WorldWideScience

Sample records for survive resource shortages

  1. 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.

  2. Metabolic and Kidney Diseases in the Setting of Climate Change, Water Shortage, and Survival Factors.

    Science.gov (United States)

    Johnson, Richard J; Stenvinkel, Peter; Jensen, Thomas; Lanaspa, Miguel A; Roncal, Carlos; Song, Zhilin; Bankir, Lise; Sánchez-Lozada, Laura G

    2016-08-01

    Climate change (global warming) is leading to an increase in heat extremes and coupled with increasing water shortage, provides a perfect storm for a new era of environmental crises and potentially, new diseases. We use a comparative physiologic approach to show that one of the primary mechanisms by which animals protect themselves against water shortage is to increase fat mass as a means for providing metabolic water. Strong evidence suggests that certain hormones (vasopressin), foods (fructose), and metabolic products (uric acid) function as survival signals to help reduce water loss and store fat (which also provides a source of metabolic water). These mechanisms are intricately linked with each other and stimulated by dehydration and hyperosmolarity. Although these mechanisms were protective in the setting of low sugar and low salt intake in our past, today, the combination of diets high in fructose and salty foods, increasing temperatures, and decreasing available water places these survival signals in overdrive and may be accelerating the obesity and diabetes epidemics. The recent discovery of multiple epidemics of CKD occurring in agricultural workers in hot and humid environments may represent harbingers of the detrimental consequences of the combination of climate change and overactivation of survival pathways. Copyright © 2016 by the American Society of Nephrology.

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

    DEFF Research Database (Denmark)

    Jonsdottir, Harpa; Madsen, Henrik

    2005-01-01

    augmentation from reservoirs. The management of these reservoirs are a human intervention in a natural flow and therefore necessarily limited by environmental regulations. During a heavy drought, the available water storage in the reservoir may not be sufficient to cater for the demand and consequently......Water resources are economically important and environmentally extremely vulnerable. The electrical power system in Iceland is hydropower based and due to the country's isolation, power import is not an option as elsewhere in Europe. In the hydropower system, a water shortage is met by flow...... important to have mathematical tools to estimate the risk of water shortage in the system when searching for the best management method. In view of the fact that the subject is to estimate the risk of events that have to be very rare, i.e. with large recurrence time, stochastic simulation is used to produce...

  4. The impact of climat change on shortages of rainfall and water resources in Dunajec basin

    Science.gov (United States)

    Limanówka, Danuta; Malota, Agnieszka; Cebulak, Elżbieta; Kasina, Michał; Doktor, Radosław; Pyrc, Robert

    2016-04-01

    Dunajec basin as a one of the larger and with the biggest potential of water resources in the whole Upper Vistula basin, has a big significant impact on the whole Vistula basin. However, there are periods of shortage of rainfall which result are droughts. These may have effects as devastating as excess in rainfall. Analysis of historical "proxy data" and contemporary instrumental measurements and observations allowed to extract the years that have experienced long lasting periods of high temperatures and shortages of rainfall. Drought periods caused low water levels in large areas of the basin. The collected historical material and the measurement was used to develop scenarios for the years 2001-2060 to determine the impact of climate change on the frequency and extent of occurrence of shortage of rainfall in the future and the impact on the water regime across the whole Vistula. In analysis of climate variability for the first time were used daily data derived from the results of six regional simulations generated in different models in the EU project ENSEMBLES Detailed analysis were performed for DMI-HIRLAM 5 ARPEGE & KNMI-RACMO2_ECHAM5 simulation.

  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. Adaptation of Propionibacterium freudenreichii to long-term survival under gradual nutritional shortage.

    Science.gov (United States)

    Aburjaile, Flavia Figueira; Rohmer, Marine; Parrinello, Hugues; Maillard, Marie-Bernadette; Beaucher, Eric; Henry, Gwénaële; Nicolas, Aurélie; Madec, Marie-Noëlle; Thierry, Anne; Parayre, Sandrine; Deutsch, Stéphanie-Marie; Cocaign-Bousquet, Muriel; Miyoshi, Anderson; Azevedo, Vasco; Le Loir, Yves; Falentin, Hélène

    2016-12-08

    Propionibacterium freudenreichii is an Actinobacterium widely used in the dairy industry as a ripening culture for Swiss-type cheeses, for vitamin B12 production and some strains display probiotic properties. It is reportedly a hardy bacterium, able to survive the cheese-making process and digestive stresses. During this study, P. freudenreichii CIRM-BIA 138 (alias ITG P9), which has a generation time of five hours in Yeast Extract Lactate medium at 30 °C under microaerophilic conditions, was incubated for 11 days (9 days after entry into stationary phase) in a culture medium, without any adjunct during the incubation. The carbon and free amino acids sources available in the medium, and the organic acids produced by the strain, were monitored throughout growth and survival. Although lactate (the preferred carbon source for P. freudenreichii) was exhausted three days after inoculation, the strain sustained a high population level of 9.3 log 10 CFU/mL. Its physiological adaptation was investigated by RNA-seq analysis and revealed a complete disruption of metabolism at the entry into stationary phase as compared to exponential phase. P. freudenreichii adapts its metabolism during entry into stationary phase by down-regulating oxidative phosphorylation, glycolysis, and the Wood-Werkman cycle by exploiting new nitrogen (glutamate, glycine, alanine) sources, by down-regulating the transcription, translation and secretion of protein. Utilization of polyphosphates was suggested.

  7. Uranium surge-staff shortage: where are the human resources for the next generation?

    Energy Technology Data Exchange (ETDEWEB)

    Waggitt, P., E-mail: P.Waggitt@iaea.org [International Atomic Energy Agency, Vienna (Austria)

    2010-07-01

    Uranium production is cyclic and for most of the past 25 years it has been at a low point. The price increase that began in 2003 has steadied now after reaching record values in 2007; but exploration is now surging ahead - in 2009 we saw at least three new mines commence production. But the personnel to support all these activities, both operators and regulators, are a dwindling and ageing group with few replacements available and few young people entering the industry over the past 25 years. The skills shortages we are experiencing cover a wide variety of disciplines. How is the global uranium industry going to cope with the staff needs for the expansion that is happening? Both operators and regulators face a crisis. This paper examines the current situation and discusses options for the future. (author)

  8. 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.

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

    Science.gov (United States)

    Saito, Shinzo

    2010-03-01

    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 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.

  10. 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.

  11. 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.

  12. 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.

  13. Impact of a critical health workforce shortage on child health in Zimbabwe: a country case study on progress in child survival, 2000–2013

    Science.gov (United States)

    Haley, Connie A; Vermund, Sten H; Moyo, Precious; Madzima, Bernard; Kanyowa, Trevor; Desta, Teshome; Mwinga, Kasonde; Brault, Marie A

    2017-01-01

    Abstract Despite notable progress reducing global under-five mortality rates, insufficient progress in most sub-Saharan African nations has prevented the achievement of Millennium Development Goal four (MDG#4) to reduce under-five mortality by two-thirds between 1990 and 2015. Country-level assessments of factors underlying why some African countries have not been able to achieve MDG#4 have not been published. Zimbabwe was included in a four-country study examining barriers and facilitators of under-five survival between 2000 and 2013 due to its comparatively slow progress towards MDG#4. A review of national health policy and strategy documents and analysis of qualitative data identified Zimbabwe’s critical shortage of health workers and diminished opportunities for professional training and education as an overarching challenge. Moreover, this insufficient health workforce severely limited the availability, quality, and utilization of life-saving health services for pregnant women and children during the study period. The impact of these challenges was most evident in Zimbabwe’s persistently high neonatal mortality rate, and was likely compounded by policy gaps failing to authorize midwives to deliver life-saving interventions and to ensure health staff make home post-natal care visits soon after birth. Similarly, the lack of a national policy authorizing lower-level cadres of health workers to provide community-based treatment of pneumonia contributed to low coverage of this effective intervention and high child mortality. Zimbabwe has recently begun to address these challenges through comprehensive policies and strategies targeting improved recruitment and retention of experienced senior providers and by shifting responsibility of basic maternal, neonatal and child health services to lower-level cadres and community health workers that require less training, are geographically broadly distributed, and are more cost-effective, however the impact of these

  14. Was there a Skills Shortage in Australia?

    OpenAIRE

    Junankar, P.N. (Raja)

    2009-01-01

    The paper analyses the problem of a "skills shortage" in Australia. It begins with an analysis of the operation of a labour market in terms of stocks and flows of labour services and human capital acquisition. It discusses the definition of a skills shortage, why it persists, and then looks at evidence from Australia, in particular, the resource rich states of Queensland and Western Australia over the past decade. It discusses possible employer responses to a skills shortage. Finally, it disc...

  15. The STEM shortage paradox

    Science.gov (United States)

    Harris, Margaret

    2014-10-01

    The UK is believed to suffer from a shortage of scientists and engineers, yet unemployment rates for new graduates in these fields are high. Does that mean the skills shortage doesn't exist, asks Margaret Harris.

  16. Indiana's Water Shortage Plan

    OpenAIRE

    Unterreiner, Jerry

    2011-01-01

    Indiana’s Water Shortage Plan was recently updated (2009) and established criteria to identify drought conditions and associated “Water Shortage Stages” designated as Normal, Watch, Warning, and Emergency. The three drought triggers are the 1-month Standardized Precipitation Index (SPI), U.S. Drought Monitor (USDM), and Percentage of Average Streamflow (28 streamflow gaging sites). The Water Shortage Stage is defined as Normal if no more than one indicator is outside of the normal ra...

  17. Survival of Jews during the Holocaust: the importance of different types of social resources

    National Research Council Canada - National Science Library

    Tammes, Peter

    2007-01-01

    Background Of the Jewish inhabitants of Amsterdam 25.9% survived the Holocaust. However, different cultural and socio-economic groups within the Jewish community may have had different social resources and different chances of survival...

  18. Factors predicting resource utilization and survival after major amputation.

    Science.gov (United States)

    Henry, Antonia J; Hevelone, Nathanael D; Hawkins, Alexander T; Watkins, Michael T; Belkin, Michael; Nguyen, Louis L

    2013-03-01

    Major amputation is associated with increased short-term healthcare resource utilization (RU), early mortality, and socioeconomic status (SES) disparities. Our objective is to study patient-specific and SES-related predictors of long-term RU and survival after amputation. This retrospective analysis identified 364 adult patients who underwent index major amputation for critical limb ischemia from January 1995 through December 2000 at two tertiary centers with outcomes through December 2010. Age, gender, SES (race, income, insurance, and marital status), comorbidities (congestive heart failure [CHF], diabetes, diabetes with complications, and renal failure [RF]), subsequent procedures, cumulative length of stay (cLOS), and mortality were analyzed. Bivariate and multivariate Poisson regression for subsequent procedures and cLOS and Cox proportional hazard modeling for all-cause mortality were undertaken. During a mean follow-up of 3.25 years, amputation patients had mean cLOS of 71.2 days per person-year (median, 17.6), 19.5 readmissions per person-year (median, 2.1), 0.57 amputation-related procedures (median, 0), and 0.31 cardiovascular procedures (median, 0). Below-knee amputation as the index procedure was performed in 70% of patients, and 25% had additional amputation procedures. Of readmissions at ≤ 30 days, 52% were amputation-related. Overall mortality during follow-up was 86.9%; 37 patients (10.2%) died within 30 days. Among patients surviving >30 days, multivariate Poisson regression demonstrated that younger age (incidence rate ratio [IRR], 0.98), public insurance (IRR, 1.63), CHF (IRR, 1.60), and RF (IRR, 2.12) were associated with increased cLOS. Diabetes with complications (IRR, 1.90) and RF (IRR, 2.47) affected subsequent amputation procedures. CHF (IRR, 1.83) and RF (IRR, 3.67) were associated with a greater number of cardiovascular procedures. Cox proportional hazard modeling indicated older age (hazard ratio [HR], 1.04), CHF (HR, 2.26), and RF (HR

  19. Prospective approach to managing antimicrobial drug shortages.

    Science.gov (United States)

    Griffith, Milena M; Patel, Jean A; Sutton, Sarah H; Bolon, Maureen K; Esterly, John S; Gross, Alan E; Postelnick, Michael J; Zembower, Teresa R; Scheetz, Marc H

    2012-07-01

    Antimicrobial drug shortages continue to increase, with few new therapeutic options available. Nationally, proposals have been offered to alleviate drug shortages; however, these recommendations are unlikely to effect change in the near future. Thus, antimicrobial stewardship leaders in acute care hospitals must develop a prospective management strategy to lessen the impact of these shortages on patient care. Herein, we describe several resources available to aid professionals in antimicrobial stewardship and healthcare epidemiology to manage drug shortages. An effective approach should include prospectively tracking shortages and maximizing inventory by appropriately managing usage. Several tenets should underpin this management. Alternative agents should be rationally chosen before the inventory of the primary agent has reached zero, ethical considerations should be taken into account, and timely notification and communication with key stakeholders should occur throughout the prescribing and dispensing process.

  20. Rethinking dentist shortages

    National Research Council Canada - National Science Library

    Vujicic, Marko

    2015-01-01

    ... aging and other demographic transitions. Dentistry is part of this debate. Much has been written over the years--empirical research, anecdote, and commentary--on whether the United States is facing, or will face, a dentist shortage...

  1. Current Vaccine Shortages and Delays

    Science.gov (United States)

    ... value="Submit" /> Related Links Vaccines & Immunizations Current Vaccine Shortages & Delays Recommend on Facebook Tweet Share Compartir ... vaccination are included in this update. Chart of Vaccines* in Delay or Shortage National Vaccine Supply Shortages ...

  2. Geopolitics, World Resources and Survival: A Role-playing Game.

    Science.gov (United States)

    Davis, Bruce E.

    1982-01-01

    Intended for college level geography courses, this game simulates the division and trade of world resources. These resources include all essential tangible and intangible elements--e.g., food, energy, technology, and political concessions--that are negotiated or exchanged on world commercial and political markets. Instructions for designing game…

  3. Global nursing shortages

    OpenAIRE

    Buchan, James

    2002-01-01

    Nursing shortages in the United Kingdom and elsewhere have been a repetitive phenomenon, usually due to an increasing demand for nurses outstripping static or a more slowly growing supply. Demand continues to grow, while projections for supply point to actual reductions in the availability of nurses in some developed and developing countries.

  4. Pediatric liver transplantation: predictors of survival and resource utilization.

    Science.gov (United States)

    Wagenaar, Amy E; Tashiro, Jun; Sola, Juan E; Ekwenna, Obi; Tekin, Akin; Perez, Eduardo A

    2016-05-01

    We sought to identify factors associated with increased resource utilization and in-hospital mortality for pediatric liver transplantation (LT). Kids' Inpatient Database (1997-2009) was used to identify cases of LT in patients liver disease was the most common (75 %). Logistic regression found higher mortality in children undergoing LT for malignant conditions (odds ratio: 4.8) and acute hepatic failure (OR 3.4). Cases complicated by renal failure (OR 7.7) and complications of LT (OR 2.7) had higher mortality rates. Resource utilization increased for children with renal failure and those with hemorrhage as a complication of LT, p failure and complications related to LT. Admission length was sensitive to payer status, hospital characteristics, and UNOS region, whereas total costs were unaffected by payer status or hospital type.

  5. 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

    at the physical layer (i.e., quality of transmission, QoT) and at the upper layer also in the case of a failure (i.e., survivability). This paper aims to apply the sharing concept to a WSON with QoT and survivability requirements (against single-link failures). QoT is guaranteed by resorting to regeneration...... is exploited to ensure survivability against single-link failures and make the sharing of network resources (regenerators and wavelengths) possible. The paper presents a novel distributed scheme (DISTR) for reservation of regenerators and wavelengths in generalized multi-protocol label switching controlled...... WSONs, in order to ensure the required level of QoT and survivability. Novel objects and selection strategies for the resource reservation protocol with traffic engineering extensions are proposed and evaluated. The DISTR scheme effectively combines regeneration and WC points, leading to a noticeable...

  6. 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.

  7. 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.

  8. 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.

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

    DEFF Research Database (Denmark)

    Hoffmann, Kira

    This study examines the effect of shortages in labor supply on asymmetric cost behavior. Building on the labor demand literature, it is argued that labor supply shortages increase adjustment costs for hiring new employees. Consistent with this explanation, results provide evidence that companies...... 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...

  10. The global nursing faculty shortage: status and solutions for change.

    Science.gov (United States)

    Nardi, Deena A; Gyurko, Charlene C

    2013-09-01

    In addition to a global shortage of nurses, there is also a shortage of academically qualified faculty available to teach in schools of nursing. A systematic review examined proposed solutions to the global shortage of nursing faculty. Metasynthesis was used to compare and critically appraise strategies offered for solving or ameliorating the global nursing faculty shortage by premier nursing organizations. 181 recommendations in 62 publications were categorized into eight major themed solutions, including centralizing data management, international collaboration in nursing research, and increased funding for full-time faculty positions in nursing programs. The nursing faculty shortage is due to a confluence of factors, including the global migration of nurses, a seeming persistent devaluation of faculty by academic programs, disincentives, and an overall reduction in full-time equivalent faculty positions. Results point to a needed change in direction and approach to solving the nursing faculty shortage. By designing new education models that fit global healthcare needs and pooling teaching resources, designing and using the same databases across organizations to track and project faculty needs, and collaborating between schools and businesses to create mutually beneficial agreements for services, nursing faculty capacity can be enhanced, and nursing's capacity to meet global healthcare needs can be expanded. The results of this systematic review can be used as a rubric for the design and development of strategies to end the nursing faculty shortage and expand global nursing capacity. © 2013 Sigma Theta Tau International.

  11. 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

  12. Survival

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — These data provide information on the survival of California red-legged frogs in a unique ecosystem to better conserve this threatened species while restoring...

  13. Effects of food resources on the fatty acid composition, growth and survival of freshwater mussels

    Science.gov (United States)

    Bartsch, Michelle; Bartsch, Lynn; Richardson, William B.; Vallazza, Jon; Moraska Lafrancois, Brenda

    2017-01-01

    Increased nutrient and sediment loading in rivers have caused observable changes in algal community composition, and thereby, altered the quality and quantity of food resources available to native freshwater mussels. Our objective was to characterize the relationship between nutrient conditions and mussel food quality and examine the effects on fatty acid composition, growth and survival of juvenile mussels. Juvenile Lampsilis cardium and L. siliquoidea were deployed in cages for 28 d at four riverine and four lacustrine sites in the lower St. Croix River, Minnesota/Wisconsin, USA. Mussel foot tissue and food resources (four seston fractions and surficial sediment) were analyzed for quantitative fatty acid (FA) composition. Green algae were abundant in riverine sites, whereas cyanobacteria were most abundant in the lacustrine sites. Mussel survival was high (95%) for both species. Lampsilis cardium exhibited lower growth relative to L. siliquoidea (p diet. In contrast, growth of L. siliquiodea was negatively related to nearly all FAs in the largest size fraction (i.e., >63 μm) of seston, including the bacterial FAs, and several of the FAs associated with sediments. Reduced mussel growth was observed in L. siliquoidea when the abundance of cyanobacteria exceeded 9% of the total phytoplankton biovolume. Areas dominated by cyanobacteria may not provide sufficient food quality to promote or sustain mussel growth.

  14. Survival analysis of a critical resource for cavity-nesting communities: patterns of tree cavity longevity.

    Science.gov (United States)

    Edworthy, Amanda B; Wiebe, Karen L; Martin, Kathy

    2012-09-01

    Tree cavities are a vital multi-annual resource used by cavity-nesting birds and mammals for nesting and shelter. The abundance of this resource will be influenced by the rates at which cavities are created and destroyed. We applied the demographic concepts of survival and longevity to populations of tree holes to investigate rates of loss for cavities in three tree species, as well as how characteristics of nest trees, habitat type, and species of excavator affected the persistence of tree cavities in trembling aspen, Populus tremuloides (95% of cavities were in aspen trees), in interior British Columbia, Canada. By modeling survival of 1635 nesting cavities in aspen over a time span of 16 years, we found that the decay stage of the nest tree was the most important factor determining cavity longevity. Cavities in trees with advanced decay had a relatively short median longevity of 7 years (95% CI 6-9 years), whereas those in living trees had a median longevity of more than 15 years. We found that cavity longevity was greater in continuous forest than in aspen grove habitat. Interestingly, cavities formed by weak excavators survived as long as those created by Northern Flickers (Colaptes auratus), despite occurring in more decayed tree stems. Thus, weak excavators may be selecting for characteristics that make a tree persistent, such as a broken top. Our results indicate that retention of cavities in large, live aspen trees is necessary to conserve persistent cavities, and that cavity longevity will have a large effect on the structure and function of cavity-using vertebrate communities.

  15. Effects of Maternal Nutrition, Resource Use and Multi-Predator Risk on Neonatal White-Tailed Deer Survival

    Science.gov (United States)

    Duquette, Jared F.; Belant, Jerrold L.; Svoboda, Nathan J.; Beyer, Dean E.; Lederle, Patrick E.

    2014-01-01

    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 environmental factors

  16. 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

  17. 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

  18. Resources

    Science.gov (United States)

    ... disease - resources Hemophilia - resources Herpes - resources Incest - resources Incontinence - resources Infertility - resources Interstitial cystitis - resources Kidney disease - resources Leukemia - resources Liver disease - resources Loss ...

  19. Doctor Shortage and Health Services*

    African Journals Online (AJOL)

    1971-08-14

    Aug 14, 1971 ... Doctor Shortage and Health Services*. 883. C. J. H. BRINK, RA., M.D., B.CH., D.P.H., D.T.M. ... Matriculation Board should have altered the regulations to remove· the stumbling block of English Higher .... emergencies the sick Pantu must resort to r~e witchdoctor or sometimes to the nurse or midwife in the ...

  20. US Congress considers bill to relieve helium shortage

    Science.gov (United States)

    Gwynne, Peter

    2013-04-01

    A bill to alleviate the threat of a significant shortage of helium was set to be debated in the US House of Representatives as Physics World went to press with the House's Natural Resources Committee putting the finished touches to the motion.

  1. Floral resource limitation severely reduces butterfly survival, condition and flight activity in simplified agricultural landscapes.

    Science.gov (United States)

    Lebeau, Julie; Wesselingh, Renate A; Van Dyck, Hans

    2016-02-01

    Agricultural intensification has a strong negative impact on farmland biodiversity (including flower-visiting insects), but understanding the mechanisms involved in this requires experimental work. We document the impact of nectar limitation on the performance of a flower-visiting insect, the meadow brown butterfly Maniola jurtina. We conducted two types of experiments: a field experiment in agricultural landscapes with grasslands of different management intensity and an experiment in outdoor flight cages in which the nectar supply was simulated. For the field experiment, we introduced an array of nectar resources in intensively managed, nectar-poor meadows and in extensively managed, flower-rich grasslands and counted flower visitors. Despite higher butterfly abundance in the extensive meadows, our introduced nectar sources were more frequently visited in intensive meadows, indicating the lack of floral resources. The 48-h confinement under nectar-poor conditions in the flight cages had a strong negative effect on body condition, flight activity and lifetime survival compared to butterflies under nectar-rich conditions. Female lifespan was reduced by 22% and male lifespan even by 43%. Agricultural landscapes that provide limited amounts of floral nectar, and no high-quality, preferred nectar sources relative to the needs of the flower-visiting species, may create ecological sinks. Regards an insect's performance, the simple presence of nectar is not necessarily functionally adequate. The effectiveness of agri-environmental schemes for flower-visiting insects (e.g. flower strips) could be improved based on ecological and evolutionary insights on the effects of specific nectar quantities and qualities.

  2. 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

  3. 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.

  4. Romanian Tourism Facing Labour Shortage

    Directory of Open Access Journals (Sweden)

    Iulia Chivu

    2008-10-01

    Full Text Available The purpose of this paper is to present the main tendencies in the Romanian tourism and their impact on the labour market. The first partof the paper presents the main tendencies in travel and tourism sector. The second part of the paper focuses on the challenges of the labour market inthe 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 the travel and tourism sector in order to better manage the multipledimensions of growth.

  5. 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.

  6. Why drug shortages are an ethical issue.

    Science.gov (United States)

    Lipworth, Wendy; Kerridge, Ian

    2013-11-30

    Drug shortages are a growing problem in developed countries. To some extent they are the result of technical and organisational failures, but to view drug shortages simply as technical and economic phenomena is to miss the fact that they are also ethical and political issues. This observation is important because it highlights both the moral and political imperative to respond to drug shortages as vigorously as possible, and the need for those addressing shortages to do so in ethically and politically sophisticated ways. This brief article outlines the ethical issues that need to be considered by anyone attempting to understand or address drug shortages.

  7. 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

  8. Strategies of survival and resource exploitation in the Antarctic fellfield ecosystem.

    Science.gov (United States)

    Block, W; Lewis Smith, R I; Kennedy, A D

    2009-08-01

    environmental stresses. During summer, organisms rely on opportunism to maintain a positive energy balance. During winter, resistance adaptations are used to withstand the potentially lethal climate, especially in habitats not protected by snow cover. This deterministic framework has led to the selection of species that are genetically and physiologically pre-adapted for resource acquisition yet sufficiently robust to withstand cold and desiccation stresses. Non-adapted taxa fail to become established. Despite the environmental selection pressures, available evidence suggests that colonisation of the fellfield habitat has not required the evolution of any adaptations, only the refinement of those already possessed to an extent by some temperate forms. This has led to the convergence of survival strategies. It is hypothesised that, in the short term, the majority of Antarctic fellfield biota are able to absorb the predicted effects of a changing climate by their high levels of physiological tolerance and life-cycle flexibility.

  9. Bioanalytical solutions to acetonitrile shortages.

    Science.gov (United States)

    Gao, Hong; Williams, John; Carrier, Scott; Brummel, Christopher L

    2010-09-01

    The acetonitrile shortage during 2008 to 2009 challenged bioanalytical scientists due to the ubiquitous role that acetonitrile plays in sample preparation and analysis. Replacement, reduction and reuse of acetonitrile were the core tenants behind each approach used to tackle the shortage. Sample preparation of biological matrices can be accomplished by protein precipitation using a variety of solvents; methanol is usually the best substitute for acetonitrile. The potential liabilities in using methanol can be handled with appropriate modifications. Often methanol is superior to acetonitrile for both protein precipitation and chromatography if phospholipid interference is a problem. Solvent consumption can be minimized by reducing column dimensions and particle size. Separations can be achieved at greatly reduced run times using sub-2-μm and fused-core particle columns. Emerging technologies, such as desorption ESI, direct analysis in real time and laser diode thermal desorption, eliminate the need for chromatography and achieve significant solvent and time savings. Acetonitrile recyclers can purify HPLC waste for reuse.

  10. 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.

  11. Pedagogies of Survival: Cultural Resources to Foster Resilience among Mexican-American Community College Students

    Science.gov (United States)

    Campa, Blanca

    2013-01-01

    This in-depth case shows how five Mexican-American community college students use their "pedagogies of survival" to build resistance and navigate through the barriers of community colleges. Pedagogies of survival emanate from social, cultural, economic, and historical struggles of the students, their families, and their communities which…

  12. 76 FR 68295 - Reducing Prescription Drug Shortages

    Science.gov (United States)

    2011-11-03

    ... 2010, and shortages are becoming more severe as well as more frequent. The affected medicines include... before a shortage becomes a crisis. However, drug manufacturers have not consistently provided the FDA... lifesaving medicines. Sec. 2. Broader Reporting of Manufacturing Discontinuances. To the extent permitted by...

  13. 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.

  14. 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.

  15. Adult children's socioeconomic resources and mothers' survival after a breast cancer diagnosis: a Swedish population-based cohort study.

    Science.gov (United States)

    Brooke, Hannah L; Ringbäck Weitoft, Gunilla; Talbäck, Mats; Feychting, Maria; Ljung, Rickard

    2017-03-30

    Socioeconomic inequalities in survival after breast cancer persist worldwide. We aim to determine whether adult offspring's socioeconomic resources contribute to inequalities in mothers' survival after breast cancer. 14 231 women, aged 65-79 years, with a child aged ≥30 years and a first primary diagnosis of breast cancer in the National Cancer Register between 2001 and 2010 were followed until death, 10 years after diagnosis, or end of study (December 2015). Relative survival proportions and excess mortality within 10 years of diagnosis by strata of offspring's education level and disposable income were estimated using flexible parametric models accounting for measures of mothers' socioeconomic position and expected mortality in the general population. 4292 women died during 102 236 person-years of follow-up. Crude 10-year relative survival proportions for mothers of children with >14, 12-14 and education were 0.89 (0.87 to 0.91), 0.87 (0.85 to 0.89) and 0.79 (0.76 to 0.81), respectively. Compared with mothers of children with >14 years of education, mothers of children with education had substantially higher excess mortality (excess HR 1.69 (1.38 to 2.07) and 1.22 (1.00 to 1.48), respectively). Higher mortality did not differ between tertiles of offspring's disposable income. Adult offspring's education level may contribute to inequalities in mothers' survival after breast cancer. Clinicians should be aware of the educational context beyond the individual and women with less educated offsprings may require extra support. This should be considered in future research, policy frameworks and interventions aimed at reducing survival inequalities. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. [Drug shortage: determinants, consequences and management].

    Science.gov (United States)

    Reis, Adriano Max Moreira; Perini, Edson

    2008-04-01

    The present study analyzes drug shortage as a problem reaching beyond the logistic aspect of the health field and discusses its consequences with respect to quality, safety and cost of health care delivery. The pharmaceutical supply chain and the factors that determine the distribution and availability of drugs are discussed. The contribution of the Pharmacy and Therapeutics Committee in preventing and managing drug shortage in health institutions is stressed and measures for drug shortage management are suggested. Finally it is emphasized that drugs should be considered health products rather than consumer goods and as such be given a different treatment by the supply chain.

  17. 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

  18. Ecological Values amid Local Interests: Natural Resource Conservation, Social Differentiation, and Human Survival in Honduras

    Science.gov (United States)

    Gareau, Brian J.

    2007-01-01

    Local peoples living in protected areas often have a different understanding about their natural space than do non-local groups that promote and declare such areas "protected." By designing protected areas without local involvement, or understandings of local social differentiation and power, natural resources management schemes will…

  19. 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

  20. 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

  1. The "lessons" of the Australian "heroin shortage"

    Directory of Open Access Journals (Sweden)

    Gilmour Stuart

    2006-05-01

    Full Text Available Abstract Heroin use causes considerable harm to individual users including dependence, fatal and nonfatal overdose, mental health problems, and blood borne virus transmission. It also adversely affects the community through drug dealing, property crime and reduced public amenity. During the mid to late 1990s in Australia the prevalence of heroin use increased as reflected in steeply rising overdose deaths. In January 2001, there were reports of an unpredicted and unprecedented reduction in heroin supply with an abrupt onset in all Australian jurisdictions. The shortage was most marked in New South Wales, the State with the largest heroin market, which saw increases in price, dramatic decreases in purity at the street level, and reductions in the ease with which injecting drug users reported being able to obtain the drug. The abrupt onset of the shortage and a subsequent dramatic reduction in overdose deaths prompted national debate about the causes of the shortage and later international debate about the policy significance of what has come to be called the "Australian heroin shortage". In this paper we summarise insights from four years' research into the causes, consequences and policy implications of the "heroin shortage".

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

    Science.gov (United States)

    de Goeij, Jasper M; van Oevelen, Dick; Vermeij, Mark J A; Osinga, Ronald; Middelburg, Jack J; de Goeij, Anton F P M; Admiraal, Wim

    2013-10-04

    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 transferred to higher trophic levels. Here we show that sponges make DOM available to fauna by rapidly expelling filter cells as detritus that is subsequently consumed by reef fauna. This "sponge loop" was confirmed in aquarium and in situ food web experiments, using (13)C- and (15)N-enriched DOM. The DOM-sponge-fauna pathway explains why biological hot spots such as coral reefs persist in oligotrophic seas--the reef's paradox--and has implications for reef ecosystem functioning and conservation strategies.

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

    Directory of Open Access Journals (Sweden)

    Fatima Rasool

    2011-02-01

    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.

  4. Plan May Ease Faculty Shortage in Engineering.

    Science.gov (United States)

    Chemical and Engineering News, 1982

    1982-01-01

    Help in solving the engineering faculty shortage crisis is being sought by the American Association of Engineering Societies (New York City) by means of a four-part proposal: establishing a faculty assistance program, graduate student assistance, academic professorial appointments (federally funded), and general improvements of university…

  5. Reproductive resilience to food shortage in a small heterothermic primate.

    Science.gov (United States)

    Canale, Cindy I; Huchard, Elise; Perret, Martine; Henry, Pierre-Yves

    2012-01-01

    The massive energetic costs entailed by reproduction in most mammalian females may increase the vulnerability of reproductive success to food shortage. Unexpected events of unfavorable climatic conditions are expected to rise in frequency and intensity as climate changes. The extent to which physiological flexibility allows organisms to maintain reproductive output constant despite energetic bottlenecks has been poorly investigated. In mammals, reproductive resilience is predicted to be maximal during early stages of reproduction, due to the moderate energetic costs of ovulation and gestation relative to lactation. We experimentally tested the consequences of chronic-moderate and short-acute food shortages on the reproductive output of a small seasonally breeding primate, the grey mouse lemur (Microcebus murinus) under thermo-neutral conditions. These two food treatments were respectively designed to simulate the energetic constraints imposed by a lean year (40% caloric restriction over eight months) or by a sudden, severe climatic event occurring shortly before reproduction (80% caloric restriction over a month). Grey mouse lemurs evolved under the harsh, unpredictable climate of the dry forest of Madagascar and should thus display great potential for physiological adjustments to energetic bottlenecks. We assessed the resilience of the early stages of reproduction (mating success, fertility, and gestation) to these contrasted food treatments, and on the later stages (lactation and offspring growth) in response to the chronic food shortage only. Food deprived mouse lemurs managed to maintain constant most reproductive parameters, including oestrus timing, estrogenization level at oestrus, mating success, litter size, and litter mass as well as their overall number of surviving offspring at weaning. However, offspring growth was delayed in food restricted mothers. These results suggest that heterothermic, fattening-prone mammals display important reproductive

  6. Reproductive resilience to food shortage in a small heterothermic primate.

    Directory of Open Access Journals (Sweden)

    Cindy I Canale

    Full Text Available The massive energetic costs entailed by reproduction in most mammalian females may increase the vulnerability of reproductive success to food shortage. Unexpected events of unfavorable climatic conditions are expected to rise in frequency and intensity as climate changes. The extent to which physiological flexibility allows organisms to maintain reproductive output constant despite energetic bottlenecks has been poorly investigated. In mammals, reproductive resilience is predicted to be maximal during early stages of reproduction, due to the moderate energetic costs of ovulation and gestation relative to lactation. We experimentally tested the consequences of chronic-moderate and short-acute food shortages on the reproductive output of a small seasonally breeding primate, the grey mouse lemur (Microcebus murinus under thermo-neutral conditions. These two food treatments were respectively designed to simulate the energetic constraints imposed by a lean year (40% caloric restriction over eight months or by a sudden, severe climatic event occurring shortly before reproduction (80% caloric restriction over a month. Grey mouse lemurs evolved under the harsh, unpredictable climate of the dry forest of Madagascar and should thus display great potential for physiological adjustments to energetic bottlenecks. We assessed the resilience of the early stages of reproduction (mating success, fertility, and gestation to these contrasted food treatments, and on the later stages (lactation and offspring growth in response to the chronic food shortage only. Food deprived mouse lemurs managed to maintain constant most reproductive parameters, including oestrus timing, estrogenization level at oestrus, mating success, litter size, and litter mass as well as their overall number of surviving offspring at weaning. However, offspring growth was delayed in food restricted mothers. These results suggest that heterothermic, fattening-prone mammals display important

  7. Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in SubSaharan Africa (ETATMBA)

    OpenAIRE

    Ellard, DR; DAVIES, D; F. Griffiths; Kandala, NB; Mazuguni, F.; Shemdoe, A.; Chimwaza, W; Chiwandira, C; Mbaruku, G.; Bergström, S; Kamwendo, F; Mhango, C.; Peile, E; Quenby, S.; Simkiss, D

    2014-01-01

    There is a chronic shortage of medical doctors in many Sub-Saharan African countries and indeed many of these countries have very little to spend on healthcare. As a consequence levels of maternal and neonatal mortality still very high and many are struggling to meet the WHO Millennium development goals. Many African countries like Malawi have a cadre of health workers called Non Physician Clinicians (NPCs) who are trained by the Ministry of Health and are often the most experienced health wo...

