Drug shortages: Implications for medical toxicology.

PubMed

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

Effects of acute psychosocial stress on neural activity to emotional and neutral faces in a face recognition memory paradigm.

PubMed

Li, Shijia; Weerda, Riklef; Milde, Christopher; Wolf, Oliver T; Thiel, Christiane M

2014-12-01

Previous studies have shown that acute psychosocial stress impairs recognition of declarative memory and that emotional material is especially sensitive to this effect. Animal studies suggest a central role of the amygdala which modulates memory processes in hippocampus, prefrontal cortex and other brain areas. We used functional magnetic resonance imaging (fMRI) to investigate neural correlates of stress-induced modulation of emotional recognition memory in humans. Twenty-seven healthy, right-handed, non-smoker male volunteers performed an emotional face recognition task. During encoding, participants were presented with 50 fearful and 50 neutral faces. One hour later, they underwent either a stress (Trier Social Stress Test) or a control procedure outside the scanner which was followed immediately by the recognition session inside the scanner, where participants had to discriminate between 100 old and 50 new faces. Stress increased salivary cortisol, blood pressure and pulse, and decreased the mood of participants but did not impact recognition memory. BOLD data during recognition revealed a stress condition by emotion interaction in the left inferior frontal gyrus and right hippocampus which was due to a stress-induced increase of neural activity to fearful and a decrease to neutral faces. Functional connectivity analyses revealed a stress-induced increase in coupling between the right amygdala and the right fusiform gyrus, when processing fearful as compared to neutral faces. Our results provide evidence that acute psychosocial stress affects medial temporal and frontal brain areas differentially for neutral and emotional items, with a stress-induced privileged processing of emotional stimuli.

Shortage in the face of plenty: improving the allocation of corneas for transplantation.

PubMed

de By, T M M H

2003-01-01

As there are plenty of potential corneal donors, theoretically there should be no shortage of corneal grafts. Practically, however, shortages have been a problem, especially with HLA-matched corneas, which are increasingly requested. This increase requires evaluation and proper adaptation to meet all requests in the future. BIS' allocation data for corneal transplants were analyzed for the years 1998 through 2001. Allocation of matched corneas almost doubled in 2000. The waiting list for matched grafts could be reduced by one third. A steep increase in demand for matched grafts could be noted by the year 2000. This signifies that the results of positive matching studies have ultimately been taken notice of by the ophthalmic surgeons with consequent adaptation of their graft orders. BIS has mostly been able to cope with these rapidly changing and increasing demands, but more efforts are continuously needed to supply those typed and matched corneas within short time. Our next step will be to offer HLA-DR matching routinely in addition to the current HLA-A/-B matching. We are looking forward with great interest to the introduction of even more specified matching algorithms in the not too far distant future, and are prepared to meet all the requirements which might be associated with such challenges.

Current Vaccine Shortages and Delays

MedlinePlus

... 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 ...

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

NASA Astrophysics Data System (ADS)

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

The STEM shortage paradox

NASA Astrophysics Data System (ADS)

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.

Prescription Drug Shortages: Implications for Ambulatory Pediatrics.

PubMed

Donnelly, Katie A; Zocchi, Mark S; Katy, Tamara A; Fox, Erin R; van den Anker, John N; Mazer-Amirshahi, Maryann E

2018-05-08

To describe contemporary drug shortages affecting general ambulatory pediatrics. Data from January 2001 to December 2015 were obtained from the University of Utah Drug Information Service. Two pediatricians reviewed drug shortages and identified agents used in ambulatory pediatrics. Shortage data were analyzed by the type of drug, formulation, reason for shortage, duration, marketing status, if a pediatric friendly-formulation was available, or if it was a single-source product. The availability of an alternative, and whether that alternative was affected by a shortage, also was noted. Of 1883 products in shortage during the study period, 314 were determined to be used in ambulatory pediatrics. The annual number of new pediatric shortages decreased initially but then increased to a high of 38 in 2011. Of the 314 pediatric shortages, 3.8% were unresolved at the end of the study. The median duration of resolved shortages was 7.6 months. The longest shortage was for ciprofloxacin 500-mg tablets. The most common class involved was infectious disease drugs. Pediatric-friendly dosage forms were affected in 19.1% of shortages. An alternative agent was available for 86% drugs; however, 29% of these also were affected. The most common reason for shortage was manufacturing problems. Drug shortages affected a substantial number of agents used in general ambulatory pediatrics. Shortages for single-source products are a concern if a suitable alternative is unavailable. Providers working in the ambulatory setting must be aware of current shortages and implement mitigation strategies to optimize patient care. Copyright © 2018 Elsevier Inc. All rights reserved.

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

PubMed

Moore, S T

1990-01-01

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

Study Shows Administrative Shortage.

ERIC Educational Resources Information Center

Sullivan, John R., Jr.

1989-01-01

Summarizes "Administrative Shortage in New England: The Evidence, the Causes, the Recommendations." High pressure, long hours, low salaries, and high housing costs are among the reasons cited for the shortage. Recommendations are centered on role identity, staff support, training, and recruitment. (SI)

Solving the Teacher Shortage Problem in Ghana: Critical Perspectives for Understanding the Issues

ERIC Educational Resources Information Center

Cobbold, Cosmas

2015-01-01

The problem of getting sufficient numbers of qualified teachers to staff classrooms is one of the most significant public policy issues facing many countries. In Ghana, the problem of teacher shortage has been a perennial one, necessitated by educational expansion as well as adverse socio-economic and political circumstances, and exacerbated by…

En face choroidal vascular feature imaging in acute and chronic central serous chorioretinopathy using swept source optical coherence tomography.

PubMed

Lee, Won June; Lee, Jung Wook; Park, Seung Hun; Lee, Byung Ro

2017-05-01

To evaluate the variable depth tomographic features of choroidal vasculature in acute and chronic central serous chorioretinopathy (CSC) using swept source optical coherence tomography (SS-OCT) en face imaging. We retrospectively reviewed the en face SS-OCT images of 29 patients that presented with acute (12 eyes) or chronic (17 eyes) CSC. All of the patient eyes underwent 6×6 macular scans with SS-OCT (DRI OCT-1, Topcon, Tokyo, Japan), fluorescein angiography and indocyanine green angiography. The en face image was used to investigate the choroidal vasculature of each layer. Moreover, we determined that some parts corresponded to choriocapillaris and Sattler's layer attenuation, whereas choroidal vessel dilatation was associated with Haller's layer. At Haller's layer level, choroidal vessel dilatation was observed in 11 of 12 acute CSC (91.7%) and 15 of 17 chronic CSC (88.2%). In acute CSC, choroidal vessel dilatation was divided into focal (9/11; 81.8%) and diffuse (2/11; 18.2%) patterns. The chronic CSC cases demonstrated different patterns of choroidal vessel dilatation: focal (5/15; 33.3%) and diffuse (10/15; 66.6%). Ten of the acute CSC eyes (83.3%) and 14 of the chronic CSC eyes (82.4%) were found to have obscured choriocapillaris and Sattler's layers on en face imaging. En face imaging of SS-OCT is useful when combined with angiography in CSC for evaluating choroidal vessel dilatation at Haller's layer and to identify obscured upper layers. We identified different choroidal vessel dilatation patterns between acute and chronic CSC. These findings might be useful for pathophysiological understanding of CSC. 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/.

[Strategies to Cope with the Shortage of Technologists: Facing the Mass-Retirement of the 'Baby-Boomer' Generation].

PubMed

Morikane, Keita; Yamada, Miyuki

2015-03-01

In Japan, the primary 'baby-boomer' generation, born between 1947 and 1949, is now in its retirement. This has caused a marked shortage of human resources nationwide. Clinical laboratory technologists are no exception, and many clinical laboratories in Japanese healthcare facilities are struggling with management because the number of new graduates, i.e., newly licensed technologists, is mostly fixed and, therefore, their recruitment is becoming more and more competitive. Our laboratory is now facing a wave of mass-retirement associated with our history. In addition, in the early 2000s, there was almost no position for new graduates replacing those retiring because of the change in the social healthcare system as well as our hospital's policy. This resulted in uneven numbers of technologists in generations, and it seemed to be getting worse. Fortunately, five years ago, the direction of social health care was changed and lots of positions became available as a result. We have been trying to recruit new graduates and experienced technologists as well, and were able to hire 18 people. Among them, 8 were non-freshmen. The generation gap has been mostly resolved. We will continue to make our laboratory more attractive not just to new graduates but also to experienced technologists, especially those who wish to return to work after a several-year absence to raise their children. We believe that this will energize our laboratory.

Superintendents' Perceptions of the Principal Shortage

ERIC Educational Resources Information Center

Pijanowski, John C.; Hewitt, Paul M.; Brady, Kevin P.

2009-01-01

The research literature on the principal shortage is inconsistent regarding the actual scope of the shortage and a clear articulation of factors contributing to the successful recruitment and retention of today's school leaders. Often, critical data related to the principal shortage are ignored, including the number of younger principals…

The financial impacts of the nursing shortage.

PubMed

Rivers, Patrick A; Tsai, Kai-Li; Munchus, George

2005-01-01

This article examines the multiple factors leading to the nursing shortage and the financial impact of the nursing shortage on hospitals and health care providers, the government, society and educational institutions. Nursing shortages have occurred in this country throughout history, however, the current shortage is especially grappling due to the financial condition of the health care system, Health Insurance Portability and Accountability Act, the Balanced Budget Act, the compounding conditions that have led up to the shortage and the forecasted health care needs. Many solutions have been proposed to improve the nursing shortage. This article provides recommendations to problem solving methods and discusses some current policy alternatives, including recently enacted "nurse-patient ratio" regulation, demonstrated by California state policy and the "Magnet Certification" program developed by American Nursing Credential Center (ANCC). This article further examines the financial impacts on nursing shortage problem.

Heading Off a Ph.D. Shortage.

ERIC Educational Resources Information Center

Vaughn, John C.; Rosenzweig, Robert M.

1991-01-01

Discussed is the projected shortage of Ph.D.s in the natural sciences and engineering by the turn of the century. Included are reasons for the shortage and three ways to reduce the projected shortages. Topics discussed include a complete federal strategy, attracting more minorities and women, and institutional reform. (KR)

The Nursing Shortage: Causes, Impact, and Innovative Remedies. Hearing Before the Committee on Education and the Workforce, House of Representatives, One Hundred Seventh Congress, First Session. Hearing Held in Washington, DC, September 25, 2001.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Education and the Workforce.

This congressional hearing consists of testimony on the nursing shortage facing the country. It examines the causes and impact of the nursing shortage that the nation faces and introduces innovative remedies currently being undertaken by educational institutions and the health care industry, and makes suggestions for further action. Testimony…

Nurse Shortage: Fact or Fiction?

DTIC Science & Technology

1982-04-23

nursing fuctions , the perceived nursing shortage can be overcome. Whethec there really is a shortage of registered nurses or merely an insufficient...probably will remain primarily a female profession. Salary is, without question, one of the primary factors that many feel influence the entry-exit rate of

Protecting food security when facing uncertain climate: Opportunities for Afghan communities

NASA Astrophysics Data System (ADS)

Salman, Dina; Amer, Saud A.; Ward, Frank A.

2017-11-01

Climate change, population growth, and weakly developed water management institutions in many of the world's dry communities have raised the importance of designing innovative water allocation methods that adapt to water supply fluctuations while respecting cultural sensitivities. For example, Afghanistan faces an ancient history of water supply fluctuations that have contributed to periodic food shortage and famine. Poorly designed and weakly enforced water allocation methods continue to result in agriculture sector underperformance and periodic food shortages when water shortfalls occur. To date, little research has examined alternative water sharing rules on a multi-basin scale to protect food security for a subsistence irrigation society when the community faces water shortage. This paper's contribution examines the economic performance of three water-sharing mechanisms for three basins in Afghanistan with the goal of protecting food security for crop irrigation under ongoing threats of drought, while meeting growing demands for food in the face of anticipated population growth. We achieved this by formulating an integrated empirical optimization model to identify water-sharing measures that minimize economic losses while protecting food security when water shortages occur. Findings show that implementation of either a water trading policy or a proportional shortage policy that respects cultural sensitivities has the potential to raise economic welfare in each basin. Such a policy can reduce food insecurity risks for all trading provinces within each basin, thus being a productive institution for adapting to water shortage when it occurs. Total economic welfare gains are highest when drought is the most severe for which suffering would otherwise be greatest. Gains would be considerably higher if water storage reservoirs were built to store wet year flows for use in dry years. Our results light a path for policy makers, donors, water administrators, and farm

A strategy to address the nursing faculty shortage.

PubMed

Ganley, Barbara J; Sheets, Ingrid

2009-07-01

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

The nursing shortage revisioning the future.

PubMed

Purnell, M J; Horner, D; Gonzalez, J; Westman, N

2001-04-01

A severe shortage of nurses is being experienced nationally and globally. In South Florida, one of the most severely impacted regions in the world, a group of healthcare organizations, educational institutions, and nursing organizations formed the Nursing Shortage Consortium to combat the nursing shortage. Strategic efforts to recruit and retain nurses are underway, with a focus on nurturing interest among young people and increasing opportunities to stimulate their interest, to increase the supply of appropriately prepared professional nurses.

Drug shortages: the cycle of quantity and quality.

PubMed

Kweder, S L; Dill, S

2013-03-01

Shortages of pharmaceutical drugs pose a serious and growing threat to public health. Although the number of drugs in shortage in the United States in any given year is very small, the number of prescription drug shortages in the country nearly tripled between 2005 and 2010. Drug shortages are becoming more severe as well as more frequent. The affected medicines include cancer treatments, anesthesia drugs, and other drugs that are critical to the treatment and prevention of serious diseases and life-threatening conditions. (The White House, Office of the Press Secretary, Executive Order 13588-Reducing Prescription Drug Shortages (http://www.whitehouse.gov/the-press-office/2011/10/31/executive-order-reducing-prescription-drug-shortages)).

Voices in Education: Teacher Shortage--Myth or Reality?

ERIC Educational Resources Information Center

Martin, Linda E.; Mulvihill, Thalia M.

2016-01-01

It appears that a teacher shortage is on the rise in the nation's schools. This is not a new issue or concern; teacher shortages have occurred off and on for some time for a variety of reasons. But this particular shortage of qualified teachers does appear to be important and different than previously reported shortages ("The Washington…

Impact of drug shortages on U.S. health systems.

PubMed

Kaakeh, Rola; Sweet, Burgunda V; Reilly, Cynthia; Bush, Colleen; DeLoach, Sherry; Higgins, Barb; Clark, Angela M; Stevenson, James

2011-10-01

A study was performed to quantify the personnel resources required to manage drug shortages, define the impact of drug shortages on health systems nationwide, and assess the adequacy of information resources available to manage drug shortages. An online survey was sent to the 1322 members of the American Society of Health-System Pharmacists who were identified as directors of pharmacy. Survey recipients were asked to identify which of the 30 most recent drug shortages listed affected their health system, to identify actions taken to manage the shortage, and to rate the impact of each shortage. Employees responsible for completing predefined tasks were identified, and the average time spent by each type of employee completing these tasks was estimated. Labor costs associated with managing shortages were calculated. A total of 353 respondents completed the survey, yielding a response rate of 27%. Pharmacists and pharmacy technicians spent more time managing drug shortages than did physicians and nurses. There was a significant association between the time spent managing shortages and the size of the institution, the number of shortages managed, and the institution's level of automation. Overall, 70% of the respondents felt that the information resources available to manage drug shortages were not good. The labor costs associated with managing shortages in the United States is an estimated $216 million annually. A survey of directors of pharmacy revealed that labor costs and the time required to manage drug shortages are significant and that current information available to manage drug shortages is considered suboptimal.

76 FR 68295 - Reducing Prescription Drug Shortages

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-03

... Reducing Prescription Drug Shortages By the authority vested in me as President by the Constitution and the... pharmaceutical drugs pose a serious and growing threat to public health. While a very small number of drugs in the United States experience a shortage in any given year, the number of prescription drug shortages...

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

ERIC Educational Resources Information Center

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

2012-01-01

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

Teacher Shortages: Truth and Consequences.

ERIC Educational Resources Information Center

Tooredman, Kathryn J.

This paper provides a broad overview of the teacher shortage situation and concludes that shortages may occur during the next 10 years, depending upon the factors of supply and demand. Demand, it appears, will increase until an additional 200,000 teachers will be needed by 1990. The supply of teachers may increase enough to met this demand, but…

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

PubMed

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

2017-11-15

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

Difficulties facing physician mothers in Japan.

PubMed

Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

2011-11-01

Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce. © 2011 Tohoku University Medical Press

What's different about this nursing shortage?

PubMed

Mee, Cheryl L; Robinson, Eileen

2003-01-01

Driven by unprecedented social and demographic changes, this nursing shortage won't be easily fixed by solutions that worked in the past. Here's what makes this shortage unique- and how you can influence the change shaping your profession.

Effects of Acute Alcohol Consumption on the Processing of Emotion in Faces: Implications for Understanding Alcohol-Related Aggression

PubMed Central

Attwood, Angela S.; Munafò, Marcus R.

2016-01-01

The negative consequences of chronic alcohol abuse are well known, but heavy episodic consumption ("binge drinking") is also associated with significant personal and societal harms. Aggressive tendencies are increased after alcohol but the mechanisms underlying these changes are not fully understood. While effects on behavioural control are likely to be important, other effects may be involved given the widespread action of alcohol. Altered processing of social signals is associated with changes in social behaviours, including aggression, but until recently there has been little research investigating the effects of acute alcohol consumption on these outcomes. Recent work investigating the effects of acute alcohol on emotional face processing has suggested reduced sensitivity to submissive signals (sad faces) and increased perceptual bias towards provocative signals (angry faces) after alcohol consumption, which may play a role in alcohol-related aggression. Here we discuss a putative mechanism that may explain how alcohol consumption influences emotional processing and subsequent aggressive responding, via disruption of OFC-amygdala connectivity. While the importance of emotional processing on social behaviours is well established, research into acute alcohol consumption and emotional processing is still in its infancy. Further research is needed and we outline a research agenda to address gaps in the literature. PMID:24920135

Medicine shortages--a study of community pharmacies in Finland.

PubMed

Heiskanen, K; Ahonen, R; Karttunen, P; Kanerva, R; Timonen, J

2015-02-01

To explore the frequency, the reasons behind, and the consequences of medicine shortages in Finnish community pharmacies. During the 27-day study period in the autumn of 2013, randomly selected pharmacies reported on medicines that were in short supply from orders made to wholesalers. Altogether 129 (66%, n=195) pharmacies participated in the study, and the study material consisted of 3311 report forms. Of the study pharmacies, 79.8% had medicine shortages daily or almost daily. Medicines in short supply were most commonly medicines that affect the nervous system (30.8%) and the cardiovascular system (17.5%). The reason behind the shortage was reported to the pharmacies in 11.2% of the shortage cases. The medicine shortages caused problems for the pharmacies in 33.0% of the cases. In most cases (67.0%) the medicine shortages did not cause problems for the pharmacies, usually because a substitutable product was available (48.5%). Medicine shortages are common in Finnish community pharmacies. Medicines in short supply were commonly used medicines. The reason behind the shortage was rarely told to the pharmacies. Medicine shortages caused problems for the pharmacies in one-third of all the shortage cases. These shortages may be significant for the customers or the pharmacies, as they cause customer dissatisfaction and increase the workload of the pharmacy staff. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Solicitation of veterinarian shortage situations... Shortage Situations § 3431.5 Solicitation of veterinarian shortage situations. (a) General. The Secretary will follow the procedures described in this part to solicit veterinarian shortage situations as the...

7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Solicitation of veterinarian shortage situations... Shortage Situations § 3431.5 Solicitation of veterinarian shortage situations. (a) General. The Secretary will follow the procedures described in this part to solicit veterinarian shortage situations as the...

7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Solicitation of veterinarian shortage situations... Shortage Situations § 3431.5 Solicitation of veterinarian shortage situations. (a) General. The Secretary will follow the procedures described in this part to solicit veterinarian shortage situations as the...

Understanding the shortage of village doctors in China and solutions under the policy of basic public health service equalization: evidence from Changzhou.

PubMed

Li, Xiaohong; Cochran, Christopher; Lu, Jun; Shen, Jay; Hao, Chao; Wang, Ying; Sun, Mei; Li, Chengyue; Chang, Fengshui; Hao, Mo

2015-01-01

As the most important public health service providers in rural China, village doctors are facing a new challenge of heavier workload resulting from the recent policy of public health service equalization. Studies on the shortage of village doctors, mainly based on the national statistics, have so far been very broad. This study conducted detailed field surveys to identify specific factors of and potential solutions to the shortage in village doctors. Eight hundred forty-four village doctors and 995 health decision makers and providers were surveyed through a questionnaire, and some of them were surveyed by in-depth face-to-face interviews and focus group interviews. Opinions on the shortage in village doctors and the potentially effective approaches to addressing the problem were sought. Some village doctors (51.3%) were at least 50 years old. Some village doctors (92.3%) did not want their children to become a village doctor, and the main reasons were "low salary" and "lack of social security". Village doctors felt that it was difficult to provide all the required public health services. Local residents indicated that they established good relationships with village doctors. Some health decision makers and providers (74.0%) thought that they needed more village doctors. The shortage in village doctors presents a major obstacle toward the realization of China's policy of public health service equalization. The aging of current village doctors exacerbates the problem. Policies and programs are needed to retain the current and attract new village doctors into the workforce. Separate measures are also needed to address disparities in socioeconomic circumstance from village to village. Copyright © 2014 John Wiley & Sons, Ltd.

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

PubMed

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

2017-12-01

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

[Physician shortage in Japan: the new postgraduate medical education program and physicians as a human medical resource].

PubMed

Nomura, Kyoko

2011-01-01

Japan now faces a serious physician shortage. After introducing the new postgraduate medical education (PGME) system and doctor-to-facility matching system, residents shifted their teaching hospitals from university hospitals to non-university hospitals. Because university hospitals had played a central role in allocating physicians to communities, the decrease in the number of physicians at university hospitals has driven this physician shortage. Japanese policymakers blame the new PGME for exacerbating this physician shortage and have tentatively agreed to reform the PGME to encourage residents to return to university hospitals. However, the PGME system should not be reformed only for political reasons; such a change requires a scientific basis. First, after the introduction of the new PGME, residents showed an improved clinical competence; therefore, it has accomplished its ultimate goal. Second, the residents' satisfaction level in terms of the residency system and clinical skills training was significantly higher at non-university hospitals than at university hospitals. This implies that training conditions at university hospitals are not as good as at non-university hospitals, which explains the decrease in the number of physicians at university hospitals. Third, in 2009, the Japanese government increased the maximum medical school enrollment to mitigate the physician shortage. However, a simple increase does not solve the problem of physician shortage unless it also addresses the problem of physician maldistribution. Fourth, the number of females entering medicine is increasing, and women constituted 30% of newly certified physicians in 2010. In this era of physician shortage, female physicians are highly recommended as a human medical resource.

Acute Solar Retinopathy Imaged With Adaptive Optics, Optical Coherence Tomography Angiography, and En Face Optical Coherence Tomography.

PubMed

Wu, Chris Y; Jansen, Michael E; Andrade, Jorge; Chui, Toco Y P; Do, Anna T; Rosen, Richard B; Deobhakta, Avnish

2018-01-01

Solar retinopathy is a rare form of retinal injury that occurs after direct sungazing. To enhance understanding of the structural changes that occur in solar retinopathy by obtaining high-resolution in vivo en face images. Case report of a young adult woman who presented to the New York Eye and Ear Infirmary with symptoms of acute solar retinopathy after viewing the solar eclipse on August 21, 2017. Results of comprehensive ophthalmic examination and images obtained by fundus photography, microperimetry, spectral-domain optical coherence tomography (OCT), adaptive optics scanning light ophthalmoscopy, OCT angiography, and en face OCT. The patient was examined after viewing the solar eclipse. Visual acuity was 20/20 OD and 20/25 OS. The patient was left-eye dominant. Spectral-domain OCT images were consistent with mild and severe acute solar retinopathy in the right and left eye, respectively. Microperimetry was normal in the right eye but showed paracentral decreased retinal sensitivity in the left eye with a central absolute scotoma. Adaptive optics images of the right eye showed a small region of nonwaveguiding photoreceptors, while images of the left eye showed a large area of abnormal and nonwaveguiding photoreceptors. Optical coherence tomography angiography images were normal in both eyes. En face OCT images of the right eye showed a small circular hyperreflective area, with central hyporeflectivity in the outer retina of the right eye. The left eye showed a hyperreflective lesion that intensified in area from inner to middle retina and became mostly hyporeflective in the outer retina. The shape of the lesion on adaptive optics and en face OCT images of the left eye corresponded to the shape of the scotoma drawn by the patient on Amsler grid. Acute solar retinopathy can present with foveal cone photoreceptor mosaic disturbances on adaptive optics scanning light ophthalmoscopy imaging. Corresponding reflectivity changes can be seen on en face OCT, especially

Medicine shortages: a commentary on causes and mitigation strategies.

PubMed

Iyengar, Swathi; Hedman, Lisa; Forte, Gilles; Hill, Suzanne

2016-09-29

Shortages of medicines and vaccines have been reported in countries of all income levels in recent years. Shortages can result from one or multiple causes, including shortages of raw materials, manufacturing capacity problems, industry consolidation, marketing practices, and procurement and supply chain management. Existing approaches to mitigate shortages include advance notice systems managed through medicine regulatory authorities, special programmes that track medicines, and interventions to improve efficiency of the medicine supply chain. Redistribution of supplies at the national level can mitigate some shortages in the short term. International redistribution and exceptional regulatory approvals may be used in limited circumstances, with the understanding that such approaches are complex and may introduce cost and quality risks. If it is necessary to prioritise patients to receive a medicine that is in shortage, evidence-based practice should be used to ensure optimal allocation. Important steps in reducing medicine shortages and their impact include identifying medicines that are most at risk, developing reporting systems to share information on current and emerging shortages, and improving data from medicine supply chains.

Causes of drug shortages in the legal pharmaceutical framework.

PubMed

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

2015-03-01

Different causes of drug shortages can be linked to the pharmaceutical legal framework, such as: parallel trade, quality requirements, economic decisions to suspend or cease production, etc. However until now no in-depth study of the different regulations affecting drug shortages is available. The aim of this paper is to provide an analysis of relevant legal and regulatory measures in the European pharmaceutical framework which influence drug shortages. Different European and national legislations governing human medicinal products were analyzed (e.g. Directive 2001/83/EC and Directive 2011/62/EU), supplemented with literature studies. For patented drugs, external price referencing may encompass the largest impact on drug shortages. For generic medicines, internal or external reference pricing, tendering as well as price capping may affect drug shortages. Manufacturing/quality requirements also contribute to drug shortages, since non-compliance leads to recalls. The influence of parallel trade on drug shortages is still rather disputable. Price and quality regulations are both important causes of drug shortages or drug unavailability. It can be concluded that there is room for improvement in the pharmaceutical legal framework within the lines drawn by the EU to mitigate drug shortages. Copyright © 2015 Elsevier Inc. All rights reserved.

[Drug shortage: determinants, consequences and management].

PubMed

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.

Skills Shortages in Europe. IRDAC Opinion.

ERIC Educational Resources Information Center

Commission of the European Communities, Brussels (Belgium). Industrial Research and Development Advisory Committee.

In 1989, the Industrial Research and Development Advisory Committee (IRDAC) of the European Community established a Working Party on education and training issues relevant to industry. A subgroup on skill shortages considered the issue from the European and macro-economic point of view. It examined such skills shortages issues as demographic…

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

PubMed

Kaposy, Chris

2014-03-01

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

Projections for antiinfective drug shortages and time to actual resolution.

PubMed

McLaughlin, Milena M; Pentoney, Zachary; Skoglund, Erik; Scheetz, Marc H

2014-12-01

The results of a national study of projected versus actual times to resolution of temporary U.S. shortages of antiinfective drugs are presented. Descriptive data on antiinfective drug shortages, including differences between manufacturer-estimated and actual times to shortage resolution, were collected over a one-year period via regular monitoring of the websites of ASHP and the Food and Drug Administration. Inventory data from one large hospital in the Midwest were collected in order to characterize realized shortages (i.e., those for which mitigation was required). During the study period, there were 47 transient shortages of antiinfective medications involving 381 unique products or formulations, of which 40% (n = 19) were emergent shortages. Generic-only and brand-only medications accounted for 53% (n = 25) and 21% (n = 10) of the evaluated shortages, respectively; the median shortage duration was 40 days (interquartile range [IQR], 22-91 days). The reasons for shortages most frequently cited by manufacturers were product or formulation discontinuation (21%), increased demand (12%), and raw material shortfalls (8%). Some shortages were resolved sooner than originally projected, but overall, actual shortage durations exceeded manufacturer-projected durations by a median of 17 days (IQR, 0-52.5 days). Ten realized shortages occurred at the hospital study site, compelling the antimicrobial stewardship team to recommend alternative therapies or restrict the use of drugs in short supply. The actual durations of evaluated antiinfective drug shortages during the study period were longer than the manufacturer-projected durations by a median of 17 days. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Where are the food animal veterinarian shortage areas anyway?

PubMed

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.

Nursing shortage: the facts and strategies in Macao society.

PubMed

Liu, Ming; Lam, Bernice; Fong, Pedro; Yuan, Hao Bin

2012-11-19

Historically, Macao, a Special Administrative Region (SAR) in the People's Republic of China, has been troubled by a shortage of nurses. This shortage became especially severe during the period immediately after the handover of Macao from Portugal to the People's Republic of China in 1999. A fast-growing population, an aging population, the risk of epidemics, and competition for personnel with other industries have all contributed to this shortage. In recent years, Macao has implemented the following successful strategies to address the shortage: increased school enrollments, benefits, and professional development, along with the development of a clinical specialist program, a transition program for new graduates, and training for more certified nursing assistants. Strong government support and collaboration among all stakeholders have also served to enhance the nursing work force. In this article, the authors describe the nursing shortage in Macao SAR, discuss factors contributing to the shortage, and present strategies used to manage the shortage. They conclude by emphasizing the importance of increasing salary and professional status and providing transition programs for new graduates.

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

PubMed

Chojnicki, Xavier; Moullan, Yasser

2018-03-01

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

Reproductive Resilience to Food Shortage in a Small Heterothermic Primate

PubMed Central

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

Reproductive resilience to food shortage in a small heterothermic primate.

PubMed

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

Challenges that nurses face in caring for morbidly obese patients in the acute care setting.

PubMed

Drake, Daniel; Dutton, Kathy; Engelke, Martha; McAuliffe, Maura; Rose, Mary Ann

2005-01-01

Despite increasing numbers of morbidly obese patients admitted to acute care facilities for surgery or treatment of nonsurgical conditions, there is little evidence of the problems nurses face in providing care to these patients. Anecdotal evidence suggests that the care of these patients is more demanding than the care of nonobese patients. The objective of this study was to describe nurses' perceptions of the challenges that they face when caring for morbidly obese patients. Focus groups of nurses from a tertiary care facility were convened. A trained facilitator posed questions to the group concerning various aspects of care for morbidly obese patients. Comments of respondents were categorized using NVIVO software. Nurses reported concerns about the increased staffing needs required for care of these patients and the particular challenges of the physical care. Concerns also included the availability, placement, and use of specialized equipment. Room size and the absence of some equipment were also problematic. Finally, nurses perceived safety issues, both for themselves and their patients. Morbidly obese patients in the acute care setting require specialized nursing care in terms of techniques, levels of staffing required, and the use of specialized equipment.

Ph.D. shortage

NASA Astrophysics Data System (ADS)

The late 1990s will see a shortage of Ph.D. graduates, according to the Association of American Universities, Washington, D.C. AAU's new comprehensive study, “The Ph.D. Shortage: The Federal Role,” reports that competition for new Ph.D.s is already intense and can only intensify because demand is greater than supply in both academic and nonacademic markets.Doctoral education plays an increasingly important role in U.S. research and development programs. Students have a pivotal part in doing research and enriching it with new ideas. The AAU report says that graduate students are “major determinants of the creativity and productivity of U.S. academic research, the source of more than 50% of the nation's basic research.’ The market for doctoral education extends beyond the university. In 1985, about 43% of all Ph.D.s employed in this country were working outside higher education; the demand for doctorate recipients in nonacademic sectors continues to grow.

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

PubMed

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

Nursing and Allied Health Shortages: TBR Responds.

ERIC Educational Resources Information Center

Berryman, Treva

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

Shortage of cardiothoracic surgeons is likely by 2020.

PubMed

Grover, Atul; Gorman, Karyn; Dall, Timothy M; Jonas, Richard; Lytle, Bruce; Shemin, Richard; Wood, Douglas; Kron, Irving

2009-08-11

Even as the burden of cardiovascular disease in the United States is increasing as the population grows and ages, the number of active cardiothoracic surgeons has fallen for the first time in 20 years. Meanwhile, the treatment of patients with coronary artery disease continues to evolve amid uncertain changes in technology. This study evaluates current and future requirements for cardiothoracic surgeons in light of decreasing rates of coronary artery bypass grafting procedures. Projections of supply and demand for cardiothoracic surgeons are based on analysis of population, physician office, hospital, and physician data sets to estimate current patterns of healthcare use and delivery. Using a simulation model, we project the future supply of cardiothoracic surgeons under alternative assumptions about the number of new fellows trained each year. Future demand is modeled, taking into account patient demographics, under current and alternative use rates that include the elimination of open revascularization. By 2025, the demand for cardiothoracic surgeons could increase by 46% on the basis of population growth and aging if current healthcare use and service delivery patterns continue. Even with complete elimination of coronary artery bypass grafting, there is a projected shortfall of cardiothoracic surgeons because the active supply is projected to decrease 21% over the same time period as a result of retirement and declining entrants. The United States is facing a shortage of cardiothoracic surgeons within the next 10 years, which could diminish quality of care if non-board-certified physicians expand their role in cardiothoracic surgery or if patients must delay appropriate care because of a shortage of well-trained surgeons.

For the Health-Care Work Force, a Critical Prognosis

ERIC Educational Resources Information Center

Rahn, Daniel W.; Wartman, Steven A.

2007-01-01

The United States faces a looming shortage of many types of health-care professionals, including nurses, physicians, dentists, pharmacists, and allied-health and public-health workers. There may also be a shortage of faculty members in the health sciences. The results will be felt acutely within the next 10 years. Colleges and health-science…

The nursing shortage: part way down the slippery slope.

PubMed

Cowin, Leanne; Jacobsson, Denise

2003-07-01

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

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

NASA Astrophysics Data System (ADS)

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.

7 CFR 3431.7 - Notification and use of designated veterinarian shortage situations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian Shortage Situations § 3431.7 Notification and use of designated veterinarian shortage situations. The Secretary will publish the designated veterinarian shortage situations on the Agency's Web site and will use the designated veterinarian shortage...

7 CFR 3431.7 - Notification and use of designated veterinarian shortage situations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of Veterinarian Shortage Situations § 3431.7 Notification and use of designated veterinarian shortage situations. The Secretary will publish the designated veterinarian shortage situations on the Agency's Web site and will use the designated veterinarian shortage situations to solicit VMLRP loan repayment...

7 CFR 3431.7 - Notification and use of designated veterinarian shortage situations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of Veterinarian Shortage Situations § 3431.7 Notification and use of designated veterinarian shortage situations. The Secretary will publish the designated veterinarian shortage situations on the Agency's Web site and will use the designated veterinarian shortage situations to solicit VMLRP loan repayment...

7 CFR 3431.7 - Notification and use of designated veterinarian shortage situations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of Veterinarian Shortage Situations § 3431.7 Notification and use of designated veterinarian shortage situations. The Secretary will publish the designated veterinarian shortage situations on the Agency's Web site and will use the designated veterinarian shortage situations to solicit VMLRP loan repayment...

Insights into European Drug Shortages: A Survey of Hospital Pharmacists

PubMed Central

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

Insights into European drug shortages: a survey of hospital pharmacists.

PubMed

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.

5 CFR 337.204 - Severe shortage of candidates.

Code of Federal Regulations, 2011 CFR

2011-01-01

... local or national labor market; (3) The existence of nationwide or geographic skills shortages; (4... geographic locations. OPM may decide independently that such a shortage exists, or may make this decision in... quality of candidates; (6) The desirability of the geographic location of the position(s); (7) The...

