipitation enhancement. Therefore, coordinated development of weather modification and sponge city construction, the shortage of water resources in Chengdu plain can be solved. Key words: Chengdu; Sponge city; Water vapor resource; Precipitation; Artificial precipitation enhancement Acknowledgements

  13. Endangered Species and Natural Resource Exploitation: Extinction vs. Coexistence

    OpenAIRE

    Tsur, Yacov; Zemel, Amos

    1994-01-01

    The threat on the survival of animal species due to intensive use of natural resources is incorporated within resource management models, paying special attention to uncertainty regarding the conditions that lead to extinction. The manner in which the potential benefits forgone due to the species extinction (denoted extinction penalty) induce more conservative exploitation policies is studied in detail. When the extinction penalty is ignored, the optimal policy is to drive the resource stock ...

  14. A union that flowed from water: "Water shortages, sanitation needs -- The unifier of Cape Town a century ago (1913)"

    CSIR Research Space (South Africa)

    Wall, K

    2012-05-01

    Full Text Available individually had the resources to embark on any of these schemes. In 1913 (next year, 100 years ago), all the municipalities of the then metropolitan area (with the exception of Wynberg) united, and additional areas were also incorporated. Thus the unified City...

  15. Data survivability vs. security in information systems

    International Nuclear Information System (INIS)

    Levitin, Gregory; Hausken, Kjell; Taboada, Heidi A.; Coit, David W.

    2012-01-01

    A multiple objective problem formulation and solution methodology is presented to select optimal information and data storage configurations considering both data survivability and data security, as well as cost. This paper considers a situation where the information is divided into several separately stored blocks in order to mitigate the risk of unauthorized access or theft. The information can be used only if all of the blocks are accessed. To impede the information theft, the defender prefers to maximize the number of blocks. On the other hand the destruction of any block destroys the integrity of information and makes it impossible to use. To impede the information destruction, the defender prefers to maximize the number of parallel (reserve) copies of each block, regardless how many blocks in series there are. Given the set of available information storage resources, the defender must consider a multi-objective optimization problem to determine how many blocks and their copies to create, and how to distribute them among available resources in order to minimize information vulnerability, insecurity, and storage cost. Non-dominated solutions to this problem are determined using a multiple objective genetic algorithm (MOGA). This methodology is demonstrated with two general examples.

  16. Cell Survival Signaling in Neuroblastoma

    Science.gov (United States)

    Megison, Michael L.; Gillory, Lauren A.; Beierle, Elizabeth A.

    2013-01-01

    Neuroblastoma is the most common extracranial solid tumor of childhood and is responsible for over 15% of pediatric cancer deaths. Neuroblastoma tumorigenesis and malignant transformation is driven by overexpression and dominance of cell survival pathways and a lack of normal cellular senescence or apoptosis. Therefore, manipulation of cell survival pathways may decrease the malignant potential of these tumors and provide avenues for the development of novel therapeutics. This review focuses on several facets of cell survival pathways including protein kinases (PI3K, AKT, ALK, and FAK), transcription factors (NF-κB, MYCN and p53), and growth factors (IGF, EGF, PDGF, and VEGF). Modulation of each of these factors decreases the growth or otherwise hinders the malignant potential of neuroblastoma, and many therapeutics targeting these pathways are already in the clinical trial phase of development. Continued research and discovery of effective modulators of these pathways will revolutionize the treatment of neuroblastoma. PMID:22934706

  17. Survivable integrated grooming in multi-granularity optical networks

    Science.gov (United States)

    Wu, Jingjing; Guo, Lei; Wei, Xuetao; Liu, Yejun

    2012-05-01

    Survivability is an important issue to ensure the service continuity in optical network. At the same time, with the granularity of traffic demands ranging from sub-wavelength-level to wavelength-level, traffic demands need to be aggregated and carried over the network in order to utilize resources effectively. Therefore, multi-granularity grooming is proposed to save the cost and reduce the number of switching ports in Optical-Cross Connects (OXCs). However, current works mostly addressed the survivable wavelength or waveband grooming. Therefore, in this paper, we propose three heuristic algorithms called Multi-granularity Dedicated Protection Grooming (MDPG), Multi-granularity Shared Protection Grooming (MSPG) and Multi-granularity Mixed Protection Grooming (MMPG), respectively. All of them are performed based on the Survivable Multi-granularity Integrated Auxiliary Graph (SMIAG) that includes one Wavelength Integrated Auxiliary Graph (WIAG) for wavelength protection and one waveBand Integrated Auxiliary Graph (BIAG) for waveband protection. Numerical results show that MMPG has the lowest average port-cost, the best resource utilization ratio and the lowest blocking probability among these three algorithms. Compared with MDPG, MSPG has lower average port-cost, better resource utilization ratio and lower blocking probability.

  18. Survival of Sami cancer patients

    Directory of Open Access Journals (Sweden)

    Leena Soininen

    2012-07-01

    Full Text Available Objectives. The incidence of cancer among the indigenous Sami people of Northern Finland is lower than among the Finnish general population. The survival of Sami cancer patients is not known, and therefore it is the object of this study. Study design. The cohort consisted of 2,091 Sami and 4,161 non-Sami who lived on 31 December 1978 in the two Sami municipalities of Inari and Utsjoki, which are located in Northern Finland and are 300–500 km away from the nearest central hospital. The survival experience of Sami and non-Sami cancer patients diagnosed in this cohort during 1979–2009 was compared with that of the Finnish patients outside the cohort. Methods. The Sami and non-Sami cancer patients were matched to other Finnish cancer patients for gender, age and year of diagnosis and for the site of cancer. An additional matching was done for the stage at diagnosis. Cancer-specific survival analyses were made using the Kaplan–Meier method and Cox regression modelling. Results. There were 204 Sami and 391 non-Sami cancer cases in the cohort, 20,181 matched controls without matching with stage, and 7,874 stage-matched controls. In the cancer-specific analysis without stage variable, the hazard ratio for Sami was 1.05 (95% confidence interval 0.85–1.30 and for non-Sami 1.02 (0.86–1.20, indicating no difference between the survival of those groups and other patients in Finland. Likewise, when the same was done by also matching the stage, there was no difference in cancer survival. Conclusion. Long distances to medical care or Sami ethnicity have no influence on the cancer patient survival in Northern Finland.

  19. Lack of agreement over the use and ownership of the internationally shared resources (such as air space, outer space and the oceans) leading to international conflict

    Science.gov (United States)

    1975-01-01

    The lack of adequate institutional mechanisms to regulate, monitor and govern the use of commonly owned world resources appears to be politically destabilizing and subject to socioeconomic pressures of overpopulation, food shortages, cartelism, terrorism, and wealth distribution to developing countries. The capacity and propensity to wage war and its potential consequences are elaborated. It is shown that technology is one of the dominant factors affecting the exploration and management of commonly shared resources.

  20. Aircraft Survivability: Survivability in The Low Altitude Regime, Summer 2009

    Science.gov (United States)

    2009-01-01

    elevation, sun location, temperature, humidity, ozone level, visibility, cloud coverage, and wind speed and direction. Survivability in the Low Altitude...JASP Summer PMSG 14–16 July 2009 Key West, FL AUG 45th AIAA/ASME/SAE/ASEE Joint Propulsion Conference and Exhibit 2–5 August 2009 Denver, CO