  8. 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.

  9. Glioblastoma treatment patterns, survival, and healthcare resource use in real-world clinical practice in the USA

    Directory of Open Access Journals (Sweden)

    Allicia C Girvan

    2015-03-01

    Full Text Available Background: Glioblastoma (GB treatment remains challenging because of recurrence and poorly defined treatment options after first-line therapy. To better understand real-world application of treatment paradigms and their impact on outcomes, we describe patterns of treatment, outcomes, and use of cancer-related healthcare resource for glioblastoma in the USA. Methods: A retrospective, online chart-abstraction study was conducted; each participating oncologist contributed ≤5 charts. Patients were ≥18 years with biopsy-confirmed primary or secondary newly diagnosed GB on or after 1 January 2010, had received first- and second-line therapies, and had information collected for ≥3 months after initiation of second-line therapy or until death. Assessments were descriptive and included Kaplan–Meier analyses from initiation to end of second-line therapy, disease progression, or death. Results: One hundred sixty physicians contributed information on 503 patient charts. During first-line therapy, patients most commonly underwent temozolomide monotherapy (76.5%. During second-line therapy, patients most commonly underwent bevacizumab monotherapy (58.1%. Median duration of second-line therapy was 130 days; median time to disease progression was 113 days. Median survival was 153 days. Use of supportive care was observed to be numerically higher in first- compared with second-line therapy except for anti-depressants, growth factors, and stimulants. Frequently used resources included corticosteroids (78.8% of patients in first-line and 62.6% in second-line therapies, anti-epileptics (45.8% and 41.5% and narcotic opioids (45.3% and 41.4%. Conclusions: Most GB patients received temozolomide during first-line therapy and bevacizumab monotherapy or combination therapy during second-line therapy. Use of supportive care appeared to be higher in first- compared with second-line therapy for some agents.

  10. Where Are the Veterinarian Shortage Areas Anyway

    OpenAIRE

    Tong Wang; Hennessy, David A.; Annette M. O'Connor

    2012-01-01

    In 2010 the United States implemented the Veterinary Medicine Loan Repayment Program (VMLRP) to address perceived regional shortages in certain veterinary occupations, including food animal practice. With county as the unit of analysis, this paper describes a pair of models to evaluate factors associated with being designated a private practice shortagearea in 2010. One model is used to explain food animal veterinarian location choices so as to provide an objective evaluation of comparative s...

  11. The nursing shortage: a worldwide problem

    Directory of Open Access Journals (Sweden)

    Rachel Z. Booth

    Full Text Available A worldwide shortage of nurses has been acknowledged by the multidisciplinary Global Advisory Group of the World Health Organization. The shortage is caused by an increased demand for nurses, while fewer people are choosing nursing as a profession and the current nurses worldwide are aging. The shortage applies to nurses in practice as well as the nurse faculty who teach students. The inter-country recruitment and migration of nurses from developing countries to developed countries exacerbates the problem. Although public opinion polls identifies the nurse as the person who makes the health care system work for them, the conditions of the work environment in which the nurse functions is unsatisfactory and must change. Numerous studies have shown the positive effects on the nurse of a healthy work environment and the positive relationships between nursing care and patient outcomes. It is important that government officials, insurance companies, and administrators and leaders of health care systems acknowledge and operationalize the value of nurses to the health care system in order to establish and maintain the integrity and viability of that system.

  12. The nursing shortage: a worldwide problem

    Directory of Open Access Journals (Sweden)

    Booth Rachel Z.

    2002-01-01

    Full Text Available A worldwide shortage of nurses has been acknowledged by the multidisciplinary Global Advisory Group of the World Health Organization. The shortage is caused by an increased demand for nurses, while fewer people are choosing nursing as a profession and the current nurses worldwide are aging. The shortage applies to nurses in practice as well as the nurse faculty who teach students. The inter-country recruitment and migration of nurses from developing countries to developed countries exacerbates the problem. Although public opinion polls identifies the nurse as the person who makes the health care system work for them, the conditions of the work environment in which the nurse functions is unsatisfactory and must change. Numerous studies have shown the positive effects on the nurse of a healthy work environment and the positive relationships between nursing care and patient outcomes. It is important that government officials, insurance companies, and administrators and leaders of health care systems acknowledge and operationalize the value of nurses to the health care system in order to establish and maintain the integrity and viability of that system.

  13. 77 FR 38838 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2012-06-29

    ... HUMAN SERVICES Health Resources and Services Administration Lists of Designated Primary Medical Care... primary medical care, mental health, and dental health professional shortage areas (HPSAs) as of April 1.... Criteria then were defined for each of seven health professional types (primary medical care, dental...

  14. Shortage of Bee, Wasp Venom Stings Those with Allergies

    Science.gov (United States)

    ... news/fullstory_167081.html Shortage of Bee, Wasp Venom Stings Those With Allergies Facing expected season-long ... News) -- A shortage of honeybee, wasp and hornet venom extract has allergists concerned. The extract treats people ...

  15. 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...

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

    African Journals Online (AJOL)

    This paper examines the form/patterns of social conflict generated as a result of water shortage in Akungba-Akoko of Ondo State; precipitating factors for water shortage and social conflict; effects of water shortage and social conflict on residents, and the conflict management style employed. Using both primary and ...

  17. Skills Shortages: Concepts, Measurement and Implications. Working Paper No. 52

    Science.gov (United States)

    Shah, Chandra; Burke, Gerald

    2003-01-01

    Despite wide publicity and common usage, the concept of skills shortage has different meaning to different people depending on their perspective. Understanding the different concepts of skills shortages, their measurement and the causes of skill shortages is important if sound policies are to be developed in the areas of employment, education,…

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

    Science.gov (United States)

    Nelissen, Ellen; Ersdal, Hege; Ostergaard, Doris; Mduma, Estomih; Broerse, Jacqueline; Evjen-Olsen, Bjørg; van Roosmalen, Jos; Stekelenburg, Jelle

    2014-03-01

    To evaluate "Helping Mothers Survive Bleeding After Birth" (HMS BAB) simulation-based training in a low-resource setting. Educational intervention study. Rural referral hospital in Northern Tanzania. Clinicians, nurse-midwives, medical attendants, and ambulance drivers involved in maternity care. In March 2012, health care workers were trained in HMS BAB, a half-day simulation-based training, using a train-the-trainer model. The training focused on basic delivery care, active management of third stage of labor, and treatment of postpartum hemorrhage, including bimanual uterine compression. Evaluation questionnaires provided information on course perception. Knowledge, skills, and confidence of facilitators and learners were tested before and after training. Four master trainers trained eight local facilitators, who subsequently trained 89 learners. After training, all facilitators passed the knowledge test, but pass rates for the skills test were low (29% pass rate for basic delivery and 0% pass rate for management of postpartum hemorrhage). Evaluation revealed that HMS BAB training was considered acceptable and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were low (3% pass rate for basic delivery and management of postpartum hemorrhage). The HMS BAB simulation-based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  19. An audit of drug shortages in a community pharmacy practice.

    Science.gov (United States)

    Costelloe, E M; Guinane, M; Nugent, F; Halley, O; Parsons, C

    2015-06-01

    There are no firm data on drug shortages in Irish community pharmacy. This prospective observational study aimed to characterise the drug shortage problem in an Irish community pharmacy. The primary aim was to determine numbers and durations of drug shortages. Secondary aims included comparing these shortages with Irish Pharmacy Union (IPU) drug shortage lists and determining the frequency with which notifications were received prior to shortages. Further secondary aims were to examine relationships between causes of drug shortages and drug costs and between causes of drug shortages and shortage durations. The study took place in a community pharmacy in a Limerick City suburb between October 2012 and February 2013. Data were collected daily regarding drugs that were dispensed, but unavailable to purchase. Suppliers/manufacturers provided data on the reasons for shortages. 65/1,232 dispensed drugs (5.3%) were in short supply over the study period. Median shortage duration was 13 days (interquartile range 4-32 days) and median cost was 8.10. Numbers of unavailable drugs by month varied from 13 to 38. Monthly IPU drug shortage lists identified between six and eight of these shortages depending on the month. Two notifications were received from suppliers/manufacturers regarding shortages. Parallel exports had the highest mean costs (mean 38.05) and manufacturing problems were associated with the longest durations (mean 57.44 days). This study highlights the drug shortage problem in an Irish community pharmacy. We propose that enhanced communication between all stakeholders is the most worthwhile solution. Further studies are needed.

  20. Identifying biomass fuel shortages in Sri Lanka

    Energy Technology Data Exchange (ETDEWEB)

    Howes, Michael (Sussex Univ., Brighton (UK). Inst. of Development Studies)

    1989-01-01

    This paper analyses data from the Sri Lankan Forestry Master Plan and other sources, to explore the causes of biomass shortages, and to identify the areas where interventions are likely to have most impact. Five districts, concentrated in the wet lowland and hill country zones, are found to be in overall biomass fuel deficit whilst in a further five, which include dry zone locations, fuelwood consumption exceeds potential supply, Within the area of overall deficit, poorer urban groups and rural families with no home gardens - who together comprise 15% of all households nationally - are affected most severely. Another 10% of households are likely to suffer to a lesser extent. (author).

  1. 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.

  2. Where are the food animal veterinarian shortage areas anyway?

    Science.gov (United States)

    Wang, Tong; Hennessy, David A; O'Connor, Annette M

    2012-05-01

    In 2010 the United States implemented the Veterinary Medicine Loan Repayment Program (VMLRP) to address perceived regional shortages in certain veterinary occupations, including food animal practice. With county as the unit of analysis, this paper describes a pair of models to evaluate factors associated with being designated a private practice shortage area in 2010. One model is used to explain food animal veterinarian location choices so as to provide an objective evaluation of comparative shortage. The other model seeks to explain the counties chosen as shortage areas. Model results are then used to evaluate the program. On the whole the program appears to perform quite well. For several states, however, VMLRP shortage designations are inconsistent with the food animal veterinarian location model. Comparative shortage is generally more severe in states that have no VMLRP designated private practice shortage counties than in states that do. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. 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

    2017-08-31

    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 2017. © 2017 Wiley Periodicals, Inc.

  4. India's Worsening Uranium Shortage

    Energy Technology Data Exchange (ETDEWEB)

    Curtis, Michael M.

    2007-01-15

    As a result of NSG restrictions, India cannot import the natural uranium required to fuel its Pressurized Heavy Water Reactors (PHWRs); consequently, it is forced to rely on the expediency of domestic uranium production. However, domestic production from mines and byproduct sources has not kept pace with demand from commercial reactors. This shortage has been officially confirmed by the Indian Planning Commission’s Mid-Term Appraisal of the country’s current Five Year Plan. The report stresses that as a result of the uranium shortage, Indian PHWR load factors have been continually decreasing. The Uranium Corporation of India Ltd (UCIL) operates a number of underground mines in the Singhbhum Shear Zone of Jharkhand, and it is all processed at a single mill in Jaduguda. UCIL is attempting to aggrandize operations by establishing new mines and mills in other states, but the requisite permit-gathering and development time will defer production until at least 2009. A significant portion of India’s uranium comes from byproduct sources, but a number of these are derived from accumulated stores that are nearing exhaustion. A current maximum estimate of indigenous uranium production is 430t/yr (230t from mines and 200t from byproduct sources); whereas, the current uranium requirement for Indian PHWRs is 455t/yr (depending on plant capacity factor). This deficit is exacerbated by the additional requirements of the Indian weapons program. Present power generation capacity of Indian nuclear plants is 4350 MWe. The power generation target set by the Indian Department of Atomic Energy (DAE) is 20,000 MWe by the year 2020. It is expected that around half of this total will be provided by PHWRs using indigenously supplied uranium with the bulk of the remainder provided by breeder reactors or pressurized water reactors using imported low-enriched uranium.

  5. Resources.

    Science.gov (United States)

    Stewart, John; MacDonald, Ian

    1980-01-01

    Presents a guide to resources on television drama available to teachers for classroom use in television curriculum. Lists American and British television drama videorecordings of both series and individual presentations and offers a bibliography of "one-off" single fiction plays produced for British television. (JMF)

  6. The dilemma of physician shortage and international recruitment in Canada

    OpenAIRE

    Islam, Nazrul

    2014-01-01

    The perception of physician shortage in Canada is widespread. Absolute shortages and relative discrepancies, both specialty-wise and in urban-rural distribution, have been a daunting policy challenge. International Medical Graduates (IMGs) have been at the core of mitigating this problem, especially as long as shortage of physicians in rural areas is concerned. Considering such recruitment as historical reality is naïve annotation, but when it is recommended per se, then the indication of int...

  7. 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.

  8. The American Nursing Shortage: Implications for Community Colleges

    Science.gov (United States)

    Friedel, Janice Nahra

    2012-01-01

    This article examines national employment and program trends in the nursing profession, the nursing shortage in Iowa, and state policy and community college responses in Iowa. During the seven-year period 2001-2008, two Iowa governors convened special task forces to study the nursing shortage and to make recommendations. The policy responses dealt…

  9. New Report Predicts Shortage of Geoscientists in the Workforce

    Science.gov (United States)

    Wendel, JoAnna

    2014-06-01

    By the end of the next decade, there may be a shortage of 135,000 geoscientists in the workforce, according to a report issued by the American Geosciences Institute on 29 May. This shortage is predicted despite rising enrollment in the geosciences and rising salaries for students graduating with bachelor's, master's, and doctorate degrees.

  10. Oak seedling survival and growth along resource gradients in Mediterranean forests: implications for regeneration in current and future environmental scenarios

    NARCIS (Netherlands)

    Gómez-Aparicio, L.; Pérez-Ramos, I.M.; Mendoza, L.; Matías, L.; Quero, J.L.; Castro, J.; Zamora, R.; Marañón, T.

    2008-01-01

    Understanding seedling performance across resource gradients is crucial for defining the regeneration niche of plant species under current environmental conditions and for predicting potential changes under a global change scenario. A 2-year field experiment was conducted to determine how seedling

  11. Management of nurse shortage and its impact on pathogen dissemination in the intensive care unit.

    Science.gov (United States)

    Ferrer, Jordi; Boelle, Pierre-Yves; Salomon, Jérôme; Miliani, Katiuska; L'Hériteau, François; Astagneau, Pascal; Temime, Laura

    2014-12-01

    Studies provide evidence that reduced nurse staffing resources are associated to an increase in health care-associated infections in intensive care units, but tools to assess the contribution of the mechanisms driving these relations are still lacking. We present an agent-based model of pathogen spread that can be used to evaluate the impact on nosocomial risk of alternative management decisions adopted to deal with transitory nurse shortage. We constructed a model simulating contact-mediated dissemination of pathogens in an intensive-care unit with explicit staffing where nurse availability could be temporarily reduced while maintaining requisites of patient care. We used the model to explore the impact of alternative management decisions adopted to deal with transitory nurse shortage under different pathogen- and institution-specific scenarios. Three alternative strategies could be adopted: increasing the workload of working nurses, hiring substitute nurses, or transferring patients to other intensive-care units. The impact of these decisions on pathogen spread was examined while varying pathogen transmissibility and severity of nurse shortage. The model-predicted changes in pathogen prevalence among patients were impacted by management decisions. Simulations showed that increasing nurse workload led to an increase in pathogen spread and that patient transfer could reduce prevalence of pathogens among patients in the intensive-care unit. The outcome of nurse substitution depended on the assumed skills of substitute nurses. Differences between predicted outcomes of each strategy became more evident with increasing transmissibility of the pathogen and with higher rates of nurse shortage. Agent-based models with explicit staff management such as the model presented may prove useful to design staff management policies that mitigate the risk of healthcare-associated infections under episodes of increased nurse shortage. Copyright © 2014 The Authors. Published by

  12. The paradoxical effects of workforce shortages on rural interprofessional practice.

    Science.gov (United States)

    McNeil, Karen; Mitchell, Rebecca; Parker, Vicki

    2015-03-01

    While interprofessional practice has been promoted as a solution to the challenges besetting rural health services, current evidence does not offer a clear explanation as to why it is effective in some domains and yet is not successful in others. At the same time, rural clinicians are frequently faced with major workforce pressures and this has a significant influence on professional practice. The aim of this study was to explore how these pressures impact on rural interprofessional practice. This study is part of a larger project investigating factors that enhance and detract from effective interprofessional working. We utilised a modified realistic evaluation approach to analyse the context, mechanisms and outcomes of rural interprofessional practice. Approval for this study was granted by an accredited research ethics committee. Semi-structured interviews were conducted with 22 rural clinicians who were purposively recruited from a range of settings, roles, locations and professions. We found that clinicians often invested in interprofessional practice because of the need to manage intense workloads and this necessitated sharing of responsibilities across disciplines and blurring of role boundaries. Paradoxically, participants noted that workload pressures hampered interprofessional working if there were long-term skill shortages. Sharing workload and responsibility is an important motivator for rural practitioners to engage in interprofessional practice; however, this driver is only effective under circumstances where there are sufficient resources to facilitate collaboration. In the context of intransient resource challenges, rural health service managers would be best to focus on enabling IPP through facilitating role understanding and respect between clinicians. This is most feasible via informal workplace learning and allowing time for teams to reflect on collaborative processes. © 2014 Nordic College of Caring Science.

  13. Insights into European Drug Shortages: A Survey of Hospital Pharmacists

    Science.gov (United States)

    Pauwels, Kim; Simoens, Steven; Casteels, Minne; Huys, Isabelle

    2015-01-01

    Drug shortages are a complex and global phenomenon. When a drug cannot be delivered at the moment of patient demand, every stakeholder in the health care system is affected. The aim of this study was to investigate the characteristics, clinical impact, financial impact and management of drug shortages in European hospital pharmacies and identify opportunities for prevention and mitigation of drug shortages in Europe. An online survey was designed based on a review of the literature and interviews and was sent to subscribers of Hospital Pharmacy Europe between June and September 2013. Forty-five percent of respondents (n = 161) indicated that life sustaining or life preserving drugs such as oncology drugs were affected by drug shortages. More than 30% of respondents indicated that drug shortages in Europe were always or often associated with increased costs for hospitals, increased personnel costs and more expensive alternative drugs (n = 161). On the question when information about a drug shortage was obtained, 42% of respondents answered that information from the pharmaceutical company was obtained at the time of no delivery, 50% indicated that information from the wholesaler was obtained at the time of no delivery, while 40% of respondents indicated that information was never or rarely received from the government (n = 161). Fifty seven percent of respondents strongly agreed that an obligation to the producer to notify further shortages could help to solve the problem (n = 161). These results showed that pharmaceutical companies and wholesalers are already involved in the management of drug shortages, while a role is still reserved for the government. Mandatory notification in advance and centralized information can help to reduce workload for hospital pharmacists, will allow early anticipation of drug shortages and will facilitate mitigation of the clinical impact on patients. PMID:25775406

  14. 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

  15. 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

    (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...... 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...

  16. 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.

  17. Enterprise Policies for Tackling the Digital Skills Shortage

    National Research Council Canada - National Science Library

    Daniela BORISOV; Adrian TANŢĂU

    2013-01-01

    ... 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...

  18. Retrieval improvement is induced by water shortage through angiotensin II.

    Science.gov (United States)

    Frenkel, Lia; Maldonado, Héctor; Delorenzi, Alejandro

    2005-03-01

    Angiotensin II (ANGII) has an evolutionary preserved role in determining adaptative responses to water-shortages. In addition, it has been shown to modulate diverse phases of memory. Still, it is not clear whether ANGII improves or spoils memory. We demonstrated that endogenous angiotensins enhance consolidation of a long-term associative memory in the crab Chasmagnathus and that water shortage improves memory consolidation through brain ANGII actions. Here, we show that weakly trained crabs, when water-deprived, exhibit enhanced retrieval. Subsequently, memory retention is indistinguishable from that of strongly trained crabs. ANGII, but not angiotensin IV, is a necessary and sufficient condition for such enhancing effect. We conclude that ANGII released due to water shortage leads to enhanced memory retrieval. Thus, it seems that ANGII has an evolutionary preserved role as a multifunction coordinator that enables an adaptative response to water-shortage. The facilitation of memory consolidation and retrieval would be among those coordinated functions.

  19. 5 CFR 337.204 - Severe shortage of candidates.

    Science.gov (United States)

    2010-01-01

    ... information such as selective placement factors or other special requirements of the position, as well as... geographic locations. OPM may decide independently that such a shortage exists, or may make this decision in...

  20. Development of biosimilars in an era of oncologic drug shortages

    Directory of Open Access Journals (Sweden)

    Li E

    2015-06-01

    Full Text Available Edward Li,1 Janakiraman Subramanian,2 Scott Anderson,3 Dolca Thomas,4 Jason McKinley,5 Ira A Jacobs4 1University of New England College of Pharmacy, Portland, ME, USA; 2Hanna Cancer Associates, Knoxville, TN, USA; 3Pfizer Inc, La Jolla, CA, USA; 4Pfizer Inc, New York, NY, USA; 5Pfizer Inc, Groton, CT, USA Abstract: Acute and chronic shortages of various pharmaceuticals and particularly of sterile injectable products are being reported on a global scale, prompting evaluation of more effective strategies to manage current shortages and development of new, high-quality pharmaceutical products to mitigate the risk of potential future shortages. Oncology drugs such as liposomal doxorubicin and 5-fluorouracil represent examples of first-choice drugs critically affected by shortages. Survey results indicate that the majority of hospitals and practicing oncologists have experienced drug shortages, which may have compromised patient safety and clinical outcomes, and increased health care costs, due to delays or changes in treatment regimens. Clinical trials evaluating novel agents in combination with standard-of-care drugs are also being affected by drug shortages. Clinical and ethical considerations on treatment objectives, drug indication, and availability of alternative options may help in prioritizing cancer patients involved in active drug shortages. The United States Food and Drug Administration and the European Medicines Agency have identified manufacturing problems, delays in supply, and lack of available active ingredients as the most frequent causes of recent or ongoing drug shortages, and have released specific guidance to monitor, manage, and reduce the risk of shortages. The upcoming loss of exclusivity for a number of anticancer biologics, together with the introduction of an abbreviated approval pathway for biosimilars, raises the question of whether these products will be vulnerable to shortages. Future supply by reliable

  1. Academic food-supply veterinarians: future demand and likely shortages.

    Science.gov (United States)

    Bruce Prince, J; Andrus, David M; Gwinner, Kevin

    2006-01-01

    The future demand for and potential shortages of food-supply veterinarians have been the subject of much concern. Using the Delphi forecasting method in a three-phase Web-based survey process, a panel of experts identified the trends and issues shaping the demand for and supply of academic food-animal veterinarians, then forecasted the likely future demand and shortages of food-supply veterinarians employed in academic institutions in the United States and Canada through 2016. The results indicate that there will be increasing future demand and persistent shortages of academic food-supply veterinarians unless current trends are countered with targeted, strategic action. The Delphi panel also evaluated the effectiveness of several strategies for reversing current trends and increasing the number of food-supply veterinarians entering into academic careers. Academic food-supply veterinarians are a key link in the system that produces food-supply veterinarians for all sectors (private practice, government service, etc.); shortages in the academic sector will amplify shortages wherever food-supply veterinarians are needed. Even fairly small shortages have significant public-health, food-safety, animal-welfare, and bio-security implications. Recent events demonstrate that in an increasingly interconnected global economic food supply system, national economies and public health are at risk unless an adequate supply of appropriately trained food-supply veterinarians is available to counter a wide variety of threats ranging from animal and zoonotic diseases to bioterrorism.

  2. Perceptions of Egyptian physicians about drug shortage during political disturbances: Survey in Greater Cairo

    Directory of Open Access Journals (Sweden)

    Ammar A. Abdelrahman

    2016-12-01

    Conclusion: Prospective studies are required to quantitatively estimate drug shortage related mortality. Enhanced drug shortage communication by drug authorities and targeted education may relieve inter-professional conflicts resulting from drug shortages.

  3. 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.

  4. The future shortage of doctoral prepared nurses and the impact on the nursing shortage.

    Science.gov (United States)

    Morgan, Deb; Somera, Patricia

    2014-01-01

    Nursing remains at the top of the job growth market and has the potential to positively or negatively impact changes in the delivery of health care today. Professional nurses play a crucial role in the prevention of medication errors, decreasing infection rates, and facilitating a patient's safe transition from acute care into the home environment. Nurses must make critical life-saving decisions associated with caring for the more acutely ill patient. Doctoral prepared nurses have the unique position to assist the direct care nurse because of their advanced education. The doctor in nursing practice concentrates on direct care, specifically research utilization for improved delivery of care, patient outcomes, and clinical systems management There is a future shortage of doctoral prepared nurses, and a resolution is needed. Doctoral prepared nurses with advanced degrees play an important role in mentoring the bedside nurse to promote an interdisciplinary collaborative relationship. The doctor in nursing practice has the ability to effect change in health care systems, organizations, and policy through focusing on the essence of nursing-the care.

  5. Demand for temporary agency nurses and nursing shortages.

    Science.gov (United States)

    Seo, Sukyong; Spetz, Joanne

    2013-08-01

    There is an ongoing debate about the reasons for the growth of temporary employment of registered nurses (RNs). Some argue that efficiency incentives to increase flexibility and reduce labor costs are the principal cause, while others point to shortages of RNs as the stronger determinant. Using hospital-level data from California's Office of Statewide Health Planning and Development, we find a significant trend of increasing demand for agency nurses during the years of RN shortage. Demand rose with inpatient days, patient demand fluctuation, and the level of fringe benefits. Competition between hospitals and unionization, however, did not affect hospitals' demand for temporary RNs. © The Author(s) 2014.

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

    Science.gov (United States)

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

    2017-02-01

    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. 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. 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. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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.

  8. An inexact risk management model for agricultural land-use planning under water shortage

    Science.gov (United States)

    Li, Wei; Feng, Changchun; Dai, Chao; Li, Yongping; Li, Chunhui; Liu, Ming

    2016-09-01

    Water resources availability has a significant impact on agricultural land-use planning, especially in a water shortage area such as North China. The random nature of available water resources and other uncertainties in an agricultural system present risk for land-use planning and may lead to undesirable decisions or potential economic loss. In this study, an inexact risk management model (IRM) was developed for supporting agricultural land-use planning and risk analysis under water shortage. The IRM model was formulated through incorporating a conditional value-at-risk (CVaR) constraint into an inexact two-stage stochastic programming (ITSP) framework, and could be used to control uncertainties expressed as not only probability distributions but also as discrete intervals. The measure of risk about the second-stage penalty cost was incorporated into the model so that the trade-off between system benefit and extreme expected loss could be analyzed. The developed model was applied to a case study in the Zhangweinan River Basin, a typical agricultural region facing serious water shortage in North China. Solutions of the IRM model showed that the obtained first-stage land-use target values could be used to reflect decision-makers' opinions on the long-term development plan. The confidence level α and maximum acceptable risk loss β could be used to reflect decisionmakers' preference towards system benefit and risk control. The results indicated that the IRM model was useful for reflecting the decision-makers' attitudes toward risk aversion and could help seek cost-effective agricultural land-use planning strategies under complex uncertainties.

  9. 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

  10. 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

  11. Immigration, labor shortages, & U.S. construction markets

    Science.gov (United States)

    Al Schuler

    2006-01-01

    As discussed in last month's column, according to Dr. Ira Wolfe, author of The Perfect Storm Fact Book, we are witnessing the beginning of a "perfect labor storm."" Globalization and demographic trends are colliding, and the result is a growing shortage of workers who possess the right skills to do the available jobs.

  12. 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 ...

  13. Perceptions of staff shortage as a predisposing factor for stress ...

    African Journals Online (AJOL)

    Perceptions of staff shortage as a predisposing factor for stress among professional orthopaedic nurses at a public hospital in Buffalo City Municipality, Eastern Cape ... Orthopaedic Unit managers should develop strategies to reduce stress in the workplace and promote coping skills for professional orthopaedic nurses.

  14. 76 FR 68770 - Product Shortage Report; Availability; Request for Comments

    Science.gov (United States)

    2011-11-07

    ... No: 2011-28723] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0690] Product Shortage Report; Availability; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice; request for comments. SUMMARY: The Food and Drug Administration (FDA) is...

  15. The Dilemma of Physician Shortage and International Recruitment in Canada

    Directory of Open Access Journals (Sweden)

    Nazrul Islam

    2014-06-01

    Full Text Available The perception of physician shortage in Canada is widespread. Absolute shortages and relative discrepancies, both specialty-wise and in urban-rural distribution, have been a daunting policy challenge. International Medical Graduates (IMGs have been at the core of mitigating this problem, especially as long as shortage of physicians in rural areas is concerned. Considering such recruitment as historical reality is naïve annotation, but when it is recommended per se, then the indication of interest overweighs the intent of ethically justified solution. Such a recommendation has not only invited policy debate and disagreement, but has also raised serious ethical concerns. Canadian healthcare policy-makers were put into a series of twisting puzzles—recruiting IMGs in mitigating physician shortage was questioned by lack of vision for Canada’s self-sufficiency. In-migration of IMGs was largely attributed to Canada’s point-based physician-friendly immigration system without much emphasizing on IMGs’ home countries’ unfavorable factors and ignoring their basic human rights and choice of livelihood. While policy-makers’ excellence in integrating the already-migrated IMGs into the Canadian healthcare is cautiously appraised, its logical consequence in passively drawing more IMGs is loudly criticised. Even the passive recruitment of IMGs raised the ethical concern of source countries’ (which are often developing countries with already-compromised healthcare system vulnerability. The current paper offers critical insights juxtaposing all these seemingly conflicting ideas and interests within the scope of national and transnational instruments.

  16. The dilemma of physician shortage and international recruitment in Canada.

    Science.gov (United States)

    Islam, Nazrul

    2014-06-01

    The perception of physician shortage in Canada is widespread. Absolute shortages and relative discrepancies, both specialty-wise and in urban-rural distribution, have been a daunting policy challenge. International Medical Graduates (IMGs) have been at the core of mitigating this problem, especially as long as shortage of physicians in rural areas is concerned. Considering such recruitment as historical reality is naïve annotation, but when it is recommended per se, then the indication of interest overweighs the intent of ethically justified solution. Such a recommendation has not only invited policy debate and disagreement, but has also raised serious ethical concerns. Canadian healthcare policy-makers were put into a series of twisting puzzles-recruiting IMGs in mitigating physician shortage was questioned by lack of vision for Canada's self-sufficiency. In-migration of IMGs was largely attributed to Canada's point-based physician-friendly immigration system without much emphasizing on IMGs' home countries' unfavorable factors and ignoring their basic human rights and choice of livelihood. While policy-makers' excellence in integrating the already-migrated IMGs into the Canadian healthcare is cautiously appraised, its logical consequence in passively drawing more IMGs is loudly criticised. Even the passive recruitment of IMGs raised the ethical concern of source countries' (which are often developing countries with already-compromised healthcare system) vulnerability. The current paper offers critical insights juxtaposing all these seemingly conflicting ideas and interests within the scope of national and transnational instruments.

  17. General surgery in crisis - the critical shortage | Kahn | South African ...

    African Journals Online (AJOL)

    ... 25 general surgeons per year. The changing demographics of medical students may be partly responsible for the decline in registrar applicants. Conclusion. The findings from this study have revealed that the shortage of general surgeons in the state sector has reached critical levels. South African Journal of Surgery Vol.

  18. Doctor shortages: Unpacking the 'Cuban solution' | Bateman | South ...

    African Journals Online (AJOL)

    South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 103, No 9 (2013) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Doctor shortages: Unpacking the 'Cuban solution'. C Bateman. Abstract.

  19. General surgery in crisis – the critical shortage

    African Journals Online (AJOL)

    and other medical specialists as well as other professionals, and to enhance the attractiveness of general surgery as a profession. There were four aspects to the study, including an assessment of the shortage of general surgeons, an assessment of the factors that impact on the choice of general surgery as a career option ...

  20. Addressing the Causes of Chef Shortages in the UK

    Science.gov (United States)

    Pratten, John; O'Leary, Barbara

    2007-01-01

    Purpose: To outline the reasons for staff shortages in the UK catering industry and then to decide if further training could help to address these issues. Design/methodology/approach: The objectives have been achieved by examining the training provisions at a college, and then asking the students, their training staff, employers and employees…

  1. Addressing the physicians' shortage in developing countries by accelerating and reforming the medical education: Is it possible?

    Science.gov (United States)

    Al-Shamsi, Mustafa

    2017-10-01

    Doctors' shortage has remained a concern worldwide. The developed countries started aids to recruit international medical graduates (IMG) to cope with the defects that the health care system suffers from; however, this solution may not work in developing countries that have a limited resource and poor budget to spend on the health care system. This study aims to present an alternative way to approach the physicians' shortage by accelerating undergraduate medical education and reform some post-graduate courses in order to cope with this problem. The literature in PubMed/Medline and Google scholar were searched using such keywords as undergraduate medical education, physician shortage, health care reform, physicians' performance, medical curriculum. The finding revealed that performance during undergraduate medical school does not have a relationship with the physician's performance post-graduation. Moreover, the overloaded curriculum and the years spent in undergraduate education have a negative impact on the students in terms of burn out, and lack of competency, and loss of motivation in medicine. The method of education was found to have a positive effect on preparing good students and ultimately good physicians. Since performance in undergraduate years does not have an impact on the practice post-graduation, the developing countries may consider the option of changing the context, and abbreviating undergraduate medical education as a solution for physicians' shortage dilemma. Moreover, modifying some post-graduate majors such as family physician, and general practitioner to allow the physicians enter the practice in areas of need is recommended.