5 CFR 337.204 - Severe shortage of candidates.

Code of Federal Regulations, 2012 CFR

2012-01-01

... local or national labor market; (3) The existence of nationwide or geographic skills shortages; (4... geographic locations. OPM may decide independently that such a shortage exists, or may make this decision in... quality of candidates; (6) The desirability of the geographic location of the position(s); (7) The...

5 CFR 337.204 - Severe shortage of candidates.

Code of Federal Regulations, 2014 CFR

2014-01-01

... local or national labor market; (3) The existence of nationwide or geographic skills shortages; (4... geographic locations. OPM may decide independently that such a shortage exists, or may make this decision in... quality of candidates; (6) The desirability of the geographic location of the position(s); (7) The...

Addressing the Shortage of Speech-Language Pathologists in School Settings

ERIC Educational Resources Information Center

Squires, Katie

2013-01-01

There is a shortage of speech-language pathologists (SLPs) in this country. This shortage is due, in part, to the limited number of openings in graduate programs and the increased need for SLPs as their scope of practice widens, the autism rate grows, and the population ages. Schools are feeling this shortage the most. There are several reasons…

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

ERIC Educational Resources Information Center

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…

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

PubMed

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.

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

PubMed

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.

Impact of drug shortages on patients receiving parenteral nutrition after laparotomy.

PubMed

Bible, Jaimee R; Evans, David C; Payne, Brett; Mostafavifar, Lisa

2014-11-01

Drug shortages, including parenteral nutrition (PN) product shortages, continue to increase and have a significant impact on healthcare. The extent to which product shortages affect bowel recovery and outcomes in patients receiving PN is unknown. The objective of this study is to examine the impact of extensive PN product shortages on patients receiving PN after laparotomy for bowel obstruction. A retrospective review was conducted for patients who underwent a laparotomy for small bowel obstruction and received PN postoperatively. Periods of limited and extensive PN product shortages at our institution were defined. PN therapy duration and composition, daily laboratory values, electrolyte supplementation, length of stay, and cost of hospitalization were recorded. Analyses using χ(2), Wilcoxon rank sum, log-rank, and t tests as appropriate were performed using SAS/STAT 9.2. Patients had longer hospital length of stays (20.0 vs 15.2 days; P = .04), trends toward longer PN therapy courses (8.8 vs 6.6 days; P = .13), and a 51% higher hospital cost during the extensive PN drug shortage period. Mean serum electrolyte concentrations were similar while the need for supplemental magnesium replacements increased during the extensive shortage period (75% vs 35%; P = .01). Supplemented patients also required higher doses of magnesium (2.7 vs 1.0 g; P < .01) and more laboratory draws during the extensive shortage period (59% vs 21% required ≥ 2 draws daily; P = .04). Fewer lipid calories were delivered during the extensive shortage period (2.4 vs 4.8 kcal/kg/d; P < .01). PN drug shortages have a negative impact on patient outcomes and require aggressive management strategies. © 2014 American Society for Parenteral and Enteral Nutrition.

Evaluation of Parenteral Nutrition Errors in an Era of Drug Shortages.

PubMed

Storey, Michael A; Weber, Robert J; Besco, Kelly; Beatty, Stuart; Aizawa, Kumiko; Mirtallo, Jay M

2016-04-01

Ingredient shortages have forced many organizations to change practices or use unfamiliar ingredients, which creates potential for error. Parenteral nutrition (PN) has been significantly affected, as every ingredient in PN has been impacted in recent years. Ingredient errors involving PN that were reported to the national anonymous MedMARx database between May 2009 and April 2011 were reviewed. Errors were categorized by ingredient, node, and severity. Categorization was validated by experts in medication safety and PN. A timeline of PN ingredient shortages was developed and compared with the PN errors to determine if events correlated with an ingredient shortage. This information was used to determine the prevalence and change in harmful PN errors during periods of shortage, elucidating whether a statistically significant difference exists in errors during shortage as compared with a control period (ie, no shortage). There were 1311 errors identified. Nineteen errors were associated with harm. Fat emulsions and electrolytes were the PN ingredients most frequently associated with error. Insulin was the ingredient most often associated with patient harm. On individual error review, PN shortages were described in 13 errors, most of which were associated with intravenous fat emulsions; none were associated with harm. There was no correlation of drug shortages with the frequency of PN errors. Despite the significant impact that shortages have had on the PN use system, no adverse impact on patient safety could be identified from these reported PN errors. © 2015 American Society for Parenteral and Enteral Nutrition.

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

PubMed

Kowalski, Karren; Kelley, Brian M

2013-01-01

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

Nursing shortages and international nurse migration.

PubMed

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

2005-12-01

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

The American Nursing Shortage: Implications for Community Colleges

ERIC Educational Resources Information Center

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…

Current face of acute otitis media: microbiology and prevalence resulting from widespread use of heptavalent pneumococcal conjugate vaccine.

PubMed

Brunton, Stephen

2006-01-01

Many causes can be proposed for a change in the microbiologic makeup of a specific disease state. However, when viewed through the scope of recent events, only one is likely to be the true cause of a change in the microbiology of acute otitis media (AOM): the release and widespread use of heptavalent pneumococcal conjugate vaccine (PCV-7). The aim of this report was to review the microbiology and prevalence of AOM before and after the release and widespread use of PCV-7. For this brief review, we used a MEDLINE search to identify English-language literature related to the microbiology of AOM before and after the release of PCV-7 in 2000 in the United States (key terms: acute otitis media, AOM, Haemophilus influenzae, H influenzae, Streptococcus pneumoniae, and S pneumoniae; years: 1980-2005). Studies using tympanocentesis to identify the pathogen in recurrent or persistent AOM were examined; US studies reporting AOM microbiology before and after the release of PCV-7 in the same population were considered for the post-PCV-7 analysis. Following the release of PCV-7, a decrease in the overall rates of AOM was noted. This decrease brings into question the resultant effect on the microbiology of AOM. Our literature search revealed 2 studies that examined the microbiology of AOM before and after the release of PCV-7 in the United States. These 2 studies, conducted in dispersed geographic regions (rural Kentucky and Rochester, New York), illustrated a change in the predominant causative pathogen in AOM, from S pneumoniae to H influenzae in the population of children 7 to 24 months of age with recurrent AOM. Given the time period of the change, these shifts could be related to the release and widespread use of PCV-7. Since the 1990s, the predominant causative pathogen in recurrent AOM changed from S pneumoniae to H influenzae, possibly as a result of the release and widespread use of PCV 7. Although PCV-7 use was slowed from August 2001 to May 2003 and again from February

Energy Shortage: A Benign Crisis?

ERIC Educational Resources Information Center

Armstrong, Ellis L.

1974-01-01

The energy shortage will have a favorable effect on city revitalizing activities as innovative thinking is applied to city and transportation planning, building design, service and recreational facilities, and sewage treatment. (Author/MF)

The nursing shortage: breach of ideology as an unexplored cause.

PubMed

Censullo, Joan L

2008-01-01

The worldwide nursing shortage is unprecedented. Studies show increasing demand for nursing services coupled with a finite nursing supply. Many theories have been developed to explain the nursing shortage, to no avail. One unexplored theory is the psychological contract, which explores the impact of unwritten yet real expectations on work relationships. Understanding breach of the psychological contract is essential to resolution of the ongoing nursing shortage.

Mental health professional shortage areas in rural Appalachia.

PubMed

Hendryx, Michael

2008-01-01

Research on health disparities in Appalachia has rarely compared Appalachia to other geographic areas in such a way as to isolate possible Appalachian effects. This study tests hypotheses that nonmetropolitan Appalachia will have higher levels of mental health professional shortage areas than other nonmetropolitan areas of the same states, but that these disparities will dissipate when accounting for social and economic differences. The study analyzed secondary data for nonmetropolitan counties (N = 618) in the 13 Appalachian states. Appalachian counties were identified from the Appalachian Regional Commission designations. Mental health professional shortages were identified from Health Resources and Services Administration data. Area Resource File data were used to measure county-level income, education, uninsurance, unemployment, race/ethnicity percentages, and urban influence codes. Logistic regression models tested whether Appalachia was significantly associated with shortage areas, and whether the Appalachian effect persisted after accounting for social and economic covariates. Seventy percent of Appalachian nonmetropolitan counties were mental health professional shortage areas, significantly higher than non-Appalachian, nonmetropolitan counties in the same states. The Appalachian effect did not persist after controlling for the full set of other variables; education and race/ethnicity emerged as significant predictors. Appalachia location is associated with mental health professional shortages, but this effect is driven by underlying social differences, in particular by lower education. This method of identifying Appalachia for comparative purposes may be applied to many other health services research questions and to other defined geographic regions.

Health worker shortages in Zambia: an assessment of government responses.

PubMed

Gow, Jeff; George, Gavin; Mutinta, Given; Mwamba, Sylvia; Ingombe, Lutungu

2011-11-01

A dire health worker shortage in Zambia's national health programs is adversely impacting the quantity and quality of health care and posing a serious barrier to achieving Millennium Development Goals to improve population health. In 2005, Zambia's Ministry of Health developed a 10-year strategic plan for human resources for health to address the crisis through improved training, hiring, and retention. The plan has neither arrested nor reduced the shortage. We review the causes of the shortage, present results from a health worker survey showing that safe work conditions, manageable workloads, and career advancement opportunities matter more to respondents than financial compensation. We comment on the adequacy of government efforts to address the health worker shortage.

A critical review of the nursing shortage in Malaysia.

PubMed

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

2010-03-01

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

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

PubMed

Kraiwong, Ratchanok; Vongsirinavarat, Mantana; Soonthorndhada, Kusol

2014-07-01

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

The Fabrazyme shortage--a call to action for metabolic physicians.

PubMed

Sirrs, Sandra

2011-01-01

The recent shortages of enzyme replacement therapy for Fabry disease have highlighted areas of vulnerability for patients who require this treatment. Guidelines on allocation of limited stock of enzyme replacement therapy are of use for clinicians dealing with the current shortages. However, the community of metabolic physicians must advocate for changes that will minimize the impact of future drug shortages for their patients with lysosomal storage diseases. Copyright © 2010 Elsevier Inc. All rights reserved.

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

PubMed

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

2018-02-12

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

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.

PubMed

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.

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

PubMed

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.

Ethical framework for resource allocation during a drug supply shortage.

PubMed

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

2012-01-01

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

New Report Predicts Shortage of Geoscientists in the Workforce

NASA Astrophysics Data System (ADS)

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.

The World Language Teacher Shortage: Taking a New Direction

ERIC Educational Resources Information Center

Swanson, Pete; Mason, Shannon

2018-01-01

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

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

PubMed

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

1981-09-01

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

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

NASA Astrophysics Data System (ADS)

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.

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

PubMed

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.

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

PubMed

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

2017-01-01

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

Can state-supported interprofessional coalitions cure preceptor shortages?

PubMed

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

2018-06-01

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

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

PubMed Central

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

Introduction 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. Objectives 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. Design 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. Results 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. Conclusion 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. PMID:27788170

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

ERIC Educational Resources Information Center

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…

The Search for Specialists and Managers. Staff Shortage in Germany.

ERIC Educational Resources Information Center

Stahl, Klaus, Ed.

1999-01-01

Despite its high unemployment level, Germany is experiencing a shortage of specialists and managers. Germany's need for highly qualified information technology (IT) workers and engineers is particularly great. Approximately 10,000 posts for computer scientists and IT specialists remained vacant in 1998. Because of the shortage of such specialists,…

78 FR 44459 - Designation of Health Professional(s) Shortage Areas

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 42 CFR Part 5 Designation of Health Professional(s) Shortage Areas CFR Correction 0 In Title 42 of the Code of Federal Regulations, Parts 1 to 399... the phrase ``as having a mental health professional(s)'', insert the word ``shortage'' before the...

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

DTIC Science & Technology

2016-10-01

MILITARY TRAUMA SYSTEM: WORKING TOWARDS IMPROVED OUTCOMES by April J. Dunlevy, Maj, USAF, NC A Research Report Submitted to the Faculty In...developed to aid in efforts to provide safe , effective and efficient care. One barrier to this goal is the current national shortage of physician...healthcare system. 5 Preface I have been working in healthcare for 24 years, practicing in both civilian and military facilities

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

PubMed

Spetz, Joanne; Given, Ruth

2003-01-01

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

Acute pharmacologically induced shifts in serotonin availability abolish emotion-selective responses to negative face emotions in distinct brain networks.

PubMed

Grady, Cheryl L; Siebner, Hartwig R; Hornboll, Bettina; Macoveanu, Julian; Paulson, Olaf B; Knudsen, Gitte M

2013-05-01

Pharmacological manipulation of serotonin availability can alter the processing of facial expressions of emotion. Using a within-subject design, we measured the effect of serotonin on the brain's response to aversive face emotions with functional MRI while 20 participants judged the gender of neutral, fearful and angry faces. In three separate and counterbalanced sessions, participants received citalopram (CIT) to raise serotonin levels, underwent acute tryptophan depletion (ATD) to lower serotonin, or were studied without pharmacological challenge (Control). An analysis designed to identify distributed brain responses identified two brain networks with modulations of activity related to face emotion and serotonin level. The first network included the left amygdala, bilateral striatum, and fusiform gyri. During the Control session this network responded only to fearful faces; increasing serotonin decreased this response to fear, whereas reducing serotonin enhanced the response of this network to angry faces. The second network involved bilateral amygdala and ventrolateral prefrontal cortex, and these regions also showed increased activity to fear during the Control session. Both drug challenges enhanced the neural response of this set of regions to angry faces, relative to Control, and CIT also enhanced activity for neutral faces. The net effect of these changes in both networks was to abolish the selective response to fearful expressions. These results suggest that a normal level of serotonin is critical for maintaining a differentiated brain response to threatening face emotions. Lower serotonin leads to a broadening of a normally fear-specific response to anger, and higher levels reduce the differentiated brain response to aversive face emotions. Copyright © 2012 Elsevier B.V. and ECNP. All rights reserved.

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

DOT National Transportation Integrated Search

1975-09-01

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

An Exploratory Study of Distinguishing Challenges Faced by Mid-Life Teacher Candidates

ERIC Educational Resources Information Center

Tanksley, James F.

2012-01-01

The United States public education system is facing a possible shortage of several hundred thousand teachers over the next decade. To overcome the projected shortfall in teacher supply, schools of education of state university and college systems may need to look to the fastest growing segment of the college student population, the non-traditional…

Teacher Shortage Areas Nationwide Listing: 1990-91 thru 2005-06

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

The nationwide Teacher Shortage Area (TSA) lists for the 2004-05 and 2005-06 school years have been completed and are listed by state in this document. A state that desires to propose teacher shortage areas for designation must submit the information required under the program regulations for the following programs: (1) Targeted teacher deferment…

Skill Shortages in the Trades during Economic Downturns. Occasional Paper

ERIC Educational Resources Information Center

Oliver, Damian

2011-01-01

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

Dual job holding general practitioners: the effect of patient shortage.

PubMed

Godager, Geir; Lurås, Hilde

2009-10-01

In 2001, a listpatient system with capitation payment was introduced in Norwegian general practice. After an allocation process where each inhabitant was listed with a general practitioner (GP), a considerable share of the GPs got fewer persons listed than they would have preferred. We examine whether GPs who experience a shortage of patients to a larger extent than other GPs seek to hold a second job in the community health service even though the wage rate is low compared with the wage rate in general practice. Assuming utility maximization, we model the effect of patient shortage on a GP's decision to contract for a second job in the community health service. The model predicts a positive relationship between patient shortage and participation in the community health service. This prediction is tested by means of censored regression analyses, taking account of labour supply as a censored variable. We find a significant effect of patient shortage on the number of hours the GPs supply to community health service. The estimated marginal effect is 1.72 hours per week.

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

PubMed

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

Consumers in an Era of Shortages and Inflation. Proceedings of the Annual Conference of the American Council on Consumer Interests (21st, Kansas City, Missouri, April 2-5, 1975).

ERIC Educational Resources Information Center

Hull, Karen, Ed.

This document contains abstracts or manuscripts of 29 presentations examining the problem of how to cope with inflation and how best to deal with resource shortages, both of which might become even more acute in the future. Conference speakers viewed the problem from various perspectives, among them (1) consumer characteristics, attitudes, and…

The Impact of a Shortage of Pharmacy-Prepared Ephedrine Syringes on Intraoperative Medication Use.

PubMed

Ladha, Karim S; Nanji, Karen C; Pierce, Eric; Poon, K Trudy; Hyder, Joseph A

2015-08-01

Anesthesia-related medication shortages have become increasingly common in the United States. We tested whether a local shortage of pharmacy-prepared ephedrine syringes, replaced by provider-prepared ephedrine, was associated with provider-level changes in ephedrine and phenylephrine use and patient-level changes in intraoperative hemodynamics. Consecutive patients undergoing general and orthopedic surgery at a tertiary care center were included 1 month before and 1 month after the start of the pharmacy-prepared ephedrine syringe shortage. Lowest mean arterial blood pressure and slowest heart rate were obtained as measures of hemodynamics. Adjusted associations were tested using mixed-effects regression with repeated measures. Three hundred four patients before the shortage and 298 patients after the shortage began were included. The administration of at least 1 bolus of ephedrine was significantly more common before versus during the shortage (148/304 [48.7]% vs 117/298 [39.3]%; P = 0.0199). After adjusting for age, sex, ASA physical status, surgery type, anesthesia provider, and operative duration, patients were significantly less likely to receive ephedrine during the shortage (relative risk [RR] = 0.78 [95% confidence interval {CI}, 0.61-0.96]; P = 0.0198) and more likely to receive a phenylephrine bolus (RR = 1.27 [95% CI, 1.02-1.51]; P = 0.0357). Patient hemodynamics assessed by slowest heart rate or lowest mean arterial blood pressure did not differ significantly during the shortage. There was an alteration in medication administration patterns during a shortage of pharmacy-prepared syringes. Changes in ephedrine and phenylephrine use were noted; however, patient hemodynamics remained comparable. Provider use patterns were sensitive even to a relative and not absolute medication shortage as observed in this study.

General surgery in crisis--the critical shortage.

PubMed

Kahn, D; Pillay, S; Veller, M G; Panieri, E; Westcott, M J R

2006-08-01

General surgery is facing a serious crisis. There has been a significant decline in the number of applicants for registrar posts and an inability to attract and retain general surgical specialists in the state sector. The Association of Surgeons of South Africa (ASSA) undertook this study to determine the extent and cause of the problem. The study involved a combination of desk research and structured interviews. In addition, the Health Professions Council of South Africa (HPCSA) database was reviewed and compared with the South African Medical Association (SAMA) and ASSA databases. The medical schools provided information about student numbers and demographics, and the National Department of Health pro vided information about the status of medical practitioner and specialist posts in the state sector. Overall, 26.1% of the specialist posts were vacant. The situation was particularly critical in Mpumalanga and the Eastern Cape, where 84% and 58% of the specialist posts were vacant. Using a predictive model, a conservative estimate of the need for general surgeons was found to be at least 50 per year. Currently the eight medical schools graduate about 25 general surgeons per year. The changing demographics of medical students may be partly responsible for the decline in registrar applicants. The findings from this study have revealed that the shortage of general surgeons in the state sector has reached critical levels.

A Microeconomic Model of the Personnel Shortage in Public Rehabilitation Agencies

ERIC Educational Resources Information Center

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…

Army Distance Learning: Potential for Reducing Shortages in Army Enlisted Occupations.

ERIC Educational Resources Information Center

Shanley, Michael G.; Leonard, Henry A.; Winkler, John D.

The potential of distance learning (DL) to expedite the U.S. Army's efforts to redress personnel shortages in Army enlisted occupations was studied by evaluating how DL-based training strategies might affect skill shortages in the following occupations: helicopter repairer; electronic switching system operator; microwave systems…

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

PubMed Central

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

2008-01-01

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

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

NASA Astrophysics Data System (ADS)

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.

Demand for temporary agency nurses and nursing shortages.

PubMed

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.

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

PubMed

Andrews, Diane Randall; Dziegielewski, Sophia F

2005-07-01

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

Nursing shortages: let's be flexible.

PubMed

Sullivan, Christine; Reading, Sonya

2002-10-01

The following paper is a report outlining a significant work pattern change in an acute cardiac ward at a large Brisbane-based private hospital. The nursing staff expressed the desire for more flexible rostering and the opportunity to work 12-hour shifts. After agreement was reached between the hospital, the union and the Industrial Relations Board, guidelines were put in place and a Flexible Rostering System was proposed and trialed. An 80% consensus of staff was required both to proceed with the trial and to implement any permanent changes. Initially, the trial was conducted for three months and extended to six months. The shifts trialed were between four and 12 hours in length with varied starting and finishing times. The Flexible Rostering System was evaluated using feedback from staff surveys and the results of a staff vote. In addition, patient feedback, incident reports, financial and managerial evaluation of staff costs, hours per patient day utilised, sick leave, and the use of permanent staff for voluntary extra shifts were also monitored. The outcome of the trial was positive with over 80% of staff voting to implement the Flexible Rostering System permanently. A significant reduction in sick leave of 41% and improved retention of skilled registered nursing staff was noted. There was no increase in the number of incident reports or patient complaints. Both patients and nurses commented on the improved continuity of care. Salaries and wages were within budget. Staff surveys showed positive feedback such as increased morale, increased flexibility with rosters, decreased fatigue levels, improved patient assessment on night duty and an increase in number of days off. In conclusion, the Flexible Rostering System has been accepted as a positive change for staff and is cost effective for the hospital. In light of nursing shortages, the outcome of this trial cannot be ignored.

Reporting the "Exodus": News Coverage of Teacher Shortage in Australian Newspapers

ERIC Educational Resources Information Center

Shine, Kathryn

2015-01-01

Many developed countries, including Australia, struggle to recruit and retain adequate numbers of school teachers. Over the past decade every Australian state has experienced teacher shortages and, at various times, there has been a national shortfall of qualified teaching staff. This paper considers the reporting of teacher shortage in four…

"Dynamic Labor Shortage" In the Offing.

ERIC Educational Resources Information Center

Olson, Lawrence

1982-01-01

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

Surgical Procedures in Health Professional Shortage Areas: Impact of a Surgical Incentive Payment Plan.

PubMed

Diaz, Adrian; Merath, Katiuscha; Bagante, Fabio; Chen, Qinyu; Akgul, Ozgur; Beal, Eliza; Idrees, Jay; Olsen, Griffin; Gani, Faiz; Pawlik, Timothy M

2018-05-15

The Affordable Care Act established a Center for Medicare/Medicaid Services based 10% reimbursement bonus for general surgeons in Health Professional Shortage Areas. We sought to assess the impact of the Affordable Care Act Surgery Incentive Payment on surgical procedures performed in Health Professional Shortage Areas. Hospital utilization data from the California Office of Statewide Health Planning and Development between January 1, 2006, and December 31, 2015, were used to categorize hospitals according to Health Professional Shortage Area location. A difference-in-differences analysis measured the effect of the Surgery Incentive Payment on year-to-year differences for inpatient and outpatient surgical procedures by hospital type pre- (2006-2010) versus post- (2011-2015) Surgery Incentive Payment implementation. Among 409 unique hospitals that performed surgical procedures for at least 1 year of the study period, 2 performed surgery in a designated Health Professional Shortage Area. The two Health Professional Shortage Area -designated hospitals were located in a rural area, were non-teaching hospitals, and had 196 and 202 hospital beds, respectively. After the enactment of the Surgery Incentive Payment, while non- Health Professional Shortage Areas had only a modest relative decrease in total inpatient procedures (Pre-Surgery Incentive Payment: 4,666,938 versus Post-Surgery Incentive Payment: 4,451,612; Δ-4.6%), the proportional decrease in inpatient surgical procedures at Health Professional Shortage Area hospitals was more marked (Pre-Surgery Incentive Payment: 25,830 versus Post-Surgery Incentive Payment: 21,503; Δ-16.7%). In contrast, Health Professional Shortage Area hospitals proportionally had a greater increase in total outpatient procedures (Pre-Surgery Incentive Payment: 17,840 versus Post-Surgery Incentive Payment: 22,375: Δ+25.4%) versus non- Health Professional Shortage Area hospitals (Pre-Surgery Incentive Payment: 5,863,300 versus Post

Male Teacher Shortage: Black Teachers' Perspectives

ERIC Educational Resources Information Center

Martino, Wayne; Rezai-Rashti, Goli M.

2010-01-01

In this paper the authors draw on the perspectives of black teachers to provide a more nuanced analysis of male teacher shortage. Interviews with two Caribbean teachers in Toronto, Canada, are employed to illuminate the limits of an explanatory framework that foregrounds the singularity of gender as a basis for advocating male teachers as role…

Addressing the impact of economic sanctions on Iranian drug shortages in the joint comprehensive plan of action: promoting access to medicines and health diplomacy.

PubMed

Setayesh, Sogol; Mackey, Tim K

2016-06-08

The U.S Congress initiated sanctions against Iran after the 1979 U.S. Embassy hostage crisis in Tehran, and since then the scope of multilateral sanctions imposed by the United States, the European Union, and the United Nations Security Council have progressively expanded throughout the intervening years. Though primarily targeted at Iran's nuclear proliferation activities, sanctions have nevertheless resulted in negative public health outcomes for ordinary Iranian citizens. This includes creating vital domestic shortages to life-saving medicines, leaving an estimated 6 million Iranian patients with limited treatment access for a host of diseases. Sanctions have also crippled Iran's domestic pharmaceutical industry, leading to the disruption of generic medicines production and forcing the country to import medicines and raw materials that are of lower or questionable quality. Countries such as the United States have responded to this medical crisis by implementing export control exemptions with the aim of easing the trade of humanitarian goods (including certain pharmaceuticals and medical devices). However, despite these efforts, pharmaceutical firms and international banking institutions remain cautious about doing business with Iran, leaving the country faced with continuing shortages. We conducted a review of key characteristics of the Iranian drug shortage that identified 73 shortage drugs that closely tracked with the disease burden in the country. Additionally, 44 % of these drugs were also classified as essential medicines by the World Health Organization. A vast majority of these drugs were also covered under export control exemptions that theoretically should make them easier to procure, but nevertheless will still in shortage. Based on our review of the sanctions regulatory framework and key characteristics of the Iranian drug shortage, we propose policy intervention leveraging the recently negotiated P5 + 1 agreement that begins the process of

Developing and Piloting Interactive Physics Experiments for Secondary Schools in Tanzania

ERIC Educational Resources Information Center

Msoka, Vidate C.; Mtebe, Joel S.; Kissaka, Mussa M.; Kalinga, Ellen C.

2015-01-01

Students in secondary schools in Tanzania have been facing difficulties in conducting laboratory experiments. This has been due to the acute shortage of laboratory facilities and poor teaching methodologies. Consequently, students perceive science subjects as unattractive, difficult and irrelevant to understanding the world around them. An…

The nursing shortage: dynamics and solutions. Reflections on a recurring theme.

PubMed

Abdellah, F G

1990-09-01

The passage of individual state nurse practice acts in the 1900s sharpened and focused attention on the practice and function of professional nurses. However, this had little effect on increasing the demand for nurses. In the 1930s student nurses were in ample supply. They staffed units in hospitals, and seniors served as charge or head nurses. It was World War II when one finally began to see the theme of nursing shortage emerge with a vengeance. The demand far exceeded the supply, creating a severe imbalance. The intervening next 4 decades brought forth many excellent models to minimize the shortage. Even the federal government contributed to the nursing shortage by offering opportunities for better-educated practitioners, teachers, and supervisors. Thus, as the nurse became better prepared, the demand for services increased. Several milestone studies are referenced during the 1970s and 1980s that attempted to balance the nursing shortage equation. The US objectives for the year 2000 provide specific guidelines as to what demands will be placed upon the nurse practitioner and educator. Can we meet those demands? Yes--with the full utilization of information technology to prepare the student and nurse practitioner to take advantage of this enormous information explosion. Will the nursing shortage continue to be a recurring theme? Yes! As nurses become better educated and ready for practice and patient-client problem solving, and as they provide strong voices in health policy formulation, the demands for their services will continue to far exceed the supply.

Assessment of serious water shortage in the Icelandic water resource system

NASA Astrophysics Data System (ADS)

Jonsdottir, H.; Eliasson, J.; Madsen, H.

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 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 there will be a shortage of electrical power. This is politically acceptable as long as it only touches heavy industries but not power deliveries to the common market. Empty or near empty reservoirs cause power shortage that will be felt by homeowners and businesses, until spring thaw sets in and inflow to the reservoirs begins. If such a power shortage event occurs, it will cause heavy social problems and a political decision making will follow. It is commonly agreed, that management methods leading to such a disastrous event as a general power shortage in the whole country, are not acceptable. It is therefore very 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 synthetically run-off records with adequate length, in order to estimate very rare droughts. The method chosen is to make the run-off series stationary in the mean and the variance and simulating the resulting stationary process. When this method is chosen, future trends in the run-off from climate change and glacier reduction can easily be incorporated in the model. The probabilities of extreme droughts are calculated and their frequencies are compared to

A Way to End the IC Designer Shortage.

ERIC Educational Resources Information Center

Robinson, Arthur L.

1980-01-01

Discusses the problem of the shortage of engineers capable of designing advanced integrated circuits (IC) and presents some suggestions for increasing the number of IC designers in universities and semiconductor companies. (HM)

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

PubMed

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.

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

PubMed

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

2008-01-01

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

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

PubMed

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.

Valuing Tropical Rainforest Protection Using the Contingent Valuation Method

Treesearch

Randall A. Kramer; D. Evan Mercer; Narendra Sharma

1996-01-01

In the last several decades, the intensity and scale of forest exploitation have increased significantly. A large number of developing countries experiencing increasing deforestation trends are also facing acute shortages of fuelwood, fodder, industrial timber, and other forest products for domestic USC. Besides potential environmental degradation, depletion of...

The hospital nursing shortage. A paradox of increasing supply and increasing vacancy rates.

PubMed Central

Aiken, L H

1989-01-01

A serious shortage of nurses has developed since 1984 despite a growing number of employed nurses and a substantial decline in the number of hospital inpatient days. The evidence suggests that the shortage is the result of an increased demand for nurses, not a decline in supply. The increased demand in large part has resulted from the substitution of registered nurses for licensed practical nurses, aides, and other patient services personnel. The substitution was feasible because nurses' wages have been depressed compared with those of other hospital employees. The shortage is likely to abate if nurses' wages increase, making substitution more costly. Even in the absence of continuing wage increases, hospitals could ease the shortage by restructuring patient services and enabling nurses to spend a greater portion of their time in direct patient care. PMID:2669349

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

PubMed

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.

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

PubMed Central

Mackey, Tim K

2012-01-01

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

The Shortage of Skilled Workers. Position Papers.

ERIC Educational Resources Information Center

American Vocational Association, Arlington, VA.

Evidence gathered through interviews with members of trade associations, unions, professional societies, business, and industry as well as data obtained from the Department of Labor, congressional testimony, and publications of the commerical and trade press reveals that the shortage of skilled workers in America is reaching crisis proportions.…

Isotope shortage triggers delays for patients

NASA Astrophysics Data System (ADS)

Gould, Paula

2009-07-01

An unplanned shutdown of a nuclear reactor in Canada is disrupting the supply of medical isotopes across North America and forcing some hospitals to cancel or postpone patients' tests. The closure of the National Research Universal (NRU) reactor in Chalk River, Ontario, has also embarrassed Canadian officials, including a senior government minister who was forced to apologize after calling the isotope shortage a "sexy" career challenge.

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

PubMed

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (<10 min) face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p < .001). Increasing reach rates by a telephonic case manager facilitates communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Effects of group response-cost procedures on cash shortages in a small business

PubMed Central

Marholin, David; Gray, Deanne

1976-01-01

The effect of a group response-cost procedure (accompanied by verbal and written instruction) designed to decrease cash shortages in a small business was evaluated with a reversal design. When cash shortages were subtracted from the six employees' salaries on days in which the shortage exceeded 1% of total daily sales, the magnitude of daily shortages sharply decreased. This response-cost contingency was used only three times throughout the study, with a maximum cost of $8.70 per subject over the 41-day period. The efficacy of the procedures may be due to either increased precision in change calculations, a decreased frequency of stealing from the cash register, increased shortchanging of customers, and/or increased incidents of register under-ringing. Ethical questions relative to the utilization of group punishment procedures are raised, and it was concluded that the procedures used were more humane than commonly used alternatives. PMID:16795515

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

ERIC Educational Resources Information Center

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…

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

PubMed Central

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

2016-01-01

Objective 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. Methods 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. Results 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. Conclusions 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. PMID:27780218

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

PubMed

DU, Jianping

2016-01-01

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

The global nursing shortage: an overview of issues and actions.

PubMed

Oulton, Judith A

2006-08-01

Today's global nursing shortage is having an adverse impact on health systems around the world. A major initiative by the International Council of Nurses (ICN) yielded important information regarding the shortage and solutions to it. These are organized into five priority areas: policy intervention; macroeconomics and health sector funding; workforce planning and policy, including regulation; positive practice environments; and retention and recruitment (includes migration); and nursing leadership. Internationally momentum is building, providing the opportunity to bring attention to these issues and to take action. This article presents an overview of the global nursing shortage (which, since 2002, has been termed a global crisis), provides the perspectives of the ICN, and discusses the ICN's initiatives regarding that crisis. Founded in 1899, the ICN is the world's first and largest organization for health professionals. As a federation of national nurses' associations in 129 countries, ICN represents the more than 13 million nurses working worldwide. It works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected, competent professional workforce.

Consequences of a global enzyme shortage of agalsidase beta in adult Dutch Fabry patients.

PubMed

Smid, Bouwien E; Rombach, Saskia M; Aerts, Johannes M F G; Kuiper, Symen; Mirzaian, Mina; Overkleeft, Hermen S; Poorthuis, Ben J H M; Hollak, Carla E M; Groener, Johanna E M; Linthorst, Gabor E

2011-10-31

Enzyme replacement therapy is currently the only approved therapy for Fabry disease. From June 2009 on, viral contamination of Genzyme's production facility resulted in a worldwide shortage of agalsidase beta leading to involuntary dose reductions (approved dose 1 mg/kg/eow, reduced dose 0.5 mg/kg/m), or switch to agalsidase alpha (administered dose 0.2 mg/kg/eow). An assessment report from the European Medicines Agency (EMA) raised serious concerns about an increase in adverse events at lower dosages of agalsidase beta. We determined the influence of the shortage on clinical event incidence and the most sensitive biochemical marker (lysoGb3) in Dutch Fabry patients. The incidence of clinical events per person per year was calculated from start of agalsidase beta treatment until the shortage, and was compared to the incidence of clinical events during the shortage period. In addition, plasma lysoGb3, eGFR, quality of life (SF-36) and brief pain inventory (BPI) questionnaires were analysed. All thirty-five Dutch Fabry patients using agalsidase beta (17 males) were included. Mean clinical event incidence was unchanged: 0.15 events per person per year before versus 0.15 during the shortage (p = 0.68). In total 28 clinical events occurred in 14 patients during 4.6 treatment years, compared to 7 events in 6 patients during the 1.3 year shortage period. eGFR and BPI scores were not significantly altered. Two SF-36 subscales were significantly but minimally reduced in females. In males, lysoGb3 increased with a median of 8.1 nM (range 2.5-29.2) after 1 year of shortage (p = 0.001). Increases in lysoGb3 were found in both patients switching to agalsidase alpha and on a reduced agalsidase beta dose. Antibody status, treatment duration or clinical event incidence showed no clear correlation to lysoGb3 increases. No increase in clinical event incidence was found in the adult Dutch Fabry cohort during the agalsidase beta shortage. Increases in lysoGb3, however, suggest

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

Treesearch

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.

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

PubMed

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

2010-07-01

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

Water shortages and extreme events: a call for research.

PubMed

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

2013-09-01

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

Difficulties facing healthcare workers in the era of AIDS treatment in Lesotho.

PubMed

Koto, Masebeo Veronica; Maharaj, Pranitha

2016-01-01

Sub-Saharan Africa is most affected by the AIDS pandemic and Lesotho is no exception. In many countries, healthcare workers are at the forefront of the fight against AIDS. This study explores the difficulties facing healthcare workers in Lesotho using a combination of qualitative methods--focus group discussions and in-depth interviews. The findings suggest that healthcare workers are afraid of contracting HIV from their patients and this affects their delivery of services. In addition, the results revealed that poor infrastructure and shortage of supplies at the facilities hinder healthcare workers from performing their duties effectively. The other concern was the heavy workload and severe time constraints which puts enormous stress on healthcare workers. Stigma and discrimination emerged as major problems for healthcare workers. Addressing the challenges facing healthcare workers is essential in effectively managing the AIDS pandemic facing the continent.