  2. 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

  3. Resource Mobilization

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

    This practical guidebook supports and promotes new and creative thinking on resource mobilization for ... sources and come up with creative resource mobilization strategies to ensure survival. The Importance of ...... funds had already been earmarked for buying new classroom facilities. Maintain integrity of auction. 2.

  4. Anticipatory maternal effects in two different clones of Daphnia magna in response to food shortage

    Directory of Open Access Journals (Sweden)

    Valeria ROSSI

    2011-08-01

    Full Text Available The effects of food shortage on growth, fecundity, male production and offspring size and starvation tolerance in two different clones of Daphnia magna (Clone L and Clone P were evaluated by disentangling the effects of resource depletion and crowding per se. Three experimental conditions were tested: high food - low daphnid density (the optimum, low food - low daphnid density and high food - high daphnid density. In the two first conditions, daphnids experienced the same population density but they had different food availability. In the two latter conditions, daphnids had the same per capita, low, food availability but they lived at different algae and daphnid densities. Moreover, the response of crowded females to recovery at high food availability and low population density was evaluated. Low food availability reduced growth and fecundity of both clones and increased male production only in the Clone L. Crowding per se did not affect growth but reduced fecundity. In both clones, low food availability due to low algae density enhanced investment in offspring size and resistance to starvation. In response to food shortage either due to low algae density and to crowding, Clone P increased the investment in offspring size and starvation tolerance but reduced fecundity to a lesser extent than Clone L and did not produce males. Clone L, in response to food shortage due to crowding at high algae density, increased development time, produced more males, as at low algae density, but halved fecundity producing offspring that were not starvationtolerant. These results might reflect differences in anticipatory maternal effects between clones and suggest that neonate quality varies according to either, the environment the mother experienced and the competitive environment the neonates will cope due to their mother life strategy.

  5. 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.

  6. Skilled labour shortage : implications, recruitment and workforce planning

    Energy Technology Data Exchange (ETDEWEB)

    Charette, A. [Canadian Council of Human Resources Association, St. Catherines, ON (Canada)

    2004-07-01

    This presentation provides information on how a long-term recruitment strategy can affect the viability of the oil and gas industry, which is currently facing a shortage of skilled labour in Canada. The problem poses a threat to the competitiveness of the industry and the problem will likely worsen unless action is taken now to prevent a crisis in the near future. A survey of business owners in 2002 indicated that 186,000 of 265,000 jobs remained vacant for at least 4 months. As the aging workforce of baby boomers reaches retirement age, the labour shortage is likely to be more pronounced by 2010 to 2015. The consequences of changing labour demographics affect costs, attracting and retaining talented workers, productivity, culture, creativity and competitiveness. figs.

  7. Strategies for dealing with the national coding shortage.

    Science.gov (United States)

    Schwieters, Jill

    2010-04-01

    Steps providers should consider to deal with a national coding shortage and implementation of ICD-10 include the following: Concentrate on employee retention (consider retention bonuses; upgrade pay scales; and offer flex-time and flexible work schedules). Begin a training program for ICD-10. Target other healthcare professionals and current employees to transition into coding positions. Collaborate with colleges, high schools, and middle schools to draw prospective students to this career path and your organization.

  8. Skill Shortage versus Subject Choice, Case of Pakistan

    OpenAIRE

    Atiq, Atiq-ur-Rehman; Anis, Hafsa; Khan, Saud Ahmed

    2009-01-01

    Higher Education is believed to be a very important determinant of economic growth. The growth can be optimized with a suitable combination of skills in various subjects. A mismatch between required combination of skills and available combination of skills carries heavy costs for developing economies since import of skill from foreign is much more in expensive for such economies. We compare skill shortage in Pakistan with the subjects choice of students recently enrolled in institutes of high...

  9. The Critical Shortage of Military Chaplains: One Possible Solution

    Science.gov (United States)

    2008-01-01

    Chaplain (Colonel) Sanford Dresin (USA-Ret), Director of M ilitary Programs for the Aleph Institute for5 advice and guidance on preparing this article...Chassidic Rabbi as a SDF Chaplain (Tenenbaum, 2007). The decision was to contact the Aleph -Institute, a Lubavitch Chabad affiliated national 501(c)(3...missions ( Aleph Institute, n.d.): Providing critical social services to families in crisis The Critical Shortage of Military Chaplains: One Possible

  10. 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.

  11. Vulnerability assessment of climate-induced water shortage in Phoenix.

    Science.gov (United States)

    Gober, Patricia; Kirkwood, Craig W

    2010-12-14

    Global warming has profound consequences for the climate of the American Southwest and its overallocated water supplies. This paper uses simulation modeling and the principles of decision making under uncertainty to translate climate information into tools for vulnerability assessment and urban climate adaptation. A dynamic simulation model, WaterSim, is used to explore future water-shortage conditions in Phoenix. Results indicate that policy action will be needed to attain water sustainability in 2030, even without reductions in river flows caused by climate change. Challenging but feasible changes in lifestyle and slower rates of population growth would allow the region to avoid shortage conditions and achieve groundwater sustainability under all but the most dire climate scenarios. Changes in lifestyle involve more native desert landscaping and fewer pools in addition to slower growth and higher urban densities. There is not a single most likely or optimal future for Phoenix. Urban climate adaptation involves using science-based models to anticipate water shortage and manage climate risk.

  12. Medicine shortages in Fiji: A qualitative exploration of stakeholders’ views

    Science.gov (United States)

    Chaar, Betty B.; Vera, Numa; Pillai, Alvish S.; Lim, Jessy S.; Bero, Lisa; Moles, Rebekah J.

    2017-01-01

    Objectives Medicine access is a human right; yet, concerningly, there are international instances of shortages. Quantitative data has allowed WHO to propose global solutions; however, individualised understanding of specific regions is still required to work towards national solutions. Fiji has an established issue with medication supply and the aim of this study was to use qualitative methods to gain a fuller understanding of this context. Methods Semi-structured interviews were used to gain the perspective of key stakeholders involved in the Fijian medicine supply chain in regards to causes, impacts and possible solutions of medicine shortages. Thematic analysis was used to analyse the interview data. Results In total, 48 stakeholders participated and the information was synthesised into three main themes, causes, impacts and solutions and the sub-themes including; political, system and patient causes, adverse health effects on patients, professional dissatisfaction, monetary loss and loss of faith in the health system, workarounds, operation improvements, government intervention and education and training. Conclusions The situation in Fiji is not dissimilar to other instances of shortages around the world and hence international solutions like that proposed by WHO are feasible; however, they must be modified to be uniquely Fijian to work in this context. PMID:28582409

  13. Medicine shortages in Fiji: A qualitative exploration of stakeholders' views.

    Science.gov (United States)

    Walker, Josephine; Chaar, Betty B; Vera, Numa; Pillai, Alvish S; Lim, Jessy S; Bero, Lisa; Moles, Rebekah J

    2017-01-01

    Medicine access is a human right; yet, concerningly, there are international instances of shortages. Quantitative data has allowed WHO to propose global solutions; however, individualised understanding of specific regions is still required to work towards national solutions. Fiji has an established issue with medication supply and the aim of this study was to use qualitative methods to gain a fuller understanding of this context. Semi-structured interviews were used to gain the perspective of key stakeholders involved in the Fijian medicine supply chain in regards to causes, impacts and possible solutions of medicine shortages. Thematic analysis was used to analyse the interview data. In total, 48 stakeholders participated and the information was synthesised into three main themes, causes, impacts and solutions and the sub-themes including; political, system and patient causes, adverse health effects on patients, professional dissatisfaction, monetary loss and loss of faith in the health system, workarounds, operation improvements, government intervention and education and training. The situation in Fiji is not dissimilar to other instances of shortages around the world and hence international solutions like that proposed by WHO are feasible; however, they must be modified to be uniquely Fijian to work in this context.

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

    OpenAIRE

    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 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...

  15. Shortage of Peritoneal Dialysis Solution and the Food and Drug Administration's Response.

    Science.gov (United States)

    Jensen, Valerie; Throckmorton, Douglas C

    2015-08-07

    Although the number of new drug shortages has been lower in recent years than in the past, severe shortages have occurred that have affected large numbers of patients. A new law entitled the Food and Drug Administration Safety and Innovation Act was enacted in July of 2012, which requires companies to notify the Food and Drug Administration of anticipated shortages. This notification requirement has allowed the Food and Drug Administration to work closely with manufacturers earlier to mitigate and, often, prevent shortages. However, not all shortages are able to be prevented, and the shortage of peritoneal dialysis solution is one that has had a significant effect on patients. The Food and Drug Administration continues to use all available tools to address this shortage with manufacturers, including temporary availability of imported peritoneal dialysis solution from Ireland. Mitigating shortages is a top priority for the Food and Drug Administration, and communication with all stakeholders is essential. Copyright © 2015 by the American Society of Nephrology.

  16. Shortage of Peritoneal Dialysis Solution and the Food and Drug Administration’s Response

    Science.gov (United States)

    Throckmorton, Douglas C.

    2015-01-01

    Although the number of new drug shortages has been lower in recent years than in the past, severe shortages have occurred that have affected large numbers of patients. A new law entitled the Food and Drug Administration Safety and Innovation Act was enacted in July of 2012, which requires companies to notify the Food and Drug Administration of anticipated shortages. This notification requirement has allowed the Food and Drug Administration to work closely with manufacturers earlier to mitigate and, often, prevent shortages. However, not all shortages are able to be prevented, and the shortage of peritoneal dialysis solution is one that has had a significant effect on patients. The Food and Drug Administration continues to use all available tools to address this shortage with manufacturers, including temporary availability of imported peritoneal dialysis solution from Ireland. Mitigating shortages is a top priority for the Food and Drug Administration, and communication with all stakeholders is essential. PMID:25896999

  17. 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

    2018-01-11

    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 m3 of virtual water (10.81 bn m3 of blue virtual water) are used by wheat and maize production and 8.77 bn m3 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. It

  18. Toward a European definition for a drug shortage: a qualitative study.

    Science.gov (United States)

    De Weerdt, Elfi; Simoens, Steven; Casteels, Minne; Huys, Isabelle

    2015-01-01

    Drug shortages are currently on the rise. In-depth investigation of the problem is necessary, however, a variety of definitions for 'drug shortages' are formulated in legislations, by different organizations, authorities, and other initiatives. For international comparison, the underlying definition for drug shortages is important to allow appropriate interpretation of national databases and the results of scientific studies. The objective is to identify the different elements which should be considered in a uniform definition for drug shortages in the European Union (EU) and to detect the different conditions for reporting drug shortages. Definitions of drug shortages were searched in the scientific databases as well as in the gray literature. Similar topics were identified and organizations were contacted to formulate the reasoning underlying the definitions. Over 20 different definitions for drug shortages were identified. A distinction is made between general definitions of drug shortages and definitions used for the reporting of drug shortages. Differences and similarities are observed in the elements within the definitions, e.g., when does a supply problem become a drug shortage, permanent and/or temporally shortages, the typology and time frame of a drug shortage. The moment a supply problem is considered as a shortage, can be defined at four levels: (i) demand side, (ii) supply side, (iii) delivery of a drug, and (iv) availability of a drug. Permanent discontinuations of drugs are not always covered in definitions for drug shortages. Some definitions only consider those drugs used for the treatment of serious diseases or drugs for which no alternative is available. Different time frames were observed, varying between 1 day and 20 days. Obtaining a uniform definition for drug shortages is important as well as identifying which conditions are preferable to report drug shortages in order to facilitate international benchmarking. This paper can be used as a

  19. 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.

  20. Projected Supply, Demand, and Shortages of Registered Nurses, 2000-2020.

    Science.gov (United States)

    Health Resources and Services Administration (DHHS/PHS), Rockville, MD. National Center for Health Workforce Analysis.

    The supply, demand, and shortages of registered nurses (RNs) were projected and analyzed for 2000-2020. According to the analysis, the national supply of full-time-equivalent registered nurses in 2000 was estimated at 1.89 million versus an estimated demand of 2 million, leaving a shortage of 110,000 (6%). The shortage is expected to grow…

  1. Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States

    Science.gov (United States)

    Mehta, Brenna; Bookstaver, P. Brandon; Sims, LaVetra D.; Stevenson, Bill

    2015-01-01

    Background: Drug shortages have become all too common and affect all aspects of the health care delivery system. The increased number of drug shortages has had a negative impact on patient care as well as costly financial implications. Objectives: This article identifies the current problems and negative outcomes drug shortages have caused and provides a framework for how to best prepare for and combat future shortages. It highlights specific problems faced by health care system pharmacies in the Southeastern United States and the managerial responses to address these shortage situations. Methods: A 34-question, multiple-choice survey was distributed to pharmacy directors in North Carolina, South Carolina, Georgia, and Florida. Results: Of 549 surveys distributed, 219 (40%) responses were received. Respondents reported that drug shortages cause 1% to 5% error rates in hospitals and that 60% of the time drug shortages create unsafe conditions for patients and staff. Many of the respondents reported a 300% to 500% markup on medications on the shortage list. Seventy-six percent of institutions have autosubstitutions for drug shortages that have been preapproved by Pharmacy & Therapeutics Committees. Conclusions: The causes of drug shortages are multifaceted, and the safety and financial implications can be costly. In the short term, health care institutions can utilize pharmacists to assist in circumventing the drug shortage problem. The combined efforts of all health care professionals, the US government, manufacturers, and the lay public are necessary to bring awareness and plausible solutions to the drug shortage problems in the long term. PMID:26448658

  2. 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

  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. 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.

  5. 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.

  6. 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

  7. Skills shortage - identification of needs for engineering training in longwalls

    Energy Technology Data Exchange (ETDEWEB)

    Peter Lugg; Dewen Liu; Rebecca Hill [CRC Mining (Australia)

    2008-11-15

    This report investigates the impacts of the skills shortage on the productivity of longwall faces. The scope is limited to the supervisors and crews that operate, maintain and procure the longwall face equipment. Using a combination of face-to-face interviews and written questionnaires, the industry was canvassed about the impacts of the skills shortage, the current level of skilling and the competence of the workforce to perform its assigned tasks without supervision. The participants also identified the skillsets and levels of understanding required to allow them to work unsupervised, and the preferred delivery methods for training in the identified skills. An Industry Advisory Group was assembled to provide insight and advice to the research team with regards to the survey process and the interpretation of results. The survey data was drawn from face to face interviews from four mines and questionnaires completed by sixteen mines in Queensland and New South Wales. The data is analysed and the results presented along with conclusions and recommendations for future training.

  8. 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.

  9. Mother and newborn survival according to point of entry and type of human resources in a maternal referral system in Kayes (Mali

    Directory of Open Access Journals (Sweden)

    Zunzunegui Maria-Victoria

    2011-05-01

    Full Text Available Abstract Background Since 2001, a referral system has been operating in Kayes (Mali to reduce maternal and perinatal deaths. Normal deliveries are managed in community health centers (CHC. Complicated cases are referred to a district health center (DHC or the regional hospital (RH. Women with obstetric emergencies can directly access the DHC and the RH. Objective To assess, in women presenting with an obstetric complication: 1 the effects of the point of entry into the referral system on joint mother-newborn survival; and 2 the effects of the configuration of healthcare team at the CHCs on joint mother-newborn survival. Method Cross-sectional study of 7,214 women users of the referral system in the region of Kayes in 2006-2009. Bivariate probit equations were fitted to estimate joint mother-newborn survival. The marginal effects of the point of entry into the referral system and of the configuration of the healthcare team at the CHCs were evaluated with a probit bivariate regression. Results Entering the referral system at the RH was associated with the best joint mother-newborn survival; the most qualified the CHCs team was, the best was mother-newborn survival. Distance traveled interacts with the point of entry and the configuration of the CHCs team. For women coming from far (over 50 km, going directly to the RH increased the probability of joint mother-newborn survival by 11.90% (p Conclusion Mother-newborn survival in the Kayes maternal referral system is influenced by combined effects of the point of care, the skill configuration of CHC personnel and distance traveled.

  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

    2016-02-01

    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. Feed resources and livestock production situation in the highland ...

    African Journals Online (AJOL)

    Feed shortage, health problem, poor genetic potential, labour and water shortage were listed as major constraints for livestock production. Natural pasture, cop residues, stubble grazing were listed as major feed resources, with minimal contribution of improved forages and local beverage by products (Diqi or atela).

  12. Water shortage and needs for wastewater re-use in the north China.

    Science.gov (United States)

    Wang, X C; Jin, P K

    2006-01-01

    This paper analyses the present condition of the water shortage in north China where annual rainfall is low and per capita water resource is below the line of regular water stress, or even the line of absolute water scarcity. Of the available water resources, the percentge of water withdrawal in all the north basins is high--the Yellow River and Huai River basins being greater than 80% and the Hai River basin mainly depending on interbasin water transfer. Over-withdrawal of water also results in serious water environmental problems including "flow cut-off" of the Yellow River main channel and water pollution of many rivers. The paper also analyses the potential of wastewater as a resource and the demand for treated wastewater re-use. In north China, due to low rainfall and high potential evaporation environmental re-use, gardening, afforestation, etc. is considered as the main usage of the treated wastewater. Considering the economic restrictions in the less developed area, a decentralised system can be taken as an important option in formulating water re-use strategies.

  13. Chronic food shortage and seasonal modulations of daily torpor and locomotor activity in the grey mouse lemur (Microcebus murinus).

    Science.gov (United States)

    Giroud, Sylvain; Blanc, Stéphane; Aujard, Fabienne; Bertrand, Frédéric; Gilbert, Caroline; Perret, Martine

    2008-06-01

    The extent to which seasonal plasticity in torpor displayed by one of the smallest Malagasy primates (Microcebus murinus) will help survival in the context of ongoing global change-induced chronic food shortage, is unknown. Body temperature (Tb) and locomotor activity were measured by telemetry in short- (SD, winter-acclimated) and long-days (LD, summer-acclimated) males (n = 24) during an experimental 35-day calorie restriction of 40 or 80%. Under SD exposure, regardless of calorie restriction intensity, mouse lemurs immediately increased torpor depth and duration by 4.6-fold, and showed greater phase-advanced entry into torpor (2.4-fold). Tb adjustments were efficient under 40% calorie restriction to maintain body mass, whereas they did not prevent a 0.71 +/- 0.11 g/day mass loss during 80% calorie restriction. The 40% food-deprived LD animals combined an early shallow deepening of torpor (1 degrees C) and a late 18% decrease in locomotor activity, resulting in a moderate 6% mass loss. After 15 days of 80% calorie restriction, LD animals exhibited a SD phenotype by increasing their torpor duration and phase-advancing the entry of torpor (16 min/day). Those adjustments had no impact on mass loss (0.93 +/- 0.07 g/day) as locomotor activity increased four-fold. Daily torpor allows M. murinus to face moderate food shortage whatever the photoperiod but poorly mitigates energy imbalance during severe food deprivation, especially under LD exposure. Although the behavioral thermoregulation role warrants further investigation in energy savings, M. murinus survival would be impaired during long-term food shortage in summer.

  14. 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 introduction 6.2% vs. 13.6%, P < 0.0001). After introducing the system, probability of multiple casualties increased. Thus the system may contribute to 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

  15. Addressing the physicians’ shortage in developing countries by accelerating and reforming the medical education: Is it possible?

    Directory of Open Access Journals (Sweden)

    MUSTAFA AL-SHAMSI

    2017-10-01

    Full Text Available Introduction: Doctors’ shortage has remained a concern worldwide. The developed countries started aids to recruit international medical graduates (IMG to cope with the defects that the health care system suffers from; however, this solution may not work in developing countries that have a limited resource and poor budget to spend on the health care system. This study aims to present an alternative way to approach the physicians’ shortage by accelerating undergraduate medical education and reform some post-graduate courses in order to cope with this problem. Methods: The literature in PubMed/Medline and Google scholar were searched using such keywords as undergraduate medical education, physician shortage, health care reform, physicians’ performance, medical curriculum. Results: The finding revealed that performance during undergraduate medical school does not have a relationship with the physician’s performance post-graduation. Moreover, the overloaded curriculum and the years spent in undergraduate education have a negative impact on the students in terms of burn out, lack of competency, and loss of motivation in medicine. The method of education was found to have a positive effect on preparing good students and ultimately good physicians. Conclusion: Since performance in undergraduate years does not have an impact on the practice post-graduation, the developing countries may consider the option of changing the context, and abbreviating undergraduate medical education as a solution for physicians’ shortage dilemma. Moreover, modifying some postgraduate majors such as family physician, and general practitioner to allow the physicians enter the practice in areas of need is recommended.

  16. 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.

  17. 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.

  18. An analysis of the pediatric vaccine supply shortage problem.

    Science.gov (United States)

    Jacobson, Sheldon H; Sewell, Edward C; Proano, Ruben A

    2006-11-01

    In 2002, several factors resulted in pediatric vaccine manufacturers not being able to produce a sufficient number of vaccines to vaccinate all the children in the United States according to the Recommended Childhood Immunization Schedule. The resulting vaccine supply shortage resulted in thousands of children not being fully immunized according to this schedule, and hence, created an unnecessary risk for epidemic outbreaks of several childhood diseases. The Centers for Disease Control and Prevention responded to this crisis by using pediatric vaccine stockpiles to mitigate the impact of future shortages. This paper presents a stochastic model that captures the vaccine supply during production interruptions. This model is used to assess the impact of pediatric vaccine stockpile levels on vaccination coverage rates, by considering the probability that all children can be immunized according to the Recommended Childhood Immunization Schedule over a given time period and the expected minimum vaccine supply. The model is also used to assess the proposed pediatric vaccine stockpile levels recommended by the United States Department of Health and Human Services. The results of this analysis suggest that the proposed vaccine stockpile levels are adequate to meet future vaccine production interruptions, provided that such production interruptions do not last more than six months (which is not surprising, given that is the time period for which they were designed). However, given that recent vaccine production interruptions have lasted (on average) for over one year, the proposed vaccine stockpile levels are insufficient to meet the nation's pediatric immunization needs during such time periods, which in turn could lead to localized and/or widespread disease outbreaks. Moreover, a moderate investment in higher vaccine stockpile levels would lead to a significantly reduced risk of such events.

  19. 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.

  20. 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.

  1. Improving human resource capacity for road network preservation

    CSIR Research Space (South Africa)

    Nxumalo, M

    2010-10-01

    Full Text Available There is compelling evidence that a significant factor contributing to the poor condition of much of Africa's rural road network is inadequate human resource capacity. This shortage of professional skills in road engineering inhibits proper...

  2. The importance of a relative shortage of food in animal ecology.

    Science.gov (United States)

    White, T C R

    1978-01-01

    It is proposed that for many if not most animals - both herbivore and carnivore, vertebrate and invertebrate - the single most important factor limiting their abundance is a relative shortage of nitrogenous food for the very young. Any component of the environment of a plant, by varying the amount of adequately nutritious plant tissue available to herbivores, may consequently affect the abundance of food through all subsequent trophic levels; in this regard weather may be important more often than is immediately obvious.The hypothesis proposes that animals live in a variably inadequate environment wherein many are born but few survive, and leads to a concept of populations being "limited from below" rather than "controlled from above". And it may lead to a reappraisal of the role of predation, competition and social and territorial behaviour as factors likely to influence the numbers of animals in the environment, the response of "pests" to manipulation of populations of their food plants by Man, and the likely effectiveness of agents of biological control.

  3. 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.

  4. 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.

  5. Resolving photon-shortage mystery in femtosecond magnetism.

    Science.gov (United States)

    Si, M S; Zhang, G P

    2010-02-24

    For nearly a decade, it has been a mystery why the small average number of photons absorbed per atom from an ultrashort laser pulse is able to induce a strong magnetization within a few hundred femtoseconds. Here we resolve this mystery by directly computing the number of photons per atom layer by layer as the light wave propagates inside the sample. We find that for all the 24 experiments considered here, each atom has more than one photon. The so-called photon shortage does not exist. By plotting the relative demagnetization change versus the number of photons absorbed per atom, we show that, depending on the experimental condition, 0.1 photon can induce about 4%-72% spin moment change. Our perturbation theory reveals that the demagnetization depends linearly on the amplitude of the laser field. In addition, we find that the transition frequency of a sample may also play a role in magnetization processes. As long as the intensity is not zero, the intensity of the laser field only affects the matching range of the transition frequencies, but not whether the demagnetization can happen or not.

  6. 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.

  7. 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.

  8. Tackling Nurse Shortages in OECD Countries. OECD Health Working Papers, No. 19

    Science.gov (United States)

    Simoens, Steven; Villeneuve, Mike; Hurst, Jeremy

    2005-01-01

    There are reports of current nurse shortages in all but a few OECD countries. With further increases in demand for nurses expected and nurse workforce ageing predicted to reduce the supply of nurses, shortages are likely to persist or even increase in the future, unless action is taken to increase flows into and reduce flows out of the workforce…

  9. 78 FR 75959 - Agency Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2013-12-13

    ... AFFAIRS Agency Information Collection (Regulation on Reduction of Nursing Shortages in State Homes....'' SUPPLEMENTARY INFORMATION: Title: Regulation on Reduction of Nursing Shortages in State Homes; Application for... determine State homes eligibility and the appropriate amount of funding. An agency may not conduct or...

  10. 78 FR 55778 - Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2013-09-11

    ... AFFAIRS Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes... agencies must obtain approval from OMB for each collection of information they conduct or sponsor. This...: Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and...

  11. 75 FR 45207 - Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2010-08-02

    ... AFFAIRS Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes... obtain approval from OMB for each collection of information they conduct or sponsor. This request for...: Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and...

  12. 75 FR 62185 - Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...

    Science.gov (United States)

    2010-10-07

    ... AFFAIRS Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes...: Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and... conduct or sponsor, and a person is not required to respond to a collection of information unless it...

  13. Zinc deficiency in a parenteral nutrition-dependent patient during a parenteral trace element product shortage.

    Science.gov (United States)

    Franck, Andrew J

    2014-07-01

    Parenteral nutrition product shortages are common and place vulnerable patients at risk for nutrient deficiencies. This case report describes a parenteral nutrition-dependent patient who was found to have zinc deficiency during a parenteral nutrition product shortage. The management of the patient's zinc deficiency is described. © 2014 American Society for Parenteral and Enteral Nutrition.

  14. 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…

  15. 76 FR 68198 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2011-11-03

    ... Administration Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage... designated as primary medical care, mental health, and dental health professional shortage areas (HPSAs) as... seven health professional types (primary medical care, dental, psychiatric, vision care, podiatric...

  16. 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…

  17. Three-year breeding cycle of rainbow trout (Oncorhynchus mykiss) fed a plant-based diet, totally free of marine resources: consequences for reproduction, fatty acid composition and progeny survival.

    Science.gov (United States)

    Lazzarotto, Viviana; Corraze, Geneviève; Leprevost, Amandine; Quillet, Edwige; Dupont-Nivet, Mathilde; Médale, Françoise

    2015-01-01

    Terrestrial plant resources are increasingly used as substitutes for fish meal and fish oil in fish feed in order to reduce the reliance of aquaculture on marine fishery resources. Although many studies have been conducted to assess the effects of such nutritional transition, no whole breeding cycles of fish fed diets free from marine resources has been reported to date. We therefore studied the reproductive performance of trout after a complete cycle of breeding while consuming a diet totally devoid of marine ingredients and thus of n-3 long chain polyunsaturated fatty acids (n-3 LC-PUFAs) that play a major role in the formation of ova. Two groups of female rainbow trout were fed from first feeding either a commercial diet (C, marine and plant ingredients), or a 100% plant-based diet (V, blend of plant proteins and vegetable oils). Livers, viscera, carcasses and ova were sampled at spawning and analyzed for lipids and fatty acids. Although the V-diet was devoid of n-3 LC-PUFAs, significant amounts of EPA and DHA were found in livers and ova, demonstrating efficient bioconversion of linolenic acid and selective orientation towards the ova. Some ova were fertilized to assess the reproductive performance and offspring survival. We observed for the first time that trout fed a 100% plant-based diet over a 3-year breeding cycle were able to produce ova and viable alevins, although the ova were smaller. The survival of offspring from V-fed females was lower (-22%) at first spawning, but not at the second. Our study showed that, in addition to being able to grow on a plant-based diet, rainbow trout reared entirely on such a diet can successfully produce ova in which neo-synthesized n-3 LC-PUFAs are accumulated, leading to viable offspring. However, further adjustment of the feed formula is still needed to optimize reproductive performance.

  18. 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

  19. Impact of Injectable Furosemide Hospital Shortage on Congestive Heart Failure Outcomes: A Time Series Analysis.

    Science.gov (United States)

    Tan, Vivian S; Nash, Danielle M; McArthur, Eric; Jain, Arsh K; Garg, Amit X; Juurlink, David N; Weir, Matthew A

    2017-11-01

    Beginning in February 2012, there was a shortage of injectable furosemide in the province of Ontario, Canada. The objective of this study was to assess the effects of the furosemide shortage on heart failure outcomes in Ontario, Canada. We determined which hospitals experienced a shortage of injectable furosemide using an online survey. We then used health administrative data to identify all patients who presented to those hospitals with congestive heart failure. Using 40 months of data from before the shortage, we determined the proportion of patients with heart failure expected to die each month. We then used time series analysis to forecast the 30-day mortality rate during the shortage period and compared it with the observed rate. Secondary outcomes included length of hospital stay, transfer to an intensive care unit, mechanical ventilation during the hospital stay, and risk of 30-day readmission for heart failure. Survey results were obtained for 82% of hospitals, 28 of which experienced a severe shortage of injectable furosemide in the year 2012. The 30-day mortality among patients presenting to these hospitals with congestive heart failure before the shortage period was 11.2%. We forecasted a mortality rate of 11.3% (95% confidence interval, 8.2-14.4) for the shortage period, which was not significantly different from the observed rate of 10.9%. Similarly, we found no significant effect of the shortage on secondary outcomes. A severe shortage of injectable furosemide did not increase the risk of adverse outcomes among patients who presented to the hospital with congestive heart failure. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  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. 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.

  2. Addressing the Primary Care Shortage on a Shoestring: A Successful Track in an Internal Medicine Residency.

    Science.gov (United States)

    Brislen, Heather; Dunn, Angela; Parada, Alisha; Rendon, Patrick

    2016-02-01

    Nationally, shortages of primary care providers are of major concern. Internal medicine programs, once the major supplier of primary care physicians, are no longer producing large numbers of primary care providers to help meet the needs of the growing patient population. In 2009, residents at the University of New Mexico created a resident-driven Primary Care Track (PCT) within the internal medicine residency, and after six years this track is thriving. The PCT allows residents to designate blocks of time specifically devoted to primary care training. Residents opt in to the track at the end of intern year and arrange their own schedules over large blocks of time in the last two years of training to allow for an individualized curriculum that prepares them for independent practice in primary care. Approximately 85% (11/13) of residents who have graduated from the track have gone on to practice in primary care after graduation, and the internal medicine residency program as a whole has also seen an increase in the fraction of residents pursuing primary care since the inception of this track. The PCT is currently at maximum capacity and may be forced to turn away applicants. To expand while still maintaining the core principles of the track, the PCT will strive to find additional ways to use New Mexico's existing resources and to develop a more robust mentoring structure and didactic programs. Formalized financial, faculty, and administrative support of the program also will be needed.

  3. 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.

  4. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution

    Directory of Open Access Journals (Sweden)

    RajaChowdhury Ahmed

    2011-01-01

    Full Text Available Abstract Background Bangladesh is identified as one of the countries with severe health worker shortages. However, there is a lack of comprehensive data on human resources for health (HRH in the formal and informal sectors in Bangladesh. This data is essential for developing an HRH policy and plan to meet the changing health needs of the population. This paper attempts to fill in this knowledge gap by using data from a nationally representative sample survey conducted in 2007. Methods The study population in this survey comprised all types of currently active health care providers (HCPs in the formal and informal sectors. The survey used 60 unions/wards from both rural and urban areas (with a comparable average population of approximately 25 000 which were proportionally allocated based on a 'Probability Proportion to Size' sampling technique for the six divisions and distribution areas. A simple free listing was done to make an inventory of the practicing HCPs in each of the sampled areas and cross-checking with community was done for confirmation and to avoid duplication. This exercise yielded the required list of different HCPs by union/ward. Results HCP density was measured per 10 000 population. There were approximately five physicians and two nurses per 10 000, the ratio of nurse to physician being only 0.4. Substantial variation among different divisions was found, with gross imbalance in distribution favouring the urban areas. There were around 12 unqualified village doctors and 11 salespeople at drug retail outlets per 10 000, the latter being uniformly spread across the country. Also, there were twice as many community health workers (CHWs from the non-governmental sector than the government sector and an overwhelming number of traditional birth attendants. The village doctors (predominantly males and the CHWs (predominantly females were mainly concentrated in the rural areas, while the paraprofessionals were concentrated in the urban

  5. The health workforce crisis in Bangladesh: shortage, inappropriate skill-mix and inequitable distribution.

    Science.gov (United States)

    Ahmed, Syed Masud; Hossain, Md Awlad; Rajachowdhury, Ahmed Mushtaque; Bhuiya, Abbas Uddin

    2011-01-22

    Bangladesh is identified as one of the countries with severe health worker shortages. However, there is a lack of comprehensive data on human resources for health (HRH) in the formal and informal sectors in Bangladesh. This data is essential for developing an HRH policy and plan to meet the changing health needs of the population. This paper attempts to fill in this knowledge gap by using data from a nationally representative sample survey conducted in 2007. The study population in this survey comprised all types of currently active health care providers (HCPs) in the formal and informal sectors. The survey used 60 unions/wards from both rural and urban areas (with a comparable average population of approximately 25 000) which were proportionally allocated based on a 'Probability Proportion to Size' sampling technique for the six divisions and distribution areas. A simple free listing was done to make an inventory of the practicing HCPs in each of the sampled areas and cross-checking with community was done for confirmation and to avoid duplication. This exercise yielded the required list of different HCPs by union/ward. HCP density was measured per 10 000 population. There were approximately five physicians and two nurses per 10 000, the ratio of nurse to physician being only 0.4. Substantial variation among different divisions was found, with gross imbalance in distribution favouring the urban areas. There were around 12 unqualified village doctors and 11 salespeople at drug retail outlets per 10 000, the latter being uniformly spread across the country. Also, there were twice as many community health workers (CHWs) from the non-governmental sector than the government sector and an overwhelming number of traditional birth attendants. The village doctors (predominantly males) and the CHWs (predominantly females) were mainly concentrated in the rural areas, while the paraprofessionals were concentrated in the urban areas. Other data revealed the number of faith

  6. Disparities of Trastuzumab Use in Resource-Limited or Resource-Abundant Regions and Its Survival Benefit on HER2 Positive Breast Cancer: A Real-World Study from China.

    Science.gov (United States)

    Li, Jianbin; Wang, Shusen; Wang, Yongsheng; Wang, Xiaojia; Wang, Haibo; Feng, Jifeng; Zhang, Qingyuan; Sun, Tao; Ouyang, Quchang; Yin, Yongmei; Liu, Yinhua; Geng, Cuizhi; Yan, Min; Jiang, Zefei

    2017-11-01

    Trastuzumab is a key component of therapy for human epidermal growth receptor 2 (HER2) positive breast cancer. Because real-world data are lacking, the present research was conducted to evaluate the actual use of and the effectiveness of trastuzumab in the real world in China. Inpatients with HER2 positive invasive breast cancer from 13 hospitals in Eastern China (2010-2015, n = 1,139) were included in this study. We aimed to assess the actual use of trastuzumab and to evaluate potential efficacy from trastuzumab in real-world research. Of 1,017 patients with early stage breast cancer (EBC), 40.5% (412/1,017) received trastuzumab therapy. Patients with EBC in resource-abundant regions (gross domestic product per capita >$15,000 and trastuzumab included in Medicare) are more likely to receive trastuzumab than those in resource-limited regions (37.3% vs. 13.0%, p world research could help to optimize HER2 therapy after metastasis, especially in regions with limited access to these expensive targeted drugs. © AlphaMed Press 2017.

  7. The new regulatory tools of the 2016 Health Law to fight drug shortages in France.

    Science.gov (United States)

    Bocquet, François; Degrassat-Théas, Albane; Peigné, Jérôme; Paubel, Pascal

    2017-05-01

    Drug shortages are becoming worrying for public health in the European Union. The French public authorities first took action against the causes of drug shortages in 2011 with a law, followed by a decree in 2012 to overcome the dysfunctions of the pharmaceutical distribution channel. These texts would establish emergency call centres implemented by pharmaceutical companies for pharmacists and for wholesalers to inform of shortages, and would oblige pharmaceutical companies to inform health authorities of any risk of potential shortage situation; they would also reinforce the declaration regime of the territory served by wholesalers. Through the Health Law of January 2016, France acquired new regulatory tools in order to fight against these shortages and wanted to target the drugs for which they are the most detrimental: the major therapeutic interest (MTI) drugs. Furthermore, this new text reinforces the legal obligations of pharmaceutical companies and of wholesalers for drug shortages and sets out the enforcement of sanctions in case of breach of these obligations. France's goal is ambitious: to implement coercive measures aiming at making the actors of the drug distribution channel aware of their responsibilities in order to take up the public health challenge triggered by drug shortages. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Caijun Yang

    Full Text Available 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.

  10. 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.

  11. Shortage of faculty in medical schools in Tanzania

    African Journals Online (AJOL)

    2 Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania. 3 Department of Internal Medicine, Catholic University of Health and Allied ... resource-intensive nature of small group bedside or practical teaching. Determining the optimal number of teaching faculty in a ...

  12. Early origins of longevity: prenatal exposures to food shortage among early Utah pioneers.

    Science.gov (United States)

    Hanson, H A; Smith, K R

    2013-04-01

    Undernutrition during critical or sensitive prenatal periods may 'program' the fetus for increased chronic disease and mortality in later life. Using birth cohorts that were or were not exposed to severe food shortage in Utah in the mid-19th century, this study examines how in utero exposure to undernutrition is associated with mortality after age 50. The Utah Population Database is used to identify 1392 prenatally exposed individuals and 29,022 individuals from subsequent, unexposed birth cohorts. Gompertz hazards with parametric frailty show that males born between April and June of the famine period (and hence exposed during critical periods in utero during the winter months) have higher mortality risks compared with post-famine cohorts. Alternative Cox non-proportional hazard models suggest that females born during the same period have higher initial mortality risks (starting at age 50) that decline over time creating a mortality crossover with unexposed women at approximately age 70, a result not found for men. An ancillary sibling analysis that uses shared frailty survival models to compare individuals with prenatal exposure to undernutrition to their younger (post-famine) same-sex siblings finds no significant differences in adult mortality for males but the pattern for females support the findings from the previous analysis. Although findings are sensitive to model choice, this study presents evidence that is consistent with an association between undernutrition in utero and adult mortality, shows that effects may be sensitive to the duration and gestational period of exposure, and illustrates the differential exposure effects between genders.

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

    Science.gov (United States)

    Chattopadhyay, Manojit; Mitra, Subrata Kumar

    2018-01-01

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

  14. 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.

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

    Science.gov (United States)

    Chattopadhyay, Manojit; Mitra, Subrata Kumar

    2016-11-01

    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.

  16. Immigration and the tech industry: As a labour shortage remedy, for innovation, or for cost savings?

    National Research Council Canada - National Science Library

    Norman Matloff

    2013-01-01

      The two main reasons cited by the U.S. tech industry for hiring foreign workers- remedying labour shortages and hiring "the best and the brightest"-are investigated, using data on wages, patents...

  17. 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.

  18. Energy-allocation in avian nestlings facing short-term food shortage

    OpenAIRE

    Moe, Børge

    2004-01-01

    This thesis investigates effects of short-term food shortage on growth, body composition and metabolic development of Pekin ducklings (Anas platyrhynchos domesticus) and European shag nestlings (Phalacrocorax aristotelis), two species representing extremes within the altricial-precocial spectrum. The aims of the thesis were to 1) characterise patterns of growth and development in response to short-term food shortage during early development, 2) examine aspects of energy allocation during thes...

  19. Access to influenza vaccine in East Harlem and the Bronx during a national vaccine shortage.

    Science.gov (United States)

    Ompad, Danielle C; Galea, Sandro; Blaney, Shannon; Coady, Micaela H; Sisco, Sarah; Glidden, Kathryn; Vlahov, David

    2007-06-01

    In October 2004, one of the major producers of the U.S. influenza vaccine supply announced that their vaccine would not be available because of production problems, resulting in approximately half of the anticipated supply suddenly becoming unavailable. This study was part of a larger effort using community-based participatory research (CBPR) principles to distribute influenza vaccine to hard-to-reach populations. Given the extant literature suggesting economic and racial disparities in influenza vaccine access in times of adequate supply and our inability to distribute vaccine due to the shortage, we sought to examine vaccine access as well as awareness of the vaccine shortage and its impact on health-seeking behaviors in eight racially-diverse and economically-disadvantaged neighborhoods in New York City (NYC) during the shortage. In our study few people had been vaccinated, both among the general community and among high risk groups; vaccination rates for adults in priority groups and non-priority groups were 21.0% and 3.5%. Awareness of the 2004 vaccine shortage was widespread with over 90% being aware of the shortage. While most attributed the shortage to production problems, almost 20% said that it was due to the government not wanting to make the vaccine available. Many respondents said they would be more likely to seek vaccination during the current and subsequent influenza seasons because of the shortage. The target neighborhoods were significantly affected by the national influenza vaccine shortage. This study highlights the challenges of meeting the preventive health care needs of hard-to-reach populations in times of public health crisis.

  20. Pediatric nurse educator shortage: implications for the nursing care of children.

    Science.gov (United States)

    Leonard, Barbara J; Fulkerson, Jayne A; Rose, Diane; Christy, Andrea

    2008-01-01

    Maternal and child health (MCH) nurses are vital to caring for the nation's infants, children, and adolescents. A shortage of pediatric nursing educators has important consequences for the preparation of the next generation of MCH nurses. A Web-based survey of administrators and pediatric nursing faculty from U.S. schools of nursing with baccalaureate and advanced degree programs was conducted to assess perceptions of a pediatric nursing faculty shortage, and implications and solutions to such a shortage. Deans (n = 191) and pediatric faculty (n = 237) from schools of nursing responded to the survey. Institutions are representative of the 660 schools of nursing across the United States. Fifty percent of deans and 70% of pediatric nursing faculty members reported a shortage of pediatric nursing faculty. Large, public institutions (total school student enrollment over 15,000) expressed the most concern. The educational impact of the reported shortage included increased faculty workload, difficulty getting appropriate clinical practice settings, elimination of acute care clinical experiences, and reduction in pediatric content in curricula. Expected retirements of the current workforce (76% were over 45 years of age) without an increase in replacements will deepen the shortage in the coming decade. Pediatric faculty members focused on the need for competitive salaries (particularly compared to clinical salaries) and active mentoring programs as important factors in recruitment and retention of new faculty. Recommendations for stemming the decline in availability of pediatric nursing faculty are provided.

  1. 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

  2. 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

  3. Modeling the national pediatric vaccine stockpile: supply shortages, health impacts and cost consequences.

    Science.gov (United States)

    Shrestha, Sundar S; Wallace, Gregory S; Meltzer, Martin I

    2010-08-31

    Pediatric vaccine stockpiles have been in place in the U.S. since 1983 to address the potential disruption in supply of routine pediatric vaccines. Increases in the number of vaccines recommended for pediatric and adolescent patients have increased the cost of stocking and maintaining the stockpile. Based on a spreadsheet-based model (VacStockpile) we developed, we estimated potential supply shortages of 14 stockpiled vaccines as of August 1, 2008 and its health and financial impacts under various shortage and stockpile scenarios. To illustrate the implications of policy options, we compared "high" to "low" stockpile scenarios. The high stockpile scenario ensures a 6-month vaccine supply to vaccinate all children according to recommended schedules. The low scenario comprised of 50% of the high scenario or existing stocks, whichever is smaller. For each vaccine, we used a weighted average of five shortage scenarios ranging from 0% to 100%, in 25% increments. Demand for each vaccine was based on current distribution or birth cohort size. The probabilities of shortages were based on number of manufacturers, market stability, history of manufacturing problems, and production complexity. CDC contract prices were used to estimate costs. Expert opinion and literature provided estimates of health impacts due to shortages. Applying the probabilities of shortages to all vaccines in a single year, the "low" scenario could cost $600 million, with 376,000 vaccine-preventable cases occurring and 1774 deaths. The "high" scenario could cost $2 billion, with an additional $1.6 billion initial stocking, and result in 7100 vaccine-preventable cases occurring and 508 deaths. Based on the assumptions in the model, there is the potential for large differences in outcomes between the scenarios although some outcomes could potentially be averted with measures such as catch-up campaigns after shortages. Using the VacStockpile policy makers can readily evaluate the implications of

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

    Science.gov (United States)

    Scheffler, Richard M; Liu, Jenny X; Kinfu, Yohannes; Dal Poz, Mario R

    2008-07-01

    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. 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. 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. 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.

  5. 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.

  6. Modelling survival

    DEFF Research Database (Denmark)

    Ashauer, Roman; Albert, Carlo; Augustine, Starrlight

    2016-01-01

    well GUTS, calibrated with short-term survival data of Gammarus pulex exposed to four pesticides, can forecast effects of longer-term pulsed exposures. Thirdly, we tested the ability of GUTS to estimate 14-day median effect concentrations of malathion for a range of species and use these estimates...

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

    Directory of Open Access Journals (Sweden)

    Yazed Sulaiman Al-Ruthia

    2017-07-01

    Full Text Available 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.

  8. 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.

  9. Does food shortage delay development of homeothermy in European shag nestlings (Phalacrocorax aristotelis)?

    Science.gov (United States)

    Moe, B; Brunvoll, S; Mork, D; Brobakk, T E; Bech, C

    2005-01-01

    Nestlings seem to face a trade-off between reducing the basal level of energy metabolism, as an energy-saving response, and maintaining thermogenic capacity during temporal food shortage. In the present study we examined developmental responses to short-term diet restriction of 12-16 day old nestling European shags kept under laboratory conditions and tested whether temporal food shortage delay the development of homeothermy. During food shortage the European shag nestlings substantially reduced basal level of energy metabolism, resulting in significant energy savings. The reduction in basal level of energy metabolism corresponded with a reduction in peak metabolic rate. At the same time, the low peak metabolic rate of diet-restricted nestlings was offset by a lower mass-specific minimal thermal conductance, and an increased mass-specific absolute scope. Consequently, the insulation and the portion of peak metabolic rate available for regulatory thermogenesis seemed to develop normally, as expected from age, during the period of food shortage. Further, the degree of homeothermy, measured as the index of homeothermy, was not significantly lower in diet-restricted nestlings compared to controls at the same age. We conclude that temporal food shortage did not significantly delay the development of homeothermy in the European shag nestlings despite substantial reductions in basal level of energy metabolism and peak metabolic rate.

  10. Local health department responses during the 2004-2005 influenza vaccine shortage.

    Science.gov (United States)

    Ransom, James; Bashir, Zarnaaz; Phillips, Cynthia

    2007-08-01

    During the 2004-2005 influenza vaccine shortage, the Centers for Disease Control and Prevention (CDC) coordinated distribution of post-October 5th 2004 doses of influenza vaccine to state and local health departments (LHDs), who subsequently distributed vaccine to community providers. The National Association of County and City Health Officials (NACCHO) conducted three Web-based surveys throughout the 2004-2005 influenza season to assess in real-time how LHDs were 1) dealing with the vaccine shortage, 2) implementing the interim recommendations from the Advisory Committee on Immunization Practices (ACIP), and 3) making efforts to reallocate and redistribute doses of influenza vaccine toward high-priority populations within their communities. This paper highlights LHD responses that alleviated adverse impacts during this public health emergency. The first survey asked LHDs to quantify their community's vaccine supply; the second survey asked them to describe their specific responses to the crisis; and the third survey asked them to reflect and evaluate the effectiveness of their efforts to vaccinate high-priority groups during the crisis. Six hundred five (605) of 717 (84%) LHDs in 44 states responded to the three surveys. Results show that LHDs leveraged preparedness plans, formed strategic community partnerships, and practiced vaccination drills to address the problems of vaccinating high-priority and hard-to-reach populations that arose out of the vaccine shortage. The practices used by LHDs during this shortage may provide valuable response lessons to minimize the impact of future influenza vaccine shortages and other public health emergencies.

  11. Drug shortage-associated increase in catheter-related blood stream infection in children.

    Science.gov (United States)

    Ralls, Matthew W; Blackwood, R Alexander; Arnold, Meghan A; Partipilo, M Luisa; Dimond, James; Teitelbaum, Daniel H

    2012-11-01

    Ethanol lock therapy (ELT) has been shown to reduce the incidence of catheter-related blood stream infections (CRBSI) in intestinal failure (IF) patients. Dosing and frequency remains undefined. Scrutiny of pharmaceutical facilities by the Food and Drug Administration led to the voluntary shutdown of the sole supplier of ethanol, resulting in a nationwide shortage. To conserve supply, we reduced ELT frequency from a daily regimen. We examined the impact that reduction in ELT frequency had on CRBSI in pediatric IF patients. We retrospectively reviewed our parenteral nutrition-dependent IF children. Primary outcome measure was CRBSI per 1000 catheter days after ELT frequency reduction. Data were compared (paired t test) to the same group over 1 year before ethanol shortage and to historical controls. During the shortage 13 outpatients received ELT. Eight met study criteria. Mean ± SD age was 9.1 ± 7.8 years. Mean CRBSI rate per 1000 catheter days was 0.7 ± 1.3 before ELT shortage. This increased to 6.2 ± 2.5 after frequency reduction (P Gram-negatives (6), methicillin-resistant Staphylococcus aureus (1), and Candida spp (1). ELT frequency reduction resulted in complete failure in CRBSI prophylaxis. The nationwide shortage of this drug has been costly both financially and in patient morbidity.

  12. The Moreau Strain of Bacillus Calmette-Guerin (BCG) for High-Risk Non-Muscle Invasive Bladder Cancer: An Alternative during Worldwide BCG Shortage?

    Science.gov (United States)

    Hofbauer, Sebastian L; Shariat, Shahrokh F; Chade, Daher C; Sarkis, Alvaro S; Ribeiro-Filho, Leopoldo A; Nahas, Willian C; Klatte, Tobias

    2016-01-01

    Bacillus Calmette-Guerin (BCG) is the standard of care for adjuvant intravesical instillation therapy for intermediate- and high-risk non-muscle invasive bladder cancer (NMIBC) after complete transurethral resection. Increasing evidence suggests that there are marked differences in outcomes according to BCG substrains. BCG-Moreau was recently introduced to the European market to cover the issue of BCG shortage, but there are little data regarding the oncologic efficacy. We retrospectively analyzed 295 consecutive patients, who received adjuvant intravesical instillation therapy with BCG-Moreau for intermediate- and high-risk NMIBC between October 2007 and April 2013 at a single institution. The end points of this study were time to first recurrence and progression to muscle-invasive disease. Median age was 66 years (interquartile range 59-74, mean 65.9 years). According to the EAU risk group, 76 patients presented with intermediate-risk and 219 patients with high-risk NMIBC. The 5-year recurrence-free survival and progression-free survival rate was 64.8% (95% CI 52.8-74.4) and 81.4% (95% CI 65.2-90.2), respectively. BCG-Moreau is an effective substrain for adjuvant instillation therapies of NMIBC, and outcomes appear to be comparable to series using other substrains. During worldwide shortage of BCG-TICE, Connaught and RIVM, BCG-Moreau may serve as an equally effective alternative. © 2015 S. Karger AG, Basel.

  13. 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.

  14. Identifying and Describing Nurse Faculty Workload Issues: A Looming Faculty Shortage.

    Science.gov (United States)

    Bittner, Nancy Phoenix; Bechtel, Cynthia Francis

    The purpose of this project was to address factors contributing to the nurse faculty shortage. There is a demonstrated need to sustain and stabilize faculty currently in the workforce to avoid exacerbating the current and future faculty shortage in nursing. Recommendations of previous studies focus on strategies for recruitment, retention, and ongoing faculty development. A survey was employed to identify and describe the workload of nurse faculty and identify the impact of retirement and other retention issues. Findings showed an aging and nondiverse nursing faculty with increased and variable workload. There was no standard means of calculating workload. With identification of increased workload, faculty are considering retirement at a higher than projected rate. Four primary areas to address the nursing faculty shortage include focus on diversity balance, development of collaborative positions (joint appointments), and clear identification of nursing faculty workload.

  15. 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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    for drug identification during drug shortages were proposed. Conclusion This study identified different barriers and facilitators for implementing drug changes. The barriers and facilitators included specific features related to drugs, health care technology as well as to financial and organisational......Background Drug tenders and shortages result in drug changes. International studies found that drug changes can adversely affect patient safety and the working procedures of healthcare professionals.1,2 The challenges of drug changes in Danish public hospitals have not previously been studied....... 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...

  17. [Responses of stomata and Kranz anatomy of maize leaves to soil water shortages].

    Science.gov (United States)

    Li, Zhen-Zhen; Zhang, Li; Li, Si; Dong, He; Wang, Qiao-Yan; Liu, Xi-Ping; Yao, Ya-Qin

    2014-10-01

    Seedlings of the popular maize cultivar "Zhengdan-958" growing in pots individually were exposed to suitable soil water conditions as control, light water shortage, moderate water shortage, and severe water shortage, corresponding to soil water contents between 75%-85%, 65%-75%, 55%-65%, and 45%-55% of field water capacity, respectively. Responses of stomatal aperture, Kranz anatomy, and vascular bundle structure to different water contents of maize leaves were investigated. Results showed that under increased water shortages, the levels of H2O2 in both guard cells and subsidiary cells were enhanced, also the fluorescence intensity of H2O2 labeled with fluorescent dye increased, while stomatal aperture and conductance decreased gradually. Moreover, Kranz cells were messily arranged and the cell size became smaller and smaller, and the structure of bundle sheath cells went irregular; and the sectional area of the big bundle and xylem, the cell number of phloem, and the thickness of whole leaf and of upper and lower epidermis reduced. In addition, the number of chloroplasts in mesophyll cells and vascular bundle sheath cells decreased, particularly under the moderate water deficit, chloroplasts in Kranz cells which located in the inside of cytoplasmic membrane and cling on the cell wall spread to the direction of cell center. It demonstrated that stomatal closing of maize could be regulated by H2O2 in guard cells and subsidiary cells together, and H2O2 in subsidiary cells maybe played a cooperative role. In conclusion, under increased soil water shortages, drought-induced H2O2 accumulations in both guard cells and subsidiary cells of maize leaves participated in the regulation of stomatal closing. And, the size of Kranz cells and bundle sheath cells, the cell number of phloem, and the area of the xylem and phloem re- duced, thereby, reducing water shortage-induced damage.

  18. Strain-specific responses of inbred mice to ethanol following food shortage.

    Science.gov (United States)

    Schroff, Karl C; Cowen, Michael S; Koch, Sabrina; Spanagel, Rainer

    2004-01-01

    Specific inbred mouse strains such as C57BL/6J and DBA/2J show differences in consumption of and reaction on drugs of abuse. For example, C57BL/6J mice voluntarily consume greater amounts of ethanol than DBA/2J mice. Recently, it could be shown that a short environmental experience--12 days of food shortage followed by a recovery period--has a strong impact on strain-specific reactions to amphetamine. The purpose of the present study was to examine whether food shortage experience has an effect on ethanol responses. The effect of a period of 12 days food restriction which resulted in a weight loss of 20% body weight and which was followed by a complete recovery period was studied on ethanol self-administration and ethanol-induced locomotor activity in C57BL/6Ico and DBA/2Ico inbred mouse strains. The experience of food shortage led to a higher ethanol intake and preference in C57BL/6Ico mice compared to control animals without food shortage experience. In contrast DBA/2Ico showed no difference in ethanol intake or preference following this experience. The effect of ethanol onto locomotor activity of both mice strains was affected only in the case of DBA/2Ico mice, where food shortage experience resulted in a significantly higher ethanol-induced locomotor activity. The present data show that in inbred mouse strains environmental experiences can have a strong impact onto the effects of ethanol. In conclusion, in the field of preclinical alcohol research gene x environment interactions in specific inbred mouse strains can contribute strongly to the outcome of studies and more specifically food shortage can profoundly affect the outcome of alcohol studies in mice.

  19. 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.

  20. How the US Food and Drug Administration can solve the prescription drug shortage problem.

    Science.gov (United States)

    Schweitzer, Stuart O

    2013-05-01

    Drug shortages are threatening care quality and cost-containment efforts. I describe the pharmaceutical marketplace changes that have caused the problem, and propose new policies to solve it, through changing incentives for producers and purchasers. I propose a grading scheme for the Food and Drug Administration when it inspects manufacturing facilities in the United States and abroad. The inspections' focus would change from closing unsafe plants to improving production process quality, reducing the likelihood that plants will be closed-the most frequent cause of drug shortages.

  1. Immigration and the tech industry: As a labour shortage remedy, for innovation, or for cost savings?

    OpenAIRE

    Norman Matloff

    2013-01-01

    The two main reasons cited by the U.S. tech industry for hiring foreign workers-remedying labour shortages and hiring “the best and the brightest”-are investigated, using data on wages, patents, and R&D work, as well as previous research and industry statements. The analysis shows that the claims of shortage and outstanding talent are not supported by the data, even after excluding the Indian IT service firms. In-stead, it is shown that the primary goals of employers in hiring foreign workers...

  2. 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.

  3. Production-inventory Management model for a weibull deteriorating item with linear demand and shortages

    Directory of Open Access Journals (Sweden)

    Gobinda Chandra Panda

    2013-06-01

    Full Text Available Background: Physical decay or deterioration of goods in stock is an important feature of real inventory systems. Material and methods: In the present paper, we discuss an production inventory model for a Weibull deteriorating item over a finite planning horizon with a linearly time-varying demand rate and a uniform production rate, allowing shortages, which are completely backlogged. Results and conclusions:  A production inventory model is developed for a Weibull deteriorating item over a finite planning horizon with a linear time varying demand, finite production rate and shortages. The optimal number of production cycles that minimizes the average system cost is determined.

  4. Deterministic inventory model for items with Time varying demand, weibull distribution deterioration and shortages

    Directory of Open Access Journals (Sweden)

    Wu Kun-Shan

    2002-01-01

    Full Text Available In this paper, an EOQ inventory model is depleted not only by time varying demand but also by Weibull distribution deterioration, in which the inventory is permitted to start with shortages and end without shortages. A theory is developed to obtain the optimal solution of the problem; it is then illustrated with the aid of several numerical examples. Moreover, we also assume that the holding cost is a continuous, non-negative and non-decreasing function of time in order to extend the EOQ model. Finally, sensitivity of the optimal solution to changes in the values of different system parameters is also studied.

  5. 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

  6. 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

  7. Innovations’ Survival

    Directory of Open Access Journals (Sweden)

    Jakub Tabas

    2016-01-01

    Full Text Available Innovations currently represent a tool of maintaining the going concern of a business entity and its competitiveness. However, effects of innovations are not infinite and if an innovation should constantly preserve a life of business entity, it has to be a continual chain of innovations, i.e. continual process. Effective live of a single innovation is limited while the limitation is derived especially from industry. The paper provides the results of research on innovations effects in the financial performance of small and medium-sized enterprises in the Czech Republic. Objective of this paper is to determine the length and intensity of the effects of technical innovations in company’s financial performance. The economic effect of innovations has been measured at application of company’s gross production power while the Deviation Analysis has been applied for three years’ time series. Subsequently the Survival Analysis has been applied. The analyses are elaborated for three statistical samples of SMEs constructed in accordance to the industry. The results obtained show significant differences in innovations’ survival within these three samples of enterprises then. The results are quite specific for the industries, and are confronted and discussed with the results of authors’ former research on the issue.

  8. 42 CFR 405.2417 - Visiting nurse services: Determination of shortage of agencies.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Visiting nurse services: Determination of shortage of agencies. 405.2417 Section 405.2417 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Rural Health Clinic and Federally Qualified Health Center Services § 405.2417 Visiting nurse services...

  9. Using Optical Sensors to Identify Water Deprivation, Nitrogen Shortage, Weed Presence and Fungal Infection in Wheat

    Directory of Open Access Journals (Sweden)

    Gerassimos G. Peteinatos

    2016-05-01

    Full Text Available The success of precision agriculture relies largely on our ability to identify how the plants’ growth limiting factors vary in time and space. In the field, several stress factors may occur simultaneously, and it is thus crucial to be able to identify the key limitation, in order to decide upon the correct contra-action, e.g., herbicide application. We performed a pot experiment, in which spring wheat was exposed to water shortage, nitrogen deficiency, weed competition (Sinapis alba L. and fungal infection (Blumeria graminis f. sp. tritici in a complete, factorial design. A range of sensor measurements were taken every third day from the two-leaf stage until booting of the wheat (BBCH 12 to 40. Already during the first 10 days after stress induction (DAS, both fluorescence measurements and spectral vegetation indices were able to differentiate between non-stressed and stressed wheat plants exposed to water shortage, weed competition or fungal infection. This meant that water shortage and fungal infection could be detected prior to visible symptoms. Nitrogen shortage was detected on the 11–20 DAS. Differentiation of more than one stress factors with the same index was difficult.

  10. 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.

  11. Solving the Nation's Teacher Shortage: How Online Learning Can Fix the Broken Teacher Labor Market

    Science.gov (United States)

    Dwinal, Mallory

    2015-01-01

    As the link between teacher quality and student performance becomes increasingly apparent, education leaders have invested significant time and energy into recruiting high-quality educators. Unfortunately, chronic teacher shortages have undercut these efforts, and many school leaders continue to struggle with staffing each year. A closer…

  12. Lake States Pulpwood Production Hampered by Adverse Weather and Labor Shortage, 1965

    Science.gov (United States)

    Arthur G. Horn

    1966-01-01

    Demand for Lake States pulpwood gained strength in 1965, but production failed to rise. Adverse weather during part of the year and a general shortage of woods labor were deterrents to a larger harvest. The total pulpwood cut was 3,636,000 cords in 1965, representing very little change over the level of the 2 previous years. The tempo of pulpwood activities started...

  13. Physiological flexibility and acclimation to food shortage in a heterothermic primate.

    Science.gov (United States)

    Canale, Cindy I; Perret, Martine; Théry, Marc; Henry, Pierre-Yves

    2011-02-15

    As ecosystems undergo changes worldwide, physiological flexibility is likely to be an important adaptive response to increased climate instability. Extreme weather fluctuations impose energetical constraints such as unpredictable food shortage. We tested how grey mouse lemurs (Microcebus murinus) could adjust their daily heterothermy and locomotor activity to these 'energetic accidents' with a food restriction experiment. The experimental design consisted of acute calorie restriction (2 weeks, 80% restriction) in the middle of winter, after a fattening season with low (11 weeks, 40% restriction) versus high (ad libitum) food availability. This design aimed at simulating the combined effects of the quality of the fattening season (acclimation effect) and a sudden, severe food shortage during the lean season. Hour of start and duration of torpor were the most flexible components of energy savings, increasing in response to the acute food shortage with facilitation by chronic restriction (acclimation effect). Modulations of locomotor activity did not support the hypothesis of energy savings, as total locomotor activity was not reduced. Nonetheless, acutely restricted individuals modified their temporal pattern of locomotor activity according to former food availability. We provide the first experimental evidence of different temporal levels of flexibility of energy-saving mechanisms in a heterotherm exposed to food shortage. The acclimation effect of past food scarcity suggests that heterothermic organisms are better able to respond to unpredicted food scarcity during the lean season. The flexible control of energy expenditure conferred by heterothermy may facilitate the plastic response of heterothermic species to more frequent climatic hazards.

  14. 76 FR 60505 - Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop...

    Science.gov (United States)

    2011-09-29

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is opening a comment period for the...

  15. Impact of a Temporary Food Shortage on Children and Their Mothers.

    Science.gov (United States)

    McDonald, Mary Alice; And Others

    1994-01-01

    Evaluated the effects of a drought and temporary food shortage on 248 Kenyan mother-child dyads' energy intake, weight, and behaviors. Found that school-age children were affected more negatively than toddlers, showing significant declines in energy intake, age-corrected weight, activity on the playground, and classroom attention. Behavior…

  16. 76 FR 45268 - Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop

    Science.gov (United States)

    2011-07-28

    ... HUMAN SERVICES Food and Drug Administration Center for Drug Evaluation and Research, Approach to Addressing Drug Shortage; Public Workshop AGENCY: Food and Drug Administration, HHS. ACTION: Notice of public workshop. SUMMARY: The Food and Drug Administration (FDA) is announcing a public workshop regarding the...

  17. Solving the Teacher Shortage: Revisiting the Lessons We've Learned

    Science.gov (United States)

    Berry, Barnett; Shields, Patrick M.

    2017-01-01

    Two decades ago, at a time when much of the country faced looming teacher shortages, a number of states invested in comprehensive strategies for strengthening the teaching profession. For example, and drawing upon recommendations from the National Commission on Teaching & America's Future, both California and North Carolina built statewide…

  18. 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

  19. Shortage of faculty in medical schools in Tanzania: A case study at ...

    African Journals Online (AJOL)

    Shortage of faculty in medical schools in Tanzania: A case study at the Catholic University of Health and Allied Health Sciences. ... the establishment of a residents-as-teachers training programme, and a faculty development programme to groom junior faculty to take on leadership roles and develop strategies to improve the ...

  20. 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…

  1. A Qualitative Case Study of the Bilingual Teacher Shortage in One Texas School District

    Science.gov (United States)

    Kennedy, Barbara H.

    2013-01-01

    The purpose of this study was to examine how stakeholders in one Texas school district perceive, experience, and respond to the Spanish bilingual teacher shortage. The research design was qualitative with an exploratory, single case study approach. The case study school district was a mid-sized suburban district in Texas that utilized a dual…

  2. 42 CFR 57.312 - Repayment of loans for service in a shortage area.

    Science.gov (United States)

    2010-10-01

    ... agreement with the Secretary to serve as a full-time registered nurse for a period of not less than 2 years... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT... health facility determined by the Secretary to have a critical shortage of nurses, will have a portion of...

  3. 78 FR 23742 - Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment...

    Science.gov (United States)

    2013-04-22

    ... National Institute of Food and Agriculture Nomination Form of Veterinary Shortage Situations for the Veterinary Medicine Loan Repayment Program (VMLRP) AGENCY: National Institute of Food and Agriculture, USDA... Act of 1995, invites the general public to comment on an information collection for the Veterinary...

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

    Science.gov (United States)

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

    2017-01-10

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

  5. Nursing Faculty Shortage Nurses' Perceptions as a Key to Administrative Solutions

    Science.gov (United States)

    Klocke, Evelyn M.

    2009-01-01

    The nursing faculty shortage is well documented. Higher education administrators turn away qualified student applicants because of the lack of qualified nursing faculty. Furthermore, they find recruitment and retention of qualified nursing faculty a challenge. The purpose of this study was to explore perceptions of the nursing faculty role, causes…

  6. Projecting shortages and surpluses of doctors and nurses in the OECD: what looms ahead.

    Science.gov (United States)

    Scheffler, Richard M; Arnold, Daniel R

    2018-01-23

    There is little debate that the health workforce is a key component of the health care system. Since the training of doctors and nurses takes several years, and the building of new schools even longer, projections are needed to allow for the development of health workforce policies. Our work develops a projection model for the demand of doctors and nurses by Organisation for Economic Co-operation and Development (OECD) countries in the year 2030. The model is based on a country's demand for health services, which includes the following factors: per capita income, out-of-pocket health expenditures and the ageing of its population. The supply of doctors and nurses is projected using country-specific autoregressive integrated moving average models. Our work shows how dramatic imbalances in the number of doctors and nurses will be in OECD countries should current trends continue. For each country in the OECD with sufficient data, we report its demand, supply and shortage or surplus of doctors and nurses for 2030. We project a shortage of nearly 400,000 doctors across 32 OECD countries and shortage of nearly 2.5 million nurses across 23 OECD countries in 2030. We discuss the results and suggest policies that address the shortages.

  7. 75 FR 26167 - Designation of Medically Underserved Populations and Health Professions Shortage Areas; Intent To...

    Science.gov (United States)

    2010-05-11

    ... poverty, infant mortality or fertility rates, overutilization, or excessive waiting times, and to consider... below the poverty level; primary care physician-to-population ratio; infant mortality rate; and percent... services (including infant mortality rates). What specific underservice/shortage indicators should be...

  8. Emigration and labour shortages: an opportunity for trade unions in new member states?

    NARCIS (Netherlands)

    Kaminska, M.E.; Kahancová, M.