42 CFR 5.3 - Procedures for designation of health professional(s) shortage areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Procedures for designation of health professional(s... SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS § 5.3 Procedures for designation of health professional(s) shortage areas. (a) Using data available to the Department from national...

Is there a shortage of laboratory animal veterinarians?

PubMed

Schub, T

2001-06-01

There is evidence of a shortage of qualified laboratory animal veterinarians. Based on conversations with directors of animal care programs and heads of laboratory animal medicine training program, the author explores the problem of attracting veterinary school graduates to the field.

A looming public health crisis: the nursing shortage of today.

PubMed

Ross, Jacqueline

2002-10-01

The present and anticipated nursing shortage poses a public health concern. This is a unique shortage because nursing is encountering both an increased demand for nursing care and a lower supply of nurses available to deliver it. Nurses, known for patient advocacy, are ethically bound to provide competent, quality care. Currently, nurses comprise the largest group of health care providers in the United States. Through increased understanding of the current situation, the profession will be in a better position to advocate and promote nursing as a viable, attractive career. Copyright 2002 by American Society of PeriAnesthesia Nurses.

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

ERIC Educational Resources Information Center

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

2018-01-01

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

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

PubMed

Rosoff, Philip M

2012-01-01

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

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

NASA Astrophysics Data System (ADS)

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.

Consequences of a global enzyme shortage of agalsidase beta in adult Dutch Fabry patients

PubMed Central

2011-01-01

Background Enzyme replacement therapy is currently the only approved therapy for Fabry disease. From June 2009 on, viral contamination of Genzyme's production facility resulted in a worldwide shortage of agalsidase beta leading to involuntary dose reductions (approved dose 1 mg/kg/eow, reduced dose 0.5 mg/kg/m), or switch to agalsidase alpha (administered dose 0.2 mg/kg/eow). An assessment report from the European Medicines Agency (EMA) raised serious concerns about an increase in adverse events at lower dosages of agalsidase beta. We determined the influence of the shortage on clinical event incidence and the most sensitive biochemical marker (lysoGb3) in Dutch Fabry patients. Methods The incidence of clinical events per person per year was calculated from start of agalsidase beta treatment until the shortage, and was compared to the incidence of clinical events during the shortage period. In addition, plasma lysoGb3, eGFR, quality of life (SF-36) and brief pain inventory (BPI) questionnaires were analysed. Results All thirty-five Dutch Fabry patients using agalsidase beta (17 males) were included. Mean clinical event incidence was unchanged: 0.15 events per person per year before versus 0.15 during the shortage (p = 0.68). In total 28 clinical events occurred in 14 patients during 4.6 treatment years, compared to 7 events in 6 patients during the 1.3 year shortage period. eGFR and BPI scores were not significantly altered. Two SF-36 subscales were significantly but minimally reduced in females. In males, lysoGb3 increased with a median of 8.1 nM (range 2.5 - 29.2) after 1 year of shortage (p = 0.001). Increases in lysoGb3 were found in both patients switching to agalsidase alpha and on a reduced agalsidase beta dose. Antibody status, treatment duration or clinical event incidence showed no clear correlation to lysoGb3 increases. Conclusions No increase in clinical event incidence was found in the adult Dutch Fabry cohort during the agalsidase beta shortage

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

PubMed

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.

3 CFR 13588 - Executive Order 13588 of October 31, 2011. Reducing Prescription Drug Shortages

Code of Federal Regulations, 2012 CFR

2012-01-01

... shortages are becoming more severe as well as more frequent. The affected medicines include cancer..., early disclosure of a shortage can help hospitals, doctors, and patients make alternative arrangements... lifesaving medicines. Sec. 2. Broader Reporting of Manufacturing Discontinuances. To the extent permitted by...

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

PubMed

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.

Update on the diagnostic radiologist shortage.

PubMed

Sunshine, Jonathan H; Maynard, C Douglas; Paros, Joan; Forman, Howard P

2004-02-01

The purpose of this study is to present the latest information available on the shortage of diagnostic radiologists. Four sources of information are available, and we present their data: first, the number of jobs for diagnostic radiologists advertised in Radiology and the American Journal of Roentgenology; second, vacancies in academic radiology departments as of July 1, 2003, ascertained by a survey of these departments; third, the ratio of job listings to job seekers at a major professional placement service, the Professional Bureau of the American College of Radiology (ACR); and fourth, diagnostic radiologists' self-reported workload burden, from the ACR's 2003 Survey of Diagnostic Radiologists. Jobs advertised in September-November 2003 (latest data available) were 28% fewer than in the same months of 2002. Vacancies per department averaged 3.9 in 2003, compared with 5.4 in 2001 and 5.1 in 2002. Listings per seeker were 1.4 in 2002 (latest data available) compared with 3.0 or more in 1999 and 2000. Responses to a question directly tying changes in workload to changes in income indicated that reported desires for workload reduction and workload increase were approximately equal. All four information sources have important limitations, but all indicate that the shortage has considerably eased. We plan to study the causes of this easing and continue to monitor the situation.

Mental Health Professional Shortage Areas in Rural Appalachia

ERIC Educational Resources Information Center

Hendryx, Michael

2008-01-01

Context: Research on health disparities in Appalachia has rarely compared Appalachia to other geographic areas in such a way as to isolate possible Appalachian effects. Purpose: This study tests hypotheses that nonmetropolitan Appalachia will have higher levels of mental health professional shortage areas than other nonmetropolitan areas of the…

Toward a Comprehensive Strategy for Addressing the Teacher Shortage.

ERIC Educational Resources Information Center

Hawley, Willis D.

1986-01-01

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

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

PubMed

Pressler, Jana L; Kenner, Carole A

2009-01-01

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

Hospital nurse wages and staffing, 1977 to 2002: cycles of shortage and surplus.

PubMed

Spetz, Joanne

2004-09-01

The author reviews the causes of nursing shortages and surpluses and examines data from California hospitals to demonstrate how these cycles are expressed in the demand for and wages of nurses. Nursing shortages have been reported cyclically for more than 50 years in the United States. There has been little data analysis demonstrating the relationship between the current shortage and changes in wages and nurse staffing. Analysis of longitudinal hospital and patient data from the California Office of Statewide Health Planning and Development. Summary statistics of patient utilization, nurse staffing, and nurse wages were computed. The data demonstrate that cyclical shortages are accompanied by higher wages and employment. This has been true in recent years. However, in medical-surgical units, hours per patient day declined between 2001 and 2002, perhaps reflecting the inability of hospitals to find more nurses to meet staffing goals. Nurse staffing per patient day and per discharge have remained stable, despite concerns about low staffing levels. Improved measures of patient care needs and studies of the precise staffing requirements for different types of patients and configurations of staff are required to make recommendations about staffing and policy.

Knowledge and Understanding of 21st Century Skills through Educator Externships: Programs in Southern New England

ERIC Educational Resources Information Center

Gibson-Cayouette, Lizann R.

2010-01-01

An acute shortage of a competent, highly-skilled workforce faces the United States workplace. Studies and reports from 1983 to present, repeatedly state that the education system in the United States must change to prepare the emergent workforce for success in the 21st century global challenges of both post-secondary education and the workplace.…

Three Years Evaluation of Drug Shortages from Educational Pharmacies in Tehran

PubMed Central

Gholami, Kheirollah; Kamalinia, Golnaz; Ahmadian Attari, Mohammad Mahdi; Salamzadeh, Jamshid

2012-01-01

The effectiveness of any drug supply systems in providing a trustworthy supply of essential drugs is a critical issue. To evaluate this effectiveness, it is necessary to watch over the status of the essential medicines in any country impartially and continuously. Some countries and also the World Health Organization (WHO) have codified a list of minimum medicines needed for a basic health care system and published them in assortments as a list of essential medicines. The aim of this study was to give an evaluation of the shortages status in Iran and identify the strengths and weaknesses of policies made in Ministry of Health during the years 2005 to 2008 in providing the essential drugs based on the WHO list of essential medicines. The reports used in this retrospective study were collected from the central purchasing unit of one of the main chain drugstores in the country (13-Aban Pharmacy) every 2 to 3 weeks. In these reports, a drug is added to the list of shortages when the requested drug is not delivered. The reports were studied and the results were analyzed based on the WHO list of essential medicines and the national drug list of Iran. The shortages always included 20 to 40 medicines from the list of essential drugs compiled by WHO. Based on this finding, the Ministry of Health and particularly Food and Drug Organization can compile a National List of Essential Medicines and try to always supply them and prevent their shortage. PMID:24250480

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

PubMed Central

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

Occupational acute anaphylactic reaction to assault by perfume spray in the face.

PubMed

Lessenger, J E

2001-01-01

Perfumes have been associated with rashes in employees exposed to scented soaps or with allergic conditions, such as rhinitis or asthma, in employees exposed to perfumes or fragrances in the air. Reported here is a case of an anaphylactic reaction and respiratory distress as a result of a deliberate assault with a perfume spray. The medical literature was searched using the key words "fragrances," "respiratory distress," "assault," and "health care workers." A female medical assistant with no history of asthma or reactions to fragrances was assaulted by a patient, who pumped three sprays of a perfume into her face. The employee experienced an acute anaphylactic reaction with shortness of breath, a suffocating sensation, wheezes, and generalized urticaria, and required aggressive medical treatment, a long period of oral bronchodilator therapy, and, finally, weaning from the medications. Perfumes are complex mixtures of more than 4,000 vegetable and animal extracts and organic and nonorganic compounds. Fragrances have been found to cause exacerbations of symptoms and airway obstruction in asthmatic patients, including chest tightening and wheezing, and are a common cause of cosmetic allergic contact dermatitis. In many work settings the use of fragrances is limited. Assault is becoming more common among workers in the health care setting. Workers should be prepared to take immediate steps should an employee go into anaphylactic shock.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-13

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0709] Agency Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and... INFORMATION: Title: Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance...

Missing Elements in the Discussion of Teacher Shortages

ERIC Educational Resources Information Center

Cowan, James; Goldhaber, Dan; Hayes, Kyle; Theobald, Roddy

2016-01-01

Though policymakers are increasingly concerned about teacher shortages in U.S. public schools, the national discussion does not reflect historical patterns of the supply of and demand for newly minted teachers. Specifically, the production of teacher candidates has increased steadily since the mid-1980s, and only about half of graduating teacher…

When Shortage Coexists with Surplus of Teachers: The Case of Arab Teachers in Israel

ERIC Educational Resources Information Center

Agbaria, Ayman K.; Pinson, Halleli

2013-01-01

This article explores the nexus between pre-service teacher education polices and the supply and demand of minority teachers. It problematizes the recent reports on teacher shortages in Israel, which tend to focus on the shortage of Jewish teachers while dealing with the surplus of Arab teachers only tangentially. Specifically, this article…

42 CFR Appendix E to Part 5 - Criteria for Designation of Areas Having Shortages of Podiatric Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... barriers (such as economic or cultural barriers). C. Determination of Degree of Shortage. Designated areas... 42 Public Health 1 2011-10-01 2011-10-01 false Criteria for Designation of Areas Having Shortages... OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS DESIGNATION OF HEALTH PROFESSIONAL(S) SHORTAGE AREAS...

7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Solicitation of veterinarian shortage situations. 3431.5 Section 3431.5 Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE VETERINARY MEDICINE LOAN...

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

PubMed

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 < 0.001). The number of drugs in shortage increased from 17 (50.0%) to 25 (73.5%) during the 2 years before and after, respectively (P = 0.046). The median shortage

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-02

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0709] Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and... use of other forms of information technology. Title: Regulation on Reduction of Nursing Shortages in...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-07

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0709] Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and... of Nursing Shortages in State Homes; Application for Assistance for Hiring and Retaining Nurses at...

SREB Study Indicates Serious Shortage of Nursing Faculty.

ERIC Educational Resources Information Center

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

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

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

NASA Astrophysics Data System (ADS)

Campbell, Nancy S.

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

Surplus or shortage? Unraveling the physician supply conundrum.

PubMed Central

Rosenblatt, R. A.; Lishner, D. M.

1991-01-01

Although the supply of physicians in the United States has doubled during the past 20 years, there is still disagreement as to whether we currently have or should expect a significant surplus of physicians. The evidence suggests that despite the rapid expansion in the pool of available physicians, serious physician shortages persist for certain rural populations, ethnic and occupational groups, and other medically disadvantaged segments of the population. Medical students' declining interest in rural practice and primary care specialties suggests that problems of geographic and specialty maldistribution may worsen despite a rising population of physicians. It is unlikely that a significant physician surplus will develop unless there is a conscious attempt to limit the proportion of national wealth expended on medical care. Pockets of shortage can be reduced by broadening the availability of health insurance, lessening large income disparities between different specialties, changing the way teaching institutions are reimbursed for their training costs, and supporting direct governmental service programs such as the National Health Service Corps. PMID:2024510

Continuous noninvasive ventilation delivered by a novel total face mask: a case series report.

PubMed

Belchior, Inês; Gonçalves, Miguel R; Winck, João Carlos

2012-03-01

Noninvasive ventilation (NIV) has been widely used to decrease the complications associated with tracheal intubation in mechanically ventilated patients. However, nasal ulcerations may occur when conventional masks are used for continuous ventilation. A total face mask, which has no contact with the more sensitive areas of the face, is a possible option. We describe 3 patients with acute respiratory failure due to amyotrophic lateral sclerosis, who developed nasal bridge skin necrosis during continuous NIV, and one patient with post-extubation respiratory failure due to a high spinal cord injury, who had facial trauma with contraindication for conventional mask use. The total face mask was very well tolerated by all the patients, and permitted safe and efficient continuous NIV for several days until the acute respiratory failure episode resolved. None of the patients required endotracheal intubation during the acute episode.

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... food animal veterinarian shortage to meet this ratio is at least 0.5. 3. Food animal veterinarians in... companion animal veterinary shortage to meet this ratio is at least 0.5. 3. Companion animal veterinarians... follows: (a) Food animal veterinarian shortage=(VLU/10,000)−(number of food animal veterinarians). (b...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... food animal veterinarian shortage to meet this ratio is at least 0.5. 3. Food animal veterinarians in... companion animal veterinary shortage to meet this ratio is at least 0.5. 3. Companion animal veterinarians... follows: (a) Food animal veterinarian shortage=(VLU/10,000)−(number of food animal veterinarians). (b...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... food animal veterinarian shortage to meet this ratio is at least 0.5. 3. Food animal veterinarians in... companion animal veterinary shortage to meet this ratio is at least 0.5. 3. Companion animal veterinarians... follows: (a) Food animal veterinarian shortage=(VLU/10,000)−(number of food animal veterinarians). (b...

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

PubMed

Gao, Xueping; Liu, Yinzhu; Sun, Bowen

2018-06-05

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

7 CFR 3431.5 - Solicitation of veterinarian shortage situations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Solicitation of veterinarian shortage situations. 3431.5 Section 3431.5 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation of Veterinarian...

The nursing shortage: an update for occupational health nurses.

PubMed

Palmer, Carol

2003-12-01

Nursing is about to realize the worst shortage in history at the same time the first baby boomers are increasing the need for health care. A large component of the current and projected nursing shortage is the aging of the RN work force. Several factors contribute to the aging of the work force, including overall decline in nursing as a chosen profession, the increasing age of nursing graduates, and the aging of the existing RN work force. Job dissatisfaction has been a key issue contributing to the crisis related to recruitment and retention of nurses. Inadequate staffing, heavy workloads, flat salaries, and increased use of mandatory overtime are primary issues related to job dissatisfaction. Job dissatisfaction issues are key components of retention of nursing personnel. Occupational health nurses are experts in dealing with issues of ergonomic challenges, workplace violence, mandatory overtime, stress related injuries, and high stress associated with nursing.

Fulsome conundrum: solving the nation's shortage of photonics personnel with education

NASA Astrophysics Data System (ADS)

Moore, Steven D.

2002-05-01

Nationwide, photonics technicians are in short supply. Even with the recent downturn in the nation's economy, thousands of technicians are needed by traditional optics manufacturing companies, telecommunications providers, defense contractors, and other industries that rely on photonics technologies. Though many reasons have been offered to explain why the shortage has occurred, the lack of technicians remains a fulsome conundrum. This paper addresses ten hypotheses commonly cited to explain the shortage of qualified technicians. Then, the evidence that supports or disconfirms the hypothesis is explored. Direct and indirect actions are identified that photonics industries could take to help alleviate the shortage of trained personnel. Direct actions include (1) collaborating with appropriate experts to study the problem in more detail; (2) conducting outreach programs with local schools and informal education centers; and (3) helping produce K - 12 educational materials that integrate photonics concepts into all areas of the school curriculum. Indirect actions include (1) collaborating in building educational systems that encourage young people to pursue technical careers: (2) becoming part of the K-college educational enterprise; (3) lobbying federal and state governmental agencies; and (4) engaging in partnerships.

Evaluation of the Effectiveness of Institutional Manpower Training in Meeting Employers' Needs in Skills Shortage Occupations. Final Report.

ERIC Educational Resources Information Center

Olympus Research Corp., Salt Lake City, UT.

Reasons for the failure of the Manpower Development and Training Act (MDTA) of 1962 to meet its major objective of alleviating skills shortages are recorded and analyzed. The lack of skills shortages was admitted to be the main reason for the shortcomings in performance, although the term "skills shortage" had yet to be defined and…

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

PubMed

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.

Education Policy Initiatives To Address The Nurse Shortage In The United States

PubMed Central

Aiken, Linda H.; Cheung, Robyn B.; Olds, Danielle M.

2009-01-01

Employment opportunities are expected to grow much faster for registered nurses (RNs) than for most other occupations. Yet a major shortage of nurses is projected by 2020. A nurse faculty shortage and financially strapped colleges and universities are limiting the ability of U.S. nursing schools to take advantage of historically high numbers of qualified applicants. Increased public subsidies are needed to provide greater access to nursing education, with a priority on baccalaureate and graduate nursing education, where job growth is expected to be the greatest. PMID:19525285

Research on water shortage risks and countermeasures in North China

NASA Astrophysics Data System (ADS)

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

The reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland.

PubMed

Heiskanen, Kati; Ahonen, Riitta; Kanerva, Risto; Karttunen, Pekka; Timonen, Johanna

2017-01-01

The aim of this study was to explore the reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland. The study took the form of semi-structured interviews. Forty-one pharmaceutical companies and pharmaceutical wholesalers were invited to participate in the study. The pharmaceutical companies were the member organizations of Pharma Industry Finland (PIF) (N = 30) and the Finnish Generic Pharmaceutical Association (FGPA) (N = 7). One company which is a central player in the pharmaceutical market in Finland but does not belong to PIF or FGPA was also invited. The pharmaceutical wholesalers were those with a nationwide distribution network (N = 3). A total of 30 interviews were conducted between March and June 2016. The data were subjected to qualitative thematic analysis. The most common reasons behind medicine shortages in Finland were the small size of the pharmaceutical market (29/30), sudden or fluctuating demand (28/30), small stock sizes (25/30), long delivery time (23/30) and a long or complex production chain (23/30). The reasons for the medicine shortages were supply-related more often than demand-related. However, the reasons were often complex and there was more than one reason behind a shortage. Supply-related reasons behind shortages commonly interfaced with the country-specific characteristics of Finland, whereas demand-related reasons were commonly associated with the predictability and attractiveness of the market. Some reasons, such as raw material shortages, were considered global and thus had similar effects on other countries.

Managing the complexity of nurse shortages: a case study of bank and agency staffing in an acute care Trust in Wales, UK.

PubMed

Massey, Lynn; Esain, Ann; Wallis, Marianne

2009-07-01

Managing nurse shortages is a major challenge in Trusts today given the worldwide shortage of nurses. To fill the gap created by a lack of permanent staff UK government agencies have increasingly used bank and agency staff. Managing this type of staffing effectively and efficiently, in the context of shrinking healthcare funds, is a major challenge in providing safe and quality healthcare. To analyse bank and agency nursing staffing patterns and factors that impact on these patterns. Case study within the largest hospital in one Welsh Integrated Healthcare Trust. De-identified bank and agency staffing electronic and manual database records and focus group interview with bank and agency office staff. A predictable bank and agency staffing pattern was found, wherein bank and agency nursing staff were used with increasing frequency towards the end of the week. Demand for bank and agency nursing staff occurred because of: hospital practices that fund a fixed staff establishment for nursing units, while patient numbers and acuity are variable; poor forward planning; sickness, and absence due to professional development or staff training. There is a need for managers to reconsider management and recruitment policies, particularly in relation to using bank and agency staff. The complexity of staffing challenges managers to focus on predictability of workload needs and other factors that affect staffing requirements, such as: professional development, flexible working rosters to match the need and minimize sickness and turnover of staff.

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

PubMed Central

Smith, Saxon D

2008-01-01

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. PMID:18507867

A student nurse experience of an intervention that addresses the perioperative nursing shortage.

PubMed

Monahan, J Carter

2015-11-01

Registered nurses are the largest group of professionals in the global healthcare system. The number of nurses is estimated to be 19.3 million throughout the world (Flinkman et al 2013). In the United States the need for registered nurses is growing. It has been predicted that 260,000 positions for registered nurses will remain unfilled by the year 2025 (Harris et al 2014) with a shortage of registered nurses projected to spread across the United States between 2009 and 2030 (Juraschek et al 2012). Compounding the projected nursing shortage is the increased attrition rate, which is as high as 61% within the first year (Pine & Tart 2007). There are several reasons for this shortage including supply and demand issues, projected changes to healthcare and the aging population. Additionally, the number of college graduates who have majored in nursing has not met the demand (Dunn 2014).

Future Skill Shortages in the U.S. Economy?

ERIC Educational Resources Information Center

Neumark, David; Johnson, Hans; Mejia, Marisol Cuellar

2013-01-01

The impending retirement of the baby boom cohort represents the first time in the history of the United States that such a large and well-educated group of workers will exit the labor force. This could imply skill shortages in the U.S. economy. We develop near-term labor force projections of the educational demands on the workforce and the supply…

The effects of a patient shortage on general practitioners' future income and list of patients.

PubMed

Iversen, Tor

2004-07-01

The literature on physician-induced demand (PID) suffers from an inability to distinguish between the effect of better access and the effect of patient shortage. Data from the Norwegian capitation trial in general practice give us an opportunity to make this distinction and hence, study whether service provision by physicians is partly income-motivated. In the capitation trial, each general practitioner (GP) has a personal list of patients. The payment system is a mix of a capitation fee and a fee for service. The data set has information on patient shortage, i.e. a positive difference between a GP's preferred and actual list size, at the individual practice level. From a model of a GP's optimal choice we derive the GP's optimal practice profile contingent on whether the GP experiences a shortage of patients or not. To what extent GPs, who experience a shortage, will undertake measures to attract patients or embark on a service-intensive practice style depends on the costs of the various measures relative to their expected benefit. The model classifies GPs into five types. In the empirical analysis a panel of GPs is followed for 5 years. Hence, transitory effects should have been exhausted. We show that GPs who experience a shortage of patients have a higher income per listed person than their unrationed colleagues.

Skill Shortages: Prevalence, Causes, Remedies and Consequences for Australian Businesses. NCVER Monograph Series 09/2012

ERIC Educational Resources Information Center

Healy, Joshua; Mavromaras, Kostas; Sloane, Peter J.

2012-01-01

Although skill shortages are often portrayed as a significant problem for the Australian economy, there is surprisingly little evidence about their prevalence, causes and consequences. It is difficult to find robust evidence about where skill shortages occur, why they occur, what businesses try to do about them and whether their responses are…

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

Code of Federal Regulations, 2011 CFR

2011-04-01

..., in the case of a partial shortage. (d) If merchandise covered by a carnet cannot be recovered intact... and birds found by the discharging officer to be dead on arrival at destination, shall be made in the...

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

Code of Federal Regulations, 2010 CFR

2010-04-01

..., in the case of a partial shortage. (d) If merchandise covered by a carnet cannot be recovered intact... and birds found by the discharging officer to be dead on arrival at destination, shall be made in the...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... Designated Primary Medical Care, Mental Health, and Dental Health Professional Shortage Areas AGENCY: Health... facilities designated as primary medical care, mental health, and dental health professional shortage areas... primary care, dental, or mental health services in these HPSAs. NHSC health [[Page 38839

Could the organ shortage ever be met?

PubMed

Levitt, Mairi

2015-01-01

The organ shortage is commonly presented as having a clear solution, increase the number of organs donated and the problem will be solved. In the light of the Northern Ireland Assembly's consultation on moving to an opt-out organ donor register this article focuses on the social factors and complexities which impact strongly on both the supply of, and demand for, transplantable organs. Judging by the experience of other countries presumed consent systems may or may not increase donations but have not met demand. Donation rates have risen considerably in all parts of the UK recently but there is also an increasing demand for organs. Looking at international donation rates and attitudes, future demand for organs and education on donation, the question is whether the organ shortage could ever be met. The increase in longevity, in rates of diabetes and obesity and in alcohol related liver disease all contribute both to increased demand for transplants, and re-transplants, and a reduction in the number of usable organs. It is unlikely that demand could ever be met, since, if supply was unlimited, the focus would move to financial resources and competing demands on the health care budget in a publicly funded health system. These factors point to the need to focus on ways of reducing, or at least stabilizing, demand where lifestyle factors contribute to the underlying disease.

Management of blood shortages in a tertiary care academic medical center: the Yale-New Haven Hospital frozen blood reserve.

PubMed

Erickson, Michelle L; Champion, Melanie H; Klein, Roger; Ross, Rebecca L; Neal, Zena M; Snyder, Edward L

2008-10-01

Threats to national and local blood supplies in America mandate development of an effective blood management system for emergency preparedness and efficient blood inventory management. Seasonal or acute blood shortages could be compounded by the unavoidable distribution inefficiencies of the blood pipeline during an emergency. The Yale-New Haven Hospital (YNHH) Blood Bank has developed a comprehensive emergency blood management plan, which includes maintenance of a tactical, limited frozen blood supply. A computer spreadsheet-based disaster prediction model has been designed to guide the use of the frozen reserve by testing various emergency scenarios. The frozen blood reserve can likely support normal hospital red blood cell (RBC) demands during typical (3-4 days) seasonal shortages, provide a reduced supply for up to 10 days, or meet an unexpected transient increased RBC demand without requiring intensive support from the regional blood center. However, the frozen blood supply is not designed to meet the massive transfusion demand associated with extreme or sustained disasters. Rather, it serves as a short-term bridge-over supply until blood center support can be reestablished. We review the reasons for initiating a blood management plan and describe how YNHH has implemented and sustains a frozen blood reserve as part of a comprehensive disaster management plan. Despite the operational complexity, the benefits of self-sufficiency, the ability to support routine hospital requirements, and the security of having a backup supply justify the expense and difficulty of maintaining a frozen blood reserve.

Primary care workforce shortages and career recommendations from practicing clinicians.

PubMed

DesRoches, Catherine M; Buerhaus, Peter; Dittus, Robert S; Donelan, Karen

2015-05-01

The success of efforts to bolster the primary care workforce rests in part on how these clinicians view their professions and their willingness to recommend their careers to others. The authors sought to examine career and job satisfaction, perceptions of workforce shortages, and willingness to make career recommendations among primary care physicians (PCPs) and primary care nurse practitioners (PCNPs). In 2012, the authors mailed a national survey concerning the issues above to 1,914 randomly chosen clinicians found on national databases: 957 PCPs and 957 PCNPs. A total of 972 eligible clinicians (505 PCPs, 467 PCNPs) returned the survey. Using standard opinion research procedures, the authors estimated there were approximately 1,589 eligible clinicians in their sample (response rate, 61.2%). PCNPs and PCPs were more likely to recommend a career as a PCNP than as a PCP, despite the perception among all clinicians of a serious shortage of PCPs nationally and in their own communities. This finding held among PCNPs who reported low workplace autonomy and among PCPs reporting that they were satisfied with their own careers. Efforts to solve the primary care workforce shortage that ignore the significant dissatisfaction of PCPs with their own careers are unlikely to be successful. Simply adding training slots and increasing reimbursement rates will do little to solve the problem if PCPs continue to view their own careers as ones they cannot recommend to others.

Moral dilemmas faced by hospitals in time of war: the Rambam Medical Center during the second Lebanon war.

PubMed

Bar-El, Yaron; Reisner, Shimon; Beyar, Rafael

2014-02-01

Rambam Medical Center, the only tertiary care center and largest hospital in northern Israel, was subjected to continuous rocket attacks in 2006. This extreme situation posed serious and unprecedented ethical dilemmas to the hospital management. An ambiguous situation arose that required routine patient care in a tertiary modern hospital together with implementation of emergency measures while under direct fire. The physicians responsible for hospital management at that time share some of the moral dilemmas faced, the policy they chose to follow, and offer a retrospective critical reflection in this paper. The hospital's first priority was defined as delivery of emergency surgical and medical services to the wounded from the battlefields and home front, while concomitantly providing the civilian population with all elective medical and surgical services. The need for acute medical service was even more apparent as the situation of conflict led to closure of many ambulatory clinics, while urgent or planned medical care such as open heart surgery and chemotherapy continued. The hospital management took actions to minimize risks to patients, staff, and visitors during the ongoing attacks. Wards were relocated to unused underground spaces and corridors. However due to the shortage of shielded spaces, not all wards and patients could be relocated to safer areas. Modern warfare will most likely continue to involve civilian populations and institutes, blurring the division between peaceful high-tech medicine and the rough battlefront. Hospitals in high war-risk areas must be prepared to function and deliver treatment while under fire or facing similar threats.

The reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland

PubMed Central

Ahonen, Riitta; Kanerva, Risto; Karttunen, Pekka; Timonen, Johanna

2017-01-01

The aim of this study was to explore the reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland. The study took the form of semi-structured interviews. Forty-one pharmaceutical companies and pharmaceutical wholesalers were invited to participate in the study. The pharmaceutical companies were the member organizations of Pharma Industry Finland (PIF) (N = 30) and the Finnish Generic Pharmaceutical Association (FGPA) (N = 7). One company which is a central player in the pharmaceutical market in Finland but does not belong to PIF or FGPA was also invited. The pharmaceutical wholesalers were those with a nationwide distribution network (N = 3). A total of 30 interviews were conducted between March and June 2016. The data were subjected to qualitative thematic analysis. The most common reasons behind medicine shortages in Finland were the small size of the pharmaceutical market (29/30), sudden or fluctuating demand (28/30), small stock sizes (25/30), long delivery time (23/30) and a long or complex production chain (23/30). The reasons for the medicine shortages were supply-related more often than demand-related. However, the reasons were often complex and there was more than one reason behind a shortage. Supply-related reasons behind shortages commonly interfaced with the country-specific characteristics of Finland, whereas demand-related reasons were commonly associated with the predictability and attractiveness of the market. Some reasons, such as raw material shortages, were considered global and thus had similar effects on other countries. PMID:28658307

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

PubMed Central

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

2014-01-01

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

Satisfaction in nursing in the context of shortage.

PubMed

Morgan, Jennifer Craft; Lynn, Mary R

2009-04-01

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

Estimating the residency expansion required to avoid projected primary care physician shortages by 2035.

PubMed

Petterson, Stephen M; Liaw, Winston R; Tran, Carol; Bazemore, Andrew W

2015-03-01

The purpose of this study was to calculate the projected primary care physician shortage, determine the amount and composition of residency growth needed, and estimate the impact of retirement age and panel size changes. We used the 2010 National Ambulatory Medical Care Survey to calculate utilization of ambulatory primary care services and the US Census Bureau to project demographic changes. To determine the baseline number of primary care physicians and the number retiring at 66 years, we used the 2014 American Medical Association Masterfile. Using specialty board and American Osteopathic Association figures, we estimated the annual production of primary care residents. To calculate shortages, we subtracted the accumulated primary care physician production from the accumulated number of primary care physicians needed for each year from 2015 to 2035. More than 44,000 primary care physicians will be needed by 2035. Current primary care production rates will be unable to meet demand, resulting in a shortage in excess of 33,000 primary care physicians. Given current production, an additional 1,700 primary care residency slots will be necessary by 2035. A 10% reduction in the ratio of population per primary care physician would require more than 3,000 additional slots by 2035, whereas changing the expected retirement age from 66 years to 64 years would require more than 2,400 additional slots. To eliminate projected shortages in 2035, primary care residency production must increase by 21% compared with current production. Delivery models that shift toward smaller ratios of population to primary care physicians may substantially increase the shortage. © 2015 Annals of Family Medicine, Inc.

Addressing the Causes of Chef Shortages in the UK

ERIC Educational Resources Information Center

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…

Effect of Noninvasive Ventilation Delivered by Helmet vs Face Mask on the Rate of Endotracheal Intubation in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.

PubMed

Patel, Bhakti K; Wolfe, Krysta S; Pohlman, Anne S; Hall, Jesse B; Kress, John P

2016-06-14

Noninvasive ventilation (NIV) with a face mask is relatively ineffective at preventing endotracheal intubation in patients with acute respiratory distress syndrome (ARDS). Delivery of NIV with a helmet may be a superior strategy for these patients. To determine whether NIV delivered by helmet improves intubation rate among patients with ARDS. Single-center randomized clinical trial of 83 patients with ARDS requiring NIV delivered by face mask for at least 8 hours while in the medical intensive care unit at the University of Chicago between October 3, 2012, through September 21, 2015. Patients were randomly assigned to continue face mask NIV or switch to a helmet for NIV support for a planned enrollment of 206 patients (103 patients per group). The helmet is a transparent hood that covers the entire head of the patient and has a rubber collar neck seal. Early trial termination resulted in 44 patients randomized to the helmet group and 39 to the face mask group. The primary outcome was the proportion of patients who required endotracheal intubation. Secondary outcomes included 28-day invasive ventilator-free days (ie, days alive without mechanical ventilation), duration of ICU and hospital length of stay, and hospital and 90-day mortality. Eighty-three patients (45% women; median age, 59 years; median Acute Physiology and Chronic Health Evaluation [APACHE] II score, 26) were included in the analysis after the trial was stopped early based on predefined criteria for efficacy. The intubation rate was 61.5% (n = 24) for the face mask group and 18.2% (n = 8) for the helmet group (absolute difference, -43.3%; 95% CI, -62.4% to -24.3%; P < .001). The number of ventilator-free days was significantly higher in the helmet group (28 vs 12.5, P < .001). At 90 days, 15 patients (34.1%) in the helmet group died compared with 22 patients (56.4%) in the face mask group (absolute difference, -22.3%; 95% CI, -43.3 to -1.4; P = .02). Adverse events included 3

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

PubMed

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.

Shortage of Mathematics Teachers in Thai Basic Education Level

ERIC Educational Resources Information Center

Puncreobutr, Vichian; Rattanatumma, Tawachai

2016-01-01

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

America's New Deficit: The Shortage of Information Technology Workers.

ERIC Educational Resources Information Center

Office of Technology Policy (DOC), Washington, DC.

According to a recent survey of midsized and large U.S. companies, approximately 190,000 information technology (IT) jobs are unfilled because of a shortage of qualified workers. The formal, four-year education system is producing only a small proportion of the workers required. IT workers can also obtain skills from two-year associate…

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

PubMed

Papenfuß, Tim; Roch, Carmen

2012-05-01

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

The Human Constraint; The Coming Shortage of Managerial Talent.

ERIC Educational Resources Information Center

Miner, John B.

The prospect of a massive managerial talent shortage in the United States and what can be done about it are the central concerns of the study, which revealed a notable decline in motivation to manage among business students and young managers. Part 1 defines the components of motivation to manage and their vital relationship to personal and…

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-07

... 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..., particularly those products regulated by the FDA Center for Drug Evaluation and Research (CDER). FDA requests...

Implementing advanced nurse practitioner roles in acute care: an evaluation of organizational change.

PubMed

Cummings, Greta G; Fraser, Kim; Tarlier, Denise S

2003-03-01

Medical shortages are seen as the driving force behind the recent implementation of the advanced nurse practitioner (ANP) role in some Canadian hospitals. The authors analyzed the implementation of the ANP role in one tertiary care teaching hospital from the organizational change perspective. Despite successful implementation, issues of role definition, scope of practice boundaries, and staff reactions remain unresolved. Recommendations are discussed for implementing ANP roles in other acute care facilities.

A critical examination of the U.S. nursing shortage: contributing factors, public policy implications.

PubMed

Fox, Rebekah L; Abrahamson, Kathleen

2009-01-01

BACKGROUND. Despite short-lived periods of adequacy in nurse availability, the nursing shortage has endured. In order to better understand the myriad factors that influence the current shortage of nurses, as well as possible solutions, this project addresses the influence of social factors and government policy on nurse staffing inadequacy. When the government intervenes in a philosophically free-market economy, the assumption is that a problem, such as the current nursing shortage, could not be solved without such intervention. PURPOSE. Nursing care arguably falls into the realm of protecting the common good, and therefore requires government oversight. We provide a critical analysis of policy intervention efforts into the nursing shortage debate by examining the passage of legislation, the provision of educational assistance, and the establishment of minimum staffing requirements and minimum quality standards for reimbursement, which all impact nursing supply and demand. RESULTS. Arguments supporting and opposing policy intervention in general, and its impact on the overall provision of nursing care in the United States, were examined. Without policy incentive to place financial value on the quality of care provided by nurses, a simple increase in the number of available nurses is unlikely to solve the current problem. IMPLICATIONS. Important considerations that should be factored into policy creation include measurement and compensation for quality care, the nature of recruitment efforts of new nurses, and the complex nature of a nursing work.

Shortage of Appendicular Skeletal Muscle Is an Independent Risk Factor for Mortality in Peritoneal Dialysis Patients.

PubMed

Jin, Sanli; Lu, Qian; Su, Chunyan; Pang, Dong; Wang, Tao

♦ BACKGROUND: Limited data are available on clinical outcomes among peritoneal dialysis patients with shortage of appendicular skeletal muscle (ASM). In this study, we tested the hypothesis that the shortage of ASM is an independent risk factor for mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. ♦ METHODS: Adult patients undergoing CAPD between March and August 2007 in a single center in China were recruited in this prospective cohort study. Body composition, protein/energy intake, clinical, and biochemical data were collected at baseline, 6 months, and 12 months. End points were all-cause mortality by 12 September 2014. The mean follow-up time was 60.21 (± 24.45) months (11.00 - 89.00). ♦ RESULTS: Compared with the baseline, the mean value of ASM in CAPD patients decreased at 12 months (19.40 ± 5.60 vs 21.85 ± 6.14, p < 0.001). According to the estimation of patient survival by Kaplan-Meier, patients with a shortage of ASM had a worse survival rate than those with normal ASM (χ 2 = 16.588, p < 0.001). In the Cox's proportional hazards model, patients' survival was independently associated with a shortage of ASM (hazard ratio [HR] = 2.318, p = 0.024, 95% confidence interval [CI] = 1.116 - 4.812). Standard daily protein intake (stDPI) and standard daily energy intake (stDEI) in patients with a shortage of ASM were significantly lower than those in patients with normal ASM in the first follow-up year (t = 2.067, p = 0.041; t = 3.673, p = 0.001). ♦ CONCLUSIONS: A shortage of ASM is an independent risk factor for mortality in CAPD patients. Further studies are needed to demonstrate that nutritional intervention helps with improving muscle mass and, consequently, the survival of CAPD patients. Copyright © 2017 International Society for Peritoneal Dialysis.

18 CFR 294.101 - Shortages of electric energy and capacity.

Code of Federal Regulations, 2011 CFR

2011-04-01

... energy and capacity. 294.101 Section 294.101 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 PROCEDURES FOR SHORTAGES OF ELECTRIC ENERGY AND CAPACITY UNDER SECTION 206 OF THE PUBLIC UTILITY...

18 CFR 294.101 - Shortages of electric energy and capacity.

Code of Federal Regulations, 2013 CFR

2013-04-01

... energy and capacity. 294.101 Section 294.101 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY REGULATORY POLICIES ACT OF 1978 PROCEDURES FOR SHORTAGES OF ELECTRIC ENERGY AND CAPACITY UNDER SECTION 206 OF THE PUBLIC UTILITY...

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

PubMed

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

Education: New Programs Aim to Ease Shortage of Qualified Toxicologists.

ERIC Educational Resources Information Center

Worthy, Ward

1983-01-01

Discusses programs designed to ease shortage of qualified toxicologists including one leading to a bachelor's degree in toxicology at the Philadelphia College of Pharmacy and Science. Also considered are emerging attitudes toward toxicology and educational issues extending beyond the education of students (such as educating the public,…

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Validity, Sensitivity, and Responsiveness of the 11-Face Faces Pain Scale to Postoperative Pain in Adult Orthopedic Surgery Patients.

PubMed

Van Giang, Nguyen; Chiu, Hsiao-Yean; Thai, Duong Hong; Kuo, Shu-Yu; Tsai, Pei-Shan

2015-10-01

Pain is common in patients after orthopedic surgery. The 11-face Faces Pain Scale has not been validated for use in adult patients with postoperative pain. To assess the validity of the 11-face Faces Pain Scale and its ability to detect responses to pain medications, and to determine whether the sensitivity of the 11-face Faces Pain Scale for detecting changes in pain intensity over time is associated with gender differences in adult postorthopedic surgery patients. The 11-face Faces Pain Scale was translated into Vietnamese using forward and back translation. Postoperative pain was assessed using an 11-point numerical rating scale and the 11-face Faces Pain Scale on the day of surgery, and before (Time 1) and every 30 minutes after (Times 2-5) the patients had taken pain medications on the first postoperative day. The 11-face Faces Pain Scale highly correlated with the numerical rating scale (r = 0.78, p < .001). When the scores from each follow-up test (Times 2-5) were compared with those from the baseline test (Time 1), the effect sizes were -0.70, -1.05, -1.20, and -1.31, and the standardized response means were -1.17, -1.59, -1.66, and -1.82, respectively. The mean change in pain intensity, but not gender-time interaction effect, over the five time points was significant (F = 182.03, p < .001). Our results support that the 11-face Faces Pain Scale is appropriate for measuring acute postoperative pain in adults. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

The Coming Teacher Shortage: What Schools Can Do about It.

ERIC Educational Resources Information Center

Dunlap, Diane M.

1986-01-01

Increased enrollments combined with teacher retirements and resignations are creating a strain on the current supply of qualified teachers. As the demand for new teachers is increasing, the number of new teaching graduates is decreasing proportionally. A national teacher shortage is imminent and already exists is some locations and in some…

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

PubMed

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

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

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

PubMed

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.

Is Higher Education Confronting Faculty Shortages? ASHE Annual Meeting Paper.

ERIC Educational Resources Information Center

Lozier, G. Gregory; Dooris, Michael J.

Retirement policies and possible effects on teacher shortages were examined. Information was obtained concerning: a 5-year summary of faculty retirements by age, the age distribution of each institution's full-time faculty by academic area, and changes over the past 5 years in personnel policies and procedures in response to anticipated faculty…

An equine pain face

PubMed Central

Gleerup, Karina B; Forkman, Björn; Lindegaard, Casper; Andersen, Pia H

2015-01-01

Objective The objective of this study was to investigate the existence of an equine pain face and to describe this in detail. Study design Semi-randomized, controlled, crossover trial. Animals Six adult horses. Methods Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis. Results Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior. Conclusions and clinical relevance An equine pain face comprising ‘low’ and/or ‘asymmetrical’ ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain. PMID:25082060

Full face transplant: the first case report.

PubMed

Barret, Juan P; Gavaldà, Joan; Bueno, Javier; Nuvials, Xavier; Pont, Teresa; Masnou, Nuria; Colomina, Maria J; Serracanta, Jordi; Arno, Anna; Huguet, Pere; Collado, Jose M; Salamero, Pere; Moreno, Carlos; Deulofeu, Roser; Martínez-Ibáñez, Vicenç

2011-08-01

Since 2005, 11 human face transplants have been performed. In each, varying amounts of tissue have been transplanted. Herein we report a "full" face transplant including all intact aesthetic and functional units. On March 27, 2010, we performed a full face transplant, including all the soft tissues and part of the underlaying bony structure, at the University Hospital Vall d'Hebron, Barcelona, Spain. The donor was a 41-year-old male, who died from a massive brain hemorrhage. The recipient was a 30-year-old male with a severe facial deformity caused by a ballistic trauma in 2005. Harvest and subsequent implant took 24 hours. The patient received initial induction (Thymoglobulin 2 mg/kg/iv; Prednisone 1 gm/iv) and maintenance (Prednisone 1 mg/kg/24hours, Tacrolimus 10-15 ng/mL/PO, and Mycophenolate mofetil 2g/daily/PO) immunosuppression and Infection prophylaxis (Valganciclovir and Co-trimoxazole). There were no intraoperative complications. Postoperative complications included; venous anastomoses thrombosis, acute oro-cutaneous fistula, right parotid sialocele and 2 acute rejection episodes, which were resolved by revision of the anastomosis, profuse irrigation and immunotherapy adjustment, respectively. The patient was discharged from the hospital at 4 months posttransplant with; near-total sensation and partial-motor recovery, no psychological complications and excellent acceptance of his new facial appearance. The early success described in this case report demonstrates the technical and clinical feasibility of transplanting all the tissues of the with all its aesthetic and functional units intact.

Acute parasitic and other infectious myelopathies in the tropics: 26 cases at the University Hospital in Conakry.

PubMed

Cisse, F A; Ekué, W A E; Barry, L; Barry, S D; Touré, M L; Cissé, A

2016-11-01

In tropical countries, laboratory-confirmed diagnostic certainty of parasitic and other infectious causes of acute myelopathy is difficult because of a shortage of medical professionals and consulting delays. We performed a retrospective study of 168 patients hospitalized for spinal disorders between 2007 and 2013 and identified 26 diagnosed with acute non-compressive myelopathy of presumed sudden onset. An parasitic or other infectious cause was established for all. A preliminary clinical infection preceding the development of neurologic signs was reported for 22 patients (84.6 %). Neurological signs were limited to the existence of a progressive sensorimotor symptomatology with sphincter disorders.

Econometrics of inventory holding and shortage costs: the case of refined gasoline

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krane, S.D.

1985-01-01

This thesis estimates a model of a firm's optimal inventory and production behavior in order to investigate the link between the role of inventories in the business cycle and the microeconomic incentives for holding stocks of finished goods. The goal is to estimate a set of structural cost function parameters that can be used to infer the optimal cyclical response of inventories and production to shocks in demand. To avoid problems associated with the use of value based aggregate inventory data, an industry level physical unit data set for refined motor gasoline is examined. The Euler equations for a refiner'smore » multiperiod decision problem are estimated using restrictions imposed by the rational expectations hypothesis. The model also embodies the fact that, in most periods, the level of shortages will be zero, and even when positive, the shortages are not directly observable in the data set. These two concerns lead us to use a generalized method of moments estimation technique on a functional form that resembles the formulation of a Tobit problem. The estimation results are disappointing; the model and data yield coefficient estimates incongruous with the cost function interpretations of the structural parameters. These is only some superficial evidence that production smoothing is significant and that marginal inventory shortage costs increase at a faster rate than do marginal holding costs.« less

The Nursing Shortage and the Role of Community Colleges in Nurse Education. Executive Summary. AACC Research Brief.

ERIC Educational Resources Information Center

Viterito, Arthur; Teich, Carolyn

This is a report by the American Association of Community Colleges (AACC) on a the shortage of registered nurses (RN) in the United States and the role of community colleges in nurse education. Reasons for the shortage include: (1) inadequate wages; (2) heavy workloads; (3) undesirable work schedules; (4) increased administrative duties; (5) low…

A Working Plan for Treating the Engineering Faculty Shortage Problem.

ERIC Educational Resources Information Center

Shoup, Terry E., Ed.

In view of the consequences of the engineering faculty shortage problem on engineering capabilities in the future in the United States, a working plan which will serve as a national agenda for prompt action has been developed. This plan involves the three key groups (federal government, academic community, industry) who have the vision,…

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

PubMed

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.

The role of the hospitalists in the workforce to address the shortages of intensivists in hospitals here in Thailand.

PubMed

Pisitsak, Chawika; Champunot, Ratapum; Morakul, Sunthiti

2014-01-01

The problem of a shortage of intensivists in Thailand is increasing annually. As stated in The Thai Society of Critical Care Medicine Database, 2013, the number of qualified intensivists currently is 163, working in 76 provinces in Thailand. This disproportion in the ratio of intensivists has affected patient outcomes. In an attempt to solve this problem, there has been an increased number of hospitalists working in place of the intensivists. Medical specialties are not available in many hospitals of Thailand. Thus, the hospitalists, who care for Intensive Care Unit (ICU) patients, are not trained to care for the acutely ill, hospitalized patients. Their competencies vary depending on their experience and training. In other countries, there has been evidence that properly trained hospitalists can work effectively in the ICU. This awareness of the importance of intensivists in Thailand is one of the stifling factors; the improvement of the hospitalists, determining the hospitalists' workforce and increasing the number of the intensivists to match future demands are needed.

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2018-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Veterinary Professional(s) G Appendix G 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. G Appendix G to Part 5—Criteria for Designation of Areas Having Shortages of Veterinary...

Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users’ experiences

PubMed Central

Mital, Sasha; Miles, Gillian; McLellan-Lemal, Eleanor; Muthui, Mercy; Needle, Richard

2016-01-01

Introduction While relatively rare events, abrupt disruptions in heroin availability have a significant impact on morbidity and mortality risk among those who are heroin dependent. A heroin shortage occurred in Coast Province, Kenya from December 2010 to March 2011. This qualitative analysis describes the shortage events and consequences from the perspective of heroin users, along with implications for health and other public sectors. Methods As part of a rapid assessment, 66 key informant interviews and 15 focus groups among heroin users in Coast Province, Kenya were conducted. A qualitative thematic analysis was undertaken in Atlas.ti. to identify salient themes related to the shortage. Results Overall, participant accounts were rooted in a theme of desperation and uncertainty, with emphasis on six sub-themes: (1) withdrawal and strategies for alleviating withdrawal, including use of medical intervention and other detoxification attempts; (2) challenges of dealing with unpredictable drug availability, cost, and purity; (3) changes in drug use patterns, and actions taken to procure heroin and other drugs; (4) modifications in drug user relationship dynamics and networks, including introduction of risky group-level injection practices; (5) family and community response; and (6) new challenges with the heroin market resurgence. Conclusions The heroin shortage led to a series of consequences for drug users, including increased risk of morbidity, mortality and disenfranchisement at social and structural levels. Availability of evidence-based services for drug users and emergency preparedness plans could have mitigated this impact. PMID:26470646

Heroin shortage in Coastal Kenya: A rapid assessment and qualitative analysis of heroin users' experiences.

PubMed

Mital, Sasha; Miles, Gillian; McLellan-Lemal, Eleanor; Muthui, Mercy; Needle, Richard

2016-04-01

While relatively rare events, abrupt disruptions in heroin availability have a significant impact on morbidity and mortality risk among those who are heroin dependent. A heroin shortage occurred in Coast Province, Kenya from December 2010 to March 2011. This qualitative analysis describes the shortage events and consequences from the perspective of heroin users, along with implications for health and other public sectors. As part of a rapid assessment, 66 key informant interviews and 15 focus groups among heroin users in Coast Province, Kenya were conducted. A qualitative thematic analysis was undertaken in Atlas.ti. to identify salient themes related to the shortage. Overall, participant accounts were rooted in a theme of desperation and uncertainty, with emphasis on six sub-themes: (1) withdrawal and strategies for alleviating withdrawal, including use of medical intervention and other detoxification attempts; (2) challenges of dealing with unpredictable drug availability, cost, and purity; (3) changes in drug use patterns, and actions taken to procure heroin and other drugs; (4) modifications in drug user relationship dynamics and networks, including introduction of risky group-level injection practices; (5) family and community response; and (6) new challenges with the heroin market resurgence. The heroin shortage led to a series of consequences for drug users, including increased risk of morbidity, mortality and disenfranchisement at social and structural levels. Availability of evidence-based services for drug users and emergency preparedness plans could have mitigated this impact. Published by Elsevier B.V.

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

ERIC Educational Resources Information Center

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…

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2013 CFR

2013-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2012 CFR

2012-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2014 CFR

2014-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

42 CFR Appendix B to Part 5 - Criteria for Designation of Areas Having Shortages of Dental Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Dental Professional(s) B Appendix B to Part 5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF..., App. B Appendix B to Part 5—Criteria for Designation of Areas Having Shortages of Dental Professional... designated as having a shortage of dental professional(s) if both the following criteria are met: (a) The...

Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews

PubMed Central

Savage, Margaret; Mello, Maeve B.; Saliyou, Sanni; Seghers, Frederic; Campbell, Michael L.; Birgirimana, Françoise; Ouedraogo, Leopold; Kidula, Nancy; Pyne-Mercier, Lee

2017-01-01

Background Benzathine penicillin G (BPG) is the only recommended treatment to prevent mother-to-child transmission of syphilis. Due to recent reports of country-level shortages of BPG, an evaluation was undertaken to quantify countries that have experienced shortages in the past 2 years and to describe factors contributing to these shortages. Methods and findings Country-level data about BPG shortages were collected using 3 survey approaches. First, a survey designed by the WHO Department of Reproductive Health and Research was distributed to 41 countries and territories in the Americas and 41 more in Africa. Second, WHO conducted an email survey of 28 US Centers for Disease Control and Prevention country directors. An additional 13 countries were in contact with WHO for related congenital syphilis prevention activities and also reported on BPG shortages. Third, the Clinton Health Access Initiative (CHAI) collected data from 14 countries (where it has active operations) to understand the extent of stock-outs, in-country purchasing, usage behavior, and breadth of available purchasing options to identify stock-outs worldwide. CHAI also conducted in-person interviews in the same 14 countries to understand the extent of stock-outs, in-country purchasing and usage behavior, and available purchasing options. CHAI also completed a desk review of 10 additional high-income countries, which were also included. BPG shortages were attributable to shortfalls in supply, demand, and procurement in the countries assessed. This assessment should not be considered globally representative as countries not surveyed may also have experienced BPG shortages. Country contacts may not have been aware of BPG shortages when surveyed or may have underreported medication substitutions due to desirability bias. Funding for the purchase of BPG by countries was not evaluated. In all, 114 countries and territories were approached to provide information on BPG shortages occurring during 2014–2016

Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews.

PubMed

Nurse-Findlay, Stephen; Taylor, Melanie M; Savage, Margaret; Mello, Maeve B; Saliyou, Sanni; Lavayen, Manuel; Seghers, Frederic; Campbell, Michael L; Birgirimana, Françoise; Ouedraogo, Leopold; Newman Owiredu, Morkor; Kidula, Nancy; Pyne-Mercier, Lee

2017-12-01

Benzathine penicillin G (BPG) is the only recommended treatment to prevent mother-to-child transmission of syphilis. Due to recent reports of country-level shortages of BPG, an evaluation was undertaken to quantify countries that have experienced shortages in the past 2 years and to describe factors contributing to these shortages. Country-level data about BPG shortages were collected using 3 survey approaches. First, a survey designed by the WHO Department of Reproductive Health and Research was distributed to 41 countries and territories in the Americas and 41 more in Africa. Second, WHO conducted an email survey of 28 US Centers for Disease Control and Prevention country directors. An additional 13 countries were in contact with WHO for related congenital syphilis prevention activities and also reported on BPG shortages. Third, the Clinton Health Access Initiative (CHAI) collected data from 14 countries (where it has active operations) to understand the extent of stock-outs, in-country purchasing, usage behavior, and breadth of available purchasing options to identify stock-outs worldwide. CHAI also conducted in-person interviews in the same 14 countries to understand the extent of stock-outs, in-country purchasing and usage behavior, and available purchasing options. CHAI also completed a desk review of 10 additional high-income countries, which were also included. BPG shortages were attributable to shortfalls in supply, demand, and procurement in the countries assessed. This assessment should not be considered globally representative as countries not surveyed may also have experienced BPG shortages. Country contacts may not have been aware of BPG shortages when surveyed or may have underreported medication substitutions due to desirability bias. Funding for the purchase of BPG by countries was not evaluated. In all, 114 countries and territories were approached to provide information on BPG shortages occurring during 2014-2016. Of unique countries and

The effects of acute alcohol intoxication on the cognitive mechanisms underlying false facial recognition.

PubMed

Colloff, Melissa F; Flowe, Heather D

2016-06-01

False face recognition rates are sometimes higher when faces are learned while under the influence of alcohol. Alcohol myopia theory (AMT) proposes that acute alcohol intoxication during face learning causes people to attend to only the most salient features of a face, impairing the encoding of less salient facial features. Yet, there is currently no direct evidence to support this claim. Our objective was to test whether acute alcohol intoxication impairs face learning by causing subjects to attend to a salient (i.e., distinctive) facial feature over other facial features, as per AMT. We employed a balanced placebo design (N = 100). Subjects in the alcohol group were dosed to achieve a blood alcohol concentration (BAC) of 0.06 %, whereas the no alcohol group consumed tonic water. Alcohol expectancy was controlled. Subjects studied faces with or without a distinctive feature (e.g., scar, piercing). An old-new recognition test followed. Some of the test faces were "old" (i.e., previously studied), and some were "new" (i.e., not previously studied). We varied whether the new test faces had a previously studied distinctive feature versus other familiar characteristics. Intoxicated and sober recognition accuracy was comparable, but subjects in the alcohol group made more positive identifications overall compared to the no alcohol group. The results are not in keeping with AMT. Rather, a more general cognitive mechanism appears to underlie false face recognition in intoxicated subjects. Specifically, acute alcohol intoxication during face learning results in more liberal choosing, perhaps because of an increased reliance on familiarity.

42 CFR 414.67 - Incentive payments for Health Professional Shortage Areas.

Code of Federal Regulations, 2010 CFR

2010-10-01

... mental health HPSA are entitled to a 10 percent incentive payment above the amount paid for their... incentive payment in mental health HPSAs that do not overlap with primary care HPSAs are psychiatrists.) (d... 42 Public Health 3 2010-10-01 2010-10-01 false Incentive payments for Health Professional Shortage...

Face-to-face: Perceived personal relevance amplifies face processing

PubMed Central

Pittig, Andre; Schupp, Harald T.; Alpers, Georg W.

2017-01-01

Abstract The human face conveys emotional and social information, but it is not well understood how these two aspects influence face perception. In order to model a group situation, two faces displaying happy, neutral or angry expressions were presented. Importantly, faces were either facing the observer, or they were presented in profile view directed towards, or looking away from each other. In Experiment 1 (n = 64), face pairs were rated regarding perceived relevance, wish-to-interact, and displayed interactivity, as well as valence and arousal. All variables revealed main effects of facial expression (emotional > neutral), face orientation (facing observer > towards > away) and interactions showed that evaluation of emotional faces strongly varies with their orientation. Experiment 2 (n = 33) examined the temporal dynamics of perceptual-attentional processing of these face constellations with event-related potentials. Processing of emotional and neutral faces differed significantly in N170 amplitudes, early posterior negativity (EPN), and sustained positive potentials. Importantly, selective emotional face processing varied as a function of face orientation, indicating early emotion-specific (N170, EPN) and late threat-specific effects (LPP, sustained positivity). Taken together, perceived personal relevance to the observer—conveyed by facial expression and face direction—amplifies emotional face processing within triadic group situations. PMID:28158672

Face-to-face: Perceived personal relevance amplifies face processing.

PubMed

Bublatzky, Florian; Pittig, Andre; Schupp, Harald T; Alpers, Georg W

2017-05-01

The human face conveys emotional and social information, but it is not well understood how these two aspects influence face perception. In order to model a group situation, two faces displaying happy, neutral or angry expressions were presented. Importantly, faces were either facing the observer, or they were presented in profile view directed towards, or looking away from each other. In Experiment 1 (n = 64), face pairs were rated regarding perceived relevance, wish-to-interact, and displayed interactivity, as well as valence and arousal. All variables revealed main effects of facial expression (emotional > neutral), face orientation (facing observer > towards > away) and interactions showed that evaluation of emotional faces strongly varies with their orientation. Experiment 2 (n = 33) examined the temporal dynamics of perceptual-attentional processing of these face constellations with event-related potentials. Processing of emotional and neutral faces differed significantly in N170 amplitudes, early posterior negativity (EPN), and sustained positive potentials. Importantly, selective emotional face processing varied as a function of face orientation, indicating early emotion-specific (N170, EPN) and late threat-specific effects (LPP, sustained positivity). Taken together, perceived personal relevance to the observer-conveyed by facial expression and face direction-amplifies emotional face processing within triadic group situations. © The Author (2017). Published by Oxford University Press.

[Secondary cardiovascular prevention after acute coronary syndrome in clinical practice].

PubMed

Colivicchi, Furio; Di Roma, Angelo; Uguccioni, Massimo; Scotti, Emilio; Ammirati, Fabrizio; Arcas, Marcello; Avallone, Aniello; Bonaccorso, Orazio; Germanò, Giuseppe; Letizia, Claudio; Manfellotto, Dario; Minardi, Giovanni; Pristipino, Christian; D'Amore, Francesco; Di Veroli, Claudio; Fierro, Aldo; Pastorellio, Ruggero; Tozzi, Quinto; Tubaro, Marco; Santini, Massimo; Angelico, Francesco; Azzolini, Paolo; Bellasi, Antonio; Brocco, Paola; Calò, Leonardo; Cerquetani, Elena; De Biase, Luciano; Di Napoli, Mauro; Galati, Alfonso; Gallieni, Maurizio; Jesi, Anna Patrizia; Lombardo, Antonella; Loricchio, Vincenzo; Menghini, Fabio; Mezzanotte, Roberto; Minutolos, Roberto; Mocini, David; Patti, Giuseppe; Patrizi, Roberto; Pajes, Giuseppe; Pulignano, Giovanni; Ricci, Renato Pietro; Ricci, Roberto; Sardella, Gennaro; Strano, Stefano; Terracina, David; Testa, Marco; Tomai, Fabrizio; Volpes, Roberto; Volterrani, Maurizio

2010-05-01

Secondary prevention after acute coronary syndromes should be aimed at reducing the risk of further adverse cardiovascular events, thereby improving quality of life, and lengthening survival. Despite compelling evidence from large randomized controlled trials, secondary prevention is not fully implemented in most cases after hospitalization for acute coronary syndrome. The Lazio Region (Italy) has about 5.3 million inhabitants (9% of the entire Italian population). Every year about 11 000 patients are admitted for acute coronary syndrome in hospitals of the Lazio Region. Most of these patients receive state-of-the art acute medical and interventional care during hospitalization. However, observational data suggest that after discharge acute coronary syndrome patients are neither properly followed nor receive all evidence-based treatments. This consensus document has been developed by 11 Scientific Societies of Cardiovascular and Internal Medicine in order develop a sustainable and effective clinical approach for secondary cardiovascular prevention after acute coronary syndrome in the local scenario of the Lazio Region. An evidence-based simplified decalogue for secondary cardiovascular prevention is proposed as the cornerstone of clinical intervention, taking into account regional laws and relative shortage of resources. The following appropriate interventions should be consistently applied: smoking cessation, blood pressure control (blood pressure < 130/80 mmHg), optimal lipid management (LDL cholesterol < 80 mmHg), weight and diabetes management, promotion of physical activity and rehabilitation, correct use of antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone system blockers.

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

PubMed

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.

National Assessment of Personnel Shortages and Training Needs in Vocational Rehabilitation.

ERIC Educational Resources Information Center

Pelavin, Diane C.; And Others

To improve the services provided to clients in vocational rehabilitation, a study was conducted to determine what staff shortages exist by occupational discipline and which of them could be addressed by education and training. Data collection involved a questionnaire completed by 95 percent of the 83 directors of state agencies responsible for…

China's water shortage could shake world food security.

PubMed

Brown, L R; Halweil, B

1998-01-01

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

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

PubMed

Rafiei, Sima; Daneshvaran, Arman; Abdollahzade, Sina

2018-01-01

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

7 CFR 3431.7 - Notification and use of designated veterinarian shortage situations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Notification and use of designated veterinarian shortage situations. 3431.7 Section 3431.7 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND AGRICULTURE VETERINARY MEDICINE LOAN REPAYMENT PROGRAM Designation...

Impact of the Nationwide Intravenous Selenium Product Shortage on the Development of Selenium Deficiency in Infants Dependent on Long-Term Parenteral Nutrition.

PubMed

Chen, Connie H; Harris, Mary Beth; Partipilo, M Luisa; Welch, Kathleen B; Teitelbaum, Daniel H; Blackmer, Allison B

2016-08-01

For patients dependent on parenteral nutrition (PN), selenium must be supplemented intravenously. A nationwide intravenous selenium shortage began in April 2011. The impact of this shortage on PN-dependent infants was evaluated by examining the provision of selenium, development of biochemical deficiency, and costs associated with the shortage. This single-center, retrospective study included PN-dependent infants aged ≤1 year who weighed ≤30 kg, received PN for ≥1 month, and had ≥1 serum selenium measurement. The primary outcome was the incidence of biochemical selenium deficiency. Secondary outcomes included severity of biochemical deficiency, clinical manifestations, costs, and relationship between serum selenium levels and selenium dose. The average selenium dose decreased 2-fold during the shortage (2.1 ± 1.2 µg/kg/d; range, 0.2-4.6 µg/kg/d) versus the nonshortage period (3.8 ± 1 µg/kg/d; range, 2.4-6 µg/kg/d; P < .001). A linear relationship between serum selenium concentration and selenium dose was observed (r(2) = 0.42), with a dose of 6 µg/kg/d expected to result in normal serum levels in most cases. Similar proportions of patients developed biochemical deficiency in both groups: shortage period, 59.1%; nonshortage, 66.7%; P = .13. The severity of biochemical deficiency was similar between groups. A significant increase in incremental cost during the shortage was observed. This is the first study examining the impact of the intravenous selenium shortage on PN-dependent infants. Both groups exhibited similarly high incidences of biochemical selenium deficiency, suggesting higher empiric doses may benefit this population. However, ongoing shortages limit the ability to provide supplementation. © 2015 American Society for Parenteral and Enteral Nutrition.

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

Code of Federal Regulations, 2010 CFR

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...

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 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...

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

PubMed

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.

The effect of acute citalopram on face emotion processing in remitted depression: a pharmacoMRI study.

PubMed

Anderson, Ian M; Juhasz, Gabriella; Thomas, Emma; Downey, Darragh; McKie, Shane; Deakin, J F William; Elliott, Rebecca

2011-01-01

Both reduced serotonergic (5-HT) function and negative emotional biases have been associated with vulnerability to depression. In order to investigate whether these might be related we examined 5-HT modulation of affective processing in 14 remitted depressed subjects compared with 12 never depressed controls matched for age and sex. Participants underwent function magnetic resonance imaging (fMRI) during a covert face emotion task with and without intravenous citalopram (7.5mg) pretreatment. Compared with viewing neutral faces, and irrespective of group, citalopram enhanced left anterior cingulate blood oxygen level dependent (BOLD) response to happy faces, right posterior insula and right lateral orbitofrontal responses to sad faces, and reduced amygdala responses bilaterally to fearful faces. In controls, relative to remitted depressed subjects, citalopram increased bilateral hippocampal responses to happy faces and increased right anterior insula response to sad faces. These findings were not accounted for by changes in BOLD responses to viewing neutral faces. These results are consistent with previous findings showing 5-HT modulation of affective processing; differences found in previously depressed participants compared with controls may contribute to emotional processing biases underlying vulnerability to depressive relapse. Copyright © 2010 Elsevier B.V. and ECNP. All rights reserved.

Surviving the nursing shortage: developing a nursing orientation program to prepare and retain intensive care unit nurses.

PubMed

Cavanaugh, Debra A; Huse, Anita L

2004-01-01

The shortage of nurses has reached crisis proportions around the world. In response to a critical shortage of qualified neonatal intensive care nurses, one institution developed an educational program so comprehensive that they were able to increase their nursing staff by 20% and staff the neonatal intensive care unit with well-prepared and proficient nurses. This strategy has also resulted in high retention rates, a decrease in overtime, and a relatively low error rate by new nurses.

Comparison of appendicectomy outcomes: acute surgical versus traditional pathway.

PubMed

Pillai, Sandhya; Hsee, Li; Pun, Andy; Mathur, Sachin; Civil, Ian

2013-10-01

The acute surgical unit (ASU) is an evolving novel concept introduced to address the challenge of maintaining key performance indicators (KPIs) in the face of an increasing acute workload. The aim of this retrospective study was to compare the performance of the ASU (from June 2008 to December 2010) at Auckland City Hospital with the traditional model (from January 2006 to May 2008) and benchmark the results against other similar published studies. The analysis was on the basis of KPIs for 1857 appendicectomies, which form a large volume of acute surgical presentations. Our results show significant improvement in length of stay (2.8 days, 2.6 days, P = 0.0001) and proportion of daytime operations (59.4%, 65.8%, P = 0.004), in keeping with other studies on benchmarking. The introduction of ASU has led to significant improvements in some KPIs for appendicectomy outcomes in the face of an increasing workload. © 2013 Royal Australasian College of Surgeons.

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

PubMed

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

2014-09-01

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

The Labor Shortage--Poverty and Educational Aspects. Hearings on Examining Alternatives Available in Coping with a Projected Labor Shortage in the Future while Facing a Poverty Surplus and Educational Gaps in the Work Force before the Committee on Labor and Human Resources. United States Senate, One Hundred First Congress, First Session (January 26 and 27, 1989).

ERIC Educational Resources Information Center

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

This document comprises hearings on the poverty and educational aspects of the labor shortage. Twenty witnesses testified, including Secretary of the U.S. Department of Labor Elizabeth Dole, Secretary of the U.S. Department of Education Lauro F. Cavazos, legislators, program administrators, and three working mothers. Testimony included the…

Recruitment, Retention and the Minority Teacher Shortage. CPRE Research Report # RR-69

ERIC Educational Resources Information Center

Ingersoll, Richard M.; May, Henry

2011-01-01

This study examines and compares the recruitment and retention of minority and White elementary and secondary teachers and attempts to empirically ground the debate over minority teacher shortages. The data we analyze are from the National Center for Education Statistics' nationally representative Schools and Staffing Survey and its longitudinal…

Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach

PubMed Central

2013-01-01

Background In Japan, a shortage of physicians, who serve a key role in healthcare provision, has been pointed out as a major medical issue. The healthcare workforce policy planner should consider future dynamic changes in physician numbers. The purpose of this study was to propose a physician supply forecasting methodology by applying system dynamics modeling to estimate future absolute and relative numbers of physicians. Method We constructed a forecasting model using a system dynamics approach. Forecasting the number of physician was performed for all clinical physician and OB/GYN specialists. Moreover, we conducted evaluation of sufficiency for the number of physicians and sensitivity analysis. Result & conclusion As a result, it was forecast that the number of physicians would increase during 2008–2030 and the shortage would resolve at 2026 for all clinical physicians. However, the shortage would not resolve for the period covered. This suggests a need for measures for reconsidering the allocation system of new entry physicians to resolve maldistribution between medical departments, in addition, for increasing the overall number of clinical physicians. PMID:23981198

Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach.

PubMed

Ishikawa, Tomoki; Ohba, Hisateru; Yokooka, Yuki; Nakamura, Kozo; Ogasawara, Katsuhiko

2013-08-27

In Japan, a shortage of physicians, who serve a key role in healthcare provision, has been pointed out as a major medical issue. The healthcare workforce policy planner should consider future dynamic changes in physician numbers. The purpose of this study was to propose a physician supply forecasting methodology by applying system dynamics modeling to estimate future absolute and relative numbers of physicians. We constructed a forecasting model using a system dynamics approach. Forecasting the number of physician was performed for all clinical physician and OB/GYN specialists. Moreover, we conducted evaluation of sufficiency for the number of physicians and sensitivity analysis. As a result, it was forecast that the number of physicians would increase during 2008-2030 and the shortage would resolve at 2026 for all clinical physicians. However, the shortage would not resolve for the period covered. This suggests a need for measures for reconsidering the allocation system of new entry physicians to resolve maldistribution between medical departments, in addition, for increasing the overall number of clinical physicians.

Keeping the nursing shortage from becoming a nursing crisis.

PubMed

Erickson, Jeanette Ives; Holm, Lauren J; Chelminiak, Lee

2004-02-01

Healthcare organizations are experiencing an unprecedented shortage of qualified nurses. How can we increase our understanding of how the potential labor pool views the nursing profession and identify recruitment themes to encourage young people and adult career switchers to choose a career in nursing? The authors discuss the results of a study that was conducted to gain a better understanding of the dynamics of career selection among these two target groups and identify what types of communication would motivate young people and career switchers to be drawn to the nursing profession.