    2011-01-01

    Emigration from the post-socialist states which joined the EU in 2004 and 2007 has reduced unemployment rates and created shortages of some skills. This should provide opportunities for trade unions to improve their situation, by facilitating union organizing and strengthening their bargaining

  9. The global workforce shortages and the migration of medical professions: the Australian policy response.

    Science.gov (United States)

    Smith, Saxon D

    2008-05-29

    Medical migration sees the providers of medical services (in particular medical practitioners) moving from one region or country to another. This creates problems for the provision of public health and medical services and poses challenges for laws in the nation state and for laws in the global community.There exists a global shortage of healthcare professionals. Nation states and health rights movements have been both responsible for, and responsive to, this global community shortage through a variety of health policy, regulation and legislation which directly affects the migration of medical providers. The microcosm responses adopted by individual nation states, such as Australia, to this workforce shortage further impact on the global workforce shortage through active recruitment of overseas-trained healthcare professionals. "Push" and "pull" factors exist which encourage medical migration of healthcare professionals. A nation state's approach to health policy, regulation and legislation dramatically helps to create these "push factors" and "pull factors". A co-ordinated global response is required with individual nation states being cognisant of the impact of their health policy, regulations and legislation on the global community through the medical migration of healthcare professionals.

  10. 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)

  11. 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

  12. 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

  13. 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

  14. 42 CFR Appendix D to Part 5 - Criteria for Designation of Areas Having Shortages of Vision Care Professional(s)

    Science.gov (United States)

    2010-10-01

    ... of Vision Care Professional(s) D Appendix D to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS Pt. 5, App. D Appendix D to Part 5—Criteria for Designation of Areas Having Shortages of Vision Care...

  15. 78 FR 9928 - Food and Drug Administration Drug Shortages Task Force and Strategic Plan; Request for Comments

    Science.gov (United States)

    2013-02-12

    ... HUMAN SERVICES Food and Drug Administration Food and Drug Administration Drug Shortages Task Force and Strategic Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice; request for... on drug shortages as required by the Food and Drug Administration Safety and Innovation Act, the...

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

    Science.gov (United States)

    2010-10-01

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

  17. Insights from past millennia into climatic impacts on human health and survival

    Science.gov (United States)

    McMichael, Anthony J.

    2012-01-01

    Climate change poses threats to human health, safety, and survival via weather extremes and climatic impacts on food yields, fresh water, infectious diseases, conflict, and displacement. Paradoxically, these risks to health are neither widely nor fully recognized. Historical experiences of diverse societies experiencing climatic changes, spanning multicentury to single-year duration, provide insights into population health vulnerability—even though most climatic changes were considerably less than those anticipated this century and beyond. Historical experience indicates the following. (i) Long-term climate changes have often destabilized civilizations, typically via food shortages, consequent hunger, disease, and unrest. (ii) Medium-term climatic adversity has frequently caused similar health, social, and sometimes political consequences. (iii) Infectious disease epidemics have often occurred in association with briefer episodes of temperature shifts, food shortages, impoverishment, and social disruption. (iv) Societies have often learnt to cope (despite hardship for some groups) with recurring shorter-term (decadal to multiyear) regional climatic cycles (e.g., El Niño Southern Oscillation)—except when extreme phases occur. (v) The drought–famine–starvation nexus has been the main, recurring, serious threat to health. Warming this century is not only likely to greatly exceed the Holocene's natural multidecadal temperature fluctuations but to occur faster. Along with greater climatic variability, models project an increased geographic range and severity of droughts. Modern societies, although larger, better resourced, and more interconnected than past societies, are less flexible, more infrastructure-dependent, densely populated, and hence are vulnerable. Adverse historical climate-related health experiences underscore the case for abating human-induced climate change. PMID:22315419

  18. Online Resources

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Genetics; Online Resources. Journal of Genetics. 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. Volume 91. 2012 | Online resources ...

  19. NATIONAL CONFERENCE ON TOOLS FOR URBAN WATER RESOURCE MANAGEMENT AND PROTECTION: PROCEEDINGS, CHICAGO, IL, FEBRUARY 7-10, 2000

    Science.gov (United States)

    A wide array of effective water quality management and protection tools have been developed for urban environments, but implementation is hindered by a shortage of technology transfer opportunities. This National Conference on Tools for Urban Water Resource Management and Protec...

  20. 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...

  1. Adaptive policy responses to water shortage mitigation in the arid regions--a systematic approach based on eDPSIR, DEMATEL, and MCDA.

    Science.gov (United States)

    Azarnivand, Ali; Chitsaz, Nastaran

    2015-02-01

    Most of the arid and semi-arid regions are located in the developing countries, while the availability of water in adequate quantity and quality is an essential condition to approach sustainable development. In this research, "enhanced Driving force-Pressure-State-Impact-Response (eDPSIR)" sustainability framework was applied to deal with water shortage in Yazd, an arid province of Iran. Then, the Decision Making Trial and Evaluation Laboratory (DEMATEL) technique was integrated into the driven components of eDPSIR, to quantify the inter-linkages among fundamental anthropogenic indicators (i.e. causes and effects). The paper's structure included: (1) identifying the indicators of DPSIR along with structuring eDPSIR causal networks, (2) using the DEMATEL technique to evaluate the inter-relationships among the causes and effects along with determining the key indicators, (3) decomposing the problem into a system of hierarchies, (4) employing the analytic hierarchy process (AHP) technique to evaluate the weight of each criterion, and (5) applying complex proportional assessment with Grey interval numbers (COPRAS-G) method to obtain the most conclusive adaptive policy response. The systematic quantitative analysis of causes and effects revealed that the root sources of water shortage in the study area were the weak enforcement of law and regulations, decline of available freshwater resources for development, and desertification consequences. According to the results, mitigating the water shortage in Yazd could be feasible by implementation of such key adaptive policy-responses as providing effective law enforcement, updating the standards and regulations, providing social learning, and boosting stakeholders' collaboration.

  2. 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 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.

  3. 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.

  4. Strategies for overcoming labour shortage challenges : best practices of industry leaders

    Energy Technology Data Exchange (ETDEWEB)

    Baron, N. [Matrikon Inc., Edmonton, AB (Canada)

    2006-07-01

    This presentation outlined strategies for addressing labour shortage challenges in the oil and gas industry. Thousands of new operations positions are likely to be established over the next decade. More than 4000 trades positions are needed to build projects that have been announced and approved for 2008. Currently, there is a housing shortage and pressing requirements for infrastructure such as education, health services and highways. This presentation addressed the issue of retirement of senior and mid-level leaders in the industry, growth opportunities in new markets, demographics, investment by competitors and environmental protection. Attraction and retention strategies such as salaries and leadership programs were discussed along with the value of flying employees in and out of field camps, increasing the luxury of camp accommodation, education, and establishment of remote control, collaborative performance centres. tabs., figs.

  5. Analysis of a government policy to address nursing shortage and nursing education quality.

    Science.gov (United States)

    Abhicharttibutra, K; Kunaviktikul, W; Turale, S; Wichaikhum, O-A; Srisuphan, W

    2017-03-01

    A well-educated, sufficient nursing workforce improves population health and standards of nursing care. Analysing workforce policies assists nurses to learn from the past and develop better future policies. Describe policy-making processes in the first Thai government plan to increase nursing capacity and improve nursing education quality. A qualitative study employing Longest's model to examine policy-making processes. Data were obtained from 28 in-depth interviews with key informants, who had been committee members and former deans of nursing involved with the policy processes in the 1990s. Both qualitative and quantitative data were extracted from relevant documents, and content analysis employed with all data. Three policy phases were identified. Policy formulation, where three streams of problems, politics and policy resulted in identification of nursing shortage, changes of government incumbents and needing to increase nurse production; Policy implementation included creating methods of implementation, appointing responsible people and committees, creating operational plans, producing more nurses and faculty development projects and Policy modification which incorporated implementing the first Thai international doctoral degree in English, a collaborative programme between universities. Not all key informants could be accessed due to the passage of time. Findings are unique to Thailand but inform internationally of nurses' abilities and need to be involved in policy. Nurses were involved in all policy phases. While the policy produced positive developments in growing nursing capacity and education in the past, nursing shortages remained and are now acute in Thailand. Lessons learned from this policy analysis help explain why the nursing education and nursing shortage policy was legislated through the government agenda, and the active involvement of Thai nurses in this process. Nurses globally need to be at the policy-making table to try to reduce nursing

  6. Stuck Between Surplus and Shortage: Demand for Skills in the Russian Industry

    OpenAIRE

    Gimpelson, Vladimir; Kapelyushnikov, Rostislav; Lukiyanova, Anna

    2008-01-01

    In order to remain competitive, firms need to keep the quantity and composition of jobs close to the optimal for their given output. Since the beginning of the transition period, Russian industrial firms have been widely reporting that the quantity and composition of hired labor is far from being close to optimal. This paper discusses what kinds of firms in the Russian manufacturing sector are not able to optimize their employment and why. Do they suffer from a labor shortage induced by rapid...

  7. Context of the inventory management expenses in the case of planned shortages

    Directory of Open Access Journals (Sweden)

    Korponai János

    2017-03-01

    Full Text Available The main purpose of the paper is to present the relations between the different cost factors of the inventory management systems, and the context between the order quantities and the cost level. The theoretical approach of the model assumes a deterministic operational environment with planned shortages. We make the examination of the contexts by applying the ceteris paribus principle; we change only one cost factor from among the initial conditions at once and examine its effect on the cost level.

  8. Potential Ways to Address Shortage Situations of (99)Mo/(99m)Tc.

    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.

  9. Two strategies for coping with food shortage in desert golden spiny mice.

    Science.gov (United States)

    Gutman, Roee; Yosha, Dotan; Choshniak, Itzhak; Kronfeld-Schor, Noga

    2007-01-30

    Desert rodents face periods of food shortage and use different strategies for coping with it, including changes in activity level. Golden spiny mice (Acomys russatus) inhabit rock crevasses and do not dig burrows nor store food. When kept under 50% food restriction most, but not all, golden spiny mice defend their body mass by physiological means. We tested the hypothesis that these rodents use two different behavioral strategies, i.e., increasing activity level and searching for food or decreasing activity level and conserving energy to cope with food shortage. Twelve golden spiny mice were fed ad libitum for 14 days, followed by 40 days of 50% food restriction, and 14 days of refeeding. Body mass, food consumption and general activity were monitored. Seven mice significantly reduced activity level, concentrating their activity around feeding time, lowering energy expenditure and thus keeping their body mass constant ("resistant"), while five ("non-resistant") significantly increased activity level (possibly searching for food) and thus energy expenditure, thereby losing mass rapidly (more than 25% of body mass). The non-resistant golden spiny mice were active throughout many hours of the day, with high variability both between and among individuals. The use of two strategies to cope with food shortage as found in the golden spiny mice may be of evolutionary advantage, since it allows a more flexible reaction to food restriction at the population level.

  10. Addressing the community/public health nursing shortage through a multifaceted regional approach.

    Science.gov (United States)

    Young, Staci; Acord, Lea; Schuler, Sue; Hansen, Judith M

    2014-01-01

    Despite increasing needs resulting from emerging societal and health care issues, the number of trained community/public health (C/PH) nurses in the United States is facing a precipitous decline. Numerous factors contribute to this shortage including an aging workforce, a poorly funded public health system, inconsistencies in C/PH nursing educational approaches and opportunities, and a shortage of sites for clinical training. Determined to address the C/PH nursing shortage in their region, a consortium of public health professionals, university deans and faculty, and state nursing leaders in southeastern Wisconsin came together to address these issues from three perspectives: (a) curricular analysis and redesign, (b) expansion of clinical placement opportunities, and (c) paid community/public health nursing internships for seniors in baccalaureate nursing programs. This article outlines briefly the activities undertaken related to curricular review and clinical placements, and then describes in detail the approach, challenges and results of the senior internship program. Together, these programs produced long-lasting results including an unprecedented level of collaboration between academic institutions and public health nursing professionals, the expansion of both traditional and nontraditional clinical sites in the region, and a transformative learning experience for seventeen senior nursing students from five participating universities. © 2014 Wiley Periodicals, Inc.

  11. 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.

  12. 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.

  13. 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.com/pregnancy/complications- ...

  14. 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

  15. Climate change and decline in water resources in Kikuletwa ...

    African Journals Online (AJOL)

    The eight villages covered by this study face a variety of water shortage and environmental challenges that are intertwined with the causes and consequences of a changing climate. Access to water is the primary natural resource concern in Pangani Basin and Kikuletwa catchment villages and a lack of infrastructure for ...

  16. Demand for actuarial resources in South Africa | Terblanche | South ...

    African Journals Online (AJOL)

    developments, such as international accounting standards and Solvency II, are creating demand. At the same time, emigration of actuaries and actuarial students creates shortages and a much tighter actuarial resource market. This paper covers the current demographics of the membership of the Actuarial Society of South ...

  17. 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 ...

  18. An EOQ inventory model for items with ramp type demand, three-parameter Weibull distribution deterioration and starting with shortage

    Directory of Open Access Journals (Sweden)

    Jain Sanjay

    2010-01-01

    Full Text Available In this present paper an inventory model is developed with ramp type demand, starting with shortage and three - parameter Weibull distribution deterioration. A brief analysis of the cost involved is carried out by an example.

  19. [Expression of ZmPIP1 subgroup genes in maize roots under water shortage].

    Science.gov (United States)

    Wu, An-Hui; Zhang, Sui-Qi; Deng, Xi-Ping; Shan, Lun; Liu, Xiao-Fang

    2006-10-01

    To investigate the role of ZmPIP1-1 and ZmPIP1-2 in water uptake of roots and drought resistance of crops, semi-quantitative PCR was used to examine the expression of ZmPIP1-1 and ZmPIP1-2 in root systems of different maize genotypes under water deficit. These genotypes showed different resistance to water shortage under field conditions. The reference gene to target genes was tubulin. Maize seedlings were grown by hydroponics in a growth chamber. Water deficit was imposed on the seedlings with PEG-6000. The result showed that ZmPIP1-1 was up-regulated under water deficit in root systems of plants of the filial generation 'Hudan 4' and the mother line 'Tiansi', which were resistant to water shortage, but there was no noticeable up-regulation of ZmPIP1-1 in the root systems of the father line '803', which was sensitive to water deprivation. The result also showed that the extent of up-regulation was positively correlated with drought resistance of maize (Fig.3). On the other hand, the expression of ZmPIP1-1 showed different degrees of tendency after different duration of water stress in the root systems of the maize seedlings of different genotypes. The result showed that ZmPIP1-2 was identically expressed in three different species of maize and under different water conditions. The results support the theory that the intercellular water transport contributes to increased water uptake in root systems under water deficit by up-regulating the number of some kinds of aquaporins. The increases amount of transcripts of aquaporins is positively correlated to drought resistance of plant varieties. But not all kinds of number of aquaporins is up-regulated during water shortage, some kinds of aquaporins are identically expressed under water deficit conditions and well watered conditions.

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

    Science.gov (United States)

    Feenstra, Sabiena G; Nahar, Quamrun; Pahan, David; Oskam, Linda; Richardus, Jan Hendrik

    2011-05-10

    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. 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). 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.

  1. Desabastecimento de medicamentos: determinantes, conseqüências e gerenciamento Drug shortage: determinants, consequences and management

    Directory of Open Access Journals (Sweden)

    Adriano Max Moreira Reis

    2008-04-01

    Full Text Available O artigo analisa o desabastecimento de medicamentos como um problema que transcende o aspecto logístico da área de saúde, discutindo suas implicações para a qualidade, segurança e custo da assistência. A cadeia de abastecimento farmacêutico e os fatores que interferem na capilaridade da distribuição e na disponibilidade do medicamento são discutidos. Ressalta a contribuição da comissão de farmácia e terapêutica para a prevenção e gerenciamento do desabastecimento de medicamentos nos estabelecimentos de saúde. Sugestões de medidas para gestão do desabastecimento de medicamentos são apresentadas. Enfatiza-se a necessidade do medicamento ser considerado pelos componentes da cadeia logística um produto de saúde, com tratamento diferenciado dos bens de consumo comuns.The present study analyzes drug shortage as a problem reaching beyond the logistic aspect of the health field and discusses its consequences with respect to quality, safety and cost of health care delivery. The pharmaceutical supply chain and the factors that determine the distribution and availability of drugs are discussed. The contribution of the Pharmacy and Therapeutics Committee in preventing and managing drug shortage in health institutions is stressed and measures for drug shortage management are suggested. Finally it is emphasized that drugs should be considered health products rather than consumer goods and as such be given a different treatment by the supply chain.

  2. Recent Food Shortage Is Associated with Leprosy Disease in Bangladesh: A Case-Control Study

    Science.gov (United States)

    Feenstra, Sabiena G.; Nahar, Quamrun; Pahan, David; Oskam, Linda; Richardus, Jan Hendrik

    2011-01-01

    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. PMID:21572979

  3. 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.

  4. Field evidence for a proximate role of food shortage in the regulation of hibernation and daily torpor: a review.

    Science.gov (United States)

    Vuarin, Pauline; Henry, Pierre-Yves

    2014-08-01

    Hibernation and daily torpor (heterothermy) have long been assumed to be adaptive responses to seasonal energy shortage. Laboratory studies have demonstrated that food shortage alone can trigger the use of heterothermy. However, their potential to predict heterothermic responses in the wild is limited, and few field studies demonstrate the dependence of heterothermy on food availability under natural conditions. Thus, the view of heterothermy as an energy saving strategy to compensate for food shortage largely remains an untested hypothesis. In this paper, we review published evidence on the proximate role of food availability in heterothermy regulation by endotherms, and emphasize alternative hypotheses that remain to be tested. Most studies have relied on correlative evidence. Manipulations of food availability, that demonstrate the proximate role of food availability, have been conducted in only five free-ranging heterotherms. Several other metabolic constraints covary with food availability and can confound its effect. Shortage in water availability, the nutritional composition of food, or subsequent conversion of food in fat storage all could be actual proximate drivers of heterothermy regulation, rather than food shortage. Social interactions, competition for food and predation also likely modulate the relative strength of food shortage between individuals. The ecological relevance of the dependence of heterothermy on food availability remains to be assessed in field experiments that account for the confounding effects of covarying environmental and internal factors.

  5. Inventory Model for deteriorating Items with Four level System and Shortages

    Directory of Open Access Journals (Sweden)

    Rakesh Prakash Tripathi

    2014-08-01

    Full Text Available This paper presents an inventory model for deteriorating items in which shortages are allowed. It is assumed that the production rate is proportional to the demand rate and greater than demand rate. The inventory model is developed by considering four different circumstances. The optimal of the problem is obtained with the help of Mathematica 7 software. Numerical examples are given to illustrate the model for different parameters. Sensitivity analysis of the model has been developed to examine the effect of changes in the values of the different parameters for optimal inventory policy. Truncated Taylor’s series is used for finding closed form optimal solution.

  6. Plasma is a strategic resource.

    Science.gov (United States)

    Strengers, Paul F W; Klein, Harvey G

    2016-12-01

    Plasma-derived medicinal products (PDMPs) such as immunoglobulins and clotting factors are listed by the World Health Organization as essential medicines. These and other PDMPs are crucial for the prophylaxis and treatment of patients with bleeding disorders, immune deficiencies, autoimmune and inflammatory diseases, and a variety of congenital deficiency disorders. While changes in clinical practice in developed countries have reduced the need for red blood cell transfusions thereby significantly reducing the collection volumes of whole blood and recovered plasma suitable for fractionation, the need for PDMPs worldwide continues to increase. The majority of plasma supplies for the manufacture of PDMPs is met by the US commercial plasma industry. However, geographic imbalance in the collection of plasma raises concerns that local disruptions of plasma supplies could result in regional and global shortages of essential PDMPs. Plasma, which fits the definition of a strategic resource, that is, "an economically important raw material which is subject to a higher risk of supply interruption," should be considered a strategic resource comparable to energy and drinking water. Plasma collections should be increased outside the United States, including in low- and middle-income countries. The need for capacity building in these countries is an essential part to strengthen quality plasma collection. This will require changes in national and regional policies. We advocate the need for the restoration of an equitable balance of the international plasma supply to reduce the risk of supply shortages worldwide. Strategic independence of plasma should be endorsed on a global level. © 2016 AABB.

  7. Fiber resources

    Science.gov (United States)

    P. J. Ince

    2004-01-01

    In economics, primary inputs or factors of production define the term ‘resources.’ Resources include land resources (plants, animals, and minerals), labor, capital, and entrepreneurship. Almost all pulp and paper fiber resources are plant materials obtained from trees or agricultural crops. These resources encompass plant materials harvested directly from the land (...

  8. 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.

  9. [Simplification of crop shortage water index and its application in drought remote sensing monitoring].

    Science.gov (United States)

    Liu, Anlin; Li, Xingmin; He, Yanbo; Deng, Fengdong

    2004-02-01

    Based on the principle of energy balance, the method for calculating latent evaporation was simplified, and hence, the construction of the drought remote sensing monitoring model of crop water shortage index was also simplified. Since the modified model involved fewer parameters and reduced computing times, it was more suitable for the operation running in the routine services. After collecting the concerned meteorological elements and the NOAA/AVHRR image data, the new model was applied to monitor the spring drought in Guanzhong, Shanxi Province. The results showed that the monitoring results from the new model, which also took more considerations of the effects of the ground coverage conditions and meteorological elements such as wind speed and the water pressure, were much better than the results from the model of vegetation water supply index. From the view of the computing times, service effects and monitoring results, the simplified crop water shortage index model was more suitable for practical use. In addition, the reasons of the abnormal results of CWSI > 1 in some regions in the case studies were also discussed in this paper.

  10. 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.

  11. Uncovering blind spots in education and practice leadership: towards a collaborative response to the nurse shortage.

    Science.gov (United States)

    Regan, Sandra; Thorne, Sally; Mildon, Barbara

    2009-01-01

    As the nursing shortage becomes an increasingly prominent everyday pressure for practice leaders, the search for quick solutions has intensified. A widespread perception has emerged within the service sector that nursing education is failing to fulfill its responsibility to prepare the next generation of nurses. This perception is escalating tensions between leaders in the education and practice sectors, and creating new barriers towards finding collaborative solutions. Although the "job ready/practice ready" debate between practice and education has been a long-standing undercurrent within nursing, extreme shortages affecting practice sector performance across the country create conditions that fuel heightened distrust and division. In this context, it becomes increasingly important that nursing leaders in education and practice engage in thoughtful and respectful dialogue to ensure that tensions between the two sectors are managed and counterproductive schisms prevented. In this paper, we deconstruct some of the current thinking regarding responsibility for the current problem by describing differences in the distinct cultures and contexts of the practice and education sectors, noting potential "blind spots" that interfere with our mutual understanding and encouraging a better-informed, shared responsibility to promote constructive engagement in preparing tomorrow's nursing workforce.

  12. 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.

  13. 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.

  14. Effect of refuge supplement on Audouin's gull chick survival

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    Jordi Prieto

    2003-07-01

    Full Text Available One of the main threats to Audouin´s gull (Larus audouinii at Chafarinas Islands is predation on eggs and chicks by the yellow-legged gull (Larus cachinnans. During the 1999 and 2000 breeding seasons we tested the effects of supplementary refuge availability on chick survival. Well before the laying period, nine adjacent enclosures were erected inside Audouin´s gull´s breeding grounds and some of them were supplied with artificial refuges. Our results showed significantly greater chick survival in the enclosures with artificial refuges than in control ones. In 2000, an overall lower breeding success of Audouin´s gull and a dilution of the refuge effect were observed. These results were probably related to food-shortage that year. We suggest that, along with other factors, an increase in refuge availability may significantly enhance Audouin´s gull chick survival.

  15. 'Negligence = Oil Shortage' and international energy conditions in the future. 'Yudan' to kongo no kokusai energy josei ni tsuite

    Energy Technology Data Exchange (ETDEWEB)

    Sakaiya, T.

    1993-12-01

    This paper introduced the Mr. Sakaiya's lecture on the 'Negligence = Oil Shortage' and international energy conditions in the future held at the 20th anniversary of the Agency of Natural Resources and Energy. The present Japan's conditions are very similar to those at the Oil Crisis. Japan is now in 'Negligence'. The prosperity brought about by the decline of oil price staggers Japan's intention of developing the nuclear power generation. There is no feeling of energy crisis all over the world. The demand/supply of oil resources, international relation, social and economical trend, and technical innovation after the Oil Crisis were explained. The pig cycle of economy can be clearly seen in energy, food, and gold price. The human being is apt to indulge into negligence in the experience in memory and the historical repetition. For the oil forecast, they say that it will be fine or cloudy and the rainfall probability is 15 %. The resources and energy requires a long term vision. The nuclear power generation is important. The social tolerance to the development of nuclear power generation is necessary to get rid of the oil dependency. Let's not repeat the trouble in railway construction. All the people have to be interested in nuclear power.

  16. 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.

  17. 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

  18. Impact of the Mais Médicos (More Doctors) Program in reducing physician shortage in Brazilian Primary Healthcare.

    Science.gov (United States)

    Girardi, Sábado Nicolau; Stralen, Ana Cristina de Sousa van; Cella, Joana Natalia; Wan Der Maas, Lucas; Carvalho, Cristiana Leite; Faria, Erick de Oliveira

    2016-09-01

    The Mais Médicos (More Doctors) Program (PMM) was put in place in Brazil aiming to reduce inequalities in access to Primary Healthcare. Based on diverse evidence that pointed to a scenario of profound shortage of doctors in the country, one of its central thrusts was emergency provision of these professionals in vulnerable areas, referred to as the Mais Médicos para o Brasil (More Doctors for Brazil) Project. The article analyses the impact of the PMM in reducing shortage of physicians in Brazilian municipalities. To do this, it uses the Primary Healthcare Physicians Shortage Index, which identifies and measures the shortage in the periods of March 2003 and September 2015, before and after implementation of the program. The results show that there was a substantial increase in the supply of physicians in primary healthcare in the period, which helped reduce the number of municipalities with shortage from 1,200 to 777. This impact also helped reduce inequalities between municipalities, but the inequities in distribution persisted. It was also found that there was a reduction in the regular supply of doctors made by municipalities, suggesting that these were being simply substituted by the supply coming from the program. Thus, an overall situation of insecurity in care persists, reflecting the dependence of municipalities on the physician supply from the federal government.

  19. Evaluation of dual-mode rainwater harvesting system to mitigate typhoon-induced water shortage in Taiwan.

    Science.gov (United States)

    Islam, M M; Chou, F N-F; Liaw, C-H

    2010-01-01

    The water shortage of today's world is one of the most challenging problems and the world is looking for the best solution to reduce it. Some human made causes and also natural causes are liable for the shortage of the existing water supply system. In Taiwan, especially during typhoon, the turbidity of raw water increases beyond the treatment level and the plant cannot supply required amount of water. To make the system effective, a couple of days are needed and the shortage occurs. The purpose of this study is to solve this emergency shortage problem. A dual-mode Rainwater Harvesting System (RWHS) was designed for this study as a supplement to the existing water supply system to support some selected non-potable components such as toilet and urinal flushing of an elementary school. An optimal design algorithm was developed using YAS (yield after spillage) and YBS (yield before spillage) release rules. The study result proved that an optimum volume of tank can solve the emergency water shortage properly. The system was found to be more reliable in Taipei area than that of Tainan area. The study also discovered that a government subsidy would be needed to promote the system in Taiwan.

  20. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants

    Directory of Open Access Journals (Sweden)

    Ann Anderson-Berry

    2012-12-01

    Full Text Available Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI, selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages.

  1. 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 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.

  2. Warming may create substantial water supply shortages in the Colorado River basin

    Science.gov (United States)

    McCabe, G.J.; Wolock, D.M.

    2007-01-01

    The high demand for water, the recent multiyear drought (1999-2007), and projections of global warming have raised questions about the long-term sustainability of water supply in the southwestern United States. In this study, the potential effects of specific levels of atmospheric warming on water-year streamflow in the Colorado River basin are evaluated using a water-balance model, and the results are analyzed within the context of a multi-century tree-ring reconstruction (1490-1998) of streamflow for the basin. The results indicate that if future warming occurs in the basin and is not accompanied by increased precipitation, then the basin is likely to experience periods of water supply shortages more severe than those inferred from the longterm historical tree-ring reconstruction. Furthermore, the modeling results suggest that future warming would increase the likelihood of failure to meet the water allocation requirements of the Colorado River Compact.

  3. Improvised purification methods for obtaining individual drinking water supply under war and extreme shortage conditions.

    Science.gov (United States)

    Kozlicic, A; Hadzic, A; Bevanda, H

    1994-01-01

    Supplying an adequate amount of drinking water to a population is a complex problem that becomes an extremely difficult task in war conditions. In this paper, several simple methods for obtaining individual supplies of drinking water by filtration of atmospheric water with common household items are reported. Samples of atmospheric water (rain and snow) were collected, filtered, and analyzed for bacteriological and chemical content. The ability of commonly available household materials (newspaper, filter paper, gauze, cotton, and white cotton cloth) to filter water from the environmental sources was compared. According to chemical and biological analysis, the best results were obtained by filtering melted snow from the ground through white cotton cloth. Atmospheric water collected during war or in extreme shortage conditions can be purified with simple improvised filtering techniques and, if chlorinated, used as an emergency potable water source.

  4. Developing an EPQ Model with Considering Preventive Maintenance, Imperfect Product, Shortage and Work in Process Inventory

    Directory of Open Access Journals (Sweden)

    Akbar Nilipour Tabatabaei

    2013-08-01

    Full Text Available Determination of optimal production lot size has been always noticed by researchers and various models have been proposed in this area. Among the subjects, which has been less considered in these models is machine failure. Obviously, a machine may encounter random failures during its working period and this makes clear the need for applying an appropriate maintenance policy for the machinery. In this paper based on assumptions such as authorized shortage, work in process inventory and possibility of producing defective products with and without the ability to re-work, EPQ model has been investigated and developed to select Preventive Maintenance (PM policy for the machinery. In addition, by minimizing system’s total cost over a period of time, a formula has been presented for determining optimal production lot size and its application has been examined using various numerical examples.

  5. Optimal inventory policies for imperfect inventory with price dependent stochastic demand and partially backlogged shortages

    Directory of Open Access Journals (Sweden)

    Bhowmick Jhuma

    2012-01-01

    Full Text Available The paper investigates a single period imperfect inventory model with price dependent stochastic demand and partial backlogging. The backorder rate is a nonlinear non-increasing function of the magnitude of shortage. Two special cases are considered assuming that the percentage of defective items follows a truncated exponential distribution and a normal distribution respectively. The optimal order quantity and the optimal mark up value are determined such that the expected total profit of the system is maximized. Numerical example is given to illustrate the proposed model which is compared with the traditional model of perfect stock. Sensitivity analysis is performed to explain the behavior of the proposed model with respect to the key parameters.

  6. 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

  7. 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.

  8. Till death do us part: stable sponge-bacteria associations under thermal and food shortage stresses.

    Science.gov (United States)

    Pita, Lucía; Erwin, Patrick M; Turon, Xavier; López-Legentil, Susanna

    2013-01-01

    Sporadic mass mortality events of Mediterranean sponges following periods of anomalously high temperatures or longer than usual stratification of the seawater column (i.e. low food availability) suggest that these animals are sensitive to environmental stresses. The Mediterranean sponges Ircinia fasciculata and I. oros harbor distinct, species-specific bacterial communities that are highly stable over time and space but little is known about how anomalous environmental conditions affect the structure of the resident bacterial communities. Here, we monitored the bacterial communities in I. fasciculata (largely affected by mass mortalities) and I. oros (overall unaffected) maintained in aquaria during 3 weeks under 4 treatments that mimicked realistic stress pressures: control conditions (13°C, unfiltered seawater), low food availability (13°C, 0.1 µm-filtered seawater), elevated temperatures (25°C, unfiltered seawater), and a combination of the 2 stressors (25°C, 0.1 µm-filtered seawater). Bacterial community structure was assessed using terminal restriction fragment length polymorphism (T-RFLP) analysis of 16S rRNA gene sequences and transmission electron microscopy (TEM). As I. fasciculata harbors cyanobacteria, we also measured chlorophyll a (chl a) levels in this species. Multivariate analysis revealed no significant differences in bacterial T-RFLP profiles among treatments for either host sponge species, indicating no effect of high temperatures and food shortage on symbiont community structure. In I. fasciculata, chl a content did not significantly differ among treatments although TEM micrographs revealed some cyanobacteria cells undergoing degradation when exposed to both elevated temperature and food shortage conditions. Arguably, longer-term treatments (months) could have eventually affected bacterial community structure. However, we evidenced no appreciable decay of the symbiotic community in response to medium-term (3 weeks) environmental anomalies

  9. Till death do us part: stable sponge-bacteria associations under thermal and food shortage stresses.

    Directory of Open Access Journals (Sweden)

    Lucía Pita

    Full Text Available Sporadic mass mortality events of Mediterranean sponges following periods of anomalously high temperatures or longer than usual stratification of the seawater column (i.e. low food availability suggest that these animals are sensitive to environmental stresses. The Mediterranean sponges Ircinia fasciculata and I. oros harbor distinct, species-specific bacterial communities that are highly stable over time and space but little is known about how anomalous environmental conditions affect the structure of the resident bacterial communities. Here, we monitored the bacterial communities in I. fasciculata (largely affected by mass mortalities and I. oros (overall unaffected maintained in aquaria during 3 weeks under 4 treatments that mimicked realistic stress pressures: control conditions (13°C, unfiltered seawater, low food availability (13°C, 0.1 µm-filtered seawater, elevated temperatures (25°C, unfiltered seawater, and a combination of the 2 stressors (25°C, 0.1 µm-filtered seawater. Bacterial community structure was assessed using terminal restriction fragment length polymorphism (T-RFLP analysis of 16S rRNA gene sequences and transmission electron microscopy (TEM. As I. fasciculata harbors cyanobacteria, we also measured chlorophyll a (chl a levels in this species. Multivariate analysis revealed no significant differences in bacterial T-RFLP profiles among treatments for either host sponge species, indicating no effect of high temperatures and food shortage on symbiont community structure. In I. fasciculata, chl a content did not significantly differ among treatments although TEM micrographs revealed some cyanobacteria cells undergoing degradation when exposed to both elevated temperature and food shortage conditions. Arguably, longer-term treatments (months could have eventually affected bacterial community structure. However, we evidenced no appreciable decay of the symbiotic community in response to medium-term (3 weeks environmental

  10. 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.