78 FR 35612 - Agency Information Collection Activities; Comment Request; Targeted Teacher Shortage Areas...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-13

... address the targeted teacher deferment provision of the Higher Education Act of 1965, as amended. The... DEPARTMENT OF EDUCATION [Docket No. ED-2013-ICCD-0076] Agency Information Collection Activities; Comment Request; Targeted Teacher Shortage Areas Nationwide Listing AGENCY: Office of Postsecondary...

Shortages in Professions Working with Young Children with Disabilities and Their Families.

ERIC Educational Resources Information Center

Hebbeler, Kathleen

This paper synthesizes information about shortages among the professions working with young children with disabilities, birth through age 5, and their families. The paper begins with a look at national data on personnel working in early intervention and preschool special education. Distinctions between the work force in early intervention (Part H…

[Professional debate on shortage of physicians].

PubMed

Gérvas, Juan; Bonis, Julio

2008-01-01

We do not know the best answer to problems due to shortage of physicians (absolute number and by specialities) but perhaps what is important is the lack of a professional debate about what means 'to be' a physician. In this paper we address four key professional questions: 1/ the over-training of physicians when health demand now includes minor problems, 2/ predominance of physician-patient direct encounters in a world of telecommunications and indirect encounters, 3/ the need to delegate power and responsibilities to other health professionals as a consequence of new technology developments and changes in role-design, and 4/ too much emphasis in diagnosis with the danger to initiate cascades with its side-effects. Practical answers to these questions require changes in pre and postgraduate education, improvement in health services organization to profit the use of telecommunications and analysis and re-design of the limits in between professions, levels of care, institutions and health and social sectors.

Arginine Vasopressin Effects on Subjective Judgments and Neural Responses to Same and Other-Sex Faces in Men and Women.

PubMed

Rilling, James K; Li, Ting; Chen, Xiangchuan; Gautam, Pritam; Haroon, Ebrahim; Thompson, Richmond R

2017-01-01

Arginine vasopressin (AVP) influences social and emotional behaviors across a wide range of species. In humans, intranasal AVP has been previously shown to alter physiological responses to and subjective judgments of same-sex faces in both men and women. The present study attempted to elucidate the neural mechanism for these effects by randomizing 40 healthy men and 40 healthy women to treatment with either 40 IU intranasal AVP or a saline placebo approximately 30 min before imaging their brain function with fMRI as they viewed same and other-sex faces. All subjects were also scanned a second time several days later with no treatment to evaluate the persistence of AVP effects over time. AVP acutely increased positive ratings of same-sex faces in women, with some evidence that these effects persisted until the second scan. While AVP had no acute effects on same-sex ratings in men, AVP increased positive ratings of same-sex faces several days later. On the other hand, AVP had no effect on other-sex face judgments in either sex. AVP modulation of brain function was focused on the nucleus accumbens (NAc) and the lateral septum, two reward processing areas involved in the formation of social bonds. AVP provoked acute increases in right NAc and bilateral lateral septum responses to female faces among men, with left lateral septum responses persisting over time while right NAc responses reversed over time. Finally, AVP modulated hypothalamic activation to faces in both men and women. The present study therefore indicates that intranasal AVP affects subjective ratings and neural responses to same and other-sex faces in men and women, with some effects persisting and others emerging over time. Future studies should investigate whether AVP effects are modulated by individual variables such as genotype, personality, or attachment style as previously reported for other nonapeptides.

Shortage or Surplus? A Long-Term Perspective on the Supply of Scientists and Engineers in the USA and the UK

ERIC Educational Resources Information Center

Smith, Emma

2017-01-01

A "crisis account" of shortages of well-qualified scientists, engineers, mathematicians and technologists has shaped education policy in the UK and the USA for decades. The apparent poor quality of school science education along with insufficient numbers of well-qualified teachers have been linked to skills shortages by government and…

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

ERIC Educational Resources Information Center

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…

Is Storage a Solution to End Water Shortage?

NASA Astrophysics Data System (ADS)

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

Some effects of alcohol and eye movements on cross-race face learning.

PubMed

Harvey, Alistair J

2014-01-01

This study examines the impact of acute alcohol intoxication on visual scanning in cross-race face learning. The eye movements of a group of white British participants were recorded as they encoded a series of own-and different-race faces, under alcohol and placebo conditions. Intoxication reduced the rate and extent of visual scanning during face encoding, reorienting the focus of foveal attention away from the eyes and towards the nose. Differences in encoding eye movements also varied between own-and different-race face conditions as a function of alcohol. Fixations to both face types were less frequent and more lingering following intoxication, but in the placebo condition this was only the case for different-race faces. While reducing visual scanning, however, alcohol had no adverse effect on memory, only encoding restrictions associated with sober different-race face processing led to poorer recognition. These results support perceptual expertise accounts of own-race face processing, but suggest the adverse effects of alcohol on face learning published previously are not caused by foveal encoding restrictions. The implications of these findings for alcohol myopia theory are discussed.

Is There a Shortage of Obstetrician-Gynecologists?

PubMed

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

2017-03-01

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

Acute glucocorticoid effects on response inhibition in borderline personality disorder.

PubMed

Carvalho Fernando, Silvia; Beblo, Thomas; Schlosser, Nicole; Terfehr, Kirsten; Wolf, Oliver Tobias; Otte, Christian; Löwe, Bernd; Spitzer, Carsten; Driessen, Martin; Wingenfeld, Katja

2013-11-01

Growing evidence suggests inhibition dysfunctions in borderline personality disorder (BPD). Moreover, abnormalities in hypothalamic-pituitary-adrenal (HPA) axis functioning have also been found in BPD patients. In healthy individuals, response inhibition has been sensitive to acute stress, and previous research indicates that effects mediated by the HPA axis become particularly apparent when emotional stimuli are processed. This study aimed to explore the influence of acute hydrocortisone administration on response inhibition of emotional stimuli in BPD patients compared to healthy control participants. After a single administration of 10mg hydrocortisone or placebo, 32 female BPD patients and 32 healthy female participants performed an adapted emotional go/no-go paradigm to assess response inhibition for emotional face stimuli in a cross-over study. Acute cortisol elevations decreased the reaction times to target stimuli in both BPD patients and healthy controls. Patients and controls did not differ in task performance; however, BPD patients with comorbid posttraumatic stress disorder (PTSD) displayed longer reaction times than patients without PTSD. In contrast, the occurrence of comorbid eating disorder had no significant impact on go/no-go performance. No significant interaction effect between the treatment condition and the emotional valence of the face stimuli was found. Acute hydrocortisone administration enhances response inhibition of face stimuli in BPD patients and healthy controls, regardless of their emotional valence. Our results agree with the suggestion that moderate cortisol enhancement increases the inhibition of task-irrelevant distracters. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

PubMed

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

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

Resolving the technologist shortage: a summary of ACR and ASRT efforts to meet the increasing demand for RTs.

PubMed

Williams, Charles D; Maloney, Eileen M; McElveny, Ceela

2004-11-01

Demand for radiologic technologists in the United States greatly outstripped supply throughout the late 1990s and peaked in 2000, when vacancy rates for radiologic technologists reached an average of 18% nationwide. To combat the shortage, the ACR and the American Society of Radiologic Technologists (ASRT) launched a series of aggressive recruitment and retention initiatives designed to boost the number of technologists. The campaigns have resulted in rising enrollments in educational programs, greater numbers of graduates and new technologists, and the expansion of the career ladder. As a result, the national vacancy rate for radiologic technologists had dropped to 12% by the end of 2003. This article reviews the radiologic technologists personnel shortage at the turn of the century, describes efforts taken by the ACR and the ASRT to ameliorate the shortage, and examines the future of the radiologic technology workforce.

Acute poisoning: understanding 90% of cases in a nutshell

PubMed Central

Greene, S; Dargan, P; Jones, A

2005-01-01

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed. PMID:15811881

Acute poisoning: understanding 90% of cases in a nutshell.

PubMed

Greene, S L; Dargan, P I; Jones, A L

2005-04-01

The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

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

PubMed

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.

Building resilience to face recurring environmental crisis in African Sahel

NASA Astrophysics Data System (ADS)

Boyd, Emily; Cornforth, Rosalind J.; Lamb, Peter J.; Tarhule, Aondover; Lélé, M. Issa; Brouder, Alan

2013-07-01

The present food shortages in the Horn of Africa and the West African Sahel are affecting 31 million people. Such continuing and future crises require that people in the region adapt to an increasing and potentially irreversible global sustainability challenge. Given this situation and that short-term weather and seasonal climate forecasting have limited skill for West Africa, the Rainwatch project illustrates the value of near real-time monitoring and improved communication for the unfavourable 2011 West African monsoon, the resulting severe drought-induced humanitarian impacts continuing into 2012, and their exacerbation by flooding in 2012. Rainwatch is now coupled with a boundary organization (Africa Climate Exchange, AfClix) with the aim of integrating the expertise and actions of relevant institutions, agencies and stakeholders to broker ground-based dialogue to promote resilience in the face of recurring crisis.

Medical directors of long-term care facilities: preventing another physician shortage?

PubMed

Frank, C; Seguin, R; Haber, Shelly; Godwin, Marshall; Stewart, G I

2006-06-01

The long-term care (LTC) sector in Canada is expanding, but little attention has been given to medical human resources in this area. Our objective was to seek LTC medical directors' opinions about medical services in LTC and about strategies for recruitment and retention. Mailed survey. Long-term care facilities and nursing homes. Seven hundred five medical directors of LTC facilities across Canada were identified from the Canadian Healthcare Association database. Responses to open- and closed-ended questions and to Likert-type scales. The response rate was 55%. The average age of medical directors was 54 years. Most had started work in LTC because of a vacant position, as opposed to self-perceived skills or training. Most (75.3%) reported satisfaction with their role as medical directors, but 82.7% believed that there was a significant shortage of physicians working in LTC, and 42% had seriously considered leaving their positions. Major sources of satisfaction identified were clinical, especially working with older patients and improving care. Important sources of dissatisfaction were remuneration for LTC work, on-call coverage, and excessive paperwork. Directors suggested increases to fee schedules as the main recruitment and retention strategy, and many believed that increasing exposure to LTC during residency would increase recruitment. Development of larger on-call groups for coverage and alternative methods of remuneration were not cited as important factors. Most did not believe that working in a teaching nursing home would increase their satisfaction. Directors did not think the use of nurse practitioners would alleviate concerns about shortages of physicians. Medical directors of LTC facilities are aging, and many are considering leaving their work in LTC. Without an increase in the number of physicians willing to work in LTC institutions, the current shortage of LTC physicians could increase in the near future. Medical directors' responses to questions

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

NASA Astrophysics Data System (ADS)

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 < .001, Cohen's f2 = .763). The model accounted for 43% of the variance in intentions to install a rainwater tank as a protective measure against future water shortages. Results further indicated that several variables uniquely contributed to the prediction of rainwater tank adoption (listed in order of relative contribution: response efficacy, threat appraisal, response costs, subjective knowledge and subjective norms). This suggests that people who perceive there is a real water shortage threat, and believe that rainwater tanks are effective in relieving the threat and require minimal or manageable effort to obtain, are more likely to install a tank on their property as a protective measure. Implications of these results are discussed from a research and policy perspective. Recommendations for future motivational research in the area of urban decentralised system acceptance and adoption are presented.

Current issues in Scandinavian acute psychiatric wards.

PubMed

Ruud, Torleif; Lindefors, Nils; Lindhardt, Anne

2006-01-01

The aim of the paper is to provide an overview of some of the most important issues faced by acute inpatient facilities in three Scandinavian countries, including reflections and critical remarks for discussion in this field. Information was drawn from scientific articles and official reports published in recent years, as well as the authors' own knowledge of acute facilities in their home countries. Acute inpatient facilities, including General Hospital Psychiatric Units (GHPUs), in all Scandinavian countries have several issues and problems in common, which include the organisation and capacity of acute services, the assessment of dangerousness and suicidality, the use of coercion and efforts to reduce coercion, the need to define and improve the quality of acute services, and the necessity to improve collaboration and continuity between acute services and other services. Although the emphasis some of these issues receive can vary across the three countries, Scandinavian mental health professionals (and policy makers) have begun to systematically share their experiences in developing a growing spirit of collaboration. Despite the role of welfare state and the deployment of substantial resources in Scandinavian countries, mental health practitioners are struggling to implement best practices in acute wards, to develop differentiated forms of acute services, and to reach the right balance and coordination between acute services and other services.

Tenofovir stock shortages have limited impact on clinic- and patient-level HIV treatment outcomes in public sector clinics in South Africa.

PubMed

Brennan, Alana T; Bor, Jacob; Davies, Mary-Ann; Conradie, Francesca; Maskew, Mhairi; Long, Lawrence; Sanne, Ian; Fox, Matthew P

2017-02-01

Using data from four public sector clinics in South Africa, we sought to investigate provider- and patient-level outcomes, to understand how the 2012 tenofovir stock shortage affected the HIV care and monitoring of ART patients. Prospective cohort analysis of ART-naïve, non-pregnant, HIV-infected patients >18 years initiating first-line ART between 1 July 2011-31 March 2013. Linear regression was used for all outcomes (number of ART initiates, days between pharmacy visits, transfers, single-drug substitutions, treatment interruptions, missed pharmacy visits, loss to follow-up and elevated viral load). We fit splines to smooth curves with knots at the beginning (1 February 2012) and end (31 August 2012) of the stock shortage and displayed results graphically by clinic. Difference-in-difference models were used to evaluate the effect of the stock shortage on outcomes. Results suggest a potential shift in the management of patients during the shortage, mainly fewer average days between visits during the shortage vs. before or after at all four clinics, and a significant difference in the proportion of patients missing visits during vs. before (RD: 1.2%; 95% CI: 0.5%, 2.0%). No significant difference was seen in other outcomes. While South Africa has made great strides to extend access to ART and increase the quality of the health services provided, patient care can be affected when stock shortages/outs occur. While our results show little effect on treatment outcomes, this most likely reflects the clinics' ability to mitigate the crisis by continuing to keep patient care and treatment as consistent as possible. © 2016 John Wiley & Sons Ltd.

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

ERIC Educational Resources Information Center

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

2017-01-01

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

Sensors, transmitters, and targets in mitochondrial oxygen shortage-a hypoxia-inducible factor relay story.

PubMed

Dehne, Nathalie; Brüne, Bernhard

2014-01-10

Cells sense and respond to a shortage of oxygen by activating the hypoxia-inducible transcription factors HIF-1 and HIF-2 and evoking adaptive responses. Mitochondria are at the center of a hypoxia sensing and responding relay system. Under normoxia, reactive oxygen species (ROS) and nitric oxide (NO) are HIF activators. As their individual flux rates determine their diffusion-controlled interaction, predictions how these radicals affect HIF appear context-dependent. Considering that the oxygen requirement for NO formation limits its role in activating HIF to conditions of ambient oxygen tension. Given the central role of mitochondrial complex IV as a NO target, especially under hypoxia, allows inhibition of mitochondrial respiration by NO to spare oxygen thus, raising the threshold for HIF activation. HIF targets seem to configure a feedback-signaling circuit aimed at gradually adjusting mitochondrial function. In hypoxic cancer cells, mitochondria redirect Krebs cycle intermediates to preserve their biosynthetic ability. Persistent HIF activation lowers the entry of electron-delivering compounds into mitochondria to reduce Krebs cycle fueling and β-oxidation, attenuates the expression of electron transport chain components, limits mitochondria biosynthesis, and provokes their removal by autophagy. Mitochondria can be placed central in a hypoxia sensing-hypoxia responding circuit. We need to determine to which extent and how mitochondria contribute to sense hypoxia, explore whether modulating their oxygen-consuming capacity redirects hypoxic responses in in vivo relevant disease conditions, and elucidate how the multiple HIF targets in mitochondria shape conditions of acute versus chronic hypoxia.

Politics, economics, and nursing shortages: a critical look at United States government policies.

PubMed

Elgie, Rob

2007-01-01

The economic concept that the independent actions of buyers and sellers tend to move the market toward equilibrium where there is no shortage or surplus is basic in the classic and current literature of economics. The problem with subsidies is that nurses who receive subsidized educations are able to provide nursing services for less compensation because they paid less or nothing for their educations. Subsidies may be politically appealing, but they override market forces of supply and demand. The demand for nurses and nursing instructors can be met and maintained for generations to come with policies that expand roles and reimbursement for APNs and encourage the nurse and nursing instructor labor markets to correct themselves by providing fair compensation under Magnet status working conditions. Politics and policies meant to correct the nursing shortage should focus less on how to reduce the cost of producing nurses, and more on how to afford to compensate nurses with wages and benefits that achieve market equilibrium.

178: FORECASTING THE SHORTAGE OF NEUROSURGEONS IN IRAN USING A SYSTEM DYNAMICS MODEL APPROACH

PubMed Central

Ezzatabadi, Mohammad Ranjbar; Zadeh, Sina Abdollah; Rafiei, Sima

2017-01-01

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

Acute Mountain Sickness and Hemoconcentration in Next Generation Spacecraft

NASA Technical Reports Server (NTRS)

Conkin, Johnny

2009-01-01

This slide presentation reviews the threat astronauts face from acute mountain sickness (AMS). It includes information about the symptoms of AMS, the potential threat to astronauts, and future efforts to mitigate the AMS threat.

Impact of acute psychological stress on cardiovascular risk factors in face of insulin resistance.

PubMed

Jones, Kristian T; Shelton, Richard C; Wan, Jun; Li, Li

2016-11-01

Individuals with insulin resistance (IR) are at greater risk for cardiovascular disease (CVD). Psychological stress may contribute to develop CVD in IR, although mechanisms are poorly understood. Our aim was to test the hypothesis that individuals with IR have enhanced emotional and physiological responses to acute psychological stress, leading to increased CVD risk. Sixty participants were enrolled into the study, and classified into IR group (n = 31) and insulin sensitive group (n = 29) according to the Quantitative insulin sensitivity check index, which was calculated based on an oral glucose tolerance test. The Trier social stress test, a standardized experimental stress paradigm, was performed on each participant, and emotional and physiological responses were examined. Blood was collected from each subject for insulin, cytokines, and cortisol measurements. Compared with the insulin-sensitive group, individuals with IR had significantly lower ratings of energy and calm, but higher fatigue levels in response to acute stressors. Individuals with IR also showed blunted heart rate reactivity following stress. In addition, the IR status was worsened by acute psychological stress as demonstrated by further increased insulin secretion. Furthermore, individuals with IR showed significantly increased levels of leptin and interleukin-6, but decreased levels of adiponectin, at baseline, stress test, and post-stress period. Our findings in individuals with IR under acute stress would allow a better understanding of the risks for developing CVD and to tailor the interventions for better outcomes.

Impact of Acute Psychological Stress on Cardiovascular Risk Factors in Face of Insulin Resistance

PubMed Central

Jones, Kristian T.; Shelton, Richard C.; Wan, Jun; Li, Li

2016-01-01

Individuals with insulin resistance (IR) are at greater risk for cardiovascular disease (CVD). Psychological stress may contribute to develop CVD in IR although mechanisms are poorly understood. Our aim was to test the hypothesis that individuals with IR have enhanced emotional and physiological responses to acute psychological stress, leading to increased CVD risk. Sixty participants were enrolled into the study, and classified into IR group (n=31) and insulin sensitive group (n=29) according to the Quantitative insulin sensitivity check index, which was calculated based on an oral glucose tolerance test. The Trier social stress test, a standardized experimental stress paradigm, was performed on each participant, and emotional and physiological responses were examined. Blood was collected from each subject for insulin, cytokines and cortisol measurements. Compared with insulin sensitive group, individuals with IR had significantly lower ratings of energy and calm, but higher fatigue levels in response to acute stressors. Individuals with IR also showed blunted heart rate reactivity following stress. In addition, the IR status was worsened by acute psychological stress as demonstrated by further increased insulin secretion. Furthermore, individuals with IR showed significantly increased levels of leptin and interleukin-6, but decreased levels of adiponectin, at baseline, stress test and post-stress period. Our findings in individuals with IR under acute stress would allow a better understanding of the risks for developing CVD and to tailor the interventions for better outcomes. PMID:27588343

Neural synchronization during face-to-face communication.

PubMed

Jiang, Jing; Dai, Bohan; Peng, Danling; Zhu, Chaozhe; Liu, Li; Lu, Chunming

2012-11-07

Although the human brain may have evolutionarily adapted to face-to-face communication, other modes of communication, e.g., telephone and e-mail, increasingly dominate our modern daily life. This study examined the neural difference between face-to-face communication and other types of communication by simultaneously measuring two brains using a hyperscanning approach. The results showed a significant increase in the neural synchronization in the left inferior frontal cortex during a face-to-face dialog between partners but none during a back-to-back dialog, a face-to-face monologue, or a back-to-back monologue. Moreover, the neural synchronization between partners during the face-to-face dialog resulted primarily from the direct interactions between the partners, including multimodal sensory information integration and turn-taking behavior. The communicating behavior during the face-to-face dialog could be predicted accurately based on the neural synchronization level. These results suggest that face-to-face communication, particularly dialog, has special neural features that other types of communication do not have and that the neural synchronization between partners may underlie successful face-to-face communication.

Mortality related to acute illness and injury in rural Uganda: task shifting to improve outcomes.

PubMed

Chamberlain, Stacey; Stolz, Uwe; Dreifuss, Bradley; Nelson, Sara W; Hammerstedt, Heather; Andinda, Jovita; Maling, Samuel; Bisanzo, Mark

2015-01-01

Due to the dual critical shortages of acute care and healthcare workers in resource-limited settings, many people suffer or die from conditions that could be easily treated if existing resources were used in a more timely and effective manner. In order to address this preventable morbidity and mortality, a novel emergency midlevel provider training program was developed in rural Uganda. This is the first study that assesses this unique application of a task-shifting model to acute care by evaluating the outcomes of 10,105 patients. Nurses participated in a two-year training program to become midlevel providers called Emergency Care Practitioners at a rural district hospital. This is a retrospective analysis of the Emergency Department's quality assurance database, including three-day follow-up data. Case fatality rates (CFRs) are reported as the percentage of cases with a specific diagnosis that died within three days of their Emergency Department visit. Overall, three-day mortality was 2.0%. The most common diagnoses of patients who died were malaria (n=60), pneumonia (n=51), malnutrition (n=21), and trauma (n=18). Overall and under-five CFRs were as follows: malaria, 2.0% and 1.9%; pneumonia, 5.5% and 4.1%; and trauma, 1.2% and 1.6%. Malnutrition-related fatality (all cases <18 years old) was 6.5% overall and 6.8% for under-fives. This study describes the outcomes of emergency patients treated by midlevel providers in a resource-limited setting. Our fatality rates are lower than previously published regional rates. These findings suggest this model of task-shifting can be successfully applied to acute care in order to address the shortage of emergency care services in similar settings as part of an integrated approach to health systems strengthening.

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

NASA Technical Reports Server (NTRS)

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;

Combating pharmacist shortage through labor certification.

PubMed

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.

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

Treesearch

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...

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

ERIC Educational Resources Information Center

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

2017-01-01

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

The Bayer Facts of Science Education XVI: "US STEM Workforce Shortage--Myth or Reality? Fortune 1000 Talent Recruiters on the Debate"

ERIC Educational Resources Information Center

Journal of Science Education and Technology, 2014

2014-01-01

A major debate is currently underway in the USA about whether there is, in fact, a science, technology, engineering and mathematics (STEM) workforce shortage in the country or not. This is the subject of the "Bayer Facts of Science Education XVI: US STEM Workforce Shortage--Myth or Reality? Fortune 1000 Talent Recruiters on the Debate."…

Nursing Shortage: Strategies for Nursing Practice and Education. Report of the National Invitational Workshop (Washington, D.C., February 22-24, 1988).

ERIC Educational Resources Information Center

Circle, Inc., McLean, VA.

This document reports the proceedings of a conference held in response to concerns about the nursing shortage and its implications for health care in the United States. Following a keynote address ("Nursing and Shortage: Part of the Problem or Part of the Solution?") by Dona Diers, the document is organized in five sections, with each section…

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

PubMed

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.

Frequency of Acute Hepatitis Following Acute Paraphenylene Diamine Intoxication.

PubMed

Ishtiaq, Rizwan; Shafiq, Sadaf; Imran, Ali; Masroor Ali, Qazi; Khan, Raheel; Tariq, Hassan; Ishtiaq, Daniyal

2017-04-21

Paraphenylene diamine (PPD) ingestion is manifesting as one of the more common ways of committing suicide in Southern Punjab, Pakistan, especially Bahawalpur. PPD is an ingredient of a compound commonly known "Kala Pathar" which means "Black Stone" in Urdu. It is readily available in the market at low cost and is used to dye hair and fur. Its intoxication inhibits cellular oxidation and affects the muscles causing rhabdomyolysis. This leads to myoglobinuria followed by renal failure and edema of face and throat resulting in respiratory difficulty. Very little is known about the impact of PPD intoxication on liver tissue. The purpose of the study was to find out the frequency of acute hepatitis following PPD intoxication. We reviewed the medical records of 109 patients with PPD intoxication admitted to Medical Unit-2, Bahawalpur Victoria Hospital from January 1, 2015, to June 30, 2015, in a descriptive, cross-sectional study. We noted the frequency of acute hepatitis and other complications, and we recorded the demographic features, clinical features, and outcomes of these patients. Our study included 32 men (29%) and 77 women (71%). The mean age was 22 ± 3.4 years, and most patients were young women aged 15 to 24 years. Suicidal ingestion was the leading cause of admission for 101 patients (93%). The most common clinical presentation was cervicofacial edema (95%), throat pain (88%), dysphonia (95%), cola-colored urine (100%), and oliguria (95%). Rhabdomyolysis (86%), acute hepatitis (51%), and acute renal failure (63%) were the most common clinical conditions following poisoning. Overall mortality was noted in 39 patients (36%) while all other patients achieved complete clinical recovery (64%). In patients with mortality, 20 of 39 (51%) developed acute hepatitis. Most patients (95%) in our study underwent tracheostomy. The frequency of acute hepatitis in PPD intoxication is high in this population, especially in young women. Measures need to be instituted

Human resource management strategies for the retention of nurses in acute care settings in hospitals in Australia.

PubMed

Hogan, Pamela; Moxham, Lorna; Dwyer, Trudy

2007-04-01

It is paramount that there is an adequate nursing workforce supply for now and in the future, to achieve equitable and quality health outcomes and consumer access to healthcare, regardless of geographic location. Nursing forms the largest body of employees in the health care system, spanning all segments of care. A shortage of nurses, particularly in the acute care settings in hospitals, jeopardizes the provision of quality health care to consumers. This article provides a literature review of Australian State and Federal Government reports into nurse retention. All reports discuss staff turnover rates; the average age of nurses; enrolment numbers in nursing courses; workloads; nursing workforce shortfalls and the effect on the work environment; leadership and management styles; organizational culture; change management; the mobility of nursing qualifications both locally and internationally and the critical need to value nurses. Then why has the situation of nurse retention not improved? Possible reasons for the continued nurse shortage and the promise of strategic HRM in addressing nurse retention are discussed.

First documented case of successful kidney transplantation from a donor with acute renal failure treated with dialysis.

PubMed

Bacak-Kocman, Iva; Peric, Mladen; Kastelan, Zeljko; Kes, Petar; Mesar, Ines; Basic-Jukic, Nikolina

2013-10-01

There is a widening gap between the needs and possibilities of kidney transplantation. In order to solve the problem of organ shortage, the selection criteria for kidney donors have been less stringent over the last years. Favorable outcome of renal transplantation from deceased donors with acute renal failure requiring dialysis may have an important role in expanding the pool of donors. We present the case of two renal transplantations from a polytraumatized 20-years old donor with acute renal failure requiring dialysis. One recipient established good diuresis from the first post-transplant day and did not require hemodialysis. The second recipient had delayed graft function and was treated with 8 hemodialysis sessions. The patient was discharged with good diuresis and normal serum creatinine. After two years of follow-up, both recipients have normal graft function. According to our experience, kidneys from deceased young donors with acute renal failure requiring dialysis may be transplanted, in order to decrease the number of patients on transplantation waiting lists.

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

NASA Astrophysics Data System (ADS)

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

Exploring Higher Education's Response to the Early Childhood Education Teacher Shortage

ERIC Educational Resources Information Center

Matczak, Melissa L.

2017-01-01

This qualitative single case study attempt is to explore how one institution of higher education can be responsive in meeting the needs of a teacher shortage in early childhood education and the factors impacting (hindering and helping) the collaborative partner process of designing an Applied Bachelor's in Science Degree in Elementary Education…

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

Code of Federal Regulations, 2010 CFR

2010-10-01

... GRANTS GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES, EDUCATIONAL IMPROVEMENTS, SCHOLARSHIPS AND STUDENT LOANS Nursing Student Loans § 57.312 Repayment of loans for service in a shortage area. (a) Service in a... in section 846(a)(1) of the Act; (2) Has obtained one or more nursing student loans or any other...

Famous face recognition, face matching, and extraversion.

PubMed

Lander, Karen; Poyarekar, Siddhi

2015-01-01

It has been previously established that extraverts who are skilled at interpersonal interaction perform significantly better than introverts on a face-specific recognition memory task. In our experiment we further investigate the relationship between extraversion and face recognition, focusing on famous face recognition and face matching. Results indicate that more extraverted individuals perform significantly better on an upright famous face recognition task and show significantly larger face inversion effects. However, our results did not find an effect of extraversion on face matching or inverted famous face recognition.

Measuring the Impact of the Home Health Nursing Shortage on Family Caregivers of Children Receiving Palliative Care.

PubMed

Weaver, Meaghann S; Wichman, Brittany; Bace, Sue; Schroeder, Denice; Vail, Catherine; Wichman, Chris; Macfadyen, Andrew

2018-06-01

The national nursing shortage translates into a gap in home nursing care available to children with complex, chronic medical conditions and their family caregivers receiving palliative care consultations. A total of 38 home health nursing surveys were completed by families receiving pediatric palliative care consultation services at a freestanding children's hospital in the Midwest. The gap in the average number of nursing hours allotted versus received was 40 h/wk per family, primarily during evening hours. Parents missed an average of 23 hours of employment per week to provide hands-on nursing care at home, ranking stress regarding personal employment due to nursing shortage at 6.2/10. Families invested an average of 10 h/mo searching for additional nursing coverage and often resorted to utilizing more than 6 different home nurse coverage personnel per month. Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage ( P < .02) correlated with the gap in home nursing access. This study examines how the pediatric home nursing shortage translates into a lived experience for families with children with complex medical conditions receiving palliative care.

Acute stress influences the discrimination of complex scenes and complex faces in young healthy men.

PubMed

Paul, M; Lech, R K; Scheil, J; Dierolf, A M; Suchan, B; Wolf, O T

2016-04-01

The stress-induced release of glucocorticoids has been demonstrated to influence hippocampal functions via the modulation of specific receptors. At the behavioral level stress is known to influence hippocampus dependent long-term memory. In recent years, studies have consistently associated the hippocampus with the non-mnemonic perception of scenes, while adjacent regions in the medial temporal lobe were associated with the perception of objects, and faces. So far it is not known whether and how stress influences non-mnemonic perceptual processes. In a behavioral study, fifty male participants were subjected either to the stressful socially evaluated cold-pressor test or to a non-stressful control procedure, before they completed a visual discrimination task, comprising scenes and faces. The complexity of the face and scene stimuli was manipulated in easy and difficult conditions. A significant three way interaction between stress, stimulus type and complexity was found. Stressed participants tended to commit more errors in the complex scenes condition. For complex faces a descriptive tendency in the opposite direction (fewer errors under stress) was observed. As a result the difference between the number of errors for scenes and errors for faces was significantly larger in the stress group. These results indicate that, beyond the effects of stress on long-term memory, stress influences the discrimination of spatial information, especially when the perception is characterized by a high complexity. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Shortage and need of physicians in Germany? Questions addressed to health services research].

PubMed

Adler, G; v d Knesebeck, J-H

2011-02-01

The problem of shortage of physicians has been discussed controversially in Germany for years, and the different positions of the interest groups involved have not been resolved. The question of the present and anticipated future requirement of physicians is central for an appropriate and necessary medical care of the population. In the analysis, supply and demand of medical care have to be distinguished. Relatively reliable data do exist for the supply of physicians; however, the changing number of working hours that male and--in particular female--physicians are willing to contribute should be taken into consideration. Reliable data for the future demand are presently not available. Several variables (e.g., demography, disease spectrum of an aging society, medical progress, the changing rules of working hours, and the shift of medical care between hospital and practice care) depend on future developments. Considering the existing serious indicators of a growing shortage of physicians, it is recommended to put more effort into the scientific investigation of these factors. More profound data should improve the basis for decisions in health and education politics.

A shortage of cadavers: The predicament of regional anatomy education in mainland China.

PubMed

Chen, Dan; Zhang, Qi; Deng, Jing; Cai, Yan; Huang, Jufang; Li, Fang; Xiong, Kun

2018-04-12

Both in mainland China and around the world, regional anatomy stands as one of the most important basic science courses in medical school curricula. As such, dissection of human cadavers and use of prosected specimens remains the most essential teaching method in anatomy education. However, medical educators have raised increasing concerns about an ongoing shortage of cadavers for medical use in mainland China, a problem which may seriously limit the future development of human anatomy education. Based on a survey on cadaver usage in anatomy education in mainland China, this study found that the cadaver resources of most given medical schools in mainland China are associated with their geographic location, academic ranking, and local support for body donation policies. Effective measures to alleviate this shortage of cadavers may include future efforts to promote national-level body donation legislation, broader acceptance of body donation among Chinese citizens, and an efficient and humane protocol for body donation. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

A single administration of cortisol acutely reduces preconscious attention for fear in anxious young men.

PubMed

Putman, Peter; Hermans, Erno J; Koppeschaar, Hans; van Schijndel, Alexandra; van Honk, Jack

2007-08-01

Chronically elevated HPA activity has often been associated with fear and anxiety, but there is evidence that single administrations of glucocorticoids may acutely reduce fear. Moreover, peri-traumatic cortisol elevation may protect against development of post-traumatic stress disorder. Hypervigilant processing of threat information plays a role in anxiety disorders and although relations with HPA functioning have been established, causality of these relations remains unclear. Presently, self-reported anxiety and response time patterns on a masked emotional Stroop task with fearful faces were measured in 20 healthy young men after double-blind, placebo-controlled oral administration of 40 mg cortisol. The masked fearful Stroop task measures vocal colornaming response latencies for pictures of neutral and fearful faces presented below the threshold for conscious perception. Results showed increased response times on trials for fearful compared to neutral faces after placebo, but this emotional Stroop effect was acutely abolished by cortisol administration. This effect was most pronounced in subjects with heightened anxiety levels. This is the first evidence showing that exogenous cortisol acutely reduces anxiety-driven selective attention to threat. These results extend earlier findings of acute fear reduction after glucocorticoid administration. This suggests interactions of HPA functioning and vigilant attention in the pathogenesis of anxiety disorders. Possible neuroendocrine mechanisms of action are discussed.

Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products.

PubMed

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.

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... LOANS Nursing Student Loans § 57.312 Repayment of loans for service in a shortage area. (a) Service in a... in section 846(a)(1) of the Act; (2) Has obtained one or more nursing student loans or any other... the Secretary determines were necessary) of attending a school of nursing; and (3) Enters into an...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... LOANS Nursing Student Loans § 57.312 Repayment of loans for service in a shortage area. (a) Service in a... in section 846(a)(1) of the Act; (2) Has obtained one or more nursing student loans or any other... the Secretary determines were necessary) of attending a school of nursing; and (3) Enters into an...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... LOANS Nursing Student Loans § 57.312 Repayment of loans for service in a shortage area. (a) Service in a... in section 846(a)(1) of the Act; (2) Has obtained one or more nursing student loans or any other... the Secretary determines were necessary) of attending a school of nursing; and (3) Enters into an...

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... LOANS Nursing Student Loans § 57.312 Repayment of loans for service in a shortage area. (a) Service in a... in section 846(a)(1) of the Act; (2) Has obtained one or more nursing student loans or any other... the Secretary determines were necessary) of attending a school of nursing; and (3) Enters into an...

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

PubMed

2013-12-13

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

Face recognition system and method using face pattern words and face pattern bytes

DOEpatents

Zheng, Yufeng

2014-12-23

The present invention provides a novel system and method for identifying individuals and for face recognition utilizing facial features for face identification. The system and method of the invention comprise creating facial features or face patterns called face pattern words and face pattern bytes for face identification. The invention also provides for pattern recognitions for identification other than face recognition. The invention further provides a means for identifying individuals based on visible and/or thermal images of those individuals by utilizing computer software implemented by instructions on a computer or computer system and a computer readable medium containing instructions on a computer system for face recognition and identification.

Acute hemorrhagic edema of infancy: report of three cases.

PubMed

Emerich, Paulo Sergio; Prebianchi, Patricia Almeida; Motta, Luciene Lage da; Lucas, Elton Almeida; Ferreira, Leonardo Mello

2011-01-01

Acute Hemorrhagic Edema of Infancy is an infrequent leukocytoclastic vasculitis which occurs almost exclusively in children between 4 months and 2 years of age. It is clinically characterized by the triad fever, purpuric lesions on the face, auricular pinna and extremities, and edema. Although the cutaneous findings are dramatic and of rapid onset, the prognosis is favorable, with spontaneous resolution within 1 to 3 weeks. Three cases are described in which clinical and histopathological findings are characteristic of acute hemorrhagic edema of infancy.

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

PubMed

2012-12-21

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

Is there a shortage of neurosurgeons in the United States?

PubMed

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.

Responding to Health Skills Shortages: Innovative Directions from Vocational Education and Training. Support Document

ERIC Educational Resources Information Center

Kilpatrick, Sue; Le, Quynh; Johns, Susan; Millar, Pat; Routley, Georgie

2007-01-01

This research examines innovative solutions developed by the vocational education and training (VET) sector in response to skill shortages in the health sector. The study focuses on VET-trained workers in the health industry, and includes enrolled nurses, nursing assistants, personal care assistants, allied health assistants and Aboriginal and…

SWOT Analysis of Dental Health Workforce in India: A Dental alarm.

PubMed

Halappa, Mythri; B H, Naveen; Kumar, Santhosh; H, Sreenivasa

2014-11-01

India faces an acute shortage of health personnel. Together with inequalities in distribution of health workers, dental health workers also become a part contributing to it impeding the progress towards achievement of the Millennium Development Goals. To assess dental health-workforce distribution, identify inequalities in dental health-workers provision and report the impact of this mal distribution in India. Situational analysis done by using the primary data from the records of Dental Council of India. In India, 0.088% of dental health worker per 1000 population exists. Inequalities in the distribution of dentists exist in India. Certain states are experiencing an acute shortage of dental health personnel whereas certain cities are over fledged with dentists like Karnataka, Maharastra, Tamilnadu being states with high concentration & Jharkhand, Rajasthan, Uttaranchal being the least. Although the production of health workers has expanded greatly in recent years by increase in number of dental colleges the problems of imbalances in their distribution persist. In the race of increasing dentist population ratio in total, inequitable distribution of appropriately trained, motivated and supported dentists gives a mere feel of saturation in jobs making youngsters to not to choose dentistry as a career giving an alarm.

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

PubMed

Lanford, A; Hardesty, P

1998-12-01

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

Virtual & Real Face to Face Teaching

ERIC Educational Resources Information Center

Teneqexhi, Romeo; Kuneshka, Loreta

2016-01-01

In traditional "face to face" lessons, during the time the teacher writes on a black or white board, the students are always behind the teacher. Sometimes, this happens even in the recorded lesson in videos. Most of the time during the lesson, the teacher shows to the students his back not his face. We do not think the term "face to…

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

PubMed

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

2014-05-01

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

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

PubMed

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.

Virtual Mentorship Network to Address the Rural Shortage of Mental Health Providers.

PubMed

Keeler, Heidi; Sjuts, Tara; Niitsu, Kosuke; Watanabe-Galloway, Shinobu; Mackie, Paul Force-Emery; Liu, Howard

2018-06-01

The process of identifying effective responses to the challenges of placing and retaining a rural behavioral health workforce remains elusive. The Virtual Mentorship Network was developed to test the feasibility of using distance technology to connect rural students interested in mental health careers with mentors. In Year 1, college and high school students were virtually mentored using a near-peer approach both live and asynchronously as a cohort over 7 months. In Year 2, college students only were virtually intensely mentored live over 1 month. High school students were asynchronously provided with informational videos produced by mentors. Program benefits were measured using the Mentoring Functions Questionnaire, and an activity satisfaction survey captured student response to the content and delivery methods. Retrospective analysis of Years 1 and 2 mentoring and satisfaction variables mean differences was performed and overall feasibility assessed. Mentoring Functions Questionnaire scores, overall interaction, and reported satisfaction significantly improved in Year 2 over Year 1. These data suggest that distance mentoring is a feasible option, but that the near-peer benefits of virtually mentoring high school and college students together are overshadowed by different mentoring needs expressed for each group. High school students expressed needs for basic information about career possibilities, whereas college student needs are specific to achieving career goals. Shorter mentoring sessions may be more sustainable long-term and focus limited mentoring resources. This project may serve as a professional pipeline model for others who face a critical shortage of mental health providers. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of

Framing faces: Frame alignment impacts holistic face perception.

PubMed

Curby, Kim M; Entenman, Robert

2016-11-01

Traditional accounts of face perception emphasise the importance of the prototypical configuration of features within faces. However, here we probe influences of more general perceptual grouping mechanisms on holistic face perception. Participants made part-matching judgments about composite faces presented in intact external oval frames or frames made from misaligned oval parts. This manipulation served to disrupt basic perceptual grouping cues that facilitate the grouping of the two face halves together. This manipulation also produced an external face contour like that in the standard misaligned condition used within the classic composite face task. Notably, by introducing a discontinuity in the external contour, grouping of the face halves into a cohesive unit was discouraged, but face configuration was preserved. Conditions where both the face parts and the frames were misaligned together, as in the typical composite task paradigm, or where just the internal face parts where misaligned, were also included. Disrupting only the face frame similarly disrupted holistic face perception as disrupting both the frame and face configuration. However, misaligned face parts presented in aligned frames also incurred a cost to holistic perception. These findings provide support for the contribution of general-purpose perceptual grouping mechanisms to holistic face perception and are presented and discussed in the context of an enhanced object-based selection account of holistic perception.

Where Are All the Nurses? Demographics, Defections Lead to Severe Shortage. ExecConnect.

ERIC Educational Resources Information Center

Schuman, Tom

2003-01-01

Demand for nurses is soaring to unprecedented levels while a variety of factors are limiting the number of available nurses. Some facts and figures related to the shortage are as follows: Indiana's per capita nurse employment decreased 2.4% between 1996 and 2000; the percentage of nurses under 30 decreased from 26% in 1980 to 9% in 2000; 1 in 5…

A systematic analysis of influenza vaccine shortage policies.

PubMed

Uscher-Pines, Lori; Barnett, Daniel J; Sapsin, Jason W; Bishai, David M; Balicer, Ran D

2008-02-01

The aim of this study was to apply SWOT analysis (strengths, weaknesses, opportunities, threats) to a domestic shortage of influenza vaccine, to identify lessons learned, and to generate effective solutions for future public health rationing emergencies. SWOT and TOWS techniques were employed to characterize the vulnerability of the USA to disruptions in the supply of influenza vaccine. A group of five researchers reviewed relevant literature, engaged in group brainstorming, and categorized elements according to the SWOT framework. Three strengths, five weaknesses, five threats and seven opportunities were identified in the areas of vaccine production, purchasing and distribution, and provision. Four future recommendations emerged with respect to government investment, communications, sanctioning of physicians, and incident command. Application of the SWOT technique is highly relevant to the health policy realm and can assist public health planners in planning for future resource scarcity.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-11

... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-0709] Proposed Information Collection (Regulation on Reduction of Nursing Shortages in State Homes; Application for Assistance for Hiring and... techniques or the use of other forms of information technology. Title: Regulation on Reduction of Nursing...

Acute rejection in vascularized composite allotransplantation.

PubMed

Fischer, Sebastian; Lian, Christine G; Kueckelhaus, Maximilian; Strom, Terry B; Edelman, Elazer R; Clark, Rachel A; Murphy, George F; Chandraker, Anil K; Riella, Leonardo V; Tullius, Stefan G; Pomahac, Bohdan

2014-12-01

Acute rejection is the most common complication after vascularized composite allotransplantation (VCA). This review provides a state-of-the-art analysis of prevention, diagnosis and treatment of acute rejection episodes and highlights recent findings with the potential to improve patient care and enhance understanding of the underlying biologic processes. Recent reports suggest that maintenance immunosuppression dose reduction and steroid withdrawal are realistic goals in VCA, despite the known high immunogenicity of the skin component. It appears that utilization of sentinel flaps, in-depth histological analyses and application of novel biomarkers have facilitated early diagnosis and characterization of acute rejection episodes, leading to timely institution of appropriate therapy. The successful management of the first highly sensitized face transplant recipient suggests the possibility of carefully considering these high-risk VCA candidates for transplantation. Acute rejection is higher in VCA than in any other organ in the field of transplantation, although most episodes are controlled by high-dose steroids and optimization of maintenance immunosuppression. Because of limitations in patient number and the duration of follow-up, the long-term safety and effectiveness of VCA remain unclear. Moreover, the tests currently used to diagnose acute rejection are of limited value. Better diagnostic tools and a better understanding of the immunologic events during acute rejection are therefore needed to improve diagnosis, treatment and outcomes of this life-changing restorative surgery.

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

PubMed Central

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

2014-01-01

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

How Well Do Computer-Generated Faces Tap Face Expertise?

PubMed

Crookes, Kate; Ewing, Louise; Gildenhuys, Ju-Dith; Kloth, Nadine; Hayward, William G; Oxner, Matt; Pond, Stephen; Rhodes, Gillian

2015-01-01

The use of computer-generated (CG) stimuli in face processing research is proliferating due to the ease with which faces can be generated, standardised and manipulated. However there has been surprisingly little research into whether CG faces are processed in the same way as photographs of real faces. The present study assessed how well CG faces tap face identity expertise by investigating whether two indicators of face expertise are reduced for CG faces when compared to face photographs. These indicators were accuracy for identification of own-race faces and the other-race effect (ORE)-the well-established finding that own-race faces are recognised more accurately than other-race faces. In Experiment 1 Caucasian and Asian participants completed a recognition memory task for own- and other-race real and CG faces. Overall accuracy for own-race faces was dramatically reduced for CG compared to real faces and the ORE was significantly and substantially attenuated for CG faces. Experiment 2 investigated perceptual discrimination for own- and other-race real and CG faces with Caucasian and Asian participants. Here again, accuracy for own-race faces was significantly reduced for CG compared to real faces. However the ORE was not affected by format. Together these results signal that CG faces of the type tested here do not fully tap face expertise. Technological advancement may, in the future, produce CG faces that are equivalent to real photographs. Until then caution is advised when interpreting results obtained using CG faces.

Avoiding a Pilot Retention Death Spiral: The Pilot Shortage and DOD’s Challenge to Maintain an Effective Fighting Force

DTIC Science & Technology

2018-04-09

pilot retention, they must move beyond solely seeing retention as a money issue and instead address the entire pilot system from production to pay...Shortage is All About the Money ,” ALPA.org, February 27, 2014, http://www.alpa.org/news-and-events/news-room/2014-02-27-Pilot-Shortage-All-About... Money (accessed October 17, 2017). 15 Air Line Pilots Association, “The Landing,” Air Line Pilot Vol. 84, No. 6 (August 2015): 37, http://www3.alpa.org

An Analysis of Medicare's Incentive Payment Program for Physicians in Health Professional Shortage Areas

ERIC Educational Resources Information Center

Chan, Leighton; Hart, L. Gary; Ricketts III, Thomas C.; Beaver, Shelli K.

2004-01-01

Medicare's Incentive Payment (MIP) program provides a 10% bonus payment to providers who treat Medicare patients in rural and urban areas where there is a shortage of generalist physicians. Purpose: To examine the experience of Alaska, Idaho, North Carolina, South Carolina, and Washington with the MIP program. We determined the program's…

77 FR 77008 - Solicitation of Veterinary Shortage Situation Nominations for the Veterinary Medicine Loan...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... (NVMSA) was passed into law adding section 1415A to the National Agricultural Research, Extension, and... pattern of need. For example, Guam and Rhode Island would be allowed to submit the same number of... shortage. For example, if the state seeks to certify a tri-county area as a food animal veterinary service...

Incidence and Determinants of Acute Diarrhoea in Malaysia: A Population-based Study

PubMed Central

Tee, G.H.; Amal, N.M.; Paramesarvathy, R.; Karuthan, C.

2011-01-01

Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea

Incidence and determinants of acute diarrhoea in Malaysia: a population-based study.

PubMed

Gurpreet, K; Tee, G H; Amal, N M; Paramesarvathy, R; Karuthan, C

2011-04-01

Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea

7 CFR 1778.4 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.4 Definitions. Acute shortage. An acute shortage is a situation in which the system either cannot deliver water at all through its... 7 Agriculture 12 2011-01-01 2011-01-01 false Definitions. 1778.4 Section 1778.4 Agriculture...

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

ERIC Educational Resources Information Center

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…

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

PubMed

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.

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

NASA Astrophysics Data System (ADS)

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

2017-12-01

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

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

PubMed

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

2018-06-01

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

Heparin in acute ischemic stroke revisited.

PubMed

Chamorro, A

2008-10-01

The evidence gathered in clinical trials of low molecular weight heparins (LMWHs) or with unfractionated heparin (UH) given subcutaneously at low or medium doses to patients with acute stroke cannot be extrapolated to the insufficiently tested effects of intravenous, weight-adjusted UH. Recent small studies have provided encouraging results but are potentially confounded and deserve confirmation in larger randomized controlled trials. In accordance with the current understanding of the biology of acute ischemic stroke and the pharmacology of UH, the new randomized controlled trials on heparin should give appropriate credit to the importance of a short therapeutic window, adequate dose adjustment of the drug, intravenous administration, and close monitoring of biological effects. UH is an orphan drug and only an academic driven trial would be able to face such an enterprise. Meanwhile, recommendations against the value of "early" anticoagulation with full dose of weight adjusted UH in the setting of acute ischemic stroke are not based on direct evidence but on extrapolations.

The Janus Face of VEGF in Stroke

PubMed Central

Geiseler, Samuel J.; Morland, Cecilie

2018-01-01

The family of vascular endothelial growth factors (VEGFs) are known for their regulation of vascularization. In the brain, VEGFs are important regulators of angiogenesis, neuroprotection and neurogenesis. Dysregulation of VEGFs is involved in a large number of neurodegenerative diseases and acute neurological insults, including stroke. Stroke is the main cause of acquired disabilities, and normally results from an occlusion of a cerebral artery or a hemorrhage, both leading to focal ischemia. Neurons in the ischemic core rapidly undergo necrosis. Cells in the penumbra are exposed to ischemia, but may be rescued if adequate perfusion is restored in time. The neuroprotective and angiogenic effects of VEGFs would theoretically make VEGFs ideal candidates for drug therapy in stroke. However, contradictory to what one might expect, endogenously upregulated levels of VEGF as well as the administration of exogenous VEGF is detrimental in acute stroke. This is probably due to VEGF-mediated blood–brain-barrier breakdown and vascular leakage, leading to edema and increased intracranial pressure as well as neuroinflammation. The key to understanding this Janus face of VEGF function in stroke may lie in the timing; the harmful effect of VEGFs on vessel integrity is transient, as both VEGF preconditioning and increased VEGF after the acute phase has a neuroprotective effect. The present review discusses the multifaceted action of VEGFs in stroke prevention and therapy. PMID:29734653

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

ERIC Educational Resources Information Center

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…

Challenges faced by international nurses when migrating: an integrative literature review.

PubMed

Pung, L-X; Goh, Y-S

2017-03-01

Results from this literature review were used to identify the challenges faced by international nurses in their host countries following migration. The increasing strain of nursing shortages in the healthcare system has led to the recruitment of international nurses among many countries. However, following migration, international nurses are faced with challenges that may result in poor integration with their host countries. Using Cooper's five stages for integrative research reviews, a literature search was conducted across seven databases using a PRISMA search strategy. Additional manual searches were also conducted on the end-references of the retrieved articles. The authors then independently reviewed the selected articles using the Joanna Briggs Institute appraisal form to extract and generate the themes for the review. Twenty-four articles were selected for the review. The themes generated included: (i) difficulty orientating; (ii) a longing for what is missing; (iii) professional development and devaluing; (iv) communication barriers; (v) discrimination and marginalization; (vi) personal and professional differences; and (vii) a meaningful support system. By identifying the challenges faced by international nurses, interventions that ensure equal treatment (e.g. multifaceted transition programmes and culturally sensitive 'buddy' systems) can be implemented to help international nurses adapt to their new environments. Adequate communication can be achieved by encouraging international nurses to speak English and learn the colloquial language and non-verbal behaviours used by native nurses. With good integration international nurses may be able to reach their full career potential as professional nurses in their host countries. The adaptation process is a dynamic process that requires effort from both international and native nurses. Thus, any strategies that are developed and implemented must be multifaceted. © 2016 International Council of Nurses.

Facing Aggression: Cues Differ for Female versus Male Faces

PubMed Central

Geniole, Shawn N.; Keyes, Amanda E.; Mondloch, Catherine J.; Carré, Justin M.; McCormick, Cheryl M.

2012-01-01

The facial width-to-height ratio (face ratio), is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judgements of aggression were associated with the face ratio even when other cues in the face related to masculinity were controlled statistically. Nevertheless, correlations between the face ratio and judgements of aggression were smaller for female than for male faces (F1,36 = 7.43, p = 0.01). In Study 1, there was no significant relationship between judgements of femininity and of aggression in female faces. In Study 2, the association between judgements of masculinity and aggression was weaker in female faces than for male faces in Study 1. The weaker association in female faces may be because aggression and masculinity are stereotypically male traits. Thus, in Study 3, observers rated faces on nurturing (a stereotypically female trait) and on femininity. Judgements of nurturing were associated with femininity (positively) and masculinity (negatively) ratings in both female and male faces. In summary, the perception of aggression differs in female versus male faces. The sex difference was not simply because aggression is a gendered construct; the relationships between masculinity/femininity and nurturing were similar for male and female faces even though nurturing is also a gendered construct. Masculinity and femininity ratings are not associated with aggression ratings nor with the face ratio for female faces. In contrast, all four variables are highly inter-correlated in male faces, likely because these cues in male faces serve as “honest signals”. PMID:22276184

Facing aggression: cues differ for female versus male faces.

PubMed

Geniole, Shawn N; Keyes, Amanda E; Mondloch, Catherine J; Carré, Justin M; McCormick, Cheryl M

2012-01-01

The facial width-to-height ratio (face ratio), is a sexually dimorphic metric associated with actual aggression in men and with observers' judgements of aggression in male faces. Here, we sought to determine if observers' judgements of aggression were associated with the face ratio in female faces. In three studies, participants rated photographs of female and male faces on aggression, femininity, masculinity, attractiveness, and nurturing. In Studies 1 and 2, for female and male faces, judgements of aggression were associated with the face ratio even when other cues in the face related to masculinity were controlled statistically. Nevertheless, correlations between the face ratio and judgements of aggression were smaller for female than for male faces (F(1,36) = 7.43, p = 0.01). In Study 1, there was no significant relationship between judgements of femininity and of aggression in female faces. In Study 2, the association between judgements of masculinity and aggression was weaker in female faces than for male faces in Study 1. The weaker association in female faces may be because aggression and masculinity are stereotypically male traits. Thus, in Study 3, observers rated faces on nurturing (a stereotypically female trait) and on femininity. Judgements of nurturing were associated with femininity (positively) and masculinity (negatively) ratings in both female and male faces. In summary, the perception of aggression differs in female versus male faces. The sex difference was not simply because aggression is a gendered construct; the relationships between masculinity/femininity and nurturing were similar for male and female faces even though nurturing is also a gendered construct. Masculinity and femininity ratings are not associated with aggression ratings nor with the face ratio for female faces. In contrast, all four variables are highly inter-correlated in male faces, likely because these cues in male faces serve as "honest signals".

Primary care physician shortages could be eliminated through use of teams, nonphysicians, and electronic communication.

PubMed

Green, Linda V; Savin, Sergei; Lu, Yina

2013-01-01

Most existing estimates of the shortage of primary care physicians are based on simple ratios, such as one physician for every 2,500 patients. These estimates do not consider the impact of such ratios on patients' ability to get timely access to care. They also do not quantify the impact of changing patient demographics on the demand side and alternative methods of delivering care on the supply side. We used simulation methods to provide estimates of the number of primary care physicians needed, based on a comprehensive analysis considering access, demographics, and changing practice patterns. We show that the implementation of some increasingly popular operational changes in the ways clinicians deliver care-including the use of teams or "pods," better information technology and sharing of data, and the use of nonphysicians-have the potential to offset completely the increase in demand for physician services while improving access to care, thereby averting a primary care physician shortage.

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

PubMed

Carroll, E; Dwyer, L

1988-01-01

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

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

PubMed

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

2017-07-01

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

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

PubMed Central

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. PMID:25942432

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

ERIC Educational Resources Information Center

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…

Responding to Teacher Shortages: Relationships among Mobility Experiences, Attitudes, and Intentions of Dutch Teachers

ERIC Educational Resources Information Center

van Geffen, Renske E.; Poell, Rob F.

2014-01-01

From all over the world there have been calls from governmental institutions to address a shortage of high quality teachers. As changing jobs generates new experiences, job mobility could be a way for teachers to adhere to the government's call to develop themselves into the teaching force needed. The research question of this study was: How do…

The Shortage of Skilled and Technical Workers; An Inquiry Into Selected Occupations in Short Supply.

ERIC Educational Resources Information Center

Franke, Walter; Sobel, Irvin

The institutional arrangements through which workers are prepared and employed in selected occupations are examined to determine whether barriers to entry and employment are susceptible to elimination or reduction, and how labor shortages effect employers. It covers six occupations in the St. Louis and Chicago metropolitan areas: licensed…

Respiratory High-Dependency Care Units for the burden of acute respiratory failure.

PubMed

Scala, Raffaele

2012-06-01

The burden of acute respiratory failure (ARF) has become one of the greatest epidemiological challenges for the modern health systems. Consistently, the imbalance between the increasing prevalence of acutely de-compensated respiratory diseases and the shortage of high-daily cost ICU beds has stimulated new health cost-effective solutions. Respiratory High-Dependency Care Units (RHDCU) provide a specialised environment for patients who require an "intermediate" level of care between the ICU and the ward, where non-invasive monitoring and assisted ventilation techniques are preferentially applied. Since they are dedicated to the management of "mono-organ" decompensations, treatment of ARF patients in RHDCU avoids the dangerous "under-assistance" in the ward and unnecessary "over-assistance" in ICU. RHDCUs provide a specialised quality of care for ARF with health resources optimisation and their spread throughout health systems has been driven by their high-level of expertise in non-invasive ventilation (NIV), weaning from invasive ventilation, tracheostomy care, and discharging planning for ventilator-dependent patients. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

The many faces of research on face perception.

PubMed

Little, Anthony C; Jones, Benedict C; DeBruine, Lisa M

2011-06-12

Face perception is fundamental to human social interaction. Many different types of important information are visible in faces and the processes and mechanisms involved in extracting this information are complex and can be highly specialized. The importance of faces has long been recognized by a wide range of scientists. Importantly, the range of perspectives and techniques that this breadth has brought to face perception research has, in recent years, led to many important advances in our understanding of face processing. The articles in this issue on face perception each review a particular arena of interest in face perception, variously focusing on (i) the social aspects of face perception (attraction, recognition and emotion), (ii) the neural mechanisms underlying face perception (using brain scanning, patient data, direct stimulation of the brain, visual adaptation and single-cell recording), and (iii) comparative aspects of face perception (comparing adult human abilities with those of chimpanzees and children). Here, we introduce the central themes of the issue and present an overview of the articles.

Water management in Egypt for facing the future challenges

PubMed Central

Omar, Mohie El Din M.; Moussa, Ahmed M.A.

2016-01-01

The current water shortage in Egypt is 13.5 Billion cubic meter per year (BCM/yr) and is expected to continuously increase. Currently, this water shortage is compensated by drainage reuse which consequently deteriorates the water quality. Therefore, this research was commenced with the objective of assessing different scenarios for 2025 using the Water Evaluation and Planning (WEAP) model and by implementing different water sufficiency measures. Field data were assembled and analyzed, and different planning alternatives were proposed and tested in order to design three future scenarios. The findings indicated that water shortage in 2025 would be 26 BCM/yr in case of continuation of current policies. Planning alternatives were proposed to the irrigation canals, land irrigation timing, aquatic weeds in waterways and sugarcane areas in old agricultural lands. Other measures were suggested to pumping rates of deep groundwater, sprinkler and drip irrigation systems in new agricultural lands. Further measures were also suggested to automatic daily surveying for distribution leak and managing the pressure effectively in the domestic and industrial water distribution systems. Finally, extra measures for water supply were proposed including raising the permitted withdrawal limit from deep groundwater and the Nubian aquifer and developing the desalination resource. The proposed planning alternatives would completely eliminate the water shortage in 2025. PMID:27222745

Water management in Egypt for facing the future challenges.

PubMed

Omar, Mohie El Din M; Moussa, Ahmed M A

2016-05-01

The current water shortage in Egypt is 13.5 Billion cubic meter per year (BCM/yr) and is expected to continuously increase. Currently, this water shortage is compensated by drainage reuse which consequently deteriorates the water quality. Therefore, this research was commenced with the objective of assessing different scenarios for 2025 using the Water Evaluation and Planning (WEAP) model and by implementing different water sufficiency measures. Field data were assembled and analyzed, and different planning alternatives were proposed and tested in order to design three future scenarios. The findings indicated that water shortage in 2025 would be 26 BCM/yr in case of continuation of current policies. Planning alternatives were proposed to the irrigation canals, land irrigation timing, aquatic weeds in waterways and sugarcane areas in old agricultural lands. Other measures were suggested to pumping rates of deep groundwater, sprinkler and drip irrigation systems in new agricultural lands. Further measures were also suggested to automatic daily surveying for distribution leak and managing the pressure effectively in the domestic and industrial water distribution systems. Finally, extra measures for water supply were proposed including raising the permitted withdrawal limit from deep groundwater and the Nubian aquifer and developing the desalination resource. The proposed planning alternatives would completely eliminate the water shortage in 2025.

A note on `a replenishment policy for items with price-dependent demand, time-proportional deterioration and no shortages'

NASA Astrophysics Data System (ADS)

Shah, Nita H.; Soni, Hardik N.; Gupta, Jyoti

2014-08-01

In a recent paper, Begum et al. (2012, International Journal of Systems Science, 43, 903-910) established pricing and replenishment policy for an inventory system with price-sensitive demand rate, time-proportional deterioration rate which follows three parameters, Weibull distribution and no shortages. In their model formulation, it is observed that the retailer's stock level reaches zero before the deterioration occurs. Consequently, the model resulted in traditional inventory model with price sensitive demand rate and no shortages. Hence, the main purpose of this note is to modify and present complete model formulation for Begum et al. (2012). The proposed model is validated by a numerical example and the sensitivity analysis of parameters is carried out.

7 CFR 1778.4 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Definitions. 1778.4 Section 1778.4 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.4 Definitions. Acute shortage. An acute shortage is a situation in whic...

Face-space: A unifying concept in face recognition research.

PubMed

Valentine, Tim; Lewis, Michael B; Hills, Peter J

2016-10-01

The concept of a multidimensional psychological space, in which faces can be represented according to their perceived properties, is fundamental to the modern theorist in face processing. Yet the idea was not clearly expressed until 1991. The background that led to the development of face-space is explained, and its continuing influence on theories of face processing is discussed. Research that has explored the properties of the face-space and sought to understand caricature, including facial adaptation paradigms, is reviewed. Face-space as a theoretical framework for understanding the effect of ethnicity and the development of face recognition is evaluated. Finally, two applications of face-space in the forensic setting are discussed. From initially being presented as a model to explain distinctiveness, inversion, and the effect of ethnicity, face-space has become a central pillar in many aspects of face processing. It is currently being developed to help us understand adaptation effects with faces. While being in principle a simple concept, face-space has shaped, and continues to shape, our understanding of face perception.

What is being done about the natural gas shortage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sampson, H.M.

1970-01-01

A natural gas shortage has definitely been established. Experts agree that demand has, and will continue to out-strip supply. The Federal Power Commission has overcompensated in trying to protect the ultimate consumer from the standpoint of price--with the result that they have failed to protect him on supply. This myopia must now give way to some reasonable basis of reflecting fair market value, which will not be subject to future change. Industry must be encouraged to solve its own problem. Gas from Canada, Alaska, synthetic fuels, and liquid from foreign sources and nuclear stimulation offer a possible supplemental source ofmore » supply. Fortunately, the Federal Power Commission and its staff now fully recognize this serious problem that confronts the industry and are now planning some possible solutions.« less

Incidence of acute occupational pesticide poisoning among male farmers in South Korea.

PubMed

Lee, Won Jin; Cha, Eun Shil; Park, Jinwoo; Ko, Yousun; Kim, Hyun Joong; Kim, Jaeyoung

2012-09-01

Pesticide poisoning from agricultural labor has been recognized as a major public health problem among farmers worldwide. The objective of this study was to examine the incidence of acute occupational pesticide poisoning among male farmers in South Korea. A nationwide sampling survey of male farmers was conducted in South Korea. This survey used a stratified multistage probability sampling design and adopted the face-to-face interview method. A total of 1,958 male farmers were interviewed in order to estimate the incidence of acute occupational pesticide poisoning in rural areas in 2010. Based on a self-reported definition, the incidence rate in 2010 and the lifetime hospitalization rate due to acute occupational pesticide poisoning among male farmers were estimated. The incidence rate of acute occupational pesticide poisoning was 24.7 (95% CI 22.1-27.2) per 100 male farmers, which corresponds to 209,512 cases across South Korea in 2010. About 12% of the pesticide poisoning cases included either visiting a medical doctor or hospitalization. The lifetime rate of hospitalization due to occupational pesticide poisoning was 6.1 (95% CI 4.9-7.3) among male farmers. Poisoning occurred mainly when farmers were applying pesticides during summer. Our nationwide sampling survey demonstrated that acute occupational pesticide poisonings are highly prevalent among male South Korean farmers. Intensive intervention efforts to reduce occupational pesticide poisoning are urgently needed in South Korea. Copyright © 2012 Wiley Periodicals, Inc.

Seeing faces is necessary for face-domain formation.

PubMed

Arcaro, Michael J; Schade, Peter F; Vincent, Justin L; Ponce, Carlos R; Livingstone, Margaret S

2017-10-01

Here we report that monkeys raised without exposure to faces did not develop face domains, but did develop domains for other categories and did show normal retinotopic organization, indicating that early face deprivation leads to a highly selective cortical processing deficit. Therefore, experience must be necessary for the formation (or maintenance) of face domains. Gaze tracking revealed that control monkeys looked preferentially at faces, even at ages prior to the emergence of face domains, but face-deprived monkeys did not, indicating that face looking is not innate. A retinotopic organization is present throughout the visual system at birth, so selective early viewing behavior could bias category-specific visual responses toward particular retinotopic representations, thereby leading to domain formation in stereotyped locations in inferotemporal cortex, without requiring category-specific templates or biases. Thus, we propose that environmental importance influences viewing behavior, viewing behavior drives neuronal activity, and neuronal activity sculpts domain formation.

Finding Hope in the Face-to-Face.

PubMed

Edgoose, Jennifer Y C; Edgoose, Julian M

2017-05-01

What does it mean to look into the face of a patient who looks back? Face-to-face encounters are at the heart of the patient-clinician relationship but their singular significance is often lost amid the demands of today's high-tech, metric-driven health care systems. Using the framework provided by the philosopher and Holocaust survivor Emmanuel Levinas, the authors explore the unique responsibility and potential for hope found only in face-to-face encounters. Revisiting this most fundamental attribute of medicine is likely our greatest chance to reclaim who we are as clinicians and why we do what we do. © 2017 Annals of Family Medicine, Inc.

Psilocybin modulates functional connectivity of the amygdala during emotional face discrimination.

PubMed

Grimm, O; Kraehenmann, R; Preller, K H; Seifritz, E; Vollenweider, F X

2018-04-24

Recent studies suggest that the antidepressant effects of the psychedelic 5-HT2A receptor agonist psilocybin are mediated through its modulatory properties on prefrontal and limbic brain regions including the amygdala. To further investigate the effects of psilocybin on emotion processing networks, we studied for the first-time psilocybin's acute effects on amygdala seed-to-voxel connectivity in an event-related face discrimination task in 18 healthy volunteers who received psilocybin and placebo in a double-blind balanced cross-over design. The amygdala has been implicated as a salience detector especially involved in the immediate response to emotional face content. We used beta-series amygdala seed-to-voxel connectivity during an emotional face discrimination task to elucidate the connectivity pattern of the amygdala over the entire brain. When we compared psilocybin to placebo, an increase in reaction time for all three categories of affective stimuli was found. Psilocybin decreased the connectivity between amygdala and the striatum during angry face discrimination. During happy face discrimination, the connectivity between the amygdala and the frontal pole was decreased. No effect was seen during discrimination of fearful faces. Thus, we show psilocybin's effect as a modulator of major connectivity hubs of the amygdala. Psilocybin decreases the connectivity between important nodes linked to emotion processing like the frontal pole or the striatum. Future studies are needed to clarify whether connectivity changes predict therapeutic effects in psychiatric patients. Copyright © 2018 Elsevier B.V. and ECNP. All rights reserved.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-29

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0690] 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...

Seeing faces is necessary for face-patch formation

PubMed Central

Arcaro, Michael J.; Schade, Peter F.; Vincent, Justin L.; Ponce, Carlos R.; Livingstone, Margaret S.

2017-01-01

Here we report that monkeys raised without exposure to faces did not develop face patches, but did develop domains for other categories, and did show normal retinotopic organization, indicating that early face deprivation leads to a highly selective cortical processing deficit. Therefore experience must be necessary for the formation, or maintenance, of face domains. Gaze tracking revealed that control monkeys looked preferentially at faces, even at ages prior to the emergence of face patches, but face-deprived monkeys did not, indicating that face looking is not innate. A retinotopic organization is present throughout the visual system at birth, so selective early viewing behavior could bias category-specific visual responses towards particular retinotopic representations, thereby leading to domain formation in stereotyped locations in IT, without requiring category-specific templates or biases. Thus we propose that environmental importance influences viewing behavior, viewing behavior drives neuronal activity, and neuronal activity sculpts domain formation. PMID:28869581

Bayesian Face Recognition and Perceptual Narrowing in Face-Space

PubMed Central

Balas, Benjamin

2012-01-01

During the first year of life, infants’ face recognition abilities are subject to “perceptual narrowing,” the end result of which is that observers lose the ability to distinguish previously discriminable faces (e.g. other-race faces) from one another. Perceptual narrowing has been reported for faces of different species and different races, in developing humans and primates. Though the phenomenon is highly robust and replicable, there have been few efforts to model the emergence of perceptual narrowing as a function of the accumulation of experience with faces during infancy. The goal of the current study is to examine how perceptual narrowing might manifest as statistical estimation in “face space,” a geometric framework for describing face recognition that has been successfully applied to adult face perception. Here, I use a computer vision algorithm for Bayesian face recognition to study how the acquisition of experience in face space and the presence of race categories affect performance for own and other-race faces. Perceptual narrowing follows from the establishment of distinct race categories, suggesting that the acquisition of category boundaries for race is a key computational mechanism in developing face expertise. PMID:22709406

Burden of Self-reported Acute Gastrointestinal Illness in Cuba

PubMed Central

Prieto, Pablo Aguiar; Finley, Rita L.; Guerin, Michele T.; Isaacs, Sandy; Domínguez, Arnaldo Castro; Marie, Gisele Coutín; Perez, Enrique

2009-01-01

Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a list maintained by the medical offices in each site. One individual per household was selected to complete a questionnaire in a face-to-face interview. The case definition was three or more bouts of loose stools in a 24-hour period within the last 30 days. In total, 97.3% of 6,576 interviews were completed. The overall prevalence of acute gastrointestinal illness was 10.6%. The risk of acute gastrointestinal illness was higher during the rainy season (odds ratio [OR]=3.85, 95% confidence interval [CI] 3.18-4.66) in children (OR=3.12, 95% CI 2.24-4.36) and teens (OR=2.27, 95% CI 1.51-3.41) compared to people aged 25-54 years, in males (OR=1.24, 95% CI 1.04-1.47), and in the municipality of Santiago de Cuba (OR=1.33, 95% CI 1.11-1.61). Of 680 cases, 17.1-38.1% visited a physician, depending on sentinel site. Of the cases who visited a physician, 33.3-53.9% were requested to submit a stool sample, and of those, 72.7-100.0% complied. Of the cases who sought medical care, 16.7- 61.5% and 0-31.6% were treated with antidiarrhoeals and antibiotics respectively. Acute gastrointestinal illness represented a substantial burden of health compared to developed countries. Targeting the identified risk factors when allocating resources for education, food safety, and infrastructure might lower the morbidity associated with acute gastrointestinal illness. PMID:19507750

Contributions of individual face features to face discrimination.