  11. Swedish sperm donors are driven by altruism, but shortage of sperm donors leads to reproductive travelling.

    Science.gov (United States)

    Ekerhovd, Erling; Faurskov, Anders; Werner, Charlotte

    2008-01-01

    Swedish legislation requires that sperm donors are identifiable to offspring. In Denmark sperm donors remain anonymous. The aim of this study was to examine sperm donation in Sweden by identifying socio-demographic backgrounds, motivations and attitudes among donors and to describe options and plans of sperm recipients. Furthermore, the willingness of Swedish health care providers to assist in treatment abroad, where sperm from an anonymous donor were to be used, was assessed. The extent of travelling to Denmark for reproductive purposes was also examined. Thirty Swedish sperm donors completed a questionnaire and were interviewed about their backgrounds, motivations and attitudes. Thirty couples where the infertility workup had shown azoospermia were interviewed about their options for achieving parenthood. The willingness to assist in fertility treatment abroad and the extent of reproductive cross border travelling were assessed by interviewing health care providers and by contacting Danish clinics. Almost all donors were Caucasian. The main motivation for sperm donors was to help others. Owing to shortage of sperm donors many Caucasian recipients intended to have treatment abroad. For most non-Caucasian recipients sperm from a donor of appropriate ethnicity were not available in Sweden. Whether the sperm donor was anonymous or identifiable was not of major importance to most sperm recipients. Health care providers expressed unanimous willingness to assist in treatment with sperm from an anonymous donor. Our inquiry indicated that more than 250 Swedish sperm recipients travel to Denmark annually. Identifiable sperm donors are driven by altruistic motives, but shortage of sperm donors leads to reproductive travelling. Recruitment strategies to increase the number of sperm donors in Sweden are therefore warranted.

  12. 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.

  13. Resource management for flood response in Mexico

    Directory of Open Access Journals (Sweden)

    Rodriguez-Espindola Oscar

    2017-01-01

    Full Text Available Emergency logistics is acquiring a crucial role aiming to provide adequate care and support for people affected by catastrophic situations; dealing with a large number of stakeholders, scarcity of resources and high stakes. Considering the importance of balancing resources from different participants to improve operations, this research introduces a bi-criteria response optimisation model aiming to maximise the service provided to disaster victims while making efficient use of resources. The model provides support for relief distribution, inventory management and resource allocation. But beyond the optimisation of logistical decisions, the model is able to determine which organisations to use at the appropriate timeframe, so as to prevent shortages and convergence. The model is applied to a case study on a flood in Mexico in order to compare its results with real activities performed by authorities and draw conclusions.

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

    DEFF Research Database (Denmark)

    Busti, Stefano; Mapelli, Valeria; Tripodi, Farida

    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...

  15. Comparison of water-energy trajectories of two major regions experiencing water shortage.

    Science.gov (United States)

    Lam, Ka Leung; Lant, Paul A; O'Brien, Katherine R; Kenway, Steven J

    2016-10-01

    Water shortage, increased demand and rising energy costs are major challenges for the water sector worldwide. Here we use a comparative case study to explore the long-term changes in the system-wide water and associated energy use in two different regions that encountered water shortage. In Australia, South East Queensland (SEQ) encountered a drought from 2001 to 2009, while Perth has experienced a decline in rainfall since the 1970s. This novel longitudinal study quantifies and compares the urban water consumption and the energy use of the water supply systems in SEQ and Perth during the period 2002 to 2014. Unlike hypothetical and long-term scenario studies, this comparative study quantifies actual changes in regional water consumption and associated energy, and explores the lessons learned from the two regions. In 2002, Perth had a similar per capita water consumption rate to SEQ and 48% higher per capita energy use in the water supply system. From 2002 to 2014, a strong effort of water conservation can be seen in SEQ during the drought, while Perth has been increasingly relying on seawater desalination. By 2014, even though the drought in SEQ had ended and the drying climate in Perth was continuing, the per capita water consumption in SEQ (266 L/p/d) was still 28% lower than that of Perth (368 L/p/d), while the per capita energy use in Perth (247 kWh/p/yr) had increased to almost five times that of SEQ (53 kWh/p/yr). This comparative study shows that within one decade, major changes in water and associated energy use occurred in regions that were similar historically. The very different "water-energy" trajectories in the two regions arose partly due to the type of water management options implemented, particularly the different emphasis on supply versus demand side management. This study also highlights the significant energy saving benefit of water conservation strategies (i.e. in SEQ, the energy saving was sufficient to offset the total energy use for

  16. 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…

  17. 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

  18. 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...

  19. Dietary diversity scores and nutritional status of women change during the seasonal food shortage in rural Burkina Faso.

    Science.gov (United States)

    Savy, Mathilde; Martin-Prével, Yves; Traissac, Pierre; Eymard-Duvernay, Sabrina; Delpeuch, Francis

    2006-10-01

    In developing countries, dietary diversity is usually assessed during a single yearly period and the effects of seasonal variations remain unknown. We studied these variations in women living in a Sahelian rural area (Burkina Faso). A representative sample of 550 women was surveyed at the beginning and at the end of the seasonal cereal shortage in April and September 2003, respectively. For each season, a dietary diversity score (DDS) representing the number of food groups consumed over a 24-h period, was computed and nutritional status was assessed by the BMI. The DDS increased from 3.4 +/- 1.1 to 3.8 +/- 1.5 food groups between the beginning and the end of the shortage season (P foods available during the cereal shortage season and despite the decrease in the consumption of some purchased foods. The increase in DDS was lower in women for whom DDS was already high in April and vice versa. Over the same period, the percentage of underweight women (BMI shortage season, when many women exhibit low DDS.

  20. Financial Incentives to Promote Teacher Recruitment and Retention: An Analysis of the Florida Critical Teacher Shortage Program

    Science.gov (United States)

    Feng, Li; Sass, Tim R.

    2015-01-01

    Staffing problems are pervasive in certain subject areas, such as secondary math and science and special education, where the combination of training requirements and relatively high alternative wages makes it difficult to attract and retain high-quality teachers. This project evaluated the impacts of the Florida Critical Teacher Shortage Program…

  1. Internationalising Work-Integrated Learning: Creating Global Citizens to Meet the Economic Crisis and the Skills Shortage

    Science.gov (United States)

    Gamble, Natalie; Patrick, Carol-joy; Peach, Deborah

    2010-01-01

    Research indicates that for many multinational companies, the global skills shortage has made it difficult to attract competent workers to some international locations. In developing economies, business leaders often cite poor business acumen and little real-world experience as serious shortcomings in the domestic pool of applicants. In addition…

  2. Collaborations between Foreign-Invested Enterprises and China's VET Schools: Making the System Work amid Localised Skill Shortages

    Science.gov (United States)

    Li, Yiqiong; Sheldon, Peter

    2014-01-01

    This article examines collaborative initiatives individual foreign-invested enterprises (FIEs) develop with China's vocational education and training (VET) schools amid localised shortages of skilled workers. It thus focuses on employer initiatives in responding to VET system weaknesses rather than, as is common, those weaknesses. Using Suzhou…

  3. 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...

  4. 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.

  5. Education for Self Reliance--South Africa's Alternative for Addressing Skills Shortage and Job Creation: A Literature Review

    Science.gov (United States)

    Twalo, T.

    2010-01-01

    South Africa's democratic state has been clouded by various social and economic ills like joblessness, skills shortage, poverty and crime. These are a result of various complex issues which include the apartheid legacy, misdirected education system and poor planning for long term national priorities. This article looks at the lost opportunities to…

  6. Recommendations on reintroduction of agalsidase Beta for patients with fabry disease in europe, following a period of shortage

    DEFF Research Database (Denmark)

    Linthorst, Gabor E; Burlina, Alessandro P; Cecchi, Franco

    2012-01-01

    The interruption of the manufacturing process of agalsidase beta has led to a worldwide shortage of this drug. In the EU, nearly all patients initially reduced their agalsidase beta dose, and many of these switched to agalsidase alfa (Replagal Shire HGT). The clinical consequences of this period...

  7. Water Resources Compound Systems: A Macro Approach to Analysing Water Resource Issues under Changing Situations

    OpenAIRE

    Wei Wang; Deshan Tang; Melissa Pilgrim; Jinan Liu

    2015-01-01

    Water resource crises are an increasing threat to human survival and development. To reveal the nature of water resource issues under changing situations, the water resources system needs to be studied from a macro and systematic perspective. This report develops a water resources system into a water resources compound system that is constantly evolving under the combined action of the development, resistant, and coordination mechanisms. Additionally, the water quotient is defined as a quanti...

  8. Progress in alternative neutron detection to address the helium-3 shortage

    Energy Technology Data Exchange (ETDEWEB)

    Kouzes, Richard T., E-mail: rkouzes@pnl.gov; Lintereur, Azaree T.; Siciliano, Edward R.

    2015-06-01

    One of the main uses for {sup 3}He is in gas proportional counters for neutron detection. Such detectors are used at neutron scattering science facilities and in radiation portal monitors deployed for homeland security and non-proliferation applications. Other uses of {sup 3}He are for research detectors, commercial instruments, well logging detectors, dilution refrigerators, lung imaging, for targets in nuclear research, and for basic research in condensed matter physics. The supply of {sup 3}He comes entirely from the decay of tritium produced for nuclear weapons in the U.S. and Russia. Due to the large increase in use of {sup 3}He for science and homeland security (since 2002), the supply could no longer meet the demand. This has led to the development of a number of alternative neutron detection schemes. - Highlights: • There is a shortage of {sup 3}He for gas proportional counters for neutron detection. • This has led to the development of alternative neutron detection schemes. • Both thermal and fast neutron detection approaches have been developed. • Thermal neutron solutions are mostly boron-based or lithium-based. • Fast neutron solutions include liquid/plastic scintillators, bubble chambers or {sup 4}He.

  9. [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.

  10. Opportunities to Create New General Surgery Residency Programs to Alleviate the Shortage of General Surgeons.

    Science.gov (United States)

    Meagher, Ashley D; Beadles, Christopher A; Sheldon, George F; Charles, Anthony G

    2016-06-01

    To estimate the capacity for supporting new general surgery residency programs among U.S. hospitals that currently do not have such programs. The authors compiled 2011 American Hospital Association data regarding the characteristics of hospitals with and without a general surgery residency program and 2012 Accreditation Council for Graduate Medical Education data regarding existing general surgery residencies. They performed an ordinary least squares regression to model the number of residents who could be trained at existing programs on the basis of residency program-level variables. They identified candidate hospitals on the basis of a priori defined criteria for new general surgery residency programs and an out-of-sample prediction of resident capacity among the candidate hospitals. The authors found that 153 hospitals in 39 states could support a general surgery residency program. The characteristics of these hospitals closely resembled the characteristics of hospitals with existing programs. They identified 435 new residency positions: 40 hospitals could support 2 residents per year, 99 hospitals could support 3 residents, 12 hospitals could support 4 residents, and 2 hospitals could support 5 residents. Accounting for progressive specialization, new residency programs could add 287 additional general surgeons to the workforce annually (after an initial five- to seven-year lead time). By creating new general surgery residency programs, hospitals could increase the number of general surgeons entering the workforce each year by 25%. A challenge to achieving this growth remains finding new funding mechanisms within and outside Medicare. Such changes are needed to mitigate projected workforce shortages.

  11. Melia azedarach plants show tolerance properties to water shortage treatment: an ecophysiological study.

    Science.gov (United States)

    Dias, Maria Celeste; Azevedo, Carla; Costa, Maria; Pinto, Glória; Santos, Conceição

    2014-02-01

    Candidate species for reforestation of areas prone to drought must combine water stress (WS) tolerance and economic or medicinal interest. Melia azedarach produces high quality timber and has insecticidal and medicinal properties. However, the impact of WS on M. azedarach has not yet been studied. Two-month old M. azedarach plants were exposed to WS during 20 days. After this period, plant's growth, water potential, photosynthetic performance and antioxidant capacity were evaluated. WS did not affect plants' growth, but induced stomatal closure, reduced net CO₂ assimilation rate (A) and the intercellular CO₂ availability in mesophyll (C(i)). WS also reduced the photosynthetic efficiency of PSII but not the pigment levels. WS up-regulated the antioxidant enzymes and stimulated the production of antioxidant metabolites, preventing lipid peroxidation. Therefore, despite some repression of photosynthetic parameters by WS, they did not compromise plant growth, and plants increased their antioxidant capacity. Our data demonstrate that M. azedarach juvenile plants have the potential to acclimate to water shortage conditions, opening new perspectives to the use of this species in reforestation/afforestation programs of drought prone areas. Copyright © 2014. Published by Elsevier Masson SAS.

  12. Effect of food shortage on the physiology and competitive abilities of sand martin (Riparia riparia) nestlings.

    Science.gov (United States)

    Brzek, P; Konarzewski, M

    2001-09-01

    We examined developmental and behavioural plasticity of sand martin (Riparia riparia) nestlings hand-reared under laboratory conditions. We created six broods of six 4-day-old nestlings and randomly assigned them to one of the two following feeding regimens, each lasting for 3 days: (1) all nestmates fed a similar, limited amount of food (FR nestlings). This simulated synchronous hatching under conditions of food restriction. (2) Half the brood were food-restricted (FR/AL nestlings), and half were fed ad libitum (AL nestlings), as in asynchronously hatched broods with differential food allocation. Under both regimens, food restriction resulted in a reduction in body mass, intestinal mass, pectoral muscle mass, fat reserves, body temperature and resting metabolic rate (RMR). However, it simultaneously triggered a significant increase in intestinal uptake rates of L-proline and locomotor activity, quantified as frequency of crawling into the artificial nest tunnel by individual nestlings. Locomotor activity and intestinal uptake rates of L-proline by FR nestlings were higher than those of FR/AL young, while body temperature and RMR of FR nestlings were lower. We conclude that food-restricted nestlings responded actively to food shortages by upregulating their gut function, reducing the energy costs of maintenance and increasing locomotor activity. These behavioural and physiological responses were strongest in broods of similar-sized FR nestlings, which can be interpreted as an escalation of sibling competition. Thus, developmental and behavioural plasticity may be an important factor in the evolution of sibling rivalry.

  13. 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.

  14. Modeling the effects of aerosols to increase rainfall in regions with shortage

    Science.gov (United States)

    Shukla, J. B.; Sundar, Shyam; Misra, A. K.; Naresh, Ram

    2013-05-01

    It is well known that the emissions of hot gases from various power stations and other industrial sources in the regional atmosphere cause decrease in rainfall around these complexes. To overcome this shortage, one method is to introduce artificially conducive aerosol particles in the atmosphere using aeroplane to increase rainfall. To prove the feasibility of this idea, in this paper, a nonlinear mathematical model is proposed involving five dependent variables, namely, the volume density of water vapour, number densities of cloud droplets and raindrops, and the concentrations of small and large size conducive aerosol particles. It is assumed that two types of aerosol particles are introduced in the regional atmosphere, one of them is of small size CCN type which is conducive to increase cloud droplets from vapour phase, while the other is of large size and is conducive to transform the cloud droplets to raindrops. The model is analyzed using stability theory of differential equations and computer simulation. The model analysis shows that due to the introduction of conducive aerosol particles in the regional atmosphere, the rainfall increases as compared to the case when no aerosols are introduced in the atmosphere of the region under consideration. The computer simulation confirms the analytical results.

  15. 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.

  16. 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...

  17. 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.

  18. 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…

  19. REDUCED-SIZE LIVER-TRANSPLANTATION, SPLIT LIVER-TRANSPLANTATION, AND LIVING-RELATED LIVER-TRANSPLANTATION IN RELATION TO THE DONOR ORGAN SHORTAGE

    NARCIS (Netherlands)

    SLOOFF, MJH

    Because of the shortage of cadaveric donors, three techniques of partial liver grafting have been developed. These techniques are placed in perspective in relation to the organ shortage. Reduced size liver transplantation (RSLTx) is widely used and has results comparable to those from whole liver

  20. 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.

  1. 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.

  2. Survival analysis of HIV-infected patients under antiretroviral ...

    African Journals Online (AJOL)

    admin

    Abstract. Background: The introduction of ART dramatically improved the survival and health quality of HIV-infected patients in the industrialized world; and the survival benefit of ART has been well studied too. However, in resource-poor settings, where such treatment was started only recently, limited data exist on treatment ...

  3. 78 FR 38718 - Lists of Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage...

    Science.gov (United States)

    2013-06-27

    ... HUMAN SERVICES Health Resources and Services Administration Lists of Designated Primary Medical Care... geographic areas, population groups, and facilities designated as primary medical care, mental health, and... (primary medical care, dental, psychiatric, vision care, podiatric, pharmacy, and veterinary care). The...

  4. Assessment of feed resources, feeding practices and coping strategies to feed scarcity by smallholder urban dairy producers in Jimma town, Ethiopia

    OpenAIRE

    Duguma, Belay; Janssens, Geert

    2016-01-01

    Smallholder dairy production is increasingly becoming popular in Jimma town. However, feed shortage is a major constraint to dairy production. The objectives of this study was to assess feed resources, feeding practices and farmers? perceived causes of feed shortage and coping strategies to feed scarcity in smallholder dairy producers in Jimma town, Oromia Regional State, Ethiopia. A total of 54 randomly selected dairy farmers were interviewed using a pre-tested structured questionnaire and t...

  5. Forecasting Japan's physician shortage in 2035 as the first full-fledged aged society.

    Directory of Open Access Journals (Sweden)

    Koichiro Yuji

    Full Text Available 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.

  6. Ducklings exhibit substantial energy-saving mechanisms as a response to short-term food shortage.

    Science.gov (United States)

    Moe, Borge; Stolevik, Einar; Bech, Claus

    2005-01-01

    We investigated whether Pekin ducklings (Anas platyrhyncos domesticus) exhibited any energy-saving mechanisms that could lessen the detrimental effects of reduced food intake during early development. Further, we evaluated the role of body compositional changes behind such potential mechanisms and the consequences on thermoregulatory capacity. The ducklings exhibited substantial energy-saving mechanisms as a response to diet restriction. After 5 d of diet restriction, the resting metabolic rate (RMR) of 10- and 20-d-old ducklings was 16.4% and 32.1% lower, respectively, than predicted from body mass compared with ad lib. fed ducklings (controls). These reductions in RMR could have been adaptive responses in anticipation of a lasting food shortage, or they could have been consequences of the restricted diet and the lack of essential nutrients. We argue that the responses were adaptive. The low RMRs were not a consequence of depleted fuel stores because the diet-restricted ducklings exhibited substantial amounts of stored lipids at the end of the diet-restriction periods. Hypothermia accounted for approximately 50% of the reduction in RMR in the 10-d-old diet-restricted ducklings, but hypothermia did not occur in the 20-d-old diet-restricted ducklings. Diet restriction resulted in a reduced liver and intestine size and an unchanged size of the leg muscles and heart, while the length of the skull increased (compared with controls of a given body mass). However, changes in body composition were only minor predictors of the observed changes in RMR. Peak metabolic rate (PMR) was approximately 10% lower in the diet-restricted ducklings compared with the controls. We have interpreted the lower PMR as a consequence of the reductions in RMR rather than as a consequence of a decreased function of the thermoregulatory effector mechanisms.

  7. 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

  8. Mineral resources

    NARCIS (Netherlands)

    Henckens, M.L.C.M.; Ierland, van E.C.; Driessen, P.P.J.; Worrell, E.

    2016-01-01

    The extractable ores of the world's geologically scarcest mineral resources (e.g. antimony, molybdenum and zinc) may be exhausted within several decades to a century, if their extraction continues to increase. This paper explores the likelihood that these scarce mineral resources can be conserved

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

    African Journals Online (AJOL)

    Conclusion: This audit identifies resource deficiencies. Healthcare workers must have regular in-service training and education on fetal monitoring, interpretation and timeous action when an abnormal CTG occurs. The hospital management must be involved in delays in CS due to staff shortages and alternate arrangements ...

  10. Learning to share the resource and the responsibility in an Andean ...

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

    Cathy Egan

    Water shortages that ruined the crops of marginal farmers led to conflicts and a demand for increased water supply that threatened to destroy a unique ecological reserve in the Ecuadorian Andes. But participatory research showed that the real problems lay with management of the resource. Solutions required the people of.

  11. 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…

  12. 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…

  13. GAVI : The Global Fund and World Bank Support for Human Resources for Health in Developing Countries

    OpenAIRE

    Vujicic, Marko; Weber, Stephanie E.; Nikolic, Irina A.; Atun, Rifat; Kumar, Ranjana

    2011-01-01

    Shortages, geographic imbalances, and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, development agencies have increasingly recognized the need to invest in Human Resources for Health (HRH) to assist countries in achieving their health system goals. In this paper we analyze the HRH-related activities of t...

  14. The Global International Waters Assessment for the Pacific Islands: aspects of transboundary, water shortage, and coastal fisheries issues.

    Science.gov (United States)

    South, G Robin; Skelton, Posa A; Veitayaki, Joeli; Resture, Alan; Carpenter, Clive; Pratt, Craig; Lawedrau, Alena

    2004-02-01

    Aspects of transboundary, water shortage, and fisheries issues are discussed in the context of the recently completed Global International Waters Assessment (GIWA) for the Pacific Islands. The region encompasses some 30 million km2 and approximately 12% of the world's ocean space, and features great geographic, demographic and developmental diversity. Global change, especially sea level rise and sea surface temperature increases, is the dominant transboundary concern as it impacts all aspects of life. Water shortage and unsustainable fishing issues are selected for discussion, as they will dominate the region into the foreseeable future, and they are illustrated with examples from Fiji, Kiribati, and Tonga. The environmental impacts are exacerbated by socioeconomic issues such as high population growth rates, urban drift, the breakdown of traditional life styles and the rapid adoption of the cash economy. Policy options that may assist in addressing these issues are proposed.

  15. A supplement to an EOQ model with imperfect quality items, inspection errors, shortage backordering, and sales return

    Directory of Open Access Journals (Sweden)

    Jia-Tzer Hsu

    2014-04-01

    Full Text Available Hsu and Hsu (2013a established a closed-form solution for an EOQ model with imperfect quality items, inspection errors, shortage backordering, and sales returns, where the customers who return the defective items will receive full price refunds; i.e., the returned items are not replaced with good items. In this note, we extend Hsu and Hsu's (2013a work to consider the case that returned items are replaced with good items. A closed-form solution is developed for the optimal order size and the maximum shortage level. Numerical examples are provided to show the differences in the optimal solutions when returned items are replaced, and when they are not.

  16. 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

  17. 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

    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...it also reduces overall cost to the patient. Currently the cost of a trauma critical care bed is $2,841.47/night while critical care nursing is

  18. 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

  19. Less is more: researcher survival guide in times of economic crisis

    OpenAIRE

    Cagnacci, Francesca; Cardini, Andrea; Ciucci, Paolo; Ferrari, Nicola; Mortelliti, Alessio; Preatoni, Damiano G.; Russo, Danilo; Scandura, Massimo; Wauters, Lucas A.; Amori, Giovanni

    2013-01-01

    The global economic crisis leads to important changes in investment policies that hit scientific research too. Scientists are currently facing a period of limited availability of research funds. However, this period of shortage of economic resources may also represent an opportunity of re- newal for scientific research, since it may call for improved efficiency and effectiveness and lead to a critical re-evaluation of strategies and priorit- ies. In this opinion paper, we collated a scattered...

  20. Rethinking resources

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, W.L. [Univ. of Texas, Austin, TX (United States)

    1994-09-01

    We class energy and mineral resources as finite because we are reasonably certain that they do not form at a rate remotely approaching man`s rate of use. We have certain environments of the earth that have limits in carrying capacity, and we presume that the global environment does as well. These facts and presumptions, coupled with anxieties over growth in population and consumption, have posed pictures of impending catastrophe from Malthus through the Club of Rome and currently, among certain advocates of what is called sustainable development. To avoid future calamity, command and control management of resource use is urged by many. But, quite simply, such management would presume a wisdom that historical experience suggests does not exist. As a recent example, consider natural gas resources. A decade and a half ago, the resource base of natural gas in the United States was judged to be near exhaustion. Estimates of remaining resources by governmental agencies, academicians, and several major energy companies indicated the ultimate resource would be at about 100 tcf today, with essential depletion by the end of the century. Such was the near universal wisdom that compelled Congress to enact legislation to outright prohibit certain use of natural gas. Today, after nearly eight years of gas supply in excess of demand and with entirely new appreciation of the impact of technology, estimates of the remaining gas resource by industry, government, and others are an order of magnitude greater than those made just 15 yr ago, and the same government that then sought to husband a resource presumed to be near depletion now aggressively promotes its use and consumption. Limits to resources and limits to environmental carrying capacity do indeed exist, but we have yet to define those limits and the paths thereto.

  1. 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

  2. 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)

    2014-01-01

    Background 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. Methods 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. Results 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

  3. Mineral Resources

    OpenAIRE

    Ababsa, Myriam

    2014-01-01

    Jordan’s natural resources are very limited: water is scarce, there is little arable land and the country has few sources of energy (fig. I.11). Jordan’s mineral industry has a long history: flint was used in prehistoric times and early copper mining started in Wadi Faynan during the Chalcolithic Period. The following is a brief presentation of Jordan’s resources. Mining and investments will be studied in Part 3. Figure I.11 — Jordan Mineral Resources. NRA 2012 Phosphates The Jordanian Natur...

  4. Opportunities and challenges of expanded criteria organs in liver and kidney transplantation as a response to organ shortage.

    Science.gov (United States)

    Solomon, Harvey

    2011-01-01

    In 1989, there were 19,000 patients on the UNOS (United Network of Organ Sharing) wait list for organs compared to 110,000 today. Without an equivalent increase in donors, the patients awaiting these organs for transplant face increasing severity of illness and risk of dying without receiving a transplant. This disparity in supply and demand has led to acceptance of organs with lower than expected success rates compared to previous standard donors variously defined as extended criteria donors in order to increase transplantation. The reluctance to wider use of these types of organs is based on the less than expected transplant center graft and patient survival results associated with their use, as well as the increased resources required to care for the patients who receive these organs. The benefits need to be compared to the survival of not receiving a transplant and remaining on the waiting list rather than on outcomes of receiving a standard donor. A lack of a systematic risk outcomes adjustment is one of the most important factors preventing more extensive utilization as transplant centers are held to patient and graft survival statistics as a performance measure by multiple regulatory organizations and insurers. Newer classification systems of such donors may allow a more systematic approach to analyzing the specific risks to individualized patients. Due to changes in donor policies across the country, there has been an increase in Extended Criteria Donors (ECD) organs procured by organ procurement organizations (OPO) but their uneven acceptance by the transplant centers has contributed to an increase in discards and organs not being used. This is one of the reasons that wider sharing of organs is currently receiving much attention. Transplanting ECD organs presents unique challenges and innovative approaches to achieve satisfactory results. Improved logistics and information technology combined strategies for improving donor quality with may prevent discards

  5. Split cornea transplantation for 2 recipients: a new strategy to reduce corneal tissue cost and shortage.

    Science.gov (United States)

    Heindl, Ludwig M; Riss, Stephan; Bachmann, Bjoern O; Laaser, Kathrin; Kruse, Friedrich E; Cursiefen, Claus

    2011-02-01

    remained clear up to 6 months after surgery. Split use of donor corneal tissue for combined DALK and DMEK procedures in 2 recipients on the same surgery day is a promising strategy to reduce donor shortage and cost in corneal transplantation surgery in the future. Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  6. 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

  7. 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.

  8. 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. ...

  9. Seaweed resources

    Digital Repository Service at National Institute of Oceanography (India)

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

    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...

  10. 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/ ...

  11. 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/depress/ ...

  12. 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 -- ...

  13. 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....

  14. 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.

  15. Aircraft Survivability: Rotorcraft Survivability. Summer 2010

    Science.gov (United States)

    2010-01-01

    protect those who serve to protect us?” The answer is a mixed bag. I am fortunate to have joined a group of dedicated men and women who represent this...and Service subject matter experts on rotorcraft safety and survivability to complete the study and report the results to the Joint Chiefs of...Operations and Support CDD TEMP DT DT/OT LUT IOT &E BLRIP TEMP TEMP LRIP Acquisition & LFT Strategies B C LFT&E Review Requirements Approve TEMPs

  16. Changes in food resources and conservation of scarab beetles

    DEFF Research Database (Denmark)

    Carpaneto, Giuseppe Maria; Mazziotta, Adriano; Piattella, Emanuele

    2005-01-01

    The aim of the research was to show how a change in land use influences the structure of a dung beetle assemblage and affect its conservation. In the Pineto Urban Regional Park (Rome), dog dung is the sole food resource currently available for scarab dung beetles, after the recent removal of wild...... showed a high percentage of tunnellers, probably because of the food shortage and, for dog scats, of the high dehydration rate. A comparison with other Roman scarab communities enhanced that: (1) the change in food resource determined a higher difference in species composition respect to other parameters...

  17. 2-DE proteomics analysis of drought treated seedlings of Quercus ilex supports a root active strategy for metabolic adaptation in response to water shortage.

    Science.gov (United States)

    Simova-Stoilova, Lyudmila P; Romero-Rodríguez, Maria C; Sánchez-Lucas, Rosa; Navarro-Cerrillo, Rafael M; Medina-Aunon, J Alberto; Jorrín-Novo, Jesús V

    2015-01-01

    Holm oak is a dominant tree in the western Mediterranean region. Despite being well adapted to dry hot climate, drought is the main cause of mortality post-transplanting in reforestation programs. An active response to drought is critical for tree establishment and survival. Applying a gel-based proteomic approach, dynamic changes in root proteins of drought treated Quercus ilex subsp. Ballota [Desf.] Samp. seedlings were followed. Water stress was applied on 20 day-old holm oak plantlets by water limitation for a period of 10 and 20 days, each followed by 10 days of recovery. Stress was monitored by changes in water status, plant growth, and electrolyte leakage. Contrary to leaves, holm oak roots responded readily to water shortage at physiological level by growth inhibition, changes in water status and membrane stability. Root proteins were extracted using trichloroacetate/acetone/phenol protocol and separated by two-dimensional electrophoresis. Coomassie colloidal stained gel images were analyzed and spot intensity data subjected to multivariate statistical analysis. Selected consistent spots in three biological replicas, presenting significant changes under stress, were subjected to MALDI-TOF mass spectrometry (peptide mass fingerprinting and MS/MS). For protein identification, combined search was performed with MASCOT search engine over NCBInr Viridiplantae and Uniprot databases. Data are available via ProteomeXchange with identifier PXD002484. Identified proteins were classified into functional groups: metabolism, protein biosynthesis and proteolysis, defense against biotic stress, cellular protection against abiotic stress, intracellular transport. Several enzymes of the carbohydrate metabolism decreased in abundance in roots under drought stress while some related to ATP synthesis and secondary metabolism increased. Results point at active metabolic adjustment and mobilization of the defense system in roots to actively counteract drought stress.

  18. 2-DE proteomics analysis of drought treated seedlings of Quercus ilex supports a root active strategy for metabolic adaptation in response to water shortage

    Directory of Open Access Journals (Sweden)

    Lyudmila Petrova Simova-Stoilova

    2015-08-01

    Full Text Available Holm oak is a dominant tree in the western Mediterranean region. Despite being well adapted to dry hot climate, drought is the main cause of mortality post-transplanting in reforestation programs. An active response to drought is critical for tree establishment and survival. Applying a gel-based proteomic approach, the dynamic changes in root proteins of drought treated Quercus ilex subsp. Ballota [Desf.] Samp. seedlings were followed. Water stress was applied on 20 day-old holm oak plantlets by water limitation for a period of 10 and 20 days, each followed by 10 days of recovery. Stress was monitored by changes in water status, plant growth and electrolyte leakage. Contrary to leaves, holm oak roots responded readily to water shortage at physiological level by growth inhibition, changes in water status and membrane stability. Root proteins were extracted using trichloroacetate/acetone/phenol protocol and subjected to two-dimensional electrophoresis. Coomassie colloidal stained gel images were analysed and spot intensity data subjected to multivariate statistical analysis. Selected consistent spots in the three biological replicas, presenting significant changes under stress, were subjected to MALDI-TOF mass spectrometry (peptide mass fingerprinting and MS/MS. For protein identification, combined search was performed with MASCOT search engine over NCBInr Viridiplantae and Uniprot databases. Data are available via ProteomeXchange with identifier PXD002484. Identified proteins were classified into functional groups: metabolism, protein biosynthesis and proteolysis, defence against biotic stress, cellular protection against abiotic stress, intracellular transport. Several enzymes of the carbohydrate metabolism decreased in abundance in roots under drought stress while some related to ATP synthesis and secondary metabolism increased. Results point at active metabolic adjustment and mobilization of the defence system in roots to actively counteract

  19. 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.

  20. 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 Wood Johnson Foundation Clinical Scholars program. Ross reports receiving research support through Yale University from Johnson and Johnson to develop methods of clinical

  1. Proof-Carrying Survivability

    Science.gov (United States)

    2013-01-15

    pp.289-302 ( Impact factor : 2.09). 2. Julic, J. and Zuo, Y. (2012). “An RFID Survivability Impact Model in the Military Domain”, Proc. of 18 th...Availability, Reliability and Security, 40(4), pp. 406-418 ( Impact factor : 2.016). 10. Zuo, Y. (2010). “A Holistic Approach for Specification of Security... Impact factor : 1.596). 20. Zuo, Y., Pimple, M. and Lande, S. (2009). “A Framework for RFID Survivability Requirement Analysis and Specification”, Proc

  2. Making the organic food service chain work and survive

    DEFF Research Database (Denmark)

    Kristensen, Niels Heine; Netterstrøm, Sune; He, Chen

    2009-01-01

    and organic procurement schemes are developing as a strategic part of policymaker’s tools. However evidence has shown that the organic change agenda in public food service supply chains seems to be fragile. This is due to the fact that the organic agenda challenges the normal way that food service provision...... works and thus it seems not enough to implement organic food once and for all. The organic supply chain is dynamic being challenged by influences as price premiums, supply shortages and problems of convenience level. This paper investigates three Danish municipalities focusing on important elements...... in the policy process that make the organic food service chain work and survive on a long-term scale....

  3. Cheese 'refinement' with whey B-vitamin removal during precipitation potentially induces temporal 'functional' dietary shortage: homocysteine as a biomarker.