PubMed

Logan, Andrew J; Gordon, Gael E; Loffler, Gunter

2017-08-01

Faces are highly complex stimuli that contain a host of information. Such complexity poses the following questions: (a) do observers exhibit preferences for specific information? (b) how does sensitivity to individual face parts compare? These questions were addressed by quantifying sensitivity to different face features. Discrimination thresholds were determined for synthetic faces under the following conditions: (i) 'full face': all face features visible; (ii) 'isolated feature': single feature presented in isolation; (iii) 'embedded feature': all features visible, but only one feature modified. Mean threshold elevations for isolated features, relative to full-faces, were 0.84x, 1.08, 2.12, 3.34, 4.07 and 4.47 for head-shape, hairline, nose, mouth, eyes and eyebrows respectively. Hence, when two full faces can be discriminated at threshold, the difference between the eyes is about four times less than what is required when discriminating between isolated eyes. In all cases, sensitivity was higher when features were presented in isolation than when they were embedded within a face context (threshold elevations of 0.94x, 1.74, 2.67, 2.90, 5.94 and 9.94). This reveals a specific pattern of sensitivity to face information. Observers are between two and four times more sensitive to external than internal features. The pattern for internal features (higher sensitivity for the nose, compared to mouth, eyes and eyebrows) is consistent with lower sensitivity for those parts affected by facial dynamics (e.g. facial expressions). That isolated features are easier to discriminate than embedded features supports a holistic face processing mechanism which impedes extraction of information about individual features from full faces. Copyright © 2017 Elsevier Ltd. All rights reserved.

Successful Decoding of Famous Faces in the Fusiform Face Area

PubMed Central

Axelrod, Vadim; Yovel, Galit

2015-01-01

What are the neural mechanisms of face recognition? It is believed that the network of face-selective areas, which spans the occipital, temporal, and frontal cortices, is important in face recognition. A number of previous studies indeed reported that face identity could be discriminated based on patterns of multivoxel activity in the fusiform face area and the anterior temporal lobe. However, given the difficulty in localizing the face-selective area in the anterior temporal lobe, its role in face recognition is still unknown. Furthermore, previous studies limited their analysis to occipito-temporal regions without testing identity decoding in more anterior face-selective regions, such as the amygdala and prefrontal cortex. In the current high-resolution functional Magnetic Resonance Imaging study, we systematically examined the decoding of the identity of famous faces in the temporo-frontal network of face-selective and adjacent non-face-selective regions. A special focus has been put on the face-area in the anterior temporal lobe, which was reliably localized using an optimized scanning protocol. We found that face-identity could be discriminated above chance level only in the fusiform face area. Our results corroborate the role of the fusiform face area in face recognition. Future studies are needed to further explore the role of the more recently discovered anterior face-selective areas in face recognition. PMID:25714434

Successful decoding of famous faces in the fusiform face area.

PubMed

Axelrod, Vadim; Yovel, Galit

2015-01-01

What are the neural mechanisms of face recognition? It is believed that the network of face-selective areas, which spans the occipital, temporal, and frontal cortices, is important in face recognition. A number of previous studies indeed reported that face identity could be discriminated based on patterns of multivoxel activity in the fusiform face area and the anterior temporal lobe. However, given the difficulty in localizing the face-selective area in the anterior temporal lobe, its role in face recognition is still unknown. Furthermore, previous studies limited their analysis to occipito-temporal regions without testing identity decoding in more anterior face-selective regions, such as the amygdala and prefrontal cortex. In the current high-resolution functional Magnetic Resonance Imaging study, we systematically examined the decoding of the identity of famous faces in the temporo-frontal network of face-selective and adjacent non-face-selective regions. A special focus has been put on the face-area in the anterior temporal lobe, which was reliably localized using an optimized scanning protocol. We found that face-identity could be discriminated above chance level only in the fusiform face area. Our results corroborate the role of the fusiform face area in face recognition. Future studies are needed to further explore the role of the more recently discovered anterior face-selective areas in face recognition.

ADRA2B genotype modulates effects of acute psychosocial stress on emotional memory retrieval in healthy young men.

PubMed

Li, Shijia; Weerda, Riklef; Guenzel, Friederike; Wolf, Oliver T; Thiel, Christiane M

2013-07-01

Previous studies have shown that acute psychosocial stress impairs retrieval of declarative memory with emotional material being especially sensitive to this effect. A functional deletion variant of the ADRA2B gene encoding the α2B-adrenergic receptor has been shown to increase emotional memory and neural activity in the amygdala. We investigated the effects of acute psychosocial stress and the ADRA2B allele on recognition memory for emotional and neutral faces. Fourty-two healthy, non-smoker male volunteers (30 deletion carriers, 12 noncarriers) were tested with a face recognition paradigm. During encoding they were presented with emotional and neutral faces. One hour later, participants underwent either a stress ("Trier Social Stress Test (TSST)") or a control procedure which was followed immediately by the retrieval session where subjects had to indicate whether the presented face was old or new. Stress increased salivary cortisol concentrations, blood pressure and pulse and impaired recognition memory for faces independent of emotional valence and genotype. Participants showed generally slower reaction times to emotional faces. Carriers of the ADRA2B functional deletion variant showed an impaired recognition and slower retrieval of neutral faces under stress. Further, they were significantly slower in retrieving fearful faces in the control condition. The findings indicate that a genetic variation of the noradrenergic system may preserve emotional faces from stress-induced memory impairments seen for neutral faces and heighten reactivity to emotional stimuli under control conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

Technical Education Facing Troubled Decade.

ERIC Educational Resources Information Center

Krieger, James

1980-01-01

Presents highlights of the findings of a recent federal government report on science and engineering education at the university level. Reasons for faculty shortages in these fields and trends in the demand for scientists and engineers are analyzed, and several recommendations are made. (WB)

Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: An exploratory study.

PubMed

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

2017-01-01

Supply problems of drugs are an increasing and worldwide problem, also in Belgium. Hospital pharmacists try to manage drug supply problems to minimize the impact on patient care. This study aims to quantify in a detailed manner how much time employees of 17 Belgian hospital pharmacies spend on drug supply problems. During six months, employees of Belgian hospital pharmacies filled in the daily time spent on drug supply problems using a template containing all steps which can be executed to manage drug supply problems. Additionally, Belgian hospital pharmacists were asked to report the drugs which experienced drug supply problems together with the solution for this problem. Hospital pharmacists spent a median of 109 minutes a week on drug supply problems, with a minimum of 40 minutes per week and a maximum of 216 minutes per week. Fifty-nine percent of the total time spent on drug supply problems was executed by hospital pharmacists, 27% by pharmacy technicians; the rest was performed by logistic or administrative personnel. About one third of the total time spent was invested in gathering information on the supply problem. About two third of the supply disruptions caused drug shortages, meaning there was a need to switch to another (generic) therapeutic alternative. For most drug shortages, a Belgian generic medicine could be found. However in some cases, the alternative had to be ordered abroad or for some drug shortages, no alternative was available. These exploratory results on time spent by hospital pharmacists on drug supply problems in Belgium highlight the economic impact of drug supply problems for hospital pharmacies. A fully reliable, daily updated list on the federal agencies websites would be a major help to hospital pharmacists.

Time spent by Belgian hospital pharmacists on supply disruptions and drug shortages: An exploratory study

PubMed Central

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

2017-01-01

Introduction Supply problems of drugs are an increasing and worldwide problem, also in Belgium. Hospital pharmacists try to manage drug supply problems to minimize the impact on patient care. This study aims to quantify in a detailed manner how much time employees of 17 Belgian hospital pharmacies spend on drug supply problems. Methods During six months, employees of Belgian hospital pharmacies filled in the daily time spent on drug supply problems using a template containing all steps which can be executed to manage drug supply problems. Additionally, Belgian hospital pharmacists were asked to report the drugs which experienced drug supply problems together with the solution for this problem. Results Hospital pharmacists spent a median of 109 minutes a week on drug supply problems, with a minimum of 40 minutes per week and a maximum of 216 minutes per week. Fifty-nine percent of the total time spent on drug supply problems was executed by hospital pharmacists, 27% by pharmacy technicians; the rest was performed by logistic or administrative personnel. About one third of the total time spent was invested in gathering information on the supply problem. About two third of the supply disruptions caused drug shortages, meaning there was a need to switch to another (generic) therapeutic alternative. For most drug shortages, a Belgian generic medicine could be found. However in some cases, the alternative had to be ordered abroad or for some drug shortages, no alternative was available. Conclusion These exploratory results on time spent by hospital pharmacists on drug supply problems in Belgium highlight the economic impact of drug supply problems for hospital pharmacies. A fully reliable, daily updated list on the federal agencies websites would be a major help to hospital pharmacists. PMID:28350827

Responses of US College and University Student Health Services to the 2004 Influenza Vaccine Shortage

ERIC Educational Resources Information Center

Alfred, Norma J.; Turner, James C.; David, Felicita; DeLozier, David M.; Strikas, Raymond A.

2005-01-01

The United States experienced a shortage of influenza vaccine for the 2004-2005 influenza season. The authors surveyed college health programs to determine whether they had targeted vaccine to priority groups and knew how to reallocate remaining vaccine. They used an electronic message to distribute a Web-based survey to the members of 3…

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

ERIC Educational Resources Information Center

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

2007-01-01

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

Cross-modal face recognition using multi-matcher face scores

NASA Astrophysics Data System (ADS)

Zheng, Yufeng; Blasch, Erik

2015-05-01

The performance of face recognition can be improved using information fusion of multimodal images and/or multiple algorithms. When multimodal face images are available, cross-modal recognition is meaningful for security and surveillance applications. For example, a probe face is a thermal image (especially at nighttime), while only visible face images are available in the gallery database. Matching a thermal probe face onto the visible gallery faces requires crossmodal matching approaches. A few such studies were implemented in facial feature space with medium recognition performance. In this paper, we propose a cross-modal recognition approach, where multimodal faces are cross-matched in feature space and the recognition performance is enhanced with stereo fusion at image, feature and/or score level. In the proposed scenario, there are two cameras for stereo imaging, two face imagers (visible and thermal images) in each camera, and three recognition algorithms (circular Gaussian filter, face pattern byte, linear discriminant analysis). A score vector is formed with three cross-matched face scores from the aforementioned three algorithms. A classifier (e.g., k-nearest neighbor, support vector machine, binomial logical regression [BLR]) is trained then tested with the score vectors by using 10-fold cross validations. The proposed approach was validated with a multispectral stereo face dataset from 105 subjects. Our experiments show very promising results: ACR (accuracy rate) = 97.84%, FAR (false accept rate) = 0.84% when cross-matching the fused thermal faces onto the fused visible faces by using three face scores and the BLR classifier.

Meta-analytic review of the development of face discrimination in infancy: Face race, face gender, infant age, and methodology moderate face discrimination.

PubMed

Sugden, Nicole A; Marquis, Alexandra R

2017-11-01

Infants show facility for discriminating between individual faces within hours of birth. Over the first year of life, infants' face discrimination shows continued improvement with familiar face types, such as own-race faces, but not with unfamiliar face types, like other-race faces. The goal of this meta-analytic review is to provide an effect size for infants' face discrimination ability overall, with own-race faces, and with other-race faces within the first year of life, how this differs with age, and how it is influenced by task methodology. Inclusion criteria were (a) infant participants aged 0 to 12 months, (b) completing a human own- or other-race face discrimination task, (c) with discrimination being determined by infant looking. Our analysis included 30 works (165 samples, 1,926 participants participated in 2,623 tasks). The effect size for infants' face discrimination was small, 6.53% greater than chance (i.e., equal looking to the novel and familiar). There was a significant difference in discrimination by race, overall (own-race, 8.18%; other-race, 3.18%) and between ages (own-race: 0- to 4.5-month-olds, 7.32%; 5- to 7.5-month-olds, 9.17%; and 8- to 12-month-olds, 7.68%; other-race: 0- to 4.5-month-olds, 6.12%; 5- to 7.5-month-olds, 3.70%; and 8- to 12-month-olds, 2.79%). Multilevel linear (mixed-effects) models were used to predict face discrimination; infants' capacity to discriminate faces is sensitive to face characteristics including race, gender, and emotion as well as the methods used, including task timing, coding method, and visual angle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Faciotopy—A face-feature map with face-like topology in the human occipital face area

PubMed Central

Henriksson, Linda; Mur, Marieke; Kriegeskorte, Nikolaus

2015-01-01

The occipital face area (OFA) and fusiform face area (FFA) are brain regions thought to be specialized for face perception. However, their intrinsic functional organization and status as cortical areas with well-defined boundaries remains unclear. Here we test these regions for “faciotopy”, a particular hypothesis about their intrinsic functional organisation. A faciotopic area would contain a face-feature map on the cortical surface, where cortical patches represent face features and neighbouring patches represent features that are physically neighbouring in a face. The faciotopy hypothesis is motivated by the idea that face regions might develop from a retinotopic protomap and acquire their selectivity for face features through natural visual experience. Faces have a prototypical configuration of features, are usually perceived in a canonical upright orientation, and are frequently fixated in particular locations. To test the faciotopy hypothesis, we presented images of isolated face features at fixation to subjects during functional magnetic resonance imaging. The responses in V1 were best explained by low-level image properties of the stimuli. OFA, and to a lesser degree FFA, showed evidence for faciotopic organization. When a single patch of cortex was estimated for each face feature, the cortical distances between the feature patches reflected the physical distance between the features in a face. Faciotopy would be the first example, to our knowledge, of a cortical map reflecting the topology, not of a part of the organism itself (its retina in retinotopy, its body in somatotopy), but of an external object of particular perceptual significance. PMID:26235800

Faciotopy-A face-feature map with face-like topology in the human occipital face area.

PubMed

Henriksson, Linda; Mur, Marieke; Kriegeskorte, Nikolaus

2015-11-01

The occipital face area (OFA) and fusiform face area (FFA) are brain regions thought to be specialized for face perception. However, their intrinsic functional organization and status as cortical areas with well-defined boundaries remains unclear. Here we test these regions for "faciotopy", a particular hypothesis about their intrinsic functional organisation. A faciotopic area would contain a face-feature map on the cortical surface, where cortical patches represent face features and neighbouring patches represent features that are physically neighbouring in a face. The faciotopy hypothesis is motivated by the idea that face regions might develop from a retinotopic protomap and acquire their selectivity for face features through natural visual experience. Faces have a prototypical configuration of features, are usually perceived in a canonical upright orientation, and are frequently fixated in particular locations. To test the faciotopy hypothesis, we presented images of isolated face features at fixation to subjects during functional magnetic resonance imaging. The responses in V1 were best explained by low-level image properties of the stimuli. OFA, and to a lesser degree FFA, showed evidence for faciotopic organization. When a single patch of cortex was estimated for each face feature, the cortical distances between the feature patches reflected the physical distance between the features in a face. Faciotopy would be the first example, to our knowledge, of a cortical map reflecting the topology, not of a part of the organism itself (its retina in retinotopy, its body in somatotopy), but of an external object of particular perceptual significance. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The American nursing shortage during World War I: the debate over the use of nurses' aids.

PubMed

Telford, Jennifer Casavant

2010-01-01

This article explores the history of the creation of the Army and Navy Female Nurse Corps and the debate that ensued between American nursing leaders Jane Delano, director of the Red Cross Nursing Service, M. Adelaide Nutting, president of the American Federation of Nurses, and Annie Goodrich, dean of the Army School of Nursing, over the use of untrained nurses' aids to offset the nursing shortage that resulted from the United States entry into the Great War in 1917. The recruitment of minimally or untrained nurses' aids to offset the nursing shortage of the World War I era was a logical solution for American nursing leaders who had to meet the needs for nursing personnel. The exclusion of trained African American nurses, however, was a gross oversight on the part of these leaders. Whether or not this action compromised the status of nursing as a profession is still a matter of interest. Moreover, the debate about the delivery of care by unlicensed personnel continues.

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

PubMed

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

2014-01-01

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

Emotional Expression and Heart Rate in High-Risk Infants during the Face-To-Face/Still-Face

PubMed Central

Mattson, Whitney I.; Ekas, Naomi V.; Lambert, Brittany; Tronick, Ed; Lester, Barry M.; Messinger, Daniel S.

2013-01-01

In infants, eye constriction—the Duchenne marker—and mouth opening appear to index the intensity of both positive and negative facial expressions. We combined eye constriction and mouth opening that co-occurred with smiles and cry-faces (respectively, the prototypic expressions of infant joy and distress) to measure emotional expression intensity. Expression intensity and heart rate were measured throughout the Face-to-Face/Still Face (FFSF) in a sample of infants with prenatal cocaine exposure who were at risk for developmental difficulties. Smiles declined and cry-faces increased in the still-face episode, but the distribution of eye constriction and mouth opening in smiles and cry-faces did not differ across episodes of the FFSF. As time elapsed in the still face episode potential indices of intensity increased, cry-faces were more likely to be accompanied by eye constriction and mouth opening. During cry-faces there were also moderately stable individual differences in the quantity of eye constriction and mouth opening. Infant heart rate was higher during cry-faces and lower during smiles, but did not vary with intensity of expression or by episode. In sum, infants express more intense negative affect as the still-face progresses, but do not show clear differences in expressive intensity between episodes of the FFSF. PMID:24095807

State Legislative Approach to Enumerating Behavioral Health Workforce Shortages: Lessons Learned in New Mexico.

PubMed

Altschul, Deborah B; Bonham, Caroline A; Faulkner, Martha J; Farnbach Pearson, Amy W; Reno, Jessica; Lindstrom, Wayne; Alonso-Marsden, Shelley M; Crisanti, Annette; Salvador, Julie G; Larson, Richard

2018-06-01

Nationally, the behavioral health workforce is in crisis because of a lack of resources, culturally responsive services, quality clinical supervision, sufficient training in evidence-based practices, and targeted recruitment and retention. Disparities in access to behavioral health care are particularly significant in New Mexico, where 25% of the population live in rural areas, and behavioral health shortages are among the highest in the nation. Additionally, as a Medicaid expansion state, New Mexico providers experience increased demand for services at a time when the state is challenged with limited workforce capacity. To address this issue, the Health Care Work Force Data Collection, Analysis and Policy Act was legislatively enacted in 2011 to systematically survey all state licensed health professionals to determine reasons for the healthcare shortage and address the shortage through policy. The Act was amended in 2012 to transfer all data to the University of New Mexico Health Sciences Center. In 2015, a total of 4,488 behavioral health providers completed a survey as a mandatory part of their license renewal. Findings from the survey indicate a dearth of licensed behavioral health providers representative of the populations served, limited access to services via Medicaid and Medicare payer sources, limited access to providers working in public health settings, and limited access to Health Information Technology. This paper describes the workforce context in New Mexico, the purpose of the legislation, the analytic findings from the survey, the policies implemented as a result of these efforts, lessons learned, and a discussion of the relevancy of the New Mexico model for other states. This article is part of a supplement entitled The Behavioral Health Workforce: Planning, Practice, and Preparation, which is sponsored by the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration of the U.S. Department of

Voicing on Virtual and Face to Face Discussion

ERIC Educational Resources Information Center

Yamat, Hamidah

2013-01-01

This paper presents and discusses findings of a study conducted on pre-service teachers' experiences in virtual and face to face discussions. Technology has brought learning nowadays beyond the classroom context or time zone. The learning context and process no longer rely solely on face to face communications in the presence of a teacher.…

Face to face with emotion: holistic face processing is modulated by emotional state.

PubMed

Curby, Kim M; Johnson, Kareem J; Tyson, Alyssa

2012-01-01

Negative emotions are linked with a local, rather than global, visual processing style, which may preferentially facilitate feature-based, relative to holistic, processing mechanisms. Because faces are typically processed holistically, and because social contexts are prime elicitors of emotions, we examined whether negative emotions decrease holistic processing of faces. We induced positive, negative, or neutral emotions via film clips and measured holistic processing before and after the induction: participants made judgements about cued parts of chimeric faces, and holistic processing was indexed by the interference caused by task-irrelevant face parts. Emotional state significantly modulated face-processing style, with the negative emotion induction leading to decreased holistic processing. Furthermore, self-reported change in emotional state correlated with changes in holistic processing. These results contrast with general assumptions that holistic processing of faces is automatic and immune to outside influences, and they illustrate emotion's power to modulate socially relevant aspects of visual perception.

The CRASH report: emergency management dilemmas facing acute physicians in patients with pulmonary arterial hypertension.

PubMed

Price, Laura C; Dimopoulos, Konstantinos; Marino, Philip; Alonso-Gonzalez, Rafael; McCabe, Colm; Kemnpy, Aleksander; Swan, Lorna; Boutsikou, Maria; Al Zahrani, Ahmed; Coghlan, Gerry J; Schreiber, Benjamin E; Howard, Luke S; Davies, Rachel; Toshner, Mark; Pepke-Zaba, Joanna; Church, Alistair C; Peacock, Andrew; Corris, Paul A; Lordan, James L; Gaine, Sean; Condliffe, Robin; Kiely, David G; Wort, Stephen John

2017-11-01

Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH. Thereafter, a review of the literature was performed centred on these specified topics and a management approach was developed based on best available evidence and expert consensus. Management protocols were developed on the following PAH emergencies: chest pain (including myocardial ischaemia), right ventricular failure, arrhythmias, sepsis, haemoptysis ('CRASH'), as well as considerations relevant to surgery, anaesthesia and pregnancy. Emergencies are not uncommon in PAH. While expertise in PAH management is essential, all physicians involved in acute care should be aware of the principles of acute management of PAH emergencies. A multidisciplinary approach is necessary, with physicians from tertiary PH centres supporting care locally and planning safe transfer of patients to PH centres when appropriate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Learning Compact Binary Face Descriptor for Face Recognition.

PubMed

Lu, Jiwen; Liong, Venice Erin; Zhou, Xiuzhuang; Zhou, Jie

2015-10-01

Binary feature descriptors such as local binary patterns (LBP) and its variations have been widely used in many face recognition systems due to their excellent robustness and strong discriminative power. However, most existing binary face descriptors are hand-crafted, which require strong prior knowledge to engineer them by hand. In this paper, we propose a compact binary face descriptor (CBFD) feature learning method for face representation and recognition. Given each face image, we first extract pixel difference vectors (PDVs) in local patches by computing the difference between each pixel and its neighboring pixels. Then, we learn a feature mapping to project these pixel difference vectors into low-dimensional binary vectors in an unsupervised manner, where 1) the variance of all binary codes in the training set is maximized, 2) the loss between the original real-valued codes and the learned binary codes is minimized, and 3) binary codes evenly distribute at each learned bin, so that the redundancy information in PDVs is removed and compact binary codes are obtained. Lastly, we cluster and pool these binary codes into a histogram feature as the final representation for each face image. Moreover, we propose a coupled CBFD (C-CBFD) method by reducing the modality gap of heterogeneous faces at the feature level to make our method applicable to heterogeneous face recognition. Extensive experimental results on five widely used face datasets show that our methods outperform state-of-the-art face descriptors.

Tobacco and the risk of acute leukaemia in adults

PubMed Central

Kane, E V; Roman, E; Cartwright, R; Parker, J; Morgan, G

1999-01-01

Self-reported smoking histories were collected during face-to-face interviews with 807 patients with acute leukaemia and 1593 age- and sex-matched controls. Individuals who had smoked regularly at some time during their lives were more likely to develop acute leukaemia than those who had never smoked (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.0–1.4). The association was strongest for current smokers, defined here as smoking 2 years before diagnosis (OR = 1.4, 95% CI 1.1–1.7). With respect to the numbers of years smoked, risk estimates were raised in all groups except those who had smoked for fewer than 10 years. Similarly, the odds ratio decreased as the number of years ‘stopped smoking’ increased, falling to one amongst those who had given up smoking for more than 10 years. No significant linear trends were found, however, with either the numbers of years smoked or the numbers of years stopped smoking, and no significant differences were found between AML and ALL. © 1999 Cancer Research Campaign PMID:10584886

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

ERIC Educational Resources Information Center

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…

Emotional expression and heart rate in high-risk infants during the face-to-face/still-face.

PubMed

Mattson, Whitney I; Ekas, Naomi V; Lambert, Brittany; Tronick, Ed; Lester, Barry M; Messinger, Daniel S

2013-12-01

In infants, eye constriction-the Duchenne marker-and mouth opening appear to index the intensity of both positive and negative facial expressions. We combined eye constriction and mouth opening that co-occurred with smiles and cry-faces (respectively, the prototypic expressions of infant joy and distress) to measure emotional expression intensity. Expression intensity and heart rate were measured throughout the face-to-face/still-face (FFSF) in a sample of infants with prenatal cocaine exposure who were at risk for developmental difficulties. Smiles declined and cry-faces increased in the still-face episode, but the distribution of eye constriction and mouth opening in smiles and cry-faces did not differ across episodes of the FFSF. As time elapsed in the still face episode potential indices of intensity increased, cry-faces were more likely to be accompanied by eye constriction and mouth opening. During cry-faces there were also moderately stable individual differences in the quantity of eye constriction and mouth opening. Infant heart rate was higher during cry-faces and lower during smiles, but did not vary with intensity of expression or by episode. In sum, infants express more intense negative affect as the still-face progresses, but do not show clear differences in expressive intensity between episodes of the FFSF. Copyright © 2013 Elsevier Inc. All rights reserved.

Face-n-Food: Gender Differences in Tuning to Faces.

PubMed

Pavlova, Marina A; Scheffler, Klaus; Sokolov, Alexander N

2015-01-01

Faces represent valuable signals for social cognition and non-verbal communication. A wealth of research indicates that women tend to excel in recognition of facial expressions. However, it remains unclear whether females are better tuned to faces. We presented healthy adult females and males with a set of newly created food-plate images resembling faces (slightly bordering on the Giuseppe Arcimboldo style). In a spontaneous recognition task, participants were shown a set of images in a predetermined order from the least to most resembling a face. Females not only more readily recognized the images as a face (they reported resembling a face on images, on which males still did not), but gave on overall more face responses. The findings are discussed in the light of gender differences in deficient face perception. As most neuropsychiatric, neurodevelopmental and psychosomatic disorders characterized by social brain abnormalities are sex specific, the task may serve as a valuable tool for uncovering impairments in visual face processing.

Face-n-Food: Gender Differences in Tuning to Faces

PubMed Central

Pavlova, Marina A.; Scheffler, Klaus; Sokolov, Alexander N.

2015-01-01

Faces represent valuable signals for social cognition and non-verbal communication. A wealth of research indicates that women tend to excel in recognition of facial expressions. However, it remains unclear whether females are better tuned to faces. We presented healthy adult females and males with a set of newly created food-plate images resembling faces (slightly bordering on the Giuseppe Arcimboldo style). In a spontaneous recognition task, participants were shown a set of images in a predetermined order from the least to most resembling a face. Females not only more readily recognized the images as a face (they reported resembling a face on images, on which males still did not), but gave on overall more face responses. The findings are discussed in the light of gender differences in deficient face perception. As most neuropsychiatric, neurodevelopmental and psychosomatic disorders characterized by social brain abnormalities are sex specific, the task may serve as a valuable tool for uncovering impairments in visual face processing. PMID:26154177

The Caledonian face test: A new test of face discrimination.

PubMed

Logan, Andrew J; Wilkinson, Frances; Wilson, Hugh R; Gordon, Gael E; Loffler, Gunter

2016-02-01

This study aimed to develop a clinical test of face perception which is applicable to a wide range of patients and can capture normal variability. The Caledonian face test utilises synthetic faces which combine simplicity with sufficient realism to permit individual identification. Face discrimination thresholds (i.e. minimum difference between faces required for accurate discrimination) were determined in an "odd-one-out" task. The difference between faces was controlled by an adaptive QUEST procedure. A broad range of face discrimination sensitivity was determined from a group (N=52) of young adults (mean 5.75%; SD 1.18; range 3.33-8.84%). The test is fast (3-4 min), repeatable (test-re-test r(2)=0.795) and demonstrates a significant inversion effect. The potential to identify impairments of face discrimination was evaluated by testing LM who reported a lifelong difficulty with face perception. While LM's impairment for two established face tests was close to the criterion for significance (Z-scores of -2.20 and -2.27) for the Caledonian face test, her Z-score was -7.26, implying a more than threefold higher sensitivity. The new face test provides a quantifiable and repeatable assessment of face discrimination ability. The enhanced sensitivity suggests that the Caledonian face test may be capable of detecting more subtle impairments of face perception than available tests. Copyright © 2015 Elsevier Ltd. All rights reserved.

Face-Lift Satisfaction Using the FACE-Q.

PubMed

Sinno, Sammy; Schwitzer, Jonathan; Anzai, Lavinia; Thorne, Charles H

2015-08-01

Face lifting is one of the most common operative procedures for facial aging and perhaps the procedure most synonymous with plastic surgery in the minds of the lay public, but no verifiable documentation of patient satisfaction exists in the literature. This study is the first to examine face-lift outcomes and patient satisfaction using a validated questionnaire. One hundred five patients undergoing a face lift performed by the senior author (C.H.T.) using a high, extended-superficial musculoaponeurotic system with submental platysma approximation technique were asked to complete anonymously the FACE-Q by e-mail. FACE-Q scores were assessed for each domain (range, 0 to 100), with higher scores indicating greater satisfaction with appearance or superior quality of life. Fifty-three patients completed the FACE-Q (50.5 percent response rate). Patients demonstrated high satisfaction with facial appearance (mean ± SD, 80.7 ± 22.3), and quality of life, including social confidence (90.4 ± 16.6), psychological well-being (92.8 ± 14.3), and early life impact (92.2 ± 16.4). Patients also reported extremely high satisfaction with their decision to undergo face lifting (90.5 ± 15.9). On average, patients felt they appeared 6.9 years younger than their actual age. Patients were most satisfied with the appearance of their nasolabial folds (86.2 ± 18.5), cheeks (86.1 ± 25.4), and lower face/jawline (86.0 ± 20.6), compared with their necks (78.1 ± 25.6) and area under the chin (67.9 ± 32.3). Patients who responded in this study were extremely satisfied with their decision to undergo face lifting and the outcomes and quality of life following the procedure.

A Face Inversion Effect without a Face

ERIC Educational Resources Information Center

Brandman, Talia; Yovel, Galit

2012-01-01

Numerous studies have attributed the face inversion effect (FIE) to configural processing of internal facial features in upright but not inverted faces. Recent findings suggest that face mechanisms can be activated by faceless stimuli presented in the context of a body. Here we asked whether faceless stimuli with or without body context may induce…

Face to Face Communications in Space

NASA Technical Reports Server (NTRS)

Cohen, Malcolm M.; Davon, Bonnie P. (Technical Monitor)

1999-01-01

It has been reported that human face-to-face communications in space are compromised by facial edema, variations in the orientations of speakers and listeners, and background noises that are encountered in the shuttle and in space stations. To date, nearly all reports have been anecdotal or subjective, in the form of post-flight interviews or questionnaires; objective and quantitative data are generally lacking. Although it is acknowledged that efficient face-to-face communications are essential for astronauts to work safely and effectively, specific ways in which the space environment interferes with non-linguistic communication cues are poorly documented. Because we have only a partial understanding of how non-linguistic communication cues may change with mission duration, it is critically important to obtain objective data, and to evaluate these cues under well-controlled experimental conditions.

Acute Myocardial Ischemia: Cellular Mechanisms Underlying ST Segment Elevation

PubMed Central

Di Diego, José M.; Antzelevitch, Charles

2014-01-01

The electrocardiogram (ECG) is an essential tool for the diagnosis of acute myocardial ischemia in the emergency department, as well as for that of an evolving acute myocardial infarction (AMI). Changes in the surface ECG in leads whose positive poles face the ischemic region are known to be related to injury currents flowing across the boundaries between the ischemic and the surrounding normal myocardium. Although experimental studies have also shown an endocardium to epicardium differential sensitivity to the effect of acute ischemia, the important contribution of this transmural heterogeneous response to the changes observed in the surface ECG are less appreciated by the clinical cardiologist. This review briefly discusses our current knowledge regarding the electrophysiology of the ischemic myocardium focusing primarily on the electrophysiologic changes underlying the ECG alterations observed at the onset of a transmural AMI. PMID:24742586

Experiences of Physical Therapists Working in the Acute Hospital Setting: Systematic Review.

PubMed

Lau, Bonnie; Skinner, Elizabeth H; Lo, Kristin; Bearman, Margaret

2016-09-01

Physical therapists working in acute care hospitals require unique skills to adapt to the challenging environment and short patient length of stay. Previous literature has reported burnout of clinicians and difficulty with staff retention; however, no systematic reviews have investigated qualitative literature in the area. The purpose of this study was to investigate the experiences of physical therapists working in acute hospitals. Six databases (MEDLINE, CINAHL Plus, EMBASE, AMED, PsycINFO, and Sociological Abstracts) were searched up to and including September 30, 2015, using relevant terms. Studies in English were selected if they included physical therapists working in an acute hospital setting, used qualitative methods, and contained themes or descriptive data relating to physical therapists' experiences. Data extraction included the study authors and year, settings, participant characteristics, aims, and methods. Key themes, explanatory models/theories, and implications for policy and practice were extracted, and quality assessment was conducted. Thematic analysis was used to conduct qualitative synthesis. Eight articles were included. Overall, study quality was high. Four main themes were identified describing factors that influence physical therapists' experience and clinical decision making: environmental/contextual factors, communication/relationships, the physical therapist as a person, and professional identity/role. Qualitative synthesis may be difficult to replicate. The majority of articles were from North America and Australia, limiting transferability of the findings. The identified factors, which interact to influence the experiences of acute care physical therapists, should be considered by therapists and their managers to optimize the physical therapy role in acute care. Potential strategies include promotion of interprofessional and collegial relationships, clear delineation of the physical therapy role, multidisciplinary team member education

A novel thermal face recognition approach using face pattern words

NASA Astrophysics Data System (ADS)

Zheng, Yufeng

2010-04-01

A reliable thermal face recognition system can enhance the national security applications such as prevention against terrorism, surveillance, monitoring and tracking, especially at nighttime. The system can be applied at airports, customs or high-alert facilities (e.g., nuclear power plant) for 24 hours a day. In this paper, we propose a novel face recognition approach utilizing thermal (long wave infrared) face images that can automatically identify a subject at both daytime and nighttime. With a properly acquired thermal image (as a query image) in monitoring zone, the following processes will be employed: normalization and denoising, face detection, face alignment, face masking, Gabor wavelet transform, face pattern words (FPWs) creation, face identification by similarity measure (Hamming distance). If eyeglasses are present on a subject's face, an eyeglasses mask will be automatically extracted from the querying face image, and then masked with all comparing FPWs (no more transforms). A high identification rate (97.44% with Top-1 match) has been achieved upon our preliminary face dataset (of 39 subjects) from the proposed approach regardless operating time and glasses-wearing condition.e

Face time: educating face transplant candidates.

PubMed

Lamparello, Brooke M; Bueno, Ericka M; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C; Pomahac, Bohdan

2013-01-01

Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. As face transplantation continues to develop, programs must create sound education programs that address patients' needs and concerns to facilitate optimal care.

Status on Texas Secondary Science Teachers

NASA Astrophysics Data System (ADS)

Mount, Jennifer; Fuller, Ed

2009-10-01

One of the most important challenges today facing public schools is the recruitment and retention of highly qualified science teachers. Policy makers in Texas adopted the 4x4 requirements for graduation, which will create an increase in the supply of science teachers. Dr. Fuller analyzed the topics concerning the shortage of secondary math and science teachers. Dr. Fuller's study clearly shows an acute shortage of well-qualified and adequately prepared secondary math and science teachers in Texas schools. The study also explains that schools serving large percentages of poor, minority, and/or low-achieving students have the least qualified teachers and the greatest shortages compared to other non-minority students. Recently, there has been a shift in teacher preparation programs. Most future teachers are being prepared by alternative certification programs and certification by exam. The attrition rates vary depending on teachers' route of certification. There is a shortage of math and science teachers in Texas, but is part of this shortage due to teacher migration? My research will expand on Dr. Fuller's study by looking at the attrition and migration rates on the subgroups of chemistry and physics teachers. Migration is typically overlooked in analytical studies because it does not change the overall supply of teachers. My study will investigate if science teachers are migrating to wealthier districts and/or higher achieving school. This presentation will summarize results found by Dr. Fuller's study as well as look at further research in science teacher attrition and migration rates.