    Science.gov (United States)

    Shapira, N

    2014-07-25

    Cottage cheese 'refinement' with massive B-vitamin losses (≈70-84%) through whey removal during precipitation may potentially induce an acute imbalance between protein/methionine load and temporal inadequacy/shortage of nutrients critical for their metabolism, i.e. B6 and B12. The temporal effect of cottage cheese consumption was evaluated using increased plasma homocysteine as a B-vitamin shortage marker. In a double-blind study, healthy, normal-weight (BMI = 22-27), premenopausal women aged 25-45 years were first given a methionine load (100 mg kg(-1), n = 15), then cottage cheese alone (500 g, ≈50 g protein, ≈1200 mg methionine, n = 49) at breakfast, and then with added B6 (2 mg, n = 8) and/or B6 + folate (1 mg + 200 mcg, n = 7). Plasma homocysteine was measured preprandially (t0) and then postprandially 5 h (t5) and ≥6-24 h. Cheese-induced homocysteine increased 28.7% (p ≤ 0.001), ≈60% of the free methionine response, remaining higher through ≥6-8 h. Co-supplementation with B6 reduced the Hcy increase by 45.0% (to 14.9%, p = 0.025), and that with B6 + folate reduced the Hcy increase by 72.3% (to 7.5%, p = 0.556, NS). Homocysteine increased more in participants with lower baselines (cheese, ≈3-fold (54.8% vs. 18.5%) or methionine, 47.3% (266.7% vs. 181.1%). Cheese B-vitamin depletion - i.e. to B6 ≈ 2.0-4.0 μg g(-1) protein, far below women's metabolic requirement (15-20 μg g(-1)) - appeared to induce acute relative shortage compared to methionine/protein loads, exemplified by greater homocysteine increases than with other animal proteins (previous data), more so with lower baseline homocysteine. Smaller increases following re-supplementation demonstrated potential for 'functional fortification'/co-supplementation. Unnoted cheese 'refinement', like white bread, potentially induces episodic vitamin shortage effects, warranting consideration for acute/cumulative implications, alternative processing/supplementation technologies, and food

  4. 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.

  5. 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....

  6. Education for Survival

    Science.gov (United States)

    Aldrich, Richard

    2010-01-01

    This article provides a brief overview of current approaches to education and concludes that none of these is sufficient to meet the challenges that now face the human race. It argues instead for a new concept of education for survival. (Contains 1 note.)

  7. Flexible survival regression modelling

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Scheike, Thomas H; Martinussen, Torben

    2009-01-01

    Regression analysis of survival data, and more generally event history data, is typically based on Cox's regression model. We here review some recent methodology, focusing on the limitations of Cox's regression model. The key limitation is that the model is not well suited to represent time-varyi...

  8. Seeds to survive

    NARCIS (Netherlands)

    Groot, S.P.C.

    2002-01-01

    Seeds are important for man, either as propagation material of crops or directly for the production of foods, fodder and drinks. The natural function of seeds is dispersal of its genes to successive generations. Survival mechanisms seed have evolved sometimes interfere with those preferred by

  9. Survival After Retirement.

    Science.gov (United States)

    Holloway, Clark; Youngblood, Stuart A.

    1986-01-01

    Examined survival rates after retirement in a large corporation. A regression analysis was performed to control for age, sex, job status, and type of work differences that may influence longevity. Short-term suvivors seemed to undergo a different adjustment process than long-term survivors. (Author/ABL)

  10. 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.

  11. Surviving After Suicide

    Science.gov (United States)

    ... of resources and programs to survivors in an attempt to lessen the pain as they travel their special path of grief. These include: Survivors of Suicide Kit: an information kit consisting of fact sheets, ...

  12. Food Shortage Causes Differential Effects on Body Composition and Tissue-Specific Gene Expression in Salmon Modified for Increased Growth Hormone Production.

    Science.gov (United States)

    Abernathy, Jason; Panserat, Stéphane; Welker, Thomas; Plagne-Juan, Elisabeth; Sakhrani, Dionne; Higgs, David A; Audouin, Florence; Devlin, Robert H; Overturf, Ken

    2015-12-01

    Growth hormone (GH) transgenic salmon possesses markedly increased metabolic rate, appetite, and feed conversion efficiency, as well as an increased ability to compete for food resources. Thus, the ability of GH-transgenic fish to withstand periods of food deprivation as occurs in nature is potentially different than that of nontransgenic fish. However, the physiological and genetic effects of transgenic GH production over long periods of food deprivation remain largely unknown. Here, GH-transgenic coho salmon (Oncorhynchus kisutch) and nontransgenic, wild-type coho salmon were subjected to a 3-month food deprivation trial, during which time performance characteristics related to growth were measured along with proximate compositions. To examine potential genetic effects of GH-transgenesis on long-term food deprivation, a group of genes related to muscle development and liver metabolism was selected for quantitative PCR analysis. Results showed that GH-transgenic fish lose weight at an increased rate compared to wild-type even though proximate compositions remained relatively similar between the groups. A total of nine genes related to muscle physiology (cathepsin, cee, insulin-like growth factor, myostatin, murf-1, myosin, myogenin, proteasome delta, tumor necrosis factor) and five genes related to liver metabolism (carnitine palmitoyltransferase, fatty acid synthase, glucose-6-phosphatase, glucose-6-phosphate dehydrogenase, glucokinase) were shown to be differentially regulated between GH-transgenic and wild-type coho salmon over time. These genetic and physiological responses assist in identifying differences between GH-transgenic and wild-type salmon in relation to fitness effects arising from elevated growth hormone during periods of long-term food shortage.

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

    Directory of Open Access Journals (Sweden)

    Tomasz Bochenek

    2018-01-01

    Full Text Available 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

  14. 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

  15. United Nations Office on Drugs and Crime International Network of Drug Dependence Treatment and Rehabilitation Resource Centres: Treatnet

    Science.gov (United States)

    Tomas-Rossello, Juana; Rawson, Richard A.; Zarza, Maria J.; Bellows, Anne; Busse, Anja; Saenz, Elizabeth; Freese, Thomas; Shawkey, Mansour; Carise, Deni; Ali, Robert; Ling, Walter

    2010-01-01

    Key to the dissemination of evidence-based addiction treatments is the exchange of experiences and mutual support among treatment practitioners, as well as the availability of accurate addiction training materials and effective trainers. To address the shortage of such resources, the United Nations Office on Drugs and Crime (UNODC) created…

  16. 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.; 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

  17. 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.

  18. Social Perception of Public Water Supply Network and Groundwater Quality in an Urban Setting Facing Saltwater Intrusion and Water Shortages.

    Science.gov (United States)

    Alameddine, Ibrahim; Jawhari, Gheeda; El-Fadel, Mutasem

    2017-04-01

    Perceptions developed by consumers regarding the quality of water reaching their household can affect the ultimate use of the water. This study identified key factors influencing consumers' perception of water quality in a highly urbanized coastal city, experiencing chronic water shortages, overexploitation of groundwater, and accelerated saltwater intrusion. Household surveys were administered to residents to capture views and perceptions of consumed water. Concomitantly, groundwater and tap water samples were collected and analyzed at each residence for comparison with perceptions. People's rating of groundwater quality was found to correlate to the measured water quality both in the dry and wet seasons. In contrast, perceptions regarding the water quality of the public water supply network did not show any correlation with the measured tap water quality indicators. Logistic regression models developed to predict perception based on salient variables indicated that age, apartment ownership, and levels of total dissolved solids play a significant role in shaping perceptions regarding groundwater quality. Perceptions concerning the water quality of the public water supply network appeared to be independent of the measured total dissolved solids levels at the tap but correlated to those measured in the wells. The study highlights misconceptions that can arise as a result of uncontrolled cross-connections of groundwater to the public supply network water and the development of misaligned perceptions based on prior consumption patterns, water shortages, and a rapidly salinizing groundwater aquifer.

  19. Social Perception of Public Water Supply Network and Groundwater Quality in an Urban Setting Facing Saltwater Intrusion and Water Shortages

    Science.gov (United States)

    Alameddine, Ibrahim; Jawhari, Gheeda; El-Fadel, Mutasem

    2017-04-01

    Perceptions developed by consumers regarding the quality of water reaching their household can affect the ultimate use of the water. This study identified key factors influencing consumers' perception of water quality in a highly urbanized coastal city, experiencing chronic water shortages, overexploitation of groundwater, and accelerated saltwater intrusion. Household surveys were administered to residents to capture views and perceptions of consumed water. Concomitantly, groundwater and tap water samples were collected and analyzed at each residence for comparison with perceptions. People's rating of groundwater quality was found to correlate to the measured water quality both in the dry and wet seasons. In contrast, perceptions regarding the water quality of the public water supply network did not show any correlation with the measured tap water quality indicators. Logistic regression models developed to predict perception based on salient variables indicated that age, apartment ownership, and levels of total dissolved solids play a significant role in shaping perceptions regarding groundwater quality. Perceptions concerning the water quality of the public water supply network appeared to be independent of the measured total dissolved solids levels at the tap but correlated to those measured in the wells. The study highlights misconceptions that can arise as a result of uncontrolled cross-connections of groundwater to the public supply network water and the development of misaligned perceptions based on prior consumption patterns, water shortages, and a rapidly salinizing groundwater aquifer.

  20. Resource Management

    Science.gov (United States)

    1993-01-01

    Summit Envirosolutions of Minneapolis, Minnesota, used remote sensing images as a source for groundwater resource management. Summit is a full-service environmental consulting service specializing in hydrogeologic, environmental management, engineering and remediation services. CRSP collected, processed and analyzed multispectral/thermal imagery and aerial photography to compare remote sensing and Geographic Information System approaches to more traditional methods of environmental impact assessments and monitoring.

  1. Successful implementation of Helping Babies Survive and Helping Mothers Survive programs-An Utstein formula for newborn and maternal survival.

    Directory of Open Access Journals (Sweden)

    Hege L Ersdal

    Full Text Available Globally, the burden of deaths and illness is still unacceptably high at the day of birth. Annually, approximately 300.000 women die related to childbirth, 2.7 million babies die within their first month of life, and 2.6 million babies are stillborn. Many of these fatalities could be avoided by basic, but prompt care, if birth attendants around the world had the necessary skills and competencies to manage life-threatening complications around the time of birth. Thus, the innovative Helping Babies Survive (HBS and Helping Mothers Survive (HMS programs emerged to meet the need for more practical, low-cost, and low-tech simulation-based training. This paper provides users of HBS and HMS programs a 10-point list of key implementation steps to create sustained impact, leading to increased survival of mothers and babies. The list evolved through an Utstein consensus process, involving a broad spectrum of international experts within the field, and can be used as a means to guide processes in low-resourced countries. Successful implementation of HBS and HMS training programs require country-led commitment, readiness, and follow-up to create local accountability and ownership. Each country has to identify its own gaps and define realistic service delivery standards and patient outcome goals depending on available financial resources for dissemination and sustainment.

  2. [Usage of marginal organs for liver transplantation: a way around the critical organ shortage?].

    Science.gov (United States)

    Pratschke, S; Loehe, F; Graeb, C; Jauch, K W; Angele, M K

    2009-04-01

    The transplantation of marginal organs or those meeting the so-called extended donor criteria (EDC) is today a significant option to alleviate the low availability or organs and to increase the number of transplantation which in turn is -accompanied by a lower mortality among wait-ing-list patients. However such an extension of the spender pool carries the risks of an increased incidence of organ dysfuntions and a higher recipient mortality. This situation presents an ethical problem when marginal organs are accepted for transplantation because the anticipated mortality for the individual recipient cannot be determined. The transplantation of marginal organs from -donors with a high MELD score seems to be linked to a higher mortality. In particular, the combina-tions of high donor age and long ischaemic time or advanced donor age and hepatitis C infection in the recipient are definitively associated with a significantly poorer organ survival rate. In view of the serious lack of organs, efforts should be made, for example, by shortening of the is-chae-mic time and the development of therapeutic strategies, to improve the function and increase the number of usable marginal organs and thus to increase pool of donor organs. The refusal of marginal organs on the basis of individual EDC without consideration of the status of recipient does not seem to be adequate.

  3. 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.

  4. Workforce Resources for Health in Developing Countries

    Directory of Open Access Journals (Sweden)

    Tollman Stephen

    2010-07-01

    Full Text Available With increased globalization and interdependence among countries, sustained health worker migration and the complex threats of rapidly spreading infectious diseases, as well as changing lifestyles, a strong health workforce is essential. Building the human resources for health should not only include healthcare professionals like physicians and nurses, but must take into consideration community health workers, mid-level workers and strengthened primary healthcare systems to increase coverage and address the basic health needs of societies. This is especially true in low and middle-income countries where healthcare access is a critical challenge.There is a global crisis in the health workforce, expressed in acute shortages and maldistribution of health workers, geographically and professionally. This massive global shortage, though imprecise quantitatively, is estimated at more than 4 million workers. To respond to this crisis, policies and actions are needed to address the dynamics of the health labour market and the production and management of the health workforce, and to strengthen the performance of existing health systems. Schools of public health need to develop the range of capacity and leadership in addition to the traditional training of healthcare managers and researchers. Countries should first identify their health problems in order to properly address their health worker needs, retention, recruitment and training, if they are to come close to reaching the Millennium Development Goals (MDGs for health.

  5. 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......, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations...... of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality....

  6. 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......, and to formulate recommendations as strong or weak, or best practice statement when applicable. RESULTS: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations...... of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality....

  7. A Multidomain Survivable Virtual Network Mapping Algorithm

    Directory of Open Access Journals (Sweden)

    Xiancui Xiao

    2017-01-01

    Full Text Available Although the existing networks are more often deployed in the multidomain environment, most of existing researches focus on single-domain networks and there are no appropriate solutions for the multidomain virtual network mapping problem. In fact, most studies assume that the underlying network can operate without any interruption. However, physical networks cannot ensure the normal provision of network services for external reasons and traditional single-domain networks have difficulties to meet user needs, especially for the high security requirements of the network transmission. In order to solve the above problems, this paper proposes a survivable virtual network mapping algorithm (IntD-GRC-SVNE that implements multidomain mapping in network virtualization. IntD-GRC-SVNE maps the virtual communication networks onto different domain networks and provides backup resources for virtual links which improve the survivability of the special networks. Simulation results show that IntD-GRC-SVNE can not only improve the survivability of multidomain communications network but also render the network load more balanced and greatly improve the network acceptance rate due to employment of GRC (global resource capacity.

  8. 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.

  9. Cracking the survival code

    Science.gov (United States)

    Füllgrabe, Jens; Heldring, Nina; Hermanson, Ola; Joseph, Bertrand

    2014-01-01

    Modifications of histones, the chief protein components of the chromatin, have emerged as critical regulators of life and death. While the “apoptotic histone code” came to light a few years ago, accumulating evidence indicates that autophagy, a cell survival pathway, is also heavily regulated by histone-modifying proteins. In this review we describe the emerging “autophagic histone code” and the role of histone modifications in the cellular life vs. death decision. PMID:24429873

  10. Artillery Survivability Model

    Science.gov (United States)

    2016-06-01

    experiment mode also enables users to set their own design of experiment by manipulating an editable CSV file. The second one is a real-time mode that...renders a 3D virtual environment of a restricted battlefield where the survivability movements of an artillery company are visualized . This mode...provides detailed visualization of the simulation and enables future experimental uses of the simulation as a training tool. 14. SUBJECT TERMS

  11. 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

  12. 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

  13. 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)

  14. Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas

    Science.gov (United States)

    2013-01-01

    Background In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Methods Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. Results The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. Conclusions The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g. census tracts), takes interaction between physicians into account, and considers distance decay. While at

  15. Accessibility to primary health care in Belgium: an evaluation of policies awarding financial assistance in shortage areas.

    Science.gov (United States)

    Dewulf, Bart; Neutens, Tijs; De Weerdt, Yves; Van de Weghe, Nico

    2013-08-22

    In many countries, financial assistance is awarded to physicians who settle in an area that is designated as a shortage area to prevent unequal accessibility to primary health care. Today, however, policy makers use fairly simple methods to define health care accessibility, with physician-to-population ratios (PPRs) within predefined administrative boundaries being overwhelmingly favoured. Our purpose is to verify whether these simple methods are accurate enough for adequately designating medical shortage areas and explore how these perform relative to more advanced GIS-based methods. Using a geographical information system (GIS), we conduct a nation-wide study of accessibility to primary care physicians in Belgium using four different methods: PPR, distance to closest physician, cumulative opportunity, and floating catchment area (FCA) methods. The official method used by policy makers in Belgium (calculating PPR per physician zone) offers only a crude representation of health care accessibility, especially because large contiguous areas (physician zones) are considered. We found substantial differences in the number and spatial distribution of medical shortage areas when applying different methods. The assessment of spatial health care accessibility and concomitant policy initiatives are affected by and dependent on the methodology used. The major disadvantage of PPR methods is its aggregated approach, masking subtle local variations. Some simple GIS methods overcome this issue, but have limitations in terms of conceptualisation of physician interaction and distance decay. Conceptually, the enhanced 2-step floating catchment area (E2SFCA) method, an advanced FCA method, was found to be most appropriate for supporting areal health care policies, since this method is able to calculate accessibility at a small scale (e.g., census tracts), takes interaction between physicians into account, and considers distance decay. While at present in health care research

  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. Food Shortages, Hunger, and Famines in the USSR, 1928-33

    Directory of Open Access Journals (Sweden)

    Nicolas Werth

    2016-09-01

    Full Text Available This paper examines policies implemented in stages from 1928 and the multi-causal phenomena that resulted in the deaths of some 6.5 to 7 million people, the majority in Ukraine and the Kuban as well as Kazakhstan, during the man-made Soviet famines of the early 1930s. These famines took on distinctively separate trajectories after the autumn of 1932 when Stalin singled out Ukraine, the largest grain-producing region of the USSR. The Kazakh famine resulted from the devastation of the traditional nomadic Kazakh economy in a misguided effort to make that region a main source of meat for the Soviet Union. Other regions—notably the Middle Volga and Central Chernozem Regions—also suffered. These events were largely driven by Soviet attempts to make the countryside a domestic colony that would provide food resources for the country’s accelerated industrialization. This is particularly evident in the manner Soviet authorities rationed and distributed food.

  18. A Qualitative Approach to a Better Understanding of the Problems Underlying Drug Shortages, as Viewed from Belgian, French and the European Union's Perspectives.

    Science.gov (United States)

    Bogaert, Petronille; Bochenek, Tomasz; Prokop, Anna; Pilc, Andrzej

    2015-01-01

    The problem of drug shortages has been reported worldwide, gaining prominence in multiple domains and several countries in recent years. The aim of the study was to analyze, characterise and assess this problem in Belgium and France, while also adopting a wider perspective from the European Union. A qualitative methodological approach was employed, including semi-structured interviews with the representatives of respective national health authorities, pharmaceutical companies and wholesalers, as well as hospital and community pharmacists. The research was conducted in early 2014. Four themes, which were identified through the interviews, were addressed in the paper, i.e. a) defining drug shortages, b) their dynamics and perception, c) their determinants, d) the role of the European and national institutions in coping with the problem. Three groups of determinants of drug shortages were identified throughout this study: manufacturing problems, distribution and supply problems, and problems related to economic aspects. Currently, the Member States of the European Union are striving to resolve the problem very much on their own, although a far more focused and dedicated collaboration may well prove instrumental in coping with drug shortages throughout Europe more effectively. To the best of the authors' knowledge, this is the first qualitative study to investigate the characteristics, key determinants, and the problem drivers of drug shortages, focusing on this particular group of countries, while also adopting the European Union's perspective.

  19. Comparative effectiveness of epsilon-aminocaproic acid and tranexamic acid on postoperative bleeding following cardiac surgery during a national medication shortage.

    Science.gov (United States)

    Blaine, Kevin P; Press, Christopher; Lau, Ken; Sliwa, Jan; Rao, Vidya K; Hill, Charles

    2016-12-01

    The aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (εACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage. A retrospective cohort study. The study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage. Demographic, clinical, and outcomes data were compared by descriptive statistics using χ 2 and t test. Surgical drainage and transfusions were compared by multivariate linear regression for patients receiving εACA before the shortage and TXA during the shortage. In multivariate analysis, no statistical difference was found for surgical drain output (OR 1.10, CI 0.97-1.26, P=.460) or red blood cell transfusion requirement (OR 1.79, CI 0.79-2.73, P=.176). Patients receiving εACA were more likely to receive rescue hemostatic medications (OR 1.62, CI 1.02-2.55, P=.041). Substitution of εACA with TXA during a national medication shortage produced equivalent postoperative bleeding and red cell transfusions, although patients receiving εACA were more likely to require supplemental hemostatic agents. Published by Elsevier Inc.

  20. Survival by Dialysis Modality-Who Cares?

    Science.gov (United States)

    Lee, Martin B; Bargman, Joanne M

    2016-06-06

    In light of the recent emphasis on patient-centered outcomes and quality of life for patients with kidney disease, we contend that the nephrology community should no longer fund, perform, or publish studies that compare survival by dialysis modality. These studies have become redundant; they are methodologically limited, unhelpful in practice, and therefore a waste of resources. More than two decades of these publications show similar survival between patients undergoing peritoneal dialysis and those receiving thrice-weekly conventional hemodialysis, with differences only for specific subgroups. In clinical practice, modality choice should be individualized with the aim of maximizing quality of life, patient-reported outcomes, and achieving patient-centered goals. Expected survival is often irrelevant to modality choice. Even for the younger and fitter home hemodialysis population, quality of life, not just duration of survival, is a major priority. On the other hand, increasing evidence suggests that patients with ESRD continue to experience poor quality of life because of high symptom burden, unsolved clinical problems, and unmet needs. Patients care more about how they will live instead of how long. It is our responsibility to align our research with their needs. Only by doing so can we meet the challenges of ESRD patient care in the coming decades. Copyright © 2016 by the American Society of Nephrology.

  1. Water resources management in Rostov region (Russia)

    Science.gov (United States)

    Nazarenko, O.

    2009-04-01

    Proper management of water resources leads to the development of the region. Nowadays there is an urgent problem - water shortage. Many European countries face this problem, Russia is not the excluding. In addition, there is a problem not only of water quantity, but quality as well. Although Rostov region is well provided with fresh water, the water resources are unevenly disturbed within region. Rostov region is heavily populated and receive moderate rainfall. Groundwater has a limited capacity for renewal. At the same time, Rostov region is industrial and agricultural one that is why pressures from agriculture, industry and domestic users affect the quantity of water resources. Both water quality and availability must be integrated in long-term planning and policy implications concerning water management. In Russia there are high standards for water quality. Effectively managed water-supply and resource protection systems generate the indispensable basis for agricultural and industrial production. Throughout the Region, urban and rural development has thrived where water sources have been effectively managed. Rostov region can be divided into three parts: northern districts, central part of the region and southern ones. Main cities in the region have not enough available drinking water. In the region ground water is used for curing and water supplying purpose.

  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. 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...

  4. Housing shortages in urban regions: aggressive interactions at tree hollows in forest remnants.

    Directory of Open Access Journals (Sweden)

    Adrian Davis

    Full Text Available Urbanisation typically results in a reduction of hollow-bearing trees and an increase in the density of particularly species, potentially resulting in an increased level of competition as cavity-nesting species compete for a limited resource. To improve understanding of hollow usage between urban cavity-nesting species in Australia, particularly parrots, we investigated how the hollow-using assemblage, visitation rate, diversity and number of interactions varied between hollows within urban remnant forest and continuous forest. Motion-activated video cameras were installed, via roped access to the canopy, and hollow usage was monitored at 61 hollows over a two-year period. Tree hollows within urban remnants had a significantly different assemblage of visitors to those in continuous forest as well as a higher rate of visitation than hollows within continuous forest, with the rainbow lorikeet making significantly more visitations than any other taxa. Hollows within urban remnants were characterised by significantly higher usage rates and significantly more aggressive interactions than hollows within continuous forest, with parrots responsible for almost all interactions. Within urban remnants, high rates of hollow visitation and both interspecific and intraspecific interactions observed at tree hollows suggest the number of available optimal hollows may be limiting. Understanding the usage of urban remnant hollows by wildlife, as well as the role of parrots as a potential flagship for the conservation of tree-hollows, is vital to prevent a decrease in the diversity of urban fauna, particularly as other less competitive species risk being outcompeted by abundant native species.

  5. 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.

  6. Housing shortage and communal politics in European cities around 1900: the cases of Basel 1889 and Belgrade 1906.

    Science.gov (United States)

    Mišković, Nataša

    2011-01-01

    In the second half of the nineteenth century, European cities faced a problem well known in postindependence India: the population escalated due to immigration from the rural areas causing rapid and considerable housing shortage. This forced large parts of the poorer classes into miserable living conditions. Lack of space, money and hygiene facilitated the epidemic spread of diseases such as tuberculosis and diarrhoea. The town authorities were called upon to stop speculation and to launch state financed housing projects. However, in reality the situation was very different depending on the place, political aims and financial possibilities arising out of the particular crisis. This article discusses the issue in two continental European cities of around 100,000 inhabitants. The Swiss town of Basel was a hub of trade in Central Europe, while Belgrade was the capital of the Southeastern European kingdom of Serbia.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    Jingya Liu

    2016-11-01

    Full Text Available 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.

  9. 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

  10. 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....

  11. 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.

  12. Design of survivable networks

    CERN Document Server

    Stoer, Mechthild

    1992-01-01

    The problem of designing a cost-efficient network that survives the failure of one or more nodes or edges of the network is critical to modern telecommunications engineering. The method developed in this book is designed to solve such problems to optimality. In particular, a cutting plane approach is described, based on polyhedral combinatorics, that is ableto solve real-world problems of this type in short computation time. These results are of interest for practitioners in the area of communication network design. The book is addressed especially to the combinatorial optimization community, but also to those who want to learn polyhedral methods. In addition, interesting new research problemsare formulated.

  13. 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.

  14. 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.

  15. 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.

  16. 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 ...

  17. OBESITY IN CANCER SURVIVAL

    Science.gov (United States)

    Parekh, Niyati; Chandran, Urmila; Bandera, Elisa V.

    2013-01-01

    Although obesity is a well known risk factor for several cancers, its role on cancer survival is poorly understood. We conducted a systematic literature review to assess the current evidence evaluating the impact of body adiposity on the prognosis of the three most common obesity-related cancers: prostate, colorectal, and breast. We included 33 studies of breast cancer, six studies of prostate cancer, and eight studies of colorectal cancer. We note that the evidence over-represents breast cancer survivorship research and is sparse for prostate and colorectal cancers. Overall, most studies support a relationship between body adiposity and site-specific mortality or cancer progression. However, most of the research was not specifically designed to study these outcomes and, therefore, several methodological issues should be considered before integrating their results to draw conclusions. Further research is urgently warranted to assess the long-term impact of obesity among the growing population of cancer survivors. PMID:22540252

  18. Surviving relatives after suicide

    DEFF Research Database (Denmark)

    Nørrelykke, Helle; Cohrt, Pernille

    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...... and conflicting feelings may result in pathological expansion of grief characterized by extremely reduced quality of life involving severe psychical and social consequences. Suicide a subject of taboo In the 1980s WHO drafted a health policy document (‘Health for all year 2000’) with 38 targets for attaining......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...

  19. Obesity in cancer survival.

    Science.gov (United States)

    Parekh, Niyati; Chandran, Urmila; Bandera, Elisa V

    2012-08-21

    Although obesity is a well-known risk factor for several cancers, its role on cancer survival is poorly understood. We conducted a systematic literature review to assess the current evidence evaluating the impact of body adiposity on the prognosis of the three most common obesity-related cancers: prostate, colorectal, and breast. We included 33 studies of breast cancer, six studies of prostate cancer, and eight studies of colo-rectal cancer. We note that the evidence overrepresents breast cancer survivorship research and is sparse for prostate and colorectal cancers. Overall, most studies support a relationship between body adiposity and site-specific mortality or cancer progression. However, most of the research was not specifically designed to study these outcomes and, therefore, several methodological issues should be considered before integrating their results to draw conclusions. Further research is urgently warranted to assess the long-term impact of obesity among the growing population of cancer survivors.

  20. Candida survival strategies.

    Science.gov (United States)

    Polke, Melanie; Hube, Bernhard; Jacobsen, Ilse D

    2015-01-01

    Only few Candida species, e.g., Candida albicans, Candida glabrata, Candida dubliniensis, and Candida parapsilosis, are successful colonizers of a human host. Under certain circumstances these species can cause infections ranging from superficial to life-threatening disseminated candidiasis. The success of C. albicans, the most prevalent and best studied Candida species, as both commensal and human pathogen depends on its genetic, biochemical, and morphological flexibility which facilitates adaptation to a wide range of host niches. In addition, formation of biofilms provides additional protection from adverse environmental conditions. Furthermore, in many host niches Candida cells coexist with members of the human microbiome. The resulting fungal-bacterial interactions have a major influence on the success of C. albicans as commensal and also influence disease development and outcome. In this chapter, we review the current knowledge of important survival strategies of Candida spp., focusing on fundamental fitness and virulence traits of C. albicans. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Psychology and survival.

    Science.gov (United States)

    Phillips, D P; Ruth, T E; Wagner, L M

    1993-11-06

    We examined the deaths of 28,169 adult Chinese-Americans, and 412,632 randomly selected, matched controls coded "white" on the death certificate. Chinese-Americans, but not whites, die significantly earlier than normal (1.3-4.9 yr) if they have a combination of disease and birthyear which Chinese astrology and medicine consider ill-fated. The more strongly a group is attached to Chinese traditions, the more years of life are lost. Our results hold for nearly all major causes of death studied. The reduction in survival cannot be completely explained by a change in the behaviour of the Chinese patient, doctor, or death-registrar, but seems to result at least partly from psychosomatic processes.

  2. Resource Mobilisation for Library and Information Services ...

    African Journals Online (AJOL)

    ... library resource mobilisation by highlighting what is going on in Tanzania in particular and Africa in general. The paper concludes that in order to survive in the information market of the 21st century, there is need to strive for innovative and sustainable services. (African Journal of Library, Archives and Information Science: ...

  3. The resource investigation and community structure characteristics ...

    African Journals Online (AJOL)

    ... the most active season of mycorrhiza was between spring and summer and the natural AMF infection rate was increased along with the increasing of forest age. The results will not only provide the theory basis for exploitation and using of mycorrhizal resource, but also enhance the survival rate of seedling and prevent the ...

  4. 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.

  5. 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.

  6. Assessing the levels of food shortage using the traffic light metaphor by analyzing the gathering and consumption of wild food plants, crop partsand crop residues in Konso, Ethiopia

    NARCIS (Netherlands)

    Lemessa Ocho, D.; Struik, P.C.; Price, L.L.; Kelbessa, E.; Kolo, K.

    2012-01-01

    Background Humanitarian relief agencies use scales to assess levels of critical food shortage to efficiently target and allocate food to the neediest. These scales are often labor-intensive. A lesser used approach is assessing gathering and consumption of wild food plants. This gathering per se is

  7. Exploring the thrifty genotype's food-shortage assumptions: a cross-cultural comparison of ethnographic accounts of food security among foraging and agricultural societies.

    Science.gov (United States)

    Benyshek, Daniel C; Watson, James T

    2006-09-01

    The "thrifty genotype hypothesis" has become firmly entrenched as one of the orienting concepts in biomedical anthropology, since first being proposed by Neel (1962 Am. J. Hum. Genet. 14:353-362) over 40 years ago. Its influence on inquiries into the evolutionary origins of diabetes, lactose tolerance, and other metabolic disorders can hardly be underestimated, as evidenced by its continued citation in many top scientific and medical journals. However, its fundamental assumption, that foragers are more likely to experience regular and severe food shortages than sedentary agriculturalists, remains largely untested. The present report tests this assumption by making a cross-cultural statistical comparison of the quantity of available food and the frequency and extent of food shortages among 94 foraging and agricultural societies as reported in the ethnographic record. Our results indicate that there is no statistical difference (P food, or the frequency or extent of food shortages in these reports between preindustrial foragers, recent foragers, and agriculturalists. The findings presented here add to a growing literature that calls into question assumptions about forager food insecurity and nutritional status in general, and ultimately, the very foundation of the thrifty genotype hypothesis: the presumed food shortages that selected for a "thrifty" metabolism in past foraging populations. 2006 Wiley-Liss, Inc.

  8. Combined effects of ultraviolet-B radiation and food shortage on the sensitivity of the Antarctic amphipod Paramoera walkeri to copper.

    Science.gov (United States)

    Liess, M; Champeau, O; Riddle, M; Schulz, R; Duquesne, S

    2001-09-01

    Investigations on the combined effects of ultraviolet (UV)-B radiation and anthropogenic toxicants have focused primarily on the chemical interactions between UV-B and organic compounds. Only a few studies have examined whether exposure to UV-B changes sensitivity to toxicants. This question is addressed in a laboratory study using the common shoreline Antarctic amphipod Paramoera walkeri and exposure to environmentally realistic levels of copper, UV-B radiation, and food shortage. Exposure to copper for 21 d in the absence of any additional stressors (food present, no UV-B) showed a lowest observable effective concentration (LOEC) of greater than 100 microg Cu/L. Exposure to copper and UV-B in combination, with no shortage of food, resulted in a LOEC of 45 microg Cu/L. When exposed to copper and UV-B, with shortage of food, a LOEC of 3 microg Cu/L was recorded. Hence, the combination of environmental stress from exposure to UV-B radiation and shortage of food increases the sensitivity of P. walkeri to copper more than 30-fold. Increased metabolic energy requirements for defense mechanisms in response to toxicants and UV-B are discussed as possible explanations. It is concluded that consideration of environmental stressors in combination with toxicants increases the accuracy of ecological risk assessments of toxicants and should be part of the process for developing guidelines for ecologically acceptable concentrations of contaminants in the environment.

  9. 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,…

  10. Level of the Environmental Risks' Awareness of Water Shortage for the Educational Sciences College's Student-Teachers at the World Islamic Sciences and Education University in Jordan

    Science.gov (United States)

    Alebous, Tahani

    2016-01-01

    The study aimed at investigating the degree of awareness of environmental risks of water shortage of students-teachers in the majors of Classroom teachers, Counseling and Special education in the Education Sciences College at WISE and their degree of awareness according to major and gender. The sample of the study which was selected randomly…

  11. 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.

  12. [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.

  13. Maintenance as a method for effective e-resources management in ...

    African Journals Online (AJOL)

    In major findings revealed from the study that e-resource are preferred by users to print, maintenance of e-resources are vital to the survival of virtual libraries, librarians are involved in planning for maintenance of e-resources, staff training and retraining is required to update knowledge and information on e-resources.

  14. Survival assays using Caenorhabditis elegans.

    Science.gov (United States)

    Park, Hae-Eun H; Jung, Yoonji; Lee, Seung-Jae V

    2017-02-01

    Caenorhabditis elegans is an important model organism with many useful features, including rapid development and aging, easy cultivation, and genetic tractability. Survival assays using C. elegans are powerful methods for studying physiological processes. In this review, we describe diverse types of C. elegans survival assays and discuss the aims, uses, and advantages of specific assays. C. elegans survival assays have played key roles in identifying novel genetic factors that regulate many aspects of animal physiology, such as aging and lifespan, stress response, and immunity against pathogens. Because many genetic factors discovered using C. elegans are evolutionarily conserved, survival assays can provide insights into mechanisms underlying physiological processes in mammals, including humans.

  15. Selecting the best responsive option to unexpected orders at the time of capacity-shortage using multi criteria decision models

    Directory of Open Access Journals (Sweden)

    Masoud parsaei

    2014-06-01

    Full Text Available The way orders are accepted or rejected is the most important factor in customer satisfaction and success of make-to-order systems. The incoming orders to such organizations have certain delivery date in which the customer expects the order to be fulfilled and delivered. In some cases, unexpectedly increased orders exceed the existing capacity for on time fulfillment. In addition to rejection of order, as a typical choice, other options like outsourcing and capacity expansion are available to compensate for capacity shortage and deliver incoming orders according to schedule. However, each of the proposed options is superior in one or more criteria and so selecting the best one is not simply possible. The main goal of this study is to provide managers with a comprehensive, systematic, and applicable approach to evaluate and select the best of the existing options. For this purpose, a model comprised of some multi-criteria techniques is delivered. Our proposed model is a blend of FAHP and FTOPSIS methods. In this model, FAHP is first used to determine the weight of criteria and then Fuzzy-TOPSIS (FTOPSIS is employed to rank the options. Finally, the proposed model is applied on an actual case to assess and examine its efficiency.

  16. The acetonitrile shortage: is reversed HILIC with water an alternative for the analysis of highly polar ionizable solutes?

    Science.gov (United States)

    dos Santos Pereira, Alberto; David, Frank; Vanhoenacker, Gerd; Sandra, Pat

    2009-06-01

    In hydrophilic interaction chromatography (HILIC), best results are obtained with high concentrations of ACN. In the framework of green chromatography and the present shortage and very high price of this hazardous solvent, reversing the stationary phase to apolar and the mobile phase to aqueous can be of interest for several applications. The features of the aqueous RP technique called per aqueous LC (PALC) are illustrated with the analysis of catecholamines, nucleobases, acids, and amino acids. The ca. three-fold higher viscosity of water compared to ACN has consequences on the shape of the Van Deemter plot. For dopamine (N = 26.450 on a 25 cm x 4.6 mm id, 5 microm bare silica column), a reduced plate height of 1.9 at an u(opt) of 0.3 mm/s was calculated. The plate number, however, strongly depends on pH and ionic strength. As in RP separations, retention is shortened by adding an organic modifier. In the framework of green chromatography, the biodegradable ethanol was used. On the other hand, retention increased by lengthening the carbon chain of ion-pair reagents supporting the RP mechanism as well.

  17. High-Risk Non-Muscle-Invasive Bladder Cancer-Therapy Options During Intravesical BCG Shortage.

    Science.gov (United States)

    Veeratterapillay, Rajan; Heer, Rakesh; Johnson, Mark I; Persad, Raj; Bach, Christian

    2016-09-01

    Bladder cancer is the second commonest urinary tract malignancy with 70-80 % being non-muscle invasive (NMIBC) at diagnosis. Patients with high-risk NMIBC (T1/Tis, with high grade/G3, or CIS) represent a challenging group as they are at greater risk of recurrence and progression. Intravesical Bacilli Calmette-Guerin (BCG) is commonly used as first line therapy in this patient group but there is a current worldwide shortage. BCG has been shown to reduce recurrence in high-risk NMIBC and is more effective that other intravesical agents including mitomycin C, epirubicin, interferon-alpha and gemcitabine. Primary cystectomy offers a high change of cure in this cohort (80-90 %) and is a more radical treatment option which patients need to be counselled carefully about. Bladder thermotherapy and electromotive drug administration with mitomycin C are alternative therapies with promising short-term results although long-term follow-up data are lacking.

  18. From school classes to UNESCO: IYL-enabled environments for tackling the STEM skills shortage through student-led outreach

    Science.gov (United States)

    Posner, Matthew T.; John, Pearl V.; Wong, Nicholas H. L.; Mittal, Vinita; Nunez-Velazquez, Martin M.

    2016-09-01

    The accepted industrial skills shortage in the subjects of science, technology, engineering and mathematics (STEM) in the United Kingdom has led to an increasing drive for universities to work with a wider pool of potential students. One contributor to this drive is the Lightwave Roadshow, a photonics-focused outreach program run by postgraduate students from the University of Southampton. The program has benefitted from the unique platform of the International Year of Light (IYL) 2015 for the development and support of hands-on and interactive outreach activities. In this report we review Lightwave activities facilitated by IYL that focused on widening participation for students aged 6 to 18 years from a multitude of societal categories; the roadshow has directly benefitted from the significance and investment into the IYL in conjunction with university recruitment strategies, local schools and the support of international organizations such as SPIE and OSA. Lightwave has used the foundation of the IYL to provide a wide range of activities for over 1,200 UK students in 53 different schools; the assessment tools used to measure learning outcomes, reach and impact are also discussed. The program's activities have been developed to make younger age groups the center of the outreach activity and create an environment which encourages youth pursuit of optics and science from a grassroots level upwards; to illustrate this we will outline a Lightwave project endorsed by the IYL steering committee to permit two 6th form students to attend the IYL opening ceremony in Paris.

  19. 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.

  20. Surviving a Suicide Attempt.

    Science.gov (United States)

    Al-Harrasi, Ahmed; Al Maqbali, Mandhar; Al-Sinawi, Hamed

    2016-09-01

    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.

  1. Will the olympics survive?.

    Science.gov (United States)

    Khosla, T.

    1977-01-01

    The United States of America dominated 58 events in athletics, field and swimming, which between them accounted for 35 per cent of all events in the Munich Olympiad. 1972; these events favour taller individuals. But, in 25 per cent of other events (1) cycling, (2) fencing, (3) gymnastics, (4) judo, (5) weightlifting and (6) Graeco Roman wrestling the U.S.A. did not win a single medal. The failure of the U.S.A. to maintain her lead in Munich was largely due to weaknesses in these other events in many of which the potential medallists can be derived from the lower half of the height distribution (events 3 to 6). These weaknesses are Russia's strength and they continued to remain unstrengthened at Montreal. Also, the domination held by the U.S.A. in swimming was seriously challenged by East Germany. The present trends indicate that the U.S.A.'s ranking is likely to slip further to the third position in Moscow 1980. Factors inhibiting the survival of the Olympics are pointed. PMID:861436

  2. [Problems and priorities in child survival].

    Science.gov (United States)

    Bobadilla, J L

    1988-01-01

    This work synthesizes the conclusions and recommendations of the 1985 International Workshop on Child Survival held in Teotihuacan, Mexico. Data are presented which document the extent of the problem of child survival in Latin America and the deficiencies of available data. Malnutrition, diseases preventable through vaccination, diarrheal diseases, acute respiratory infections, perinatal disorders, and shortcomings in quality of care are separately discussed following an assessment of their socioeconomic and cultural determining factors. Recent advances in the preventive component of primary health care programs are discussed. In Latin America, 900 of each 1000 live born babies survive to the 5th year of life compared to 980 in developed countries. Although the mortality rate of children under 5 in Latin America declined from 128 in 1950-55 to 63 in 1980-85, there are wide disparities between countries. Most countries of Latin America were classified as having high or very high infant and child mortality. There are serious differences in child survival between geographic regions and social groups of each country. The mortality decline in Costa Rica, Cuba, and Chile demonstrates that other countries could avoid a large proportion of deaths by ensuring that benefits of current programs have broader coverage. The severe economic crisis in Mexico and other countries threatens the progress already achieved in child survival. The recommendations of the conference are based on the premise that recent efforts to improve survival have been insufficient and a more rational use of the available resources and knowledge is required. In the area of health policy, priority should continue to be given to providing care for mothers and small children. Investments should be reoriented toward extending coverage of primary health care. The proportion of mothers attended during delivery by trained paramedical personnel or physicians should be increased, and family planning programs in

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

    Science.gov (United States)

    2012-01-01

    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 potentially effective

  4. Energy resources - cornucopia or empty barrel?

    Science.gov (United States)

    McCabe, P.J.

    1998-01-01

    Over the last 25 yr, considerable debate has continued about the future supply of fossil fuel. On one side are those who believe we are rapidly depleting resources and that the resulting shortages will have a profound impact on society. On the other side are those who see no impending crisis because long-term trends are for cheaper prices despite rising production. The concepts of resources and reserves have historically created considerable misunderstanding in the minds of many nongeologists. Hubbert-type predictions of energy production assume that there is a finite supply of energy that is measurable; however, estimates of resources and reserves are inventories of the amounts of a fossil fuel perceived to be available over some future period of time. As those resources/reserves are depleted over time, additional amounts of fossil fuels are inventoried. Throughout most of this century, for example, crude oil reserves in the United States have represented a 10-14-yr supply. For the last 50 yr, resource crude oil estimates have represented about a 60-70-yr supply for the United States. Division of reserve or resource estimates by current or projected annual consumption therefore is circular in reasoning and can lead to highly erroneous conclusions. Production histories of fossil fuels are driven more by demand than by the geologic abundance of the resource. Examination of some energy resources with well-documented histories leads to two conceptual models that relate production to price. The closed-market model assumes that there is only one source of energy available. Although the price initially may fall because of economies of scale long term, prices rise as the energy source is depleted and it becomes progressively more expensive to extract. By contrast, the open-market model assumes that there is a variety of available energy sources and that competition among them leads to long-term stable or falling prices. At the moment, the United States and the world

  5. Survival After Relapse of Medulloblastoma.

    Science.gov (United States)

    Koschmann, Carl; Bloom, Karina; Upadhyaya, Santhosh; Geyer, J Russell; Leary, Sarah E S

    2016-05-01

    Survival after recurrence of medulloblastoma has not been reported in an unselected cohort of patients in the contemporary era. We reviewed 55 patients diagnosed with medulloblastoma between 2000 and 2010, and treated at Seattle Children's Hospital to evaluate patterns of relapse treatment and survival. Fourteen of 47 patients (30%) over the age of 3 experienced recurrent or progressive medulloblastoma after standard therapy. The median time from diagnosis to recurrence was 18.0 months (range, 3.6 to 62.6 mo), and site of recurrence was metastatic in 86%. The median survival after relapse was 10.3 months (range, 1.3 to 80.5 mo); 3-year survival after relapse was 18%. There were trend associations between longer survival and having received additional chemotherapy (median survival 12.8 vs. 1.3 mo, P=0.16) and radiation therapy (15.4 vs. 5.9 mo, P=0.20). Isolated local relapse was significantly associated with shorter survival (1.3 vs. 12.8 mo, P=0.009). Recurrence of medulloblastoma is more likely to be metastatic than reported in previous eras. Within the limits of our small sample, our data suggest a potential survival benefit from retreatment with cytotoxic chemotherapy and radiation even in heavily pretreated patients. This report serves as a baseline against which to evaluate novel therapy combinations.

  6. 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

  7. Resources, Harshness, and Unpredictability

    Directory of Open Access Journals (Sweden)

    Peter K. Jonason

    2016-02-01

    Full Text Available We sought to test the hypothesis that the Dark Triad traits are condition-dependent responses to a particular set of socioecological conditions in childhood. In three cross-sectional studies (N = 1,403, we examined how the Dark Triad traits were correlated with measures of resource availability, harshness, and unpredictability in one’s childhood and adulthood. The Dark Triad traits were correlated with self-reports of an unpredictable childhood when using both the Short Dark Triad and the Dirty Dozen measures. These effects were somewhat stronger in men than in women and were replicable across samples. We also replicated sex differences in the Dark Triad traits but found none for our measures of socioecological conditions. Results are discussed in terms of the recurrent unpredictability in evolutionary history necessitating the sensitivity and responsiveness to such features to enable survival and reproduction. We contend that the Dark Triad traits might be condition-sensitive adaptations to socioecological unpredictability that all people could have if properly motivated.

  8. Is current irrigation sustainable in the United States? An integrated assessment of climate change impact on water resources and irrigated crop yields

    OpenAIRE

    Blanc, Elodie; Caron, Justin; Fant, Charles; Monier, Erwan

    2017-01-01

    Abstract While climate change impacts on crop yields has been extensively studied, estimating the impact of water shortages on irrigated crop yields is challenging because the water resources management system is complex. To investigate this issue, we integrate a crop yield reduction module and a water resources model into the MIT Integrated Global System Modeling framework, an integrated assessment model linking a global economic model to an Earth system model. We assess the effects of clima...

  9. 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.

  10. Hydrological Regime and Water Shortage as Drivers of the Seasonal Incidence of Diarrheal Diseases in a Tropical Montane Environment.

    Science.gov (United States)

    Boithias, Laurie; Choisy, Marc; Souliyaseng, Noy; Jourdren, Marine; Quet, Fabrice; Buisson, Yves; Thammahacksa, Chanthamousone; Silvera, Norbert; Latsachack, Keooudone; Sengtaheuanghoung, Oloth; Pierret, Alain; Rochelle-Newall, Emma; Becerra, Sylvia; Ribolzi, Olivier

    2016-12-01

    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) indicating that

  11. 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

  12. 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.

  13. Homeothermy and primate bipedalism: is water shortage or solar radiation the main threat to baboon (Papio hamadryas) homeothermy?

    Science.gov (United States)

    Mitchell, Duncan; Fuller, Andrea; Maloney, Shane K

    2009-05-01

    Other than the hominin lineage, baboons are the diurnally active primates that have colonized the arid plains of Africa most successfully. While the hominin lineage adopted bipedalism before colonizing the open, dry plains, baboons retained a quadrupedal mode of locomotion. Because bipedalism has been considered to reduce the thermoregulatory stress of inhabiting open dry plains, we investigated how baboons cope with thermal loads and water restriction. Using implanted data loggers, we measured abdominal temperature every 5 min in six unrestrained baboons while they were exposed to simulated desert conditions (15 degrees C at night rising to 35 degrees C during the day, with and without extra radiant heating), or an ambient temperature of 22 degrees C. At 22 degrees C, core temperature averaged 37.9 degrees C and cycled nychthemerally by 1.7 degrees C. Mean, minimum, and maximum daily core temperatures in euhydrated baboons in the simulated desert environments did not differ from the temperatures displayed in the 22 degrees C environment, even when radiant heating was applied. At 22 degrees C, restricting water intake did not affect core temperature. During the desert simulations, maximum core temperature increased significantly on each day of water deprivation, with the highest temperatures (>40 degrees C) on the third day in the simulation that included radiant heat. When drinking water heated to 38 degrees C was returned, core temperature decreased rapidly to a level lower than normal for that time of day. We conclude that baboons with access to water can maintain homeothermy in the face of high air temperatures and radiant heat loads, but that a lack of access to drinking water poses a major threat to baboon homeothermy. We speculate that any competitive thermoregulatory advantage of bipedalism in early hominins was related to coping with water shortage in hot environments, and that their freed hands might have enabled them to transport enough water to avoid

  14. 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.

  15. Delayed Flood Recession in Central Yangtze Floodplains Can Cause Significant Food Shortages for Wintering Geese: Results of Inundation Experiment

    Science.gov (United States)

    Guan, Lei; Wen, Li; Feng, Duoduo; Zhang, Hong; Lei, Guangchun

    2014-12-01

    Carex meadows are critical habitat for wintering geese in the floodplains of the middle and lower reaches of Yangtze River, China. These meadows follow a growth cycle closely tied to the seasonal hydrological fluctuation: as water levels recede in the fall, exposed mudflats provide habitat for Carex spp. growth. The seasonal growth of Carex overlaps the arrival of wintering geese and provides an important food source for the migrants. Recent alterations to the Yangtze's hydrology, however, have disrupted the synchronous relationship between water levels, Carex growth and wintering geese at Dongting Lake. In October 2012, we carried out an outdoor mesocosm experiment to investigate potential impacts of delayed water recession on the germination and growth of Carex heterolepis, the dominant Carex species at Dongting Lake, to understand how changes in hydrology might impact wintering goose habitat. Results showed that the delayed flood recession exerted significant impact on the first growth cycle of Carex growth. Prolonged inundation significantly lowered the intrinsic growth rate ( P = 0.03) and maximum growth rates ( P = 0.02). It also took significantly longer time to reach the peak growth rate ( P = 0.04 and 0.05 for number of shoot and biomass, respectively). As a result, biomass accumulation was reduced by 45, 62 and 90 % for 10-day, 20-day and 30-day inundation treatments, respectively. These results indicate a severe risk of food shortage for wintering geese when water recession delayed. This potential risk should be taken into consideration when operating any hydrological control structures that alter the flood regimes in Dongting Lake.

  16. 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.

  17. Depression and health-related quality of life among persons with sensory disabilities in a health professional shortage area.

    Science.gov (United States)

    Armstrong, Trey W; Surya, Shruti; Elliott, Timothy R; Brossart, Daniel F; Burdine, James N

    2016-08-01

    The authors examined depression and health-related quality of life among individuals with self-reported sensory impairments living in a health professional shortage area. Health surveys of residents were conducted in 2006 and 2010. Responses were analyzed by groups of residents reporting vision loss, hearing loss, dual hearing and vision loss, and no sensory loss. In 2006, the total sample size was n = 2,591, and in 2010, it was n = 3,955. The CESD-5 scale (Shrout & Yager, 1989) was included in 2006, and the PHQ-9 (Kroenke, Spitzer, & Williams, 2001) was included in 2010. Rates of depression on the CESD-5 were determined by the recommended cut-off scores and on the PHQ-9 by the recommended algorithm. The Centers for Disease Control (CDC) Healthy Days instrument (Moriarty, Zack, & Kobau, 2003) was used in both surveys to assess health-related quality of life. In both surveys, individuals who reported sensory loss had higher rates of depression and lower health-related quality of life than individuals with no reported sensory loss. Individuals reporting sensory loss had high rates of depression and a compromised quality of life compared to respondents without these impairments. These data imply strategic community-based health care services, including mental health initiatives, may be indicated for individuals with sensory loss living in underserved regions. Implications for rehabilitation psychology research, service, and policy are discussed as innovations in these areas are needed to better understand and address the disparities that may compromise the overall well-being of residents of underserved communities. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  18. Regulation of water resources for sustaining global future socioeconomic development

    Science.gov (United States)

    Chen, J.; SHI, H.; Sivakumar, B.

    2016-12-01

    With population projections indicating continued growth during this century, socio-economic problems (e.g., water, food, and energy shortages) will be most likely to occur, especially if proper planning, development, and management strategies are not adopted. In the present study, firstly, we explore the vital role of dams in promoting economic growth through analyzing the relationship between dams and Gross Domestic Product (GDP) at both global and national scales. Secondly, we analyze the current situation of global water scarcity based on the data representing water resources availability, dam development, and the level of economic development. Third, with comprehensive consideration of population growth as the major driving force, water resources availability as the basic supporting factor, and topography as the important constraint, this study addresses the question of dam development in the future and predicts the locations of future dams around the world.

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

    Directory of Open Access Journals (Sweden)

    Isabel Guzmán-Arias

    2014-03-01

    Full Text Available 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, of which very few can envision growth expectations in terms of water consumption. The proposed resource planning process integrates the analysis conducted in this thesis and tries to identify the basic steps to be followed for the pro­per management of the resource in the future.

  20. Reproduction, preweaning survival, and survival of adult sea otters at Kodiak Island, Alaska

    Science.gov (United States)

    Monson, Daniel H.; DeGange, Anthony R.

    1995-01-01

    Radiotelemetry methods were used to examine the demographic characteristics of sea otters inhabiting the leading edge of an expanding population on Kodiak Island, Alaska. Fifteen male and 30 female sea otters were instrumented and followed from 1986 to 1990. Twenty-one percent of females were sexually mature (had pupped) at age 2, 57% by age 3, 88% by age 4, and 100% by age 5. Fifteen females produced 26 pups, an overall reproduction rate of 94% for mature females. The reproduction rate was 17, 45, 66, and 100% for 2-, 3-, 4-, and 5-year-olds, respectively. Eighty-five percent of observed pups survived to weaning (120 days), and the percentage of pups weaned ranged from 34% for pups of 2-year-olds to 100% for pups of 5-year-olds. At least three of four known pup losses occurred within a month of parturition. The mean pup dependency period for weaned pups was 153 days and the mean gestation period was 218 days. No synchrony in pupping activity was observed. Mean annual survival of adults was high. Estimates of survival ranged from 89 to 96% for females and 86 to 91% for males. Human harvest was the primary source of known mortality of adults. Our estimates of reproductive rates and survival of adults are at the high end of those reported for sea otters, but preweaning survival stands out as being particularly high. Abundant food resources and the availability of protected water presumably contributed to the high reproductive success observed in this recently established sea otter population.

  1. Evaluation and Prediction of Water Resources Based on AHP

    Science.gov (United States)

    Li, Shuai; Sun, Anqi

    2017-01-01

    Nowadays, the shortage of water resources is a threat to us. In order to solve the problem of water resources restricted by varieties of factors, this paper establishes a water resources evaluation index model (WREI), which adopts the fuzzy comprehensive evaluation (FCE) based on analytic hierarchy process (AHP) algorithm. After considering influencing factors of water resources, we ignore secondary factors and then hierarchical approach the main factors according to the class, set up a three-layer structure. The top floor is for WREI. Using analytic hierarchy process (AHP) to determine weight first, and then use fuzzy judgment to judge target, so the comprehensive use of the two algorithms reduce the subjective influence of AHP and overcome the disadvantages of multi-level evaluation. To prove the model, we choose India as a target region. On the basis of water resources evaluation index model, we use Matlab and combine grey prediction with linear prediction to discuss the ability to provide clean water in India and the trend of India’s water resources changing in the next 15 years. The model with theoretical support and practical significance will be of great help to provide reliable data support and reference for us to get plans to improve water quality.

  2. A stochastic optimization approach for integrated urban water resource planning.

    Science.gov (United States)

    Huang, Y; Chen, J; Zeng, S; Sun, F; Dong, X

    2013-01-01

    Urban water is facing the challenges of both scarcity and water quality deterioration. Consideration of nonconventional water resources has increasingly become essential over the last decade in urban water resource planning. In addition, rapid urbanization and economic development has led to an increasing uncertain water demand and fragile water infrastructures. Planning of urban water resources is thus in need of not only an integrated consideration of both conventional and nonconventional urban water resources including reclaimed wastewater and harvested rainwater, but also the ability to design under gross future uncertainties for better reliability. This paper developed an integrated nonlinear stochastic optimization model for urban water resource evaluation and planning in order to optimize urban water flows. It accounted for not only water quantity but also water quality from different sources and for different uses with different costs. The model successfully applied to a case study in Beijing, which is facing a significant water shortage. The results reveal how various urban water resources could be cost-effectively allocated by different planning alternatives and how their reliabilities would change.

  3. Global Activities and Plant Survival

    DEFF Research Database (Denmark)

    Bandick, Roger

    2014-01-01

    This chapter provides an extensive review of the empirical evidence found for Sweden concerning plant survival. The result reveals that foreign MNE plants and exporting non-MNE plants have the lowest exit rates, followed by purely domestic-oriented plants, and that domestic MNE plants have...... 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...... exporters, but not other types of plants, improves post acquisition....

  4. 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....

  5. Sustainability assessment of regional water resources under the DPSIR framework

    Science.gov (United States)

    Sun, Shikun; Wang, Yubao; Liu, Jing; Cai, Huanjie; Wu, Pute; Geng, Qingling; Xu, Lijun

    2016-01-01

    Fresh water is a scarce and critical resource in both natural and socioeconomic systems. Increasing populations combined with an increasing demand for water resources have led to water shortages worldwide. Current water management strategies may not be sustainable, and comprehensive action should be taken to minimize the water budget deficit. Sustainable water resources management is essential because it ensures the integration of social, economic, and environmental issues into all stages of water resources management. This paper establishes the indicators to evaluate the sustainability of water utilization based on the Drive-Pressure-Status-Impact-Response (DPSIR) model. Based on the analytic hierarchy process (AHP) method, a comprehensive assessment of changes to the sustainability of the water resource system in the city of Bayannur was conducted using these indicators. The results indicate that there is an increase in the driving force of local water consumption due to changes in society, economic development, and the consumption structure of residents. The pressure on the water system increased, whereas the status of the water resources continued to decrease over the study period due to the increasing drive indicators. The local government adopted a series of response measures to relieve the decreasing water resources and alleviate the negative effects of the increasing driver in demand. The response measures improved the efficiency of water usage to a large extent, but the large-scale expansion in demands brought a rebounding effect, known as ;Jevons paradox; At the same time, the increasing emissions of industrial and agriculture pollutants brought huge pressures to the regional water resources environment, which caused a decrease in the sustainability of regional water resources. Changing medium and short-term factors, such as regional economic pattern, technological levels, and water utilization practices, can contribute to the sustainable utilization of

  6. 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

  7. Geographical distribution of radiotherapy resources in Japan: investigating the inequitable distribution of human resources by using the Gini coefficient.

    Science.gov (United States)

    Tanikawa, Takumi; Ohba, Hisateru; Ogasawara, Katsuhiko; Okuda, Yasuo; Ando, Yutaka

    2012-01-01

    This is a pilot study that aims to elucidate regional disparities in the distribution of medical resources in Japan. For this purpose, we employed the Gini coefficient (GC) in order to analyze the distribution of radiotherapy resources, which are allocated to each prefecture in Japan depending on the size of its population or physical area. Our study used data obtained from the 2005 and 2007 national surveys on the structure of radiation oncology in Japan, conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO). Our analysis showed that the regional disparities regarding the radiation oncologists and radiotherapy technologists were small, and concluded that such resources were almost equitably distributed. However, medical physicists are inequitably distributed. Thus, policymakers should create and implement measures to train and retain medical physicists in areas with limited radiotherapy resources. Further, almost 26% of the secondary medical service areas lacked radiotherapy institutions. We attribute this observation to the existence of tertiary medical service areas, and almost all of prefectures face a shortage of such resources. Therefore, patients' accessibility to these resources in such areas should be improved.

  8. 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...

  9. A fuzzy inventory model with unit production cost, time depended holding cost, with-out shortages under a space constraint: a parametric geometric programming approach

    OpenAIRE

    Sahidul Islam; Wasim Akram Mandal

    2017-01-01

    In this paper, an Inventory model with unit production cost, time depended holding cost, with-out shortages is formulated and solved. We have considered here a single objective inventory model. In most real world situation, the objective and constraint function of the decision makers are imprecise in nature, hence the coefficients, indices, the objective function and constraint goals are imposed here in fuzzy environment. Geometric programming provides a powerful tool for solving a variety of...

  10. An optimal EOQ inventory model for non-instantaneous deteriorating items with ramp type demand rate, time dependent holding cost and shortages

    Science.gov (United States)

    Rangarajan, K.; Karthikeyan, K.

    2017-11-01

    An economic order quantity inventory model for non-instantaneous deteriorating items has been developed with ramp type demand rate, time dependent deterioration rate and time dependent holding cost. Shortages in inventory are allowed in this model, which is partially backlogged. The main objective of this model is to develop an optimal replenishment policy that minimizes the total average inventory cost. Numerical examples are used to illustrate the developed model.

  11. Capability of Colleges and Universities to Offer Graduate Degree Programs in Shortage Disciplines as Part of the Military Voluntary Education Programs.

    Science.gov (United States)

    1980-06-01

    STANDARDS 1 96 A DANTUS REPORT 340 CAPABILITY-OF COLLEGES AND UNIVERSITIES TO OFFER GRADUATE DEGREE PROGRAMS IN SHORTAGE DICIPLINES AS PART OF THE...to this survey.) P 5I. ~;- d 5.1 Army findings MASTER’S PROGRAM IN: (A) (B) POTENTIAL INSTITUTIONS: Operations research (eng.) 16% 7% AMERICAN TECH...UNIV CF HAWAII Operations analysis 9% 0% AMERICAN TECH UNIV, TXFLORIDA INST OF TECH I GEORGE WASH UNIV, DC GEORGIA INST OF TECH TROY ST UNIV, AL UNIV

  12. The influence of spatiotemporal conditions and personality on survival in reintroductions-evolutionary implications.

    Science.gov (United States)

    Haage, Marianne; Maran, Tiit; Bergvall, Ulrika Alm; Elmhagen, Bodil; Angerbjörn, Anders

    2017-01-01

    Personality exists in non-human animals and can impact fitness. There is, however, a shortage of empirical studies in certain areas within the field, and fundamental evolutionary theory on personality remains largely untested. For example, little is known on how variation in personality is maintained over evolutionary time. Theory suggests that fluctuating selection pressures due to spatiotemporal variation in conditions, e.g. food availability, is a possible mechanism and a few studies have shown that the success of different personality types varies with spatiotemporal conditions. However, it remains unknown whether different mechanisms can maintain personality within a species. Here we use a reintroduction programme for the critically endangered European mink (Mustela lutreola) to test whether multiple personality trait domains (boldness, exploration and sociability) affected survival in two different years and islands. This was done through pre-release personality tests and post-release radio-tracking monitoring. Survival was positively correlated with boldness, whereas the relationship with exploration was either negative or positive depending on year/island. The results show a complex relationship between personality and survival and suggest that exploration can be maintained over evolutionary time via spatiotemporal variation in conditions. However, in contrast to exploration, boldness did not vary spatiotemporally and sociability had no impact on survival. This indicates that different personality trait domains might be maintained by different mechanisms. To date, personality has been studied primarily within behavioural sciences, but through empirical findings we highlight the importance of personality also in ecology and conservation biology.

  13. Red blood cell use outside the operating theater: a prospective observational study with modeling of potential blood conservation during severe blood shortages.

    Science.gov (United States)

    Joseph, Bridgid G; Hendry, Catrina; Walsh, Timothy S

    2009-10-01

    National guidance recommends planning for future blood shortages, but few studies have evaluated how reduced demand could be achieved acutely. A trained observer collected data concerning red blood cell (RBC) transfusion events outside the operating theater during 68 hours of blood bank monitoring over 7 weeks. Data were gathered at the patients' bedside from clinical staff and charts. Transfusions were classified according to the presence of bleeding and medical specialty (medical, surgical, other). Hemoglobin (Hb) transfusion triggers, RBCs transfused, and posttransfusion Hb values were collected. Evidence-based scenarios were used to model the potential RBC savings that could be achieved if acute shortages occurred, incorporating ischemic heart disease as a potential decision modifier. A total of 83 patients received 100 transfusion events, comprising 207 RBC units, during the sampling periods. The relative use of RBC units across specialties was as follows: medical, 74%; surgical, 22%; and other, 4%. For medical and surgical patients, respectively, 31 and 10% of all RBC units were transfused for anemia without evidence of bleeding, and 38 and 12% were transfused for non-life-threatening bleeding. Eight-five percent of all patients who received transfusions had stable vital signs before transfusion. Our model suggested that only 11% of RBCs would be conserved by cancellation of major surgery, whereas 23% to 47% of all RBCs could be conserved by controlling transfusions to medical patients. In institutions with patterns of blood use similar to ours, control of transfusions to medical patients is the most effective response to acute blood shortages.

  14. [Physical activity and cancer survival].

    Science.gov (United States)

    Romieu, Isabelle; Touillaud, Marina; Ferrari, Pietro; Bignon, Yves-Jean; Antoun, Sami; Berthouze-Aranda, Sophie; Bachmann, Patrick; Duclos, Martine; Ninot, Grégory; Romieu, Gilles; Sénesse, Pierre; Behrendt, Jan; Balosso, Jacques; Pavic, Michel; Kerbrat, Pierre; Serin, Daniel; Trédan, Olivier; Fervers, Béatrice

    2012-10-01

    Physical activity has been shown in large cohort studies to positively impact survival in cancer survivors. Existing randomized controlled trials showed a beneficial effect of physical activity on physical fitness, quality of life, anxiety and self-esteem; however, the small sample size, the short follow-up and the lack of standardization of physical activity intervention across studies impaired definite conclusion in terms of survival. Physical activity reduces adiposity and circulating estrogen levels and increases insulin sensitivity among other effects. A workshop was conducted at the International Agency for Research on Cancer in April 2011 to discuss the role of physical activity on cancer survival and the methodology to develop multicentre randomized intervention trials, including the type of physical activity to implement and its association with nutritional recommendations. The authors discuss the beneficial effect of physical activity on cancer survival with a main focus on breast cancer and report the conclusions from this workshop.

  15. 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...

  16. Water Resources Compound Systems: A Macro Approach to Analysing Water Resource Issues under Changing Situations

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2015-12-01

    Full Text Available Water resource crises are an increasing threat to human survival and development. To reveal the nature of water resource issues under changing situations, the water resources system needs to be studied from a macro and systematic perspective. This report develops a water resources system into a water resources compound system that is constantly evolving under the combined action of the development, resistant, and coordination mechanisms. Additionally, the water quotient is defined as a quantitative representation of the sustainable development state of the water resources compound system. Four cities in China, Beijing, Fuzhou, Urumqi, and Lhasa, were selected as the study areas. The differences in the three types of mechanisms and the water quotient of the water resources compound system of each city in 2013 were compared. The results indicate that the different subsystems that comprise the compound system of a given area have different development mechanisms and resistant mechanisms. There are clear differences in the mechanisms and the water quotients for the water resources compound systems of different regions. Pertinent measures should be taken into account during integrated water resource management to improve the sustainable development status of regional water resources compound systems.

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

    Directory of Open Access Journals (Sweden)

    Nogawa Hiroki

    2011-05-01

    Full Text Available Abstract Background 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. Methods Simulation modeling of the Japanese medical workforce. Results 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. Conclusions The plan to increase the medical student quota will bring about a serious doctor surplus in the long run.

  18. An analysis of GAVI, the Global Fund and World Bank support for human resources for health in developing countries

    OpenAIRE

    Vujicic, Marko; Weber, Stephanie E.; Nikolic, Irina A.; Atun, Rifat; Kumar, Ranjana

    2017-01-01

    Shortages, geographic imbalances and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, multilateral agencies have increasingly recognized the need to invest in human resources for health (HRH) to assist countries in achieving their health system goals. In this paper we analyse the HRH-related activities of three agencies: the Global Alliance for Vaccines and Immunisation (GAVI); the Global Fund for Aids, Tuberc...

  19. Knowledge and Natural Resources

    DEFF Research Database (Denmark)

    Bertelsen, Rasmus Gjedssø; Justinussen, Jens Christian Svabo

    2016-01-01

    Arctic economies are generally natural resource based economies, whether they are indigenous economies largely dependent on living on the land or industrialized economies depending on marine resources, mineral resources or fossil or renewable energy resources. However, the central role of knowledge...

  20. The Global Resource Nexus

    NARCIS (Netherlands)

    Ridder, M. de; Duijne, F. van; Jong, S. de; Jones, J.; Luit, E. van; Bekkers, F.F.; Auping, W.

    2014-01-01

    Supply and demand of resources are connected in a complex way. This interconnectivity has been framed as the global resource nexus and can conceivebly include all types of resources. This study focus on the nexus of five essential natural resources: land, food, energy, water and minerals. Together