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

PubMed

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.

Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction

PubMed Central

de Matos, Ana Cristina Carvalho; Requião-Moura, Lúcio Roberto; Clarizia, Gabriela; Durão, Marcelino de Souza; Tonato, Eduardo José; Chinen, Rogério; de Arruda, Érika Ferraz; Filiponi, Thiago Corsi; Pires, Luciana Mello de Mello Barros; Bertocchi, Ana Paula Fernandes; Pacheco-Silva, Alvaro

2015-01-01

ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, a condition considered by many as a contraindication for organ acceptance and therefore one of the main causes for kidney discard. Since these are well-selected donors and with no chronic diseases, such as hypertension, renal disease, or diabetes, many studies showed that the use of donors with acute renal failure should be encouraged, because, in general, acute renal dysfunction is reversible. Although most studies demonstrated these grafts have more delayed function, the results of graft and patient survival after transplant are very similar to those with the use of standard donors. Clinical and morphological findings of donors, the use of machine perfusion, and analysis of its parameters, especially intrarenal resistance, are important tools to support decision-making when considering the supply of organs with renal dysfunction. PMID:26154553

From face processing to face recognition: Comparing three different processing levels.

PubMed

Besson, G; Barragan-Jason, G; Thorpe, S J; Fabre-Thorpe, M; Puma, S; Ceccaldi, M; Barbeau, E J

2017-01-01

Verifying that a face is from a target person (e.g. finding someone in the crowd) is a critical ability of the human face processing system. Yet how fast this can be performed is unknown. The 'entry-level shift due to expertise' hypothesis suggests that - since humans are face experts - processing faces should be as fast - or even faster - at the individual than at superordinate levels. In contrast, the 'superordinate advantage' hypothesis suggests that faces are processed from coarse to fine, so that the opposite pattern should be observed. To clarify this debate, three different face processing levels were compared: (1) a superordinate face categorization level (i.e. detecting human faces among animal faces), (2) a face familiarity level (i.e. recognizing famous faces among unfamiliar ones) and (3) verifying that a face is from a target person, our condition of interest. The minimal speed at which faces can be categorized (∼260ms) or recognized as familiar (∼360ms) has largely been documented in previous studies, and thus provides boundaries to compare our condition of interest to. Twenty-seven participants were included. The recent Speed and Accuracy Boosting procedure paradigm (SAB) was used since it constrains participants to use their fastest strategy. Stimuli were presented either upright or inverted. Results revealed that verifying that a face is from a target person (minimal RT at ∼260ms) was remarkably fast but longer than the face categorization level (∼240ms) and was more sensitive to face inversion. In contrast, it was much faster than recognizing a face as familiar (∼380ms), a level severely affected by face inversion. Face recognition corresponding to finding a specific person in a crowd thus appears achievable in only a quarter of a second. In favor of the 'superordinate advantage' hypothesis or coarse-to-fine account of the face visual hierarchy, these results suggest a graded engagement of the face processing system across processing

[Shortage of doctors in psychiatric hospitals--providing for the future by reorganizing medical services].

PubMed

Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Cohrs, Stefan

2011-11-01

Increasing psychiatric disorder treatment need, increased work load, changes in the working hour regulations, the nation-wide shortage of physicians, efficiency principle and economisation can necessitate a reorganisation of medical services. The essential steps and instruments of process optimisation in medical services for a psychiatric clinic are elucidated and discussed in the context of demographic changes, generation change, and a new concept of values. © Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

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

Conjunction Faces Alter Confidence-Accuracy Relations for Old Faces

ERIC Educational Resources Information Center

Reinitz, Mark Tippens; Loftus, Geoffrey R.

2017-01-01

The authors used a state-trace methodology to investigate the informational dimensions used to recognize old and conjunction faces (made by combining parts of separately studied faces). Participants in 3 experiments saw faces presented for 1 s each. They then received a recognition test; faces were presented for varying brief durations and…

Bayesian Face Recognition and Perceptual Narrowing in Face-Space

ERIC Educational Resources Information Center

Balas, Benjamin

2012-01-01

During the first year of life, infants' face recognition abilities are subject to "perceptual narrowing", the end result of which is that observers lose the ability to distinguish previously discriminable faces (e.g. other-race faces) from one another. Perceptual narrowing has been reported for faces of different species and different races, in…

Holistic face training enhances face processing in developmental prosopagnosia

PubMed Central

Cohan, Sarah; Nakayama, Ken

2014-01-01

Prosopagnosia has largely been regarded as an untreatable disorder. However, recent case studies using cognitive training have shown that it is possible to enhance face recognition abilities in individuals with developmental prosopagnosia. Our goal was to determine if this approach could be effective in a larger population of developmental prosopagnosics. We trained 24 developmental prosopagnosics using a 3-week online face-training program targeting holistic face processing. Twelve subjects with developmental prosopagnosia were assessed before and after training, and the other 12 were assessed before and after a waiting period, they then performed the training, and were then assessed again. The assessments included measures of front-view face discrimination, face discrimination with view-point changes, measures of holistic face processing, and a 5-day diary to quantify potential real-world improvements. Compared with the waiting period, developmental prosopagnosics showed moderate but significant overall training-related improvements on measures of front-view face discrimination. Those who reached the more difficult levels of training (‘better’ trainees) showed the strongest improvements in front-view face discrimination and showed significantly increased holistic face processing to the point of being similar to that of unimpaired control subjects. Despite challenges in characterizing developmental prosopagnosics’ everyday face recognition and potential biases in self-report, results also showed modest but consistent self-reported diary improvements. In summary, we demonstrate that by using cognitive training that targets holistic processing, it is possible to enhance face perception across a group of developmental prosopagnosics and further suggest that those who improved the most on the training task received the greatest benefits. PMID:24691394

Consensus definitions of 14 severe acute toxic effects for childhood lymphoblastic leukaemia treatment: a Delphi consensus.

PubMed

Schmiegelow, Kjeld; Attarbaschi, Andishe; Barzilai, Shlomit; Escherich, Gabriele; Frandsen, Thomas Leth; Halsey, Christina; Hough, Rachael; Jeha, Sima; Kato, Motohiro; Liang, Der-Cherng; Mikkelsen, Torben Stamm; Möricke, Anja; Niinimäki, Riitta; Piette, Caroline; Putti, Maria Caterina; Raetz, Elizabeth; Silverman, Lewis B; Skinner, Roderick; Tuckuviene, Ruta; van der Sluis, Inge; Zapotocka, Ester

2016-06-01

Although there are high survival rates for children with acute lymphoblastic leukaemia, their outcome is often counterbalanced by the burden of toxic effects. This is because reported frequencies vary widely across studies, partly because of diverse definitions of toxic effects. Using the Delphi method, 15 international childhood acute lymphoblastic leukaemia study groups assessed acute lymphoblastic leukaemia protocols to address toxic effects that were to be considered by the Ponte di Legno working group. 14 acute toxic effects (hypersensitivity to asparaginase, hyperlipidaemia, osteonecrosis, asparaginase-associated pancreatitis, arterial hypertension, posterior reversible encephalopathy syndrome, seizures, depressed level of consciousness, methotrexate-related stroke-like syndrome, peripheral neuropathy, high-dose methotrexate-related nephrotoxicity, sinusoidal obstructive syndrome, thromboembolism, and Pneumocystis jirovecii pneumonia) that are serious but too rare to be addressed comprehensively within any single group, or are deemed to need consensus definitions for reliable incidence comparisons, were selected for assessment. Our results showed that none of the protocols addressed all 14 toxic effects, that no two protocols shared identical definitions of all toxic effects, and that no toxic effect definition was shared by all protocols. Using the Delphi method over three face-to-face plenary meetings, consensus definitions were obtained for all 14 toxic effects. In the overall assessment of outcome of acute lymphoblastic leukaemia treatment, these expert opinion-based definitions will allow reliable comparisons of frequencies and severities of acute toxic effects across treatment protocols, and facilitate international research on cause, guidelines for treatment adaptation, preventive strategies, and development of consensus algorithms for reporting on acute lymphoblastic leukaemia treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Occupational therapy practice in acute physical hospital settings: Evidence from a scoping review.

PubMed

Britton, Lauren; Rosenwax, Lorna; McNamara, Beverley

2015-12-01

Increased accountability and growing fiscal limitations in global health care continue to challenge how occupational therapy practices are undertaken. Little is known about how these changes affect current practice in acute hospital settings. This article reviews the relevant literature to further understanding of occupational therapy practice in acute physical hospital settings. A scoping review of five electronic databases was completed using the keywords Occupational therapy, acute hospital settings/acute physical hospital settings, acute care setting/acute care hospital setting, general medicine/general medical wards, occupational therapy service provision/teaching hospitals/tertiary care hospitals. Criteria were applied to determine suitability for inclusion and the articles were analysed to uncover key themes. In total 34 publications were included in the review. Analysis of the publications revealed four themes: (1) Comparisons between the practice of novice and experienced occupational therapists in acute care (2) Occupational therapists and the discharge planning process (3) Role of occupation in the acute care setting and (4) Personal skills needed and organisation factors affecting acute care practice. The current literature has highlighted the challenges occupational therapists face in practicing within an acute setting. Findings from this review enhance understanding of how occupational therapy department managers and educators can best support staff that practise in acute hospital settings. © 2015 Occupational Therapy Australia.

Impact of the 2004-2005 Influenza Vaccine Shortage on Immunization Practices in Long-Term Care Facilities

PubMed Central

Mody, Lona; Langa, Kenneth M.; Malani, Preeti N.

2012-01-01

Objective To assess the response of long-term care facilities (LTCFs) to the 2004-2005 influenza vaccine shortage and the impact on resident and healthcare worker (HCW) immunization rates. Methods A 12-item questionnaire was sent to 824 randomly selected LTCFs in December 2004. The following 2 open-ended questions were also asked: “How did you cope with the vaccine shortage?” and “Who helped you get your supply?” Immunization rates reported by LTCF administrators for 2003-2003 and 2003-2004 were compared with those for 2004-2005. Immunization rates were defined as the proportion of all eligible residents and HCWs who received influenza vaccine. Results Responses were received from 380 LTCFs (46.3%), which had a total of 38,447 beds. Resident mean influenza immunization rates (±SD) decreased from 85% ± 15.3% in 2002-2003 and 85.1% ± 15.3% in 2003-2004 to 81.9% ± 19.4% in the 2004-2005 influenza season (P = .025). The immunization rates among HCWs also decreased from 51% in 2002-2003 and 2003-2004 to 38.4% in 2004-2005 (P < .001). In response to one of the open-ended questions, 96 facilities (25.3%) reported that they obtained vaccine from 2 or more sources. Eight percent commented on specific intensified infection control efforts, and only 2.3% commented on emergency preparedness. Conclusions The influenza vaccine shortage in 2004-2005 impacted immunization practices of LTCFs across the United States, leading to decreases in both resident and HCW vaccination rates. The significant decrease in vaccination rates in LTCFs is of concern and has broad implications for policy makers working on emergency preparedness for a possible pandemic of influenza. PMID:16622817

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-N-0124] Food and Drug Administration Drug Shortages Task Force and Strategic Plan; Request for Comments AGENCY: Food and Drug Administration, HHS. ACTION: Notice; request for comments. SUMMARY: To assist the Food...

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

ERIC Educational Resources Information Center

Ng, Jennifer C.

2003-01-01

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

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

ERIC Educational Resources Information Center

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…

The Public Face of Transplantation: The Potential of Education to Expand the Face Donor Pool.

PubMed

Plana, Natalie M; Kimberly, Laura L; Parent, Brendan; Khouri, Kimberly S; Diaz-Siso, J Rodrigo; Fryml, Elise M; Motosko, Catherine C; Ceradini, Daniel J; Caplan, Arthur; Rodriguez, Eduardo D

2018-01-01

Despite the growing success of facial transplantation, organ donor shortages remain challenging. Educational health campaigns can effectively inform the general public and institute behavioral modifications. A brief educational introduction to facial transplantation may positively influence the public's position on facial donation. The authors anonymously surveyed 300 participants, gathering basic demographic information, donor registration status, awareness of facial transplantation, and willingness to donate solid organs and facial allografts. Two-hundred of these participants were presented an educational video and subsequently resurveyed on facial donation. Factorial parametric analyses were performed to compare exposure responses before and after watching video exposure. Among participants completing the survey alone (control group), 49 percent were registered donors, 78 percent reported willingness to donate solid organs, and 52 percent reported willingness to donate facial allograft. Of participants who watched the video (video group) 52 percent were registered; 69 and 51 percent were willing to donate solid organs and face, respectively. Following educational intervention, 69 percent of participants in the video group reported willingness to donate facial tissue, an 18 percent increase (p < 0.05), that equated to those willing to donate solid organs. The greatest increase was observed among younger participants (23 percent); women (22 percent); Jewish (22 percent), Catholic (22 percent), and black/African American (25 percent) participants; and respondents holding a higher degree. No significant differences according to gender or ethnicity were observed. Educational interventions hold much promise for increasing the general public's awareness of facial transplantation and willingness to participate in donation of facial allografts.

The complex duration perception of emotional faces: effects of face direction.

PubMed

Kliegl, Katrin M; Limbrecht-Ecklundt, Kerstin; Dürr, Lea; Traue, Harald C; Huckauf, Anke

2015-01-01

The perceived duration of emotional face stimuli strongly depends on the expressed emotion. But, emotional faces also differ regarding a number of other features like gaze, face direction, or sex. Usually, these features have been controlled by only using pictures of female models with straight gaze and face direction. Doi and Shinohara (2009) reported that an overestimation of angry faces could only be found when the model's gaze was oriented toward the observer. We aimed at replicating this effect for face direction. Moreover, we explored the effect of face direction on the duration perception sad faces. Controlling for the sex of the face model and the participant, female and male participants rated the duration of neutral, angry, and sad face stimuli of both sexes photographed from different perspectives in a bisection task. In line with current findings, we report a significant overestimation of angry compared to neutral face stimuli that was modulated by face direction. Moreover, the perceived duration of sad face stimuli did not differ from that of neutral faces and was not influenced by face direction. Furthermore, we found that faces of the opposite sex appeared to last longer than those of the same sex. This outcome is discussed with regards to stimulus parameters like the induced arousal, social relevance, and an evolutionary context.

[Acute Stress and Broken Heart Syndrome. A Case Report].

PubMed

Vergel, Juliana; Tamayo-Orozco, Sebastián; Vallejo-Gómez, Andrés Felipe; Posada, María Teresa; Restrepo, Diana

Stress has been associated with an acute heart failure syndrome of important morbidity and mortality. Case report and non-systematic review of the relevant literature. A 65-year-old woman with a history of an untreated generalized anxiety disorder, whom after the violent death of her son presented with oppressive chest pain irradiated to neck and left superior extremity, lasting for more than 30minutes, initial clinical suspect suggests acute coronary syndrome. Tako-tsubo cardiomyopathy is characterized by a reversible left ventricular dysfunction and wall movement abnormalities, without any compromise of the coronary arteries, associated to high plasma levels of catecholamines which in most cases correlates with an acute stress of emotional or physical type. Tako-tsubo cardiomyopathy has to be considered by physicians among the differential diagnosis when facing a patient with suspected acute coronary syndrome, especially in post-menopausal women with a history of psychiatric comorbidities such as a generalized anxiety disorder. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Face detection and eyeglasses detection for thermal face recognition

NASA Astrophysics Data System (ADS)

Zheng, Yufeng

2012-01-01

Thermal face recognition becomes an active research direction in human identification because it does not rely on illumination condition. Face detection and eyeglasses detection are necessary steps prior to face recognition using thermal images. Infrared light cannot go through glasses and thus glasses will appear as dark areas in a thermal image. One possible solution is to detect eyeglasses and to exclude the eyeglasses areas before face matching. In thermal face detection, a projection profile analysis algorithm is proposed, where region growing and morphology operations are used to segment the body of a subject; then the derivatives of two projections (horizontal and vertical) are calculated and analyzed to locate a minimal rectangle of containing the face area. Of course, the searching region of a pair of eyeglasses is within the detected face area. The eyeglasses detection algorithm should produce either a binary mask if eyeglasses present, or an empty set if no eyeglasses at all. In the proposed eyeglasses detection algorithm, block processing, region growing, and priori knowledge (i.e., low mean and variance within glasses areas, the shapes and locations of eyeglasses) are employed. The results of face detection and eyeglasses detection are quantitatively measured and analyzed using the manually defined ground truths (for both face and eyeglasses). Our experimental results shown that the proposed face detection and eyeglasses detection algorithms performed very well in contrast with the predefined ground truths.

A causal relationship between face-patch activity and face-detection behavior.

PubMed

Sadagopan, Srivatsun; Zarco, Wilbert; Freiwald, Winrich A

2017-04-04

The primate brain contains distinct areas densely populated by face-selective neurons. One of these, face-patch ML, contains neurons selective for contrast relationships between face parts. Such contrast-relationships can serve as powerful heuristics for face detection. However, it is unknown whether neurons with such selectivity actually support face-detection behavior. Here, we devised a naturalistic face-detection task and combined it with fMRI-guided pharmacological inactivation of ML to test whether ML is of critical importance for real-world face detection. We found that inactivation of ML impairs face detection. The effect was anatomically specific, as inactivation of areas outside ML did not affect face detection, and it was categorically specific, as inactivation of ML impaired face detection while sparing body and object detection. These results establish that ML function is crucial for detection of faces in natural scenes, performing a critical first step on which other face processing operations can build.

Face Time: Educating Face Transplant Candidates

PubMed Central

Lamparello, Brooke M.; Bueno, Ericka M.; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C.; Pomahac, Bohdan

2013-01-01

Objective: Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. Methods: We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. Results: We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Conclusions: Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. Practice Implications: As face transplantation continues to develop, programs must create sound education programs that address patients’ needs and concerns to facilitate optimal care. PMID:23861990

Vulnerability of the Metropolitan District of Quito's Water Resources in the face of Climatic and Anthropogenic Uncertainties

NASA Astrophysics Data System (ADS)

Depsky, N. J.; Flores-Lopez, F.

2014-12-01

Earlier this year the Stockholm Environment Institute (SEI) concluded a vulnerability analysis for the Metropolitan District of Quito (DMQ) in Ecuador. Vulnerability assessments were done for five sectors in the region: water resources, public health, agriculture, ecosystems and forest fires. This abstract focuses specifically on the vulnerability of the DMQ's water resources to climatic and anthropogenic uncertainties. This analysis focused on vulnerability of potable water supply for the city of Quito, as well as industrial and agricultural water needs. Current and future vulnerability was assessed in the face of a number of scenarios of climatic and non-climatic uncertainties. The assessment used an integrated water resources model developed by Quito's National Polytechnic University for the surrounding Guayllabamba river basin. The model was built using the Water Evaluation and Planning (WEAP) software, and encompasses the urban, rural/agricultural, and industrial demands throughout the basin, linking them with existing surface and ground-water supplies. Five future scenarios were constructed in the WEAP basin model out the year 2050 in order to assess their effects: Urban population growth (~70% by 2050). Urban population growth + rising mean air temperatures (~+2°C by 2050). Urban population growth + rising temperatures + drought (recurring 3-year drought cycles built into the projection) Urban population growth + rising temperatures + conversion of 'paramo' alpine tundra ecosystem into cultivated land. (WEAP allows the user to define various types of land cover extent throughout the basin, along with their unique physical characteristics to simulate rainfall-runoff. Conversion of 'paramo' land cover to agriculture was evaluated to see potential effects it may have on the system's hydrology) Urban population growth + rising temperatures + drought + conversion of 'paramos' Coverage of demands in the model was used as the primary vulnerability metric, with

Development of a novel information and communication technology system to compensate for a sudden shortage of emergency department physicians.

PubMed

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 < 0.0001). On the whole, the probability of multiple casualties increased more than 2 times after system 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 analysis on the extreme water shortage event in Hangzhou in 1247 AD and its natural and social backgrounds

NASA Astrophysics Data System (ADS)

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

Alternative face models for 3D face registration

NASA Astrophysics Data System (ADS)

Salah, Albert Ali; Alyüz, Neşe; Akarun, Lale

2007-01-01

3D has become an important modality for face biometrics. The accuracy of a 3D face recognition system depends on a correct registration that aligns the facial surfaces and makes a comparison possible. The best results obtained so far use a one-to-all registration approach, which means each new facial surface is registered to all faces in the gallery, at a great computational cost. We explore the approach of registering the new facial surface to an average face model (AFM), which automatically establishes correspondence to the pre-registered gallery faces. Going one step further, we propose that using a couple of well-selected AFMs can trade-off computation time with accuracy. Drawing on cognitive justifications, we propose to employ category-specific alternative average face models for registration, which is shown to increase the accuracy of the subsequent recognition. We inspect thin-plate spline (TPS) and iterative closest point (ICP) based registration schemes under realistic assumptions on manual or automatic landmark detection prior to registration. We evaluate several approaches for the coarse initialization of ICP. We propose a new algorithm for constructing an AFM, and show that it works better than a recent approach. Finally, we perform simulations with multiple AFMs that correspond to different clusters in the face shape space and compare these with gender and morphology based groupings. We report our results on the FRGC 3D face database.

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

PubMed

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.

Withholding response to self-face is faster than to other-face.

PubMed

Zhu, Min; Hu, Yinying; Tang, Xiaochen; Luo, Junlong; Gao, Xiangping

2015-01-01

Self-face advantage refers to adults' response to self-face is faster than that to other-face. A stop-signal task was used to explore how self-face advantage interacted with response inhibition. The results showed that reaction times of self-face were faster than that of other-face not in the go task but in the stop response trials. The novelty of the finding was that self-face has shorter stop-signal reaction time compared to other-face in the successful inhibition trials. These results indicated the processing mechanism of self-face may be characterized by a strong response tendency and a corresponding strong inhibition control.

Mesenchymal Stem Cell/Red Blood Cell-Inspired Nanoparticle Therapy in Mice with Carbon Tetrachloride-Induced Acute Liver Failure.

PubMed

Liang, Hongxia; Huang, Ke; Su, Teng; Li, Zhenhua; Hu, Shiqi; Dinh, Phuong-Uyen; Wrona, Emily A; Shao, Chen; Qiao, Li; Vandergriff, Adam C; Hensley, M Taylor; Cores, Jhon; Allen, Tyler; Zhang, Hongyu; Zeng, Qinglei; Xing, Jiyuan; Freytes, Donald O; Shen, Deliang; Yu, Zujiang; Cheng, Ke

2018-06-26

Acute liver failure is a critical condition characterized by global hepatocyte death and often time needs a liver transplantation. Such treatment is largely limited by donor organ shortage. Stem cell therapy offers a promising option to patients with acute liver failure. Yet, therapeutic efficacy and feasibility are hindered by delivery route and storage instability of live cell products. We fabricated a nanoparticle that carries the beneficial regenerative factors from mesenchymal stem cells and further coated it with the membranes of red blood cells to increase blood stability. Unlike uncoated nanoparticles, these particles promote liver cell proliferation in vitro and have lower internalization by macrophage cells. After intravenous delivery, these artificial stem cell analogs are able to remain in the liver and mitigate carbon tetrachloride-induced liver failure in a mouse model, as gauged by histology and liver function test. Our technology provides an innovative and off-the-shelf strategy to treat liver failure.

About-face on face recognition ability and holistic processing.

PubMed

Richler, Jennifer J; Floyd, R Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically.

About-face on face recognition ability and holistic processing

PubMed Central

Richler, Jennifer J.; Floyd, R. Jackie; Gauthier, Isabel

2015-01-01

Previous work found a small but significant relationship between holistic processing measured with the composite task and face recognition ability measured by the Cambridge Face Memory Test (CFMT; Duchaine & Nakayama, 2006). Surprisingly, recent work using a different measure of holistic processing (Vanderbilt Holistic Face Processing Test [VHPT-F]; Richler, Floyd, & Gauthier, 2014) and a larger sample found no evidence for such a relationship. In Experiment 1 we replicate this unexpected result, finding no relationship between holistic processing (VHPT-F) and face recognition ability (CFMT). A key difference between the VHPT-F and other holistic processing measures is that unique face parts are used on each trial in the VHPT-F, unlike in other tasks where a small set of face parts repeat across the experiment. In Experiment 2, we test the hypothesis that correlations between the CFMT and holistic processing tasks are driven by stimulus repetition that allows for learning during the composite task. Consistent with our predictions, CFMT performance was correlated with holistic processing in the composite task when a small set of face parts repeated over trials, but not when face parts did not repeat. A meta-analysis confirms that relationships between the CFMT and holistic processing depend on stimulus repetition. These results raise important questions about what is being measured by the CFMT, and challenge current assumptions about why faces are processed holistically. PMID:26223027

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

NASA Astrophysics Data System (ADS)

Saranya, R.; Varadarajan, R.

2018-04-01

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

Acute injury and chronic disability resulting from surfboard riding.

PubMed

Taylor, D McD; Bennett, D; Carter, M; Garewal, D; Finch, C F

2004-12-01

We undertook a cross-sectional survey of surfers at eight Victorian beaches between February and May 2003 and analysed acute injury and chronic disability sustained while surfing during the preceding 12 months. Significant injuries were defined as requiring medical attention or time off surfing/work. 646 surfers were enrolled (90.2% male, median age 27 years, median years of surfing 10). 145 surfers sustained 168 significant acute injuries in the preceding 12 months (0.26 injuries/surfer/year, 95% CI 0.22-0.30). Most were caused by striking a surfboard or another surfer (45.2%, 95% CI 37.6-53.1), "wiping out" (36.3%, 95% CI 29.1-44.1) or striking the seabed (17.9%, 95% CI 12.6-24.7). Injuries included lacerations (46.4%, 95% CI 38.8-54.3), sprains (28.6%, 95% CI 22.0-36.1), dislocations (10.7%, 95% CI 6.7-16.6) and fractures (8.9%, 95% CI 5.3-14.6). Body parts most frequently injured were the lower limb (45.8%, 95% CI 38.2-53.7) and the head/face (26.2%, 95% CI 19.9-33.6). Surfing injuries that were treated in Victorian emergency departments over a six year period revealed a similar pattern, although there was a greater proportion of head/face injuries (42.0%, 95% CI 36.0-48.1, p = 0.001). 20 surfers reported long-term effects from acute injuries, mainly unstable/stiff/painful joints. 136 surfers reported chronic health problems not related to acute injury including chronic/recurrent otitis externa and exostoses, muscle and joint pain/stiffness and pterygium. Significant injury while surfing is not uncommon. Although head injury accounts for a considerable proportion, very few surfers wear protective headgear. Greater use of protective headgear should be considered.

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

PubMed

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.

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

ERIC Educational Resources Information Center

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…

Anaesthesia and intensive care management of face transplantation.

PubMed

Sedaghati-nia, A; Gilton, A; Liger, C; Binhas, M; Cook, F; Ait-Mammar, B; Scherrer, E; Hivelin, M; Lantieri, L; Marty, J; Plaud, B

2013-10-01

The face-grafting techniques are innovative and highly complex, requiring well-defined organization of all the teams involved. Subsequent to the first report in France in 2005, there have been 17 facial allograft transplantations performed worldwide. We describe anaesthesia and postoperative management, and the problems encountered, during the course of seven facial composite tissue grafts performed between 2007 and 2011 in our hospital. The reasons for transplantation were ballistic trauma in four patients, extensive neurofibromatosis in two patients, and severe burns in one patient. Anaesthesia for this long procedure involves advanced planning for airway management, vascular access, technique of anaesthesia, and fluid management. Preparation and grafting phases were highly haemorrhagic (>one blood volume), requiring massive transfusion. Median (range) volumes given for packed red cell (PRC) and fresh-frozen plasma (FFP) were 64.2 ml kg(-1) (35.5-227.5) and 46.2 ml kg(-1) (6.3-173.7), respectively. Blood loss quantification was difficult because of diffuse bleeding to the drapes. The management of patients with neurofibromatosis or burns involving the whole face was more difficult and haemorrhagic than the patients with lower face transplantation. Average surgical duration was 19.1 h (15-28 h). Postoperative severe graft oedema was present in most patients. Most patients encountered complications in ICU, such as renal insufficiency, acute respiratory distress syndrome, and jugular thrombosis. Opportunistic bacterial infections were a feature during the postoperative period in these highly immunosuppressed patients.

[Platelet aggregation and antiplatelet agents in acute coronary syndromes].

PubMed

Collet, Jean-Philippe; Choussat, Rémi; Montalescot, Gilles

2004-03-01

Antiplatelet agents are the cornerstone therapy of acute coronary syndromes. In the setting of ST elevation myocardial infarction, antiplatelet therapy prevent the prothrombotic effect of reperfusion therapy including thrombolysis and primary percutaneous coronary intervention. In non ST-elevation acute coronary syndromes, antiplatelet therapy prevent s complete coronary thrombotic occlusion and therefore the occurrence of ST elevation myocardial infarction. Antiplatelet agent benefit is related to the patient's risk profile. It is well established that combined antiplatelet therapy is the most effective in high risk patients. Several important issues have to be faced including the identification of non responders, dose adjustment and the management of temporary interruption of antiplatelet agents in stable coronary artery disease patients.

Carbon-Type Analysis and Comparison of Original and Reblended FACE Diesel Fuels (FACE 2, FACE 4, and FACE 7)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bays, J. Timothy; King, David L.; O'Hagan, Molly J.

This report summarizes the carbon-type analysis from 1H and 13C{1H} nuclear magnetic resonance spectroscopy (NMR) of Fuels for Advanced Combustion Engines (FACE) diesel blends, FD-2B, FD 4B, and FD-7B, and makes comparison of the new blends with the original FACE diesel blends, FD 2A, FD 4A, and FD-7A, respectively. Generally, FD-2A and FD-2B are more similar than the A and B blends of FD-4 and FD-7. The aromatic carbon content is roughly equivalent, although the new FACE blends have decreased monoaromatic content and increased di- and tri-cycloaromatic content, as well as a higher overall aromatic content, than the original FACEmore » blends. The aromatic components of the new FACE blends generally have a higher alkyl substitution with longer alkyl substituents. The naphthenic and paraffinic contents remained relatively consistent. Based on aliphatic methyl and methylene carbon ratios, cetane numbers for FD-2A and -2B, and FD-7A and -7B are predicted to be consistent, while the cetane number for FD-4B is predicted to be higher than FD-4A. Overall, the new FACE fuel blends are fairly consistent with the original FACE fuel blends, but there are observable differences. In addition to providing important comparative compositional information on reformulated FACE diesel blends, this report also provides important information about the capabilities of the team at Pacific Northwest National Laboratory in the use of NMR spectroscopy for the detailed characterization and comparison of fuels and fuel blends.« less

Face-to-face or face-to-screen? Undergraduates' opinions and test performance in classroom vs. online learning

PubMed Central

Kemp, Nenagh; Grieve, Rachel

2014-01-01

As electronic communication becomes increasingly common, and as students juggle study, work, and family life, many universities are offering their students more flexible learning opportunities. Classes once delivered face-to-face are often replaced by online activities and discussions. However, there is little research comparing students' experience and learning in these two modalities. The aim of this study was to compare undergraduates' preference for, and academic performance on, class material and assessment presented online vs. in traditional classrooms. Psychology students (N = 67) at an Australian university completed written exercises, a class discussion, and a written test on two academic topics. The activities for one topic were conducted face-to-face, and the other online, with topics counterbalanced across two groups. The results showed that students preferred to complete activities face-to-face rather than online, but there was no significant difference in their test performance in the two modalities. In their written responses, students expressed a strong preference for class discussions to be conducted face-to-face, reporting that they felt more engaged, and received more immediate feedback, than in online discussion. A follow-up study with a separate group (N = 37) confirmed that although students appreciated the convenience of completing written activities online in their own time, they also strongly preferred to discuss course content with peers in the classroom rather than online. It is concluded that online and face-to-face activities can lead to similar levels of academic performance, but that students would rather do written activities online but engage in discussion in person. Course developers could aim to structure classes so that students can benefit from both the flexibility of online learning, and the greater engagement experienced in face-to-face discussion. PMID:25429276

Face-to-face or face-to-screen? Undergraduates' opinions and test performance in classroom vs. online learning.

PubMed

Kemp, Nenagh; Grieve, Rachel

2014-01-01

As electronic communication becomes increasingly common, and as students juggle study, work, and family life, many universities are offering their students more flexible learning opportunities. Classes once delivered face-to-face are often replaced by online activities and discussions. However, there is little research comparing students' experience and learning in these two modalities. The aim of this study was to compare undergraduates' preference for, and academic performance on, class material and assessment presented online vs. in traditional classrooms. Psychology students (N = 67) at an Australian university completed written exercises, a class discussion, and a written test on two academic topics. The activities for one topic were conducted face-to-face, and the other online, with topics counterbalanced across two groups. The results showed that students preferred to complete activities face-to-face rather than online, but there was no significant difference in their test performance in the two modalities. In their written responses, students expressed a strong preference for class discussions to be conducted face-to-face, reporting that they felt more engaged, and received more immediate feedback, than in online discussion. A follow-up study with a separate group (N = 37) confirmed that although students appreciated the convenience of completing written activities online in their own time, they also strongly preferred to discuss course content with peers in the classroom rather than online. It is concluded that online and face-to-face activities can lead to similar levels of academic performance, but that students would rather do written activities online but engage in discussion in person. Course developers could aim to structure classes so that students can benefit from both the flexibility of online learning, and the greater engagement experienced in face-to-face discussion.

Mapping Teacher-Faces

ERIC Educational Resources Information Center

Thompson, Greg; Cook, Ian

2013-01-01

This paper uses Deleuze and Guattari's concept of faciality to analyse the teacher's face. According to Deleuze and Guattari, the teacher-face is a special type of face because it is an "overcoded" face produced in specific landscapes. This paper suggests four limit-faces for teacher faciality that actualise different mixes of significance and…

Faces forming traces: neurophysiological correlates of learning naturally distinctive and caricatured faces.

PubMed

Schulz, Claudia; Kaufmann, Jürgen M; Kurt, Alexander; Schweinberger, Stefan R

2012-10-15

Distinctive faces are easier to learn and recognise than typical faces. We investigated effects of natural vs. artificial distinctiveness on performance and neural correlates of face learning. Spatial caricatures of initially non-distinctive faces were created such that their rated distinctiveness matched a set of naturally distinctive faces. During learning, we presented naturally distinctive, caricatured, and non-distinctive faces for later recognition among novel faces, using different images of the same identities at learning and test. For learned faces, an advantage in performance was observed for naturally distinctive and caricatured over non-distinctive faces, with larger benefits for naturally distinctive faces. Distinctive and caricatured faces elicited more negative occipitotemporal ERPs (P200, N250) and larger centroparietal positivity (LPC) during learning. At test, earliest distinctiveness effects were again seen in the P200. In line with recent research, N250 and LPC were larger for learned than for novel faces overall. Importantly, whereas left hemispheric N250 was increased for learned naturally distinctive faces, right hemispheric N250 responded particularly to caricatured novel faces. We conclude that natural distinctiveness induces benefits to face recognition beyond those induced by exaggeration of a face's idiosyncratic shape, and that the left hemisphere in particular may mediate recognition across different images. Copyright © 2012 Elsevier Inc. All rights reserved.

Mapping attractor fields in face space: the atypicality bias in face recognition.

PubMed

Tanaka, J; Giles, M; Kremen, S; Simon, V

1998-09-01

A familiar face can be recognized across many changes in the stimulus input. In this research, the many-to-one mapping of face stimuli to a single face memory is referred to as a face memory's 'attractor field'. According to the attractor field approach, a face memory will be activated by any stimuli falling within the boundaries of its attractor field. It was predicted that by virtue of its location in a multi-dimensional face space, the attractor field of an atypical face will be larger than the attractor field of a typical face. To test this prediction, subjects make likeness judgments to morphed faces that contained a 50/50 contribution from an atypical and a typical parent face. The main result of four experiments was that the morph face was judged to bear a stronger resemblance to the atypical face parent than the typical face parent. The computational basis of the atypicality bias was demonstrated in a neural network simulation where morph inputs of atypical and typical representations elicited stronger activation of atypical output units than of typical output units. Together, the behavioral and simulation evidence supports the view that the attractor fields of atypical faces span over a broader region of face space that the attractor fields of typical faces.